Recovery Opinions: Growth and Evolution

First off, I never wanted to be a therapist or a “drug and alcohol counselor”. I never wanted to be the CEO or founder of mental health and substance use disorder service organizations (FAVOR Greenville and youturn.net). My undergraduate degree is in business management. I got into the “behavioral health field” because I got into recovery.

 I never wanted to be addicted and never wanted to “need recovery”. I would prefer to be in some other profession. I would prefer to have NEVER had a problem with substance use or mental health. It would be better if I was an outsider with “no opinion” on substance use disorder and mental health. Furthermore, I never wanted to be a family member in need of “family recovery”.

What you want and what you get are often two different things. Life is full of strange twists and turns. You don’t necessarily get to choose your fate. I have been in need of family recovery my whole entire life. Growing up in the classic adult child of an alcoholic manner.  I experienced my own addition and, THANK GOD, I am now experiencing my own recovery.

 And, ultimately, I have been immersed as a professional in this field for over 20 years.

 Strong Opinions, loosely held!

Therefore, I have some pretty strong opinions on substance use disorder, mental health, and recovery. More accurately, I have had many different and contradictory opinions on recovery over the years.

Let me explain.

In 1999, I "hung around" recovery rooms. To get the heat off.  My opinion on recovery was pretty silly at that time. If I were to summarize my take on recovery in 1999 it would be as follows: "It's impossible for me to recover. Recovery is for other people. A select few. Like winning the lottery".

In 2001 my opinion shifted dramatically. It wasn't a moment of clarity. It was simply clarity. It did not come and go--like a moment. Suddenly, things were incredibly clear and they remain incredibly clear--to this day. I realized, substance use disorder was a real disease and I sure as hell “had it”. More importantly, it was clear that I could recover. I could live without drugs and alcohol. I've been in recovery since.

In 2002, I started working full time in the drug and alcohol treatment industry and the mental health field. I always had to work multiple jobs at the same time, because you couldn't make a living on the entry-level salary in this field. You don't get paid much. So you work part-time and constantly have side hustles to pay the bills. I went back to school and got a Masters of Arts degree in Sociology with a concentration in addiction studies. I also earned an MBA with a concentration in healthcare management. I was learning on the fly. I learned a lot. And I adopted the opinions of the industry. I was a hard-core "traditionalist". There was one way to recover. My opinion had evolved from “recovery is impossible” to “recovery is guaranteed IF YOU DO IT MY WAY”.

In 2004 things started to change. I became the director of an assertive community treatment team. Working with folks with long-term mental health and co-occurring disorders. I was "forced" into an immersive training program in motivational interviewing. I was “forced” to adopt harm-reduction techniques. It was clear that my personal recovery pathway was not the only way. It was clear that many people required harm-reduction. It was clear that many, many people did not have the resources I had. They did not have the recovery capital that I had.

It was unfair to assume everyone could follow the same path I took. At the end of the day, I still thought there was only one way to recover. But my opinion was evolving. The evidence was clear and I was a compassionate person. I knew the industry needed to be more open-minded. But I wasn't sure how to make sense of all of this.  My opinion evolved from “I am sure there is one way” to “maybe I’m wrong”. 

In 2007, I started working full time with adolescents muddying the water even more. A 16 year-old marijuana smoker is entirely different than a 40 year-old alcoholic. Yet the basic programming was the same. The messaging was the same: "quit all substances now and forever and go to meetings". I thought to myself, the model must be different for these kids. I got deeper into motivational interviewing and got trained in family systems. My opinion evolved. Clearly, the family was key and there were many ways to "get better". Family systems theory and multiple pathways to recovery became my professional battle cry. However, I had no idea how to integrate that into my personal recovery. I was 2 different people. Open-minded Rich at work. One way only Rich at meetings.

2007-2012: The opioid epidemic ramped up and Western Pennsylvania was ground zero. People started to die before they even had a chance to recover. Several "kids" I knew well died tragically. I felt like there was imminent danger all around. The concept of "hitting bottom" started to sound like non-sense. So many things that seemed to be self-evident truths now seemed to be dangerous slogans.

Medication-assisted treatment started to get promoted. But many people in the rooms, and many professionals, rejected MAT. They rejected the idea of harm-reduction. I simply could not toe the company and industry line. I started to say things that were not acceptable within the traditional framework of recovery "thinking" (eg...multiple pathways etc...).

My opinion had evolved. Truth is, my opinion was problematic. I was not playing by the rules. I was saying unacceptable things. And, for the record, I was getting louder and louder with my opinions. As a matter of fact. I start to get downright aggravated with conventional thinking.

2012: I land at FAVOR Greenville and I go next level. My role as an "advocate" was hard to manage. When do I speak out? How do I speak out? I started doing "car rants". I pushed back hard against conventional "recovery" wisdom. Admittedly, things got a bit ridiculous. My opinion had evolved from there is only one way to recovery to “there are endless ways to recover”. The pendulum had swung the other way.

2019-2020: My opinion evolved "too much". The pandemic crushed me and my family. The stress, the co-occurring mental health. I lost touch with the basics. It became apparent that the "pendulum" swung too far the other way. I became borderline obsessed with alternative models.

Recently I have realized the following: there is a big part of me that needs traditional models. Both professionally (for referrals etc...) and personally (because it works).

I do not want the “old school” models and existing systems to go away. I want to add things to existing systems. NOT destroy existing systems.  But I'm not sure I communicate that clearly.

2020 through 2021: My opinion evolves even further

When my family needed “help” I found that help through very traditional programming. And I am grateful the programs were there. I need to highlight a couple things:

1. I believe in the conventional pathways. I really do.
2. There are some bad programs and bad people out there representing "traditional recovery". Very bad. I mean, really horrible people lurking around out there “in recovery”.
3. However, we need rehabs and we need abstinence-based programming.  And there are really high-quality programs available. WE NEED ALL OF THE ABOVE.

We have no room for "harm reduction" versus abstinence-based recovery thinking.

We have no room for the "medication-assisted treatment" versus abstinence-only argument.

We need all of the above. I need all of the above. When my family was in need we needed all of the above. We will continue to need all of the above.

I can admit when I'm wrong. Maybe not as "promptly" as I should. But I will come around. For example, I get "too pushy” with the moderation management vibe. I don't take back the message. But I do want to re-evaluate the way in which I deliver the message.

I can be very one-sided. I get fired up and I get on my "soap box". And my soap box gets out of control. I need to be more balanced.

There are some people, myself included, who need to abstain from all substances in order to reduce harm. Alcohol is a destructive force that would take over my life if I tried to moderate. I know this because I tried to moderate for years. And blackout drunk is not moderating. Sometimes we need to hang up the cleats and walk away from the game. Better yet, run in the other direction.

I just want to be clear. I believe in abstinence-based, 12-step recovery. And I need to do a better job in communicating that belief. In my effort to promote multiple pathways I sometimes go too far. We need to honor all pathways included the traditional routes of recovery. Start the process of recovery and don't quit. Keep going and keep trying. People do recover. In all kinds of ways.

Constant forward momentum.

And then there's the family. That's a whole other topic for another time.