What does it mean to support a friend in recovery from addiction? An interesting question....no manual for this, at least that I am aware of. I was recently reminded of a great example of this from, of all places, the world of professional sports.

As has been widely publicized, Texas Rangers outfielder Josh Hamilton continues his recovery from a long battle with alcohol and other drug addiction which derailed his promising baseball career for many years.  Hamilton has only recently begun to reach his potential, leading to his  being named the Most Valuable Player in the American League for 2010 when his team won the pennant and advanced to the World Series. The Rangers recently clinched the American League West once again and celebrated accordingly...or did they?

Baseball tradition almost dictates the obligatory champagne-spraying celebration, but here is where Hamilton's recovery comes into play. In 2010, the team replaced the champagne with ginger ale, out of respect for and sensitivity to, their leader's personal situation and his commitment to maintaining his abstinence from alcohol and other drugs. From the photos of this year's celebration, it appears that this adjustment was continued (although it looked to me like Mountain Dew was substituted this year!). 

It would have been easy, I think, for Hamilton's teammates to stick with the standard champagne and beer festivities, putting the onus on him to decide whether he could even participate--and potentially endangering his recovery. Instead, they recognized that a simple acccomodation could preserve their desire to celebrate, while respecting Hamilton's situation. 

Would they have done the same thing for a lesser player? Hard to say, but let's give credit where credit is due.

Now, how do we as individuals support support those in our lives who are engaged in the same effort as Hamilton is? Would we be willing to accompany a friend to an (open) A.A. meeting? Would we be willing not to serve alcohol at an event if our friend was early in recovery and not yet ready to be around it? What other things might we do to help someone along the way? Interesting to consider, and probably not hard to do. Hamilton's teammates provided us with a nice example of one way to be supportive and are to be commended for doign so





 

Writing in the NIDA journal Addiction Science and Clinical Practice, Alexandre B. Laudet challenges us to look at what it means if we do accept the premise that addiction is a chronic condition by suggesting that is this indeed the case we must assess success (or recovery)differently. Noting that previous assessment of treatment success has narrowly focused on abstinence from substances, Laudet proposes that "quality of life" must be considered in determining how much treatment has really helped an individual with a chronic condition.

This makes complete sense to me. In other words, it is hard to defend the idea that a miserable recovering person, regardless of how long he or she has been abstinent, represents a fully successful treatment outcome--or an individual who returns to criminal or abusive behavior, even if not using substances. The question, of course, is how to measure the construct "quality of life," and if it is solely from the perspective of the individual patient/client/addicted person, or if some external source has a say in this assessment.

On balance, however, the idea of adding a quality of life measure to the assessment of treatment outcome is another step in the right direction, it seems to me, of truly looking at substance use disorders as the chronic conditions they are, and not as the black-and-white, right-and-wrong conditions the so-called moral model has often dictated.

Be well.... 
 

In 25 years as a counselor and 12 or so teaching college students, as well as being an interested observer of how American culture views addiction, treatment, and recovery, I am struck by what seems to be one of the biggest misconceptions that people have about treatment, namely that an individual must "want" help in order to be helped.

My reaction to this perceived truism is a resounding"no!" The reality is that the desire to recover, the motivation to change, if you will, is most often something that develops during the course of counseling or treatment. Yes, ultimately the individual client or patient does need to want to change, to recover, but this desire is frequently very low or even non-existent at the commencement of treatment or counseling. All that is really required at the front end is some willingness to show up or participate--the professionals can take it from there.

Imagine if it were true that for treatment to be successful the individual must really want help. Here is a somewhat-over-the-top depiction of what an initial counseling exchange would look like:

Counselor: How can I help you today?


Client: Well, my drug use is really causing me a problem, so I called your treatment center for help, I know I need treatment, I cannot stop on my own, and I think you are the folks to help me, regardless of how much it might cost or how much work (or school) I might miss.

I am not sure many of us who do this work have ever heard quite that sentence--and part of me wonders what we would do if we did.  A much more common exchange would be something like:

Counselor: What brings you here today?

Client: I don't know. My family thinks I have a drug problem because I just got fired from my job for testing positive on a drug test, but it was just marijuana, which should be legal anyway, and I could stop any time I want. It's no big deal, and I don't need to be in this place with all these drug addicts, that's for sure.


That gives us somewhere to start. In reality, it is very common for the desire to recover to be something that grows gradually during the course of treatment. In the language of motivational interviewing, clients frequently come to treatment in the precontemplation or contemplation stages, rather than in the action stage.

Just a thought--thanks for letting me share with you.