i have been working in substance treatment and recovery for almost 10 years now and have been sober for almost 12. the reason i got involved was because i felt so misunderstood during my early recovery process and i hoped to contribute something to that process for others.
i remain astounded that the system itself has changed so little over the last 10 years. it seems it only scrapes the surface of the problem but doesn’t really get to a solution. there is much talk about integrating the behavioral health systems with medical care systems, but it also seems that the individual systems (and their directors) may still be too busy scrapping for their own territories and funding to make a real effort to collaborate and work toward better outcomes.
case in point- medicaid and private insurance continue to require licenses for practitioners receiving payment for services in lieu of attaching outcomes to those payments. it’s as if it is assumed that once a provider becomes licensed that there is a better chance that their client/patient will have a better chance of healthy re-integration back into the community. and the need for fellow travelers on this journey to reconnecting to the community is just as imperative as the triage-or the triage is wasted- as evidenced by the hundreds of thousands of relapses over the last decades
but this triage (as treatment) as a first approach continues to present as a semi-baked approach. that somehow treatment is the goal of both private insurance as well as federally and state funded services is lining pockets and not solution focused. it seems that provider -driven treatment provides only a triage application addressing an individual while the holistic focus of re-integration is left out of the conversation. the funding and the research however, address treatment as the goal.
my generation and our society at large is evolving. the understanding of our processes is evolving too. the needs of our community are changing rapidly with easier access to prescription medication and access to information about drug and alcohol use targeting younger and younger citizens every year. our proposed approaches to dealing with the aftermath of this cultural shift needs to happen as well-hopefully sooner rather than later.
for me- this is not happening anywhere near fast enough. overdoses are increasing yearly and although some new treatments (triages) have appeared, there has not been a new operating system unveiled to make any real change. i think back to the onset of the AIDS epidemic. Providers were satisfied with isolating infected patients and providing them with ineffective medication and go on with business as usual.
our country and its people needed the influx of patients’ voices and ACTUP to create a system change which ultimately affected the entire globe. we need activist voices even if their truth makes us uncomfortable or even cringe. it might be a much better starting point to acknowledge we don’t have all the answers and be willing to try something new than to deny that fact and insist that something be proven before we try it. lives depend on this.
i am sharing some words from justin luke reilly who is the ceo of the national organization of young persons in recovery. he touches on these themes. the recovery movement is a wonderful thing, but it’s not enough to save lives and change minds. america needs more.
and when i think of fresh voices, i think of nicolas jaar. he’s a dj, a musician, a poet, an entrepreeur, a scribe, and a journalist. in my mind, he’s a renaissance man for the 21st century