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October 13, 2011 Volume 2, Issue 38
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by Howard Josepher, LCSW
In one form or another, I have been a recovery advocate for more than 40 years. My journey began in 1968, after treatment in a therapeutic community program helped me overcome a 7-year heroin addiction. Treatment as we know it today did not exist, and the commonly held belief was "once an addict, always an addict."

I began giving testimony on the effectiveness of the therapeutic community treatment that was emerging. Those of us who had kicked our heroin habits began spreading the message of hope, and the media was heralding our transcendental stories on television and in the movies. We had a good deal of success changing the perception of drug addiction as an incurable condition, and as more resources were made available, treatment programs began to open all over the country.

In the 1980s, when crack entered the picture, perceptions of drug users began changing for the worse. Our nation's war on drugs became in some ways a war on those abusing substances. Addiction and addicts were demonized, and many in recovery were reluctant to speak out, feeling powerless and stigmatized. Anonymity became the wiser choice. As drug laws became increasingly punitive and our prisons were filled with drug-addicted individuals, advocates were silent.

In 1988, when we were becoming aware that tens of thousands of people addicted to drugs were being infected with HIV and dying from AIDS-related illnesses, I was asked to help start one of the first HIV/AIDS programs for drug-addicted people in the U.S. I also connected with a few brave individuals in recovery who were handing out clean needles in drug-infested neighborhoods. The AIDS epidemic forced us to put life-saving health and wellness approaches ahead of getting people off drugs. While my primary role was to be a service provider, I couldn't ignore the pain in the community and took on a new role as an advocate and community organizer. I mobilized groups of people recovering from addiction and some still battling addiction and traveled to Albany, New York and Washington, D.C., to share our stories and demand more action to prevent drug-related deaths. We joined with Act Up and the gay community in numerous demonstrations, drawing attention to the plight of our underserved and voiceless community.

By the 1990s, much had changed. The Ryan White CARE Act had been enacted and life-saving HIV/AIDS medication became available. My agency was growing, adding drug treatment, recovery, and prison reentry services. Our advocacy efforts also changed. We saw treatment services for substance abuse become more mainstream, professional, paternalistic, and dominated by the criminal justice system while the role of the recovering person was increasingly diminished. Many of us felt we could bring more people into recovery if the recovering individual played a larger role in the delivery system. We had witnessed the power of grassroots involvement in AIDS work and believed we could reinvigorate treatment if those recovering from addiction were given more employment opportunities, representation on the boards of treatment agencies, and chances to be active participants in forums on drug policy and law. We held meetings with other fledgling advocacy groups like Senator Harold Hughes' Society of Americans for Recovery, but felt recovery from drug addiction was very different than recovery from alcoholism. We believed we needed to forge our own path to address drug addiction issues.

In 1995, I formed Friends of the Addicted for Comprehensive Treatment (FACT), an advocacy training organization that developed the skills of those recovering from drug addiction so they could become advocates for what we came to view as our constituency. FACT developed an agenda supporting policies and programs we believed would bring more people into recovery. We frequently challenged President Clinton to change his policy for funding syringe exchange programs, demanding he recognize the overwhelming amount of science validating clean needle programs that prevented HIV infection without promoting or creating more drug use.

In 1998, when Mayor Rudy Giuliani arbitrarily decided to close down New York City's methadone programs, FACT organized a rally at City Hall and created a full-page advertisement in The New York Times demanding the Mayor support the valid treatment option and important door to recovery. Our advocacy efforts generated criticism of the Mayor's decision from other elected officials, drug experts, and treatment providers, finally leading Giuliani to reverse his decision.

In 1998, our advocacy efforts focused on repealing New York's draconian Rockefeller drug laws. Drug-addicted people were being sentenced to mandatory 20-year-to-life prison terms for possessing small amounts of drugs. Advocates felt these laws did more harm than good, destroying people's opportunity to recover and hurting their families as well. Our role was to organize and bring recovering people to New York's lawmakers, sharing stories about how their recovery resulted from participating in programs—a better option than sending people to prison. These advocacy initiatives had a beneficial clinical effect as well, generating self-esteem in advocates as they were received and heard by elected officials.

In 2009, Governor David Patterson eliminated the mandatory aspect of these cruel and punitive laws. Advocates did not achieve repeal, but the new law empowered judges to send first-time felons to treatment instead of prison. What remained untouched, however, was the basic punishment structure of the laws, and we believe this is what recovery advocates need to address today.

Rockefeller drug laws exist throughout the country, filling our prisons with non-violent, addicted individuals and punishing them for their disease. Many advocates have realized that making criminals out of people who have a disease or who self-medicate conditions like depression, bipolar disorder, or schizophrenia, ultimately creates more harm than good. If drug users are not hurting anyone, if they are not violent in their drive to self-medicate, they should not be considered criminals, especially when treatment and recovery options are available in the community.

How much longer will we punish people suffering from an illness that may not be their fault? However addiction comes about, whether it is a result of genetics, brain malfunction, trauma, a chemical imbalance, or choice, programs are a better option than prison, and those in recovery need to get behind policy change and new laws. I'm not saying people shouldn't be punished for crimes against persons and property. But for mere possession, we need a mechanism to get that person help. And that mechanism exists.

For the past few years, we have been developing a new delivery system of care for addiction called the Recovery-Oriented System of Care. It has the capacity to help thousands through a compassionate, evidenced-based approach and encompasses the most effective known tool for overcoming addiction: the power of community. It embraces the core values and practice that gave birth to drug treatment in this country.

This is the direction recovery advocacy must take. Though we face a commonly held belief that people who abuse drugs won't seek help without coercion, my experience as a service provider for the past 23 years proves otherwise. I've found when we focus on people's health and well-being and offer the tools and skills they need to handle challenges, they will accept the help. We need to expand our delivery system to include approaches that give people choices, acknowledging that recovery has many doors and recovering people can take many different paths.

I realize advocating for people who are actively addicted to drugs as well as those in recovery might seem radical to some. This is the community I came from and where the pain exists. It is the community that helped me heal—the one I wholeheartedly serve. When I see someone who is stuck in self-destructive ways, I say to myself, "There but for the grace of some mysterious force, I go." I don't know how I got so lucky or why I was chosen or blessed to do this work. But I am incredibly grateful.

Howard Josepher, LCSW, is the founder and president of Exponents, a minority-led, community-based organization for people struggling with substance abuse, HIV/AIDS, and community reentry after incarceration.

RTP Webinar Presentation and Recording Available Online
SAMHSA's Recovery to Practice PowerPoint presentation and recording for the October 6, 2011 Webinar, "Step 4 in the Recovery-Oriented Care Continuum: Graduation," are now available for download at http://www.dsgonline.com/rtp/resources.html.

We value your feedback on the Webinar!
If you participated in the live event, please take a few minutes to evaluate the Webinar by clicking on the following link: https://www.surveymonkey.com/s/6K2W32H.

Feel free to contact us at recoverytopractice@dsgonline.com with questions or comments.

SAMHSA's Road to Recovery
Ask the Expert
Barbara Kornblau, J.D., answered questions about SAMHSA's August Road to Recovery episode, "Treatment and Recovery in Behavioral Health for Americans With Disabilities," in Ask the Expert. From April to September, Ask the Expert addresses topics covered in Road to Recovery programs.

Ms. Kornblau is a professor and former dean of the School of Health Professions and Studies at University of Michigan–Flint. A recipient of the prestigious Robert Wood Johnson Health Policy Fellowship, she worked with Senators Jay Rockefeller (D-WV) and Tom Harkin (D-IA) on health and disability issues, taking a crucial role in developing the President's health care reform plan.

Read Ask the Expert.

Study Explores Gender-Based Diagnoses
According to a study published in the Journal of Abnormal Psychology and highlighted in October's RECOVERe-works, gender affects prevalence of certain mental illnesses. Researchers found that women are more susceptible to developing anxiety and depression, while men are more likely to have substance abuse problems or antisocial disorders. Specific manifestations of behavior were also connected to gender. Women with anxiety disorders tend to keep their emotions to themselves, which can lead to social withdrawal and depression, while men seem to express emotions with aggressive, impulsive, or coercive behavior.

Read the article.

RECOVERe-works is an electronic circular of The Coalition of Behavioral Health Agencies' Center for Rehabilitation and Recovery. To subscribe, email oifa@azdhs.gov with "Subscribe to Recovery WORKS" in the subject line.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in
recovery-oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or
other recovery resources, please contact Stephanie Bernstein, MSW, at 877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.

The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.