“I got sober in 2001 – I look at it as a JV version of what the problem is. I got sober for a couple of years… then I started drinking again every day…it is important for me to be sober now… I wasn’t who I thought I was. It was so painful and so disappointing… With sobriety I can understand more about depression and anxiety.” Ben Affleck

Hello! My name is Christopher Sullivan and I am recovering from my father’s alcoholism. The countless nights of grief and regret, of feeling like I could have prevented my father’s passing if I was more knowledgeable on addiction, led me to seek help from SMART Recovery. SMART is helping me to fully understand what he was going through and discover ways in which I can help those who are experiencing what he went through. What was once complete ignorance on the topic of addiction, is now a sense of understanding and acceptance. I still have a ways to go in terms of learning about addiction and recovery, but I just know SMART will guide me through my life beyond my father’s addiction.

Please note: although SMART actively seeks to refrain from using labels like “addict” and “alcoholic,” we recognize that when others describe their experience they may choose to do so. Thank you for understanding.

Watch on our YouTube channel.

Subscribe to the SMART Recovery YouTube Channel

Video storytelling is a powerful tool in recovery, and we are proud to share our SMART Recovery content free-of-charge, available anywhere, on any device. Our videos hope to inform, entertain, and inspire anyone in the recovery community.

Subscribe to our YouTube channel and be notified every time we release a new video.

PLEASE NOTE BEFORE YOU COMMENT:

SMART Recovery welcomes comments on our blog posts—we enjoy hearing from you! In the interest of maintaining a respectful and safe community atmosphere, we ask that you adhere to the following guidelines when making or responding to others’ comments, regardless of your point of view. Thank you.

• Be kind in tone and intent.
• Be respectful in how you respond to opinions that are different than your own.
• Be brief and limit your comment to a maximum of 500 words.
• Be careful not to mention specific drug names.
• Be succinct in your descriptions, graphic details are not necessary.
• Be focused on the content of the blog post itself.

If you are interested in addiction recovery support, we encourage you to visit the SMART Recovery website.

IMPORTANT NOTE:

If you or someone you love is in great distress and considering self-harm, please call 911 for immediate help, or reach out to The National Suicide Prevention Hotline @ 800-273-8255, https://suicidepreventionlifeline.org/

We look forward to you joining the conversation!

*SMART Recovery reserves the right to not publish comments we consider outside our guidelines.*

Ray has been facilitating meetings since May of 2019, initially it was simply because there were no SMART meetings in the area. If he wanted one, he had to lead the charge and step out of his comfort zone. Over the next six months he saw the impact SMART was having on others, as it did him. During this time, he observed other attendees that were as motivated as he was about teaching the tools SMART Recovery has to offer. After some time, Ray was granted the opportunity to be the Regional Coordinator in Arkansas. Together, with this team of facilitators starting their own meetings, SMART Recovery support meetings can be attended three times a week in public forums, as well as multiple meetings in recovery homes in the surrounding area.

Ray and his team are currently working on a venue near the college campus at the University of Arkansas to start meetings there, as well as future plans for Family and Friends meetings. Ray wanted to make sure that we all know that his motivation and passion for others to have the same freedom he has in recovery is shared by his team. The growth SMART has in this area is a direct reflection of that. He encourages others everywhere in recovery to step out of their comfort zones and become part of a team that is helping change lives for the better. Who doesn’t want to be part of that?

Watch on our YouTube channel.

Learn more about becoming a SMART volunteer.

Subscribe to the SMART Recovery YouTube Channel

Video storytelling is a powerful tool in recovery, and we are proud to share our SMART Recovery content free-of-charge, available anywhere, on any device. Our videos hope to inform, entertain, and inspire anyone in the recovery community.

Subscribe to our YouTube channel and be notified every time we release a new video.

PLEASE NOTE BEFORE YOU COMMENT:

SMART Recovery welcomes comments on our blog posts—we enjoy hearing from you! In the interest of maintaining a respectful and safe community atmosphere, we ask that you adhere to the following guidelines when making or responding to others’ comments, regardless of your point of view. Thank you.

• Be kind in tone and intent.
• Be respectful in how you respond to opinions that are different than your own.
• Be brief and limit your comment to a maximum of 500 words.
• Be careful not to mention specific drug names.
• Be succinct in your descriptions, graphic details are not necessary.
• Be focused on the content of the blog post itself.

If you are interested in addiction recovery support, we encourage you to visit the SMART Recovery website.

IMPORTANT NOTE:

If you or someone you love is in great distress and considering self-harm, please call 911 for immediate help, or reach out to The National Suicide Prevention Hotline @800-273-8255, https://suicidepreventionlifeline.org/

We look forward to you joining the conversation!

*SMART Recovery reserves the right to not publish comments we consider outside our guidelines.*

“We have to hammer on the abusers in every way possible, they are the culprits and the problem. They are reckless criminals.” – Dr. Richard Sackler

The multibillion-dollar Opioid Settlement. The infamous first family of overdose deaths, the real criminals get awarded immunity. The “abusers” get hammered, once again. Families lost their chance at justice. We see and feel how our institutions marginalize the marginalized, once again.   

Let’s break down how it happened. The key to the outcome is called “Nonconsensual Third-Party Release.” The word nonconsensual is clear, it means without permission. Third Party means “a person or group besides the two primarily involved in a situation, especially in a dispute.” Release in the legal sense is defined as “a contractual agreement by which one individual assents to relinquish a claim or right under the law to another individual against whom such claim or right is enforceable.” So, a group that is characterized as outsiders (the families who watched their loved ones die) had their rights removed without their permission through an agreement by the other “primary” parties. Once the families were out the way, the corporate interests who made up the majority of the committee could divide up the spoils and take their legal fees. Try and explaining that to the kids of these families as “justice.”

I have been following with some interest over the years how the Sackler family misrepresented their products. They weaponized stigma to reap vast sums of money even as hundreds of thousands of other families across America buried their loved ones or tried to rebuild lives shattered by addiction. The costs of the settlement to the Sackler’s is less than what they will earn from their money horde over the span of the settlement payout. The settlement is just a business deal, worth every blood tainted penny pried out of their clutches to shield one of Americas wealthiest families from the consequences of their actions with the prize of immunity.

Not all families in America really are equal under the law, at least in practice. That is what is evident here. This family, the Sackler family the ones who lied about the risks of their drug and weaponized stigma were able to use their vast fortune to avoid the consequences of their conduct. They even pretended they represented the impacted families using a stealth campaign targeting the Justice Department in the weeks prior to the agreement. They got away with it all!  What would happen to any other American family who did that?

We have a long history of capitalizing the profits and socializing the consequences here in the United States. Each and every one of us will pay for what they did with our tax dollars and with the devastation in our communities for a few generations. The New York Times noted in an article on September 1^st that “The Purdue settlement aligns with what some experts predicted from the outset: The money extracted through litigation will not be sufficient to cover the costs of the epidemic — including for law enforcement, treatment and social services — which some economists put in the trillions.” They profit, we pay, some of us with our lives.

I agree with Ryan Hampton’s New  York Times Op-ed, we need system reform. We also need to follow the money earmarked for our communities and ensure that what is promised gets there. We need to ask some hard questions to keep similar dynamics from playing out in the future. Another big pharma company cashing in, people becoming addicted and the weaponizing of stigma to blame the victims. How did our institutions fail? Who looked the other way all those years? Is it happening again with any other company?  I would imagine it would, because demonstrably, what they did worked. The organism does what has worked for the organism. This is how the big profits are made. Look at tobacco, alcohol, and cannabis as examples.

Perhaps the one thing that all these families want is a way to ensure that this never happens again. Just maybe, the egregious nature of this settlement hit a nerve in our federal government. Following a national letter writing campaign, on September 16^th, the Justice Department filed an appeal seeking to block the travesty that is this bankruptcy plan.

Do we dare hope for a positive outcome?

SMART Recovery is delighted to announce a partnership with The Fletcher Group to bring SMART Recovery into recovery homes in rural counties, as designated by Health Resources & Services Administration, the funding agency for this endeavor. This partnership enables SMART Recovery to increase our footprint in rural communities and fulfill our mission to empower people with limited access to achieve independence from addiction problems with our science-based 4-Point Program^®. We are excited to bring these opportunities to our dedicated & amazing SMART experienced volunteers*.

A few of the key actions that SMART will undertake as part of this partnership are:

• Hire a full-time, paid Project Coordinator dedicated to the administration, coordination, planning, and setup of a SMART Recovery 12-session program, using the Successful Life Skills handbook in 100 recovery homes located in rural areas across the U.S.
• Recruit experienced SMART Recovery facilitators for each 12-session program.
• Provide training for up to 100 recovery home staff to become future facilitators of our SMART Recovery program, allowing them to continue offering SMART after the initial 12-week session has ended.

As a result of our partnership with The Fletcher Group, we are able to extend two unique opportunities to our volunteers*.

• First, we would like to invite qualified and experienced SMART volunteers to apply for the Project Coordinator position. The Project Coordinator will be the lead contact and will be working closely with the Fletcher Group Project Coordinators and Administrators as well as the assigned program coordinator of each of the 100 recovery homes. Their primary responsibility will be to effectively align and manage all needed resources to ensure the successful planning and execution of the 12-week meeting programs. This will include effective scheduling coordination for all participating recovery homes and SMART resources, budget oversight to maintain pre-approved expenditures, technical support, meeting delivery, evaluations to help reach the goals and deadlines of the project, and occasionally filling in on an as-needed basis as a meeting facilitator. This position reports directly to the Executive Director and Assistant Executive Director but will work closely with SMART Volunteer Managers.  CLICK HERE to view the full job description, requirements, and application process.
• The second opportunity is for facilitators who would like to be part of getting these 12-week sessions started. Ideally, we would like to have teams of 1-3 facilitators to run the first 12-week session at each of the 100 recovery houses. The meetings will be hybrid and can be held through Zoom and/or a physical location. We do not anticipate all 100 meetings starting at the same time, but rather be staggered throughout the year. If you are interested in facilitating one or more of these 12-week sessions, please fill out this form.

*These opportunities are for volunteers in the U.S. only.

PLEASE NOTE BEFORE YOU COMMENT:

SMART Recovery welcomes comments on our blog posts—we enjoy hearing from you! In the interest of maintaining a respectful and safe community atmosphere, we ask that you adhere to the following guidelines when making or responding to others’ comments, regardless of your point of view. Thank you.

• Be kind in tone and intent.
• Be respectful in how you respond to opinions that are different than your own.
• Be brief and limit your comment to a maximum of 500 words.
• Be careful not to mention specific drug names.
• Be succinct in your descriptions, graphic details are not necessary.
• Be focused on the content of the blog post itself.

If you are interested in addiction recovery support, we encourage you to visit the SMART Recovery website.

IMPORTANT NOTE:

If you or someone you love is in great distress and considering self-harm, please call 911 for immediate help, or reach out to The National Suicide Prevention Hotline @ 800-273-8255, https://suicidepreventionlifeline.org/

We look forward to you joining the conversation!

*SMART Recovery reserves the right to not publish comments we consider outside our guidelines.*

I must have signed tens of thousands of prescriptions over the years for a variety of medical conditions from athlete’s foot to diabetes. Not one patient, as far as I can remember, has congratulated me on my expertise around knowledge of the evidence base, guideline awareness, titration skills, dose precision, grasp of pharmacodynamics or knowledge of drug interactions. Important and necessary as all of these are, these things are often valued more by science than they are by patients.

Don’t get me wrong – I respect medication and its impact. People’s lives often improve because of what we prescribe, but when people have fed back to me after meds have been started, the take home message has not been about the medication. The patients I work with rank other things higher than the prescription and even its impact.

It is the anecdote that connects us to our patients, it is understanding the individual for whom we care that brings us joy, and it is connecting with their personal experiences that makes our work so rewarding.

Meagan Brennan

What I’ve learned from patient feedback is that certain values – listening, empathising, caring, and taking time with them – are far more valued than the drugs I prescribe, regardless of what the evidence base says. Sometimes the medication does not work the way we hoped it would and sometimes it does. While many medications are undoubtedly effective, generally I believe we doctors tend to over-value what a pill, cream or liquid can do. I certainly have done – many times. However there are other things in our meetings with patients that have value and these are not always recognised.

We make treatment plans for patients using the latest drugs. Usually they work well, but when they don’t, we label the patient “non-compliant.” After all, they must be doing something wrong because we have enacted an “evidence based” plan.

Meagan Brennan

In her blog^[1] for the BMJ, Meagan Brennan raises the concern that as we focus more and more on the evidence, we lose the humanity that is essential for good care and outcomes. She points out that the promising-sounding ‘personalised medicine’ that is now being introduced, in fact, takes us further from ‘the heart of doctor-patient interactions and deeper into the realm of impersonal science’.

She lauds the new interest in the humanities that is developing in medical student teaching. I remember so strongly when I was at medical school missing the subjects I had studied at school that had nothing to do with science. I was missing out on things that inspired me and sent my imagination and creative spirit soaring. Dealing with suffering, the impact of trauma, the bleakness of illness and death – and what those things actually mean – was not something I was prepared for in any way by my scientific training at university. In fact during a six month hospital job in a cancer unit, I almost gave up on medicine as a career. My spirit had been diminished by watching the suffering my patients experienced – sadly a significant number were to die despite the best treatment available. I wasn’t able to admit it at the time, but I was frightened and out of my depth. My difficulty in dealing with this was not unique but this simply wasn’t something we junior doctors were encouraged to talk about. Several decades later I find myself considering the question raised by Brennan: could the study of medical humanities have helped?

Medical Humanities: Its advocates contend that it can develop empathic practice and a social justice conscience in medical students. It is also being explored as a tool to enhance job satisfaction and reduce burnout in consultant physicians and junior doctors.

Studying the medical humanities can help doctors gain insight into what illness means for patients, but crucially can increase self-awareness and self-perception. The subjects that come under this banner take in concepts like relationship, emotion, the narrative, and spirituality. While medical humanities may help us humanise our own and our patients’ experiences, stigma does a very effective job at doing the opposite. 

In another paper^[2] by Harry Sumnall and colleagues, the dehumanising of heroin users is evidenced – framing those who use heroin as different, less worthy, and even ‘disgusting’. People who use heroin become less than human and more animal-like. Such characterisation is associated with ‘moral disengagement’ and distancing by others and can have real-life consequences including the ‘denial of human agency’ in popular and political discourse. This can lead to reduction of treatment funding when policymakers rationalise that due to lack of public support, there will be little protest when resources for addiction treatment are slashed. Many of us experienced harsh cuts to treatment services not that long ago. I remember thinking that cutting paediatric or cancer services to that degree would have been seen as unconscionable, yet it happened in addictions.

How do Sumnall and colleagues think dehumanising should be tackled? Simply, as it turns out: by social inclusion and by humanising narratives. Letting people tell their stories in the media – ‘encouraging compassionate media representations’ is likely to humanise. After all, listening is a two-way street. My listening to my patients is appreciated by them, but the same process has the power to change the way I see their world – how I perceive and relate to them.

The topics of humanising and dehumanising are ultimately about relationship and connection, or lack of it. When I am connected to you, I see your humanity – I value you more and draw closer. In a doctor/patient relationship this may be expressed as commitment. My determination to support you strengthens the more connected to you I become. This process needs healthy boundaries to be effective, but many of us can find ourselves distancing from pain and suffering because of the emotional cost of connecting. My frightened junior doctor self did not recognise that although I could not save every life from cancer, I was doing something meaningful by being present, listening and connecting. Perhaps this represented being spiritually available.

Mark Galantar and colleagues frame deeply felt commitment as a spiritual component in the recovery process which in itself adds to recovery capital – the resources people can call upon to help them resolve their problems and recover. In a paper about spirituality in addiction medicine^[3] they point out that recovery can signify finding ‘meaning and purpose in life’.

“Spirituality has been defined with regard to clinical settings as a commitment to transcendent or existential personal meaning in one’s life, typically involving a connection with something larger than oneself and is distinguished from the pursuit of material needs or organised religion”.

Galantar et al

Galanter et al reference the strong evidence behind the spiritual approach of 12-step groups citing the recent Cochrane review on Alcoholics Anonymous, and although they point to neuro-imaging research that may support the potential benefits of spirituality, they also highlight that the dominance of a biological/medication perspective is often at the expense of integrative approaches which acknowledge the ‘interconnections of mind, body and society’.

“Abstinence after discharge from professional treatment was found in one study to be three times as likely among patients who reported having had a spiritual awakening”.

Galantar et al

They assert that spirituality is often ‘culturally resonant’ with underserved or disadvantaged groups and that ‘engaging spirituality and related community organisations in treatment is an important aspect of improving treatment access, outcomes, and equity for underserved groups’.

Addiction, the behaviours associated with it, society’s stigmatising attitudes and the shame that so many people carry with them as a result, can result in dehumanising attitudes and responses. Studying the medical humanities may help current and future doctors be better physicians and to be more connected to themselves and their patients. Hard science alone cannot provide us with all of the tools that we need – a spiritual dimension is also required. 

Everyone will have their own understanding and experience of ‘spirituality’, but in my practice, I think of it simply as things that enrich my spirit – that make me spirited. When my spirit is quickened, then I am a better doctor. Listening to patient narratives – ‘what’s happened to you?’ – finding meaning in those stories, putting judgement aside, empathising with the individual, connecting with that person in front of me and meeting them where they are – are for me deeply spiritual things. Others may choose to call the same things something more scientific – a complex interaction between oxytocin, serotonin and dopamine perhaps, but I find myself resisting that urge.

What if, as Meagan Brennan suggests, we are missing a piece of the evidence in our evidence-based practice? What if this something is both profound and necessary? Whether we call it humanity, connection, spirituality or something else, the amazing thing is that by adding this in and truly listening to our patients’ stories we will help not just them but ourselves too.

To be a good doctor you need to have a robust grasp of the science of medicine, but that’s not enough in itself. We need to come alongside our patients, draw close and travel a bit with them. Listening compassionately to their story is the way to do this. When the day comes that I hang up my stethoscope for the last time, my hope is that I am not so much remembered for my prescriptions or my medical expertise (such as it is) as I am for my humanity.

Continue the discussion on Twitter: @DocDavidM

^[1] https://blogs.bmj.com/bmj/2021/09/02/are-we-losing-our-humanity-in-medicines-quest-for-pure-science/

^[2] Sumnall, H., Atkinson, A., Gage, S., Hamilton, I. and Montgomery, C. (2021), “Less than human: dehumanisation of people who use heroin”, Health Education, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/HE-07-2021-0099

^[3] Galanter M, Hansen H, Potenza MN. The role of spirituality in addiction medicine: a position statement from the spirituality interest group of the international society of addiction medicine. Subst Abus. 2021 Jul 2:1-3. doi: 10.1080/08897077.2021.1941514. Epub ahead of print. PMID: 34214398.

For decades, a significant portion of NIDA’s research portfolio has funded science at the intersection of substance use and HIV, due to the intertwined nature of these two health conditions. Sharing of injection equipment is a major mode of viral transmission, and many kinds of substance use increase the likelihood of engaging in unprotected high-risk sex. Research demonstrates substance use disorders (SUDs) exacerbate the effects of HIV in the body, reduce the effectiveness of anti-retroviral therapy, serve as a barrier to prevention and treatment access, impede care-seeking, and decrease the likelihood of retention in treatment.   

NIDA’s portfolio of HIV-related research is the second largest at NIH (after the National Institute of Allergy and Infectious Diseases), and it is diverse, ranging from basic science to implementation research. NIDA created its AIDS Research Program (ARP) in 2004 to coordinate this research across our Institute and to encourage transformative science addressing SUD and HIV. Now, to better characterize our scientific investment as we move into the third decade of the century and to help combat the stigma that still attaches to HIV, we have decided to rename this office the HIV Research Program. It is a change of name but not of mission.

Much has changed in the landscape of HIV and HIV research since the ARP was founded. AIDS describes the often-fatal condition of severe damage to the immune system caused by untreated HIV, but thanks to antiretroviral treatments, most people with HIV in the U.S. do not develop AIDS. Consequently, NIDA research now focuses on the virus itself and the many ways it continues to intertwine with drug use and addiction. Today, it is more accurate to say NIDA’s research focuses on HIV, not AIDS.  

The name change also better aligns our Institute with the desire of patients, families, and communities to use less stigmatizing language. The term AIDS can evoke the haunting images from the early days of the HIV pandemic, when there was no treatment, there were few prevention options, and too many people succumbed to extreme illness. Antiretroviral medications developed in the late 1990s turned HIV from what had been a fatal disease into a manageable and livable condition, and we now know they can also prevent transmission of HIV.

While the reality for many people living with HIV has moved beyond the images of an earlier era, AIDS activism played a key role in scientific and societal advancements over the last 40 years. HIV/AIDS activists revolutionized the concept of disease advocacy, informing and improving the work of governments, scientists, medicine, and industry in the United States and globally. The progress we make today honors those contributions.  

The scientific advances over the past two decades have been instrumental in reducing the stigma of HIV, but we still have a long way to go in eliminating that stigma. The stigma of HIV intersects with that of substance use disorders, still among the most stigmatized of health conditions. For both HIV and addiction, advocates have emphasized how important it is to underscore that medications and other treatments allow people to lead vibrant, long, and otherwise healthy lives. Nor do either HIV or an SUD need to define the individual.

NIDA’s investment in HIV research has advanced the science in significant ways. For instance, over a decade ago we supported the seminal study showing that treatment of HIV in people who inject drugs is prevention, reducing transmission in the community and community-level viral load. NIDA also funded a phase 3 trial showing that medication treatment for opioid use disorder improves viral load, infection-fighting CD4 cell count, and HIV treatment retention and is thus vital in HIV care. Recently another study conducted through NIDA’s Clinical Trials Network demonstrated the successful integration of HIV testing into SUD treatment.

Though the program’s name is changing, NIDA’s commitment to HIV research, its HIV budget, and its HIV research priorities are not. We will continue to support a wide range of studies, from the basic science of HIV pathogenesis and the immune response in the presence of addictive substances to research on feasibility and acceptability of new pre-exposure prophylaxis (PrEP) products among people who use drugs. NIDA-funded scientists are also now investigating the intersections of SUD, HIV, racial inequity, and COVID-19, as well as contributing to the effort to develop an HIV vaccine.

I am proud of the accomplishments of the office now called the HIV Research Program, under the capable leadership of Dr. Redonna Chandler and with the help of Dr. Vasundhara Varthakavi. I look forward to many more years of cutting-edge research with the aim of developing and implementing effective prevention and treatment interventions for HIV and SUDs and eliminating HIV transmission among people who use drugs.

The topic of this article concerns defects in the alcoholic family system that are caused by the birth of a well baby. This article is not about defects found in a newborn.

As we consider the topic of defects in the family system, for the purposes of this article, let’s consider the family system as one whole solid object.

Sometimes the idea of a planned child is that the arrival of the new family member will repair the alcoholic home.

But we know that the birth of a newborn is a stressor for any family system – alcoholic or not. And we know that in some families the arrival of and ongoing presence of a newborn degrades the function or structure of the family system, or both.

I would like to suggest that the stress brought by the newborn’s arrival might finally bring the pressure necessary to create a fundamental crack or break (a basic fault) in the structure of the alcoholic family system. This can be thought of as creating a new seismic fissure or fault in the totality (or whole) of the family system.

This stress in a home with active alcoholism or a home without sufficient recovery stability could cause a fracture in the basic structure of the family system. And that could leave the family system forever weakened and unsafe for others.

A metaphor for the family system

One metaphor or image commonly used to capture the idea of a family system is that of a mobile, with each part of the mobile representing a different member of the family. And showing the mobile as out of balance is the way a problem in one of the people, or in the system, is shown.

But for this concept the image would not be that of a mobile. Rather, the image is that of an entire solid granite continental shelf a few miles thick. And the problem being shown is represented as a deep break – a new fault. And the break is caused by a new pressure (such as a new birth) – that would normally be thought of as both normal and good.

Extending the metaphor or image of a one-piece solid geologic structure, we should recognize at least two possible problems other than a new deep break exist. The first is that within some families the added stressor would simply make the defects that already existed in the system visible for perhaps the first time. And in other family systems the added stressor would simply make an existing break larger.

Questions include:

• Why does the topic of “birth defects” seem to always and only pertain to defects in the person of the newborn infant? And why do we have such a limited perspective from which to view the situation?
• Can our thinking also pertain to new malformations in the family system as a whole?
• What newly emerging defects of the family system threaten the newborn’s health and well-being?  And for how long?
• In our clinical work do we examine the integrity and stability of the family system?
• Do we help the family system accommodate the positive pressures of its existing members, new members, returning members, members shifting into abstinence, and members shifting into recovery?

From ACES to Recovery Capital

This causes me to wonder if we can apply the list of Adverse Childhood Experiences Survey (“ACES”) in a positive way. Such an effort could help us reverse the concept of ACES and identify the features of a healthy-enough recovery community at various social levels, starting with the family system.

What is good enough “parenting”?

• For the alcoholic home to aspire to?
• For the abstinent home to aspire to?
• For the recovering family to aspire to?
• For the recovery community to aspire to?

Conclusion

If our babies break us, are we a “healing forest”? Or are we only looking at the trees?

To help anchor these concepts and areas of attention we could coin new terms.

1. One term would be for the problems in the family system caused by the arrival of a newborn. Perhaps for this phenomenon we could coin the term “Birth-related family system defect”.
2. And we could coin a term for the permanent damage in the actively addicted family system, or the newly abstinent but not recovering family system, caused by the pressures brought by the birth of a newborn. Perhaps that term could be “Fetal recovery syndrome”, given it is the new life present in the new person of the infant that in some cases seemingly deforms the family.

Can we improve our systems of care for chronic, severe, and complex substance use disorders to include evaluation, positive change, and on-going recovery support of the entirety of the family system until the critical threshold of structural instability is resolved?

Suggested Reading

Balint, M. (1969). The Basic Fault: Therapeutic Aspects of Regression. Northwestern University Press.

Coon, B. WHERE is Addiction? July 8, 2021. Recovery Review.

Coon, B. We All Need to Learn “Prevention”. August 13, 2021. Recovery Review.

Herzog, J. I. & Schmahi, C. (2018). Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Frontiers in Psychology.  doi: 10.3389/fpsyt.2018.00420

Swedish Agency for Health Technology Assessment and Assessment of Social Services. (2016). Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) – conditions and interventions. sbu.se

Touloumakos, A. K. & Barrable, A. (2020). Adverse Childhood Experiences: The Protective and Therapeutic Potential of Nature. Frontiers In Psychology. doi: 10.3389/fpsyg.2020.597935

White, W. (2011). Unraveling the mystery of personal and family recovery. An interview with Stephanie Brown, PhD.

Winnicott, D. (1974). Fear of Breakdown. International Review of Psycho-Analysis. 1(1-2): 103-107.

SMART Recovery is proud to support Sober Voices for FLOW.

This international event is open to those in early sobriety, sober-curious, and in long-term sobriety of any kind.

The four days will be filled with content from a diverse array of leaders in the sober movement. Among them will be Mike Hooper, SMART’s State Outreach Director for Ohio, who will be speaking during the event.

For more information and to purchase tickets, go to: https://flow.sobervoices.co

Use to the promo code SMARTRECOVERY50 to save 50% off the ticket price.

PLEASE NOTE BEFORE YOU COMMENT:

SMART Recovery welcomes comments on our blog posts—we enjoy hearing from you! In the interest of maintaining a respectful and safe community atmosphere, we ask that you adhere to the following guidelines when making or responding to others’ comments, regardless of your point of view. Thank you.

• Be kind in tone and intent.
• Be respectful in how you respond to opinions that are different than your own.
• Be brief and limit your comment to a maximum of 500 words.
• Be careful not to mention specific drug names.
• Be succinct in your descriptions, graphic details are not necessary.
• Be focused on the content of the blog post itself.

If you are interested in addiction recovery support, we encourage you to visit the SMART Recovery website.

IMPORTANT NOTE:

If you or someone you love is in great distress and considering self-harm, please call 911 for immediate help, or reach out to The National Suicide Prevention Hotline @ 800-273-8255, https://suicidepreventionlifeline.org/

We look forward to you joining the conversation!

*SMART Recovery reserves the right to not publish comments we consider outside our guidelines.*