Tag Archives: addiction

Recovery Contagion within the Family

Posted on March 10, 2022 by Melissa Killeen

By Bill White

Addiction runs in families, but far less known is the fact that recovery also runs in families. Recovery Contagion is a phenomenon have captured my attention in recent decades and been the focus of numerous articles. Recovery contagion is defined as the recovery from a disease spread by close contact.

Scientific studies are unravelling the factors that combine to elevate risk of intergenerational transmission of addiction and related problems. These mechanisms of transmission include genetic and neurobiological influences, fetal alcohol spectrum disorders, assortative mating (attraction of those exposed to parental addition to individuals who share this family history), co-occurring conditions, temperament, developmental and historical trauma, family dynamics (e.g., parental/sibling modeling and collusion), early age of alcohol and other drug (AOD) exposure, and disruption of family rituals. (See Here for review of studies). Rigorous studies have yet to be conducted on the prevalence, patterns, and mechanisms through which addiction recovery of one family member increased the probability of other addicted family members also initiating a recovery process. The purpose of this article is to offer some observations on these issues drawn from decades of observation of families impacted by and recovering from severe and persistent Alcohol or Drug misuse problems. The following suggestions should be viewed as hypotheses to be tested via scientific studies and more expansive clinical observations.

  • Innumerable patterns of recovery transmission exist within families. Recovery transmission may occur intergenerationally (e.g., parent to child) and Intragenerationally (between siblings) and reach the extended family and social network. The recovery influence may also be bi-directional, e.g., mother in recovery to addicted child, child in recovery to addicted mother). Recovery transmission, like addiction, can also skip generations.
  • The probability of recovery initiation of an addicted family member increases as the density of recovery within an addiction-affected family network increase. The contagiousness of recovery and the push and pull forces towards recovery increase exponentially as other family members initiate recovery and as overall health of the family system improves.
  • The mechanisms of recovery transmission within affected families include:

1) infusion into the family of increased knowledge about addiction and recovery by the family member(s) in recovery,

2) withdrawal of family support for active addiction,

3) truth-telling about the addicted family member’s behavior and its effects on the family, 4) elicitation of hope,

5) recovery role modeling,

6) active engagement and recovery guidance by family member(s) in recovery,

7) assertive linkage and co-participation in recovery mutual aid and other recovery support institutions,

8) assistance when needed in accessing professional treatment,

9) post-treatment monitoring and support, and

10) adjustments in family life to accommodate recovery support activities for recovering members and family as a whole.

These individual mechanisms achieve heightened power when sequenced and combined over time.

  • Recovery of a family member can spark personal reevaluations of AOD consumption of other family members, resulting in a potential decrease in AOD use and related risk behaviors, even among family members without a substance use disorder. This may constitute a hidden benefit of recovery in lowering addiction-related costs to community and society.
  • The recovery contagion effect on other family members exists even when the recovering family member isolated themselves from the family to protect his or her own recovery stability. The family’s knowledge of the reality of his or her continued recovery and its effects on their health and functioning exerts pressure towards recovery even in absence of direct contact.
  • One of the most complicated forms of recovery contagion is between intimate partners who both experience AOD problems. The recovery of one partner destabilizes the relationship and increases the probability of recovery initiation of the other; addiction recurrence in one partner increases the recurrence risk in the other partner. Recovery stability is greatest when each partner established their own recovery program in tandem with activities to support “couple recovery.”
  • Where conflict exists between a family member in recovery and a family member in active addiction (e.g., a father in recovery and an actively addicted son), the conflict can serve as an obstacle to recovery initiation of the addicted family member. Though recovery initiation may be slowed, recovery prognosis is still increased, and the conflicted relationship is often reconciled when both parties are in recovery. When not reconciled, conflict can continue to be played out via different pathways of recovery.

It is rare to escape injury to family within the addiction experience. Such injuries increase progressively within families in which multiple people are experiencing AOD-related problems. For those of us who find ourselves in such circumstances, the greatest gift we can offer our family is our own recovery.

Related Papers of Potential Interest

Evans, A. C., Lamb, R., & White, W. L. (2014). Promoting intergenerational resilience and recovery: Policy, clinical, and recovery support strategies to alter the intergenerational transmission of alcohol, drug, and related problems. Philadelphia: Department of Behavioral Health and Intellectual disAbility Services. Posted at http://www.williamwhitepapers.com/pr/2014%20Breaking%20Intergenerational%20Cycles%20of%20Addiction.pdf

Navarra, R. & White, W. (2014) Couple recovery. Posted at http://www.williamwhitepapers.com/blog/2018/03/couple-recovery-robert-navarra-psyd-lmft-mac-and-bill-white.html

White, W. & Savage, B. (2003) All in the Family: Addiction, recovery, advocacy.   Posted at http://www.williamwhitepapers.com/pr/2005AllintheFamily.pdf

White, W. (2014) Addiction recovery and intergenerational resilience Posted at http://www.williamwhitepapers.com/blog/2014/07/addiction-recovery-and-intergenerational-resilience.html

White, W. (2017). Family recovery 101. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. Addiction/Recovery as a family tradition. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. (2015) All in the family: Recovery resource review. http://www.williamwhitepapers.com/blog/2015/11/all-in-the-family-recovery-resource-review.html

White, W. L. & Chaney, R. A. (2008). Intergenerational patterns of resistance and recovery within families with histories of alcohol and other drug problems: What we need to know. Posted at http://www.williamwhitepapers.com/pr/2012%20Intergenerational%20Resilience%20%26%20Recovery.pdf

 White, W. L. & White. A. M. (2011).  Tips for recovering parents wishing to break intergenerational cycles of addiction. Posted at: http://www.williamwhitepapers.com/pr/Tips%20for%20Recovering%20Parents.pdf

About the author:

Bill White published this article on his web site on September 05, 2019.. Bill White is a preeminent researcher on addiction and recovery. He received a Lifetime Achievement Award from the Faces and Voices of Recovery in 2015. William L. White is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past chair of the board of Recovery Communities United. Bill has a master’s degree in Addiction Studies and has worked full time in the addictions field since 1969 as a streetworker, counselor, clinical director, researcher and well-traveled trainer and consultant. He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 20 books. His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery. Bill was featured in the Bill Moyers’ PBS special “Close to Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.” Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC: The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement. Bill’s widely read papers on recovery advocacy have been published by the Johnson Institute in a book entitled Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement.

His web site is: http://www.williamwhitepapers.com/

*Definition of Recovery Contagion:

The recovery from a disease spread by close contact.

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Getting through the tough times

Posted on December 6, 2016 by Melissa Killeen

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As a recovery coach, I often see my clients need some help getting through the tough times, without using drugs, picking up a drink or acting out. Recently, I personally encountered some rough patches in my own life, so I went to my library of recovery books. Reading books on recovery is an import tool I use regularly in my practice. Several years ago, I was curious about Buddhist recovery, so I became an avid reader of the books by Pema Chodron.

Pema Chodron Celebrates 80 Years

Pema Chodron, is a Buddhist nun, she was born in 1936, in New York City, and is celebrating her 80th year. After a divorce, in her mid-thirties, Pema traveled to the French Alps and encountered Buddhist teacher Lama Chime Rinpoche, and she studied with him for several years. She became a novice Buddhist nun in 1974. Pema moved to rural Cape Breton, Nova Scotia in 1984, ­­­to be the director of Gampo Abbey and worked to establish a place to teach the Buddhist monastic traditions (waking before sunrise, chanting scriptures, daily chores, communal meals and providing blessings for the laity). In Nova Scotia and through the Chodron Foundation, she works with others, sharing her ideas and teachings. She has written several books, and in my time of deep spiritual need, I went to her book “When Things Fall Apart”.

Drawn from traditional Buddhist wisdom, Pema’s radical and compassionate advice for what to do when things fall apart in our lives helped me. There is not only one approach to suffering that is of lasting benefit, Pema teaches several approaches that involve moving toward the painful situation and relaxing us to realize the essential groundlessness of our situation. It is in this book, I discovered a simple breathing exercise I can use during these chaotic times so I can move into a better space. Pema advocates this tool as a breathing exercise, although this exercise could also be considered a mindful meditation.

I use Chodron’s tool whenever and wherever life hits me below the belt. I share this tool with my clients. It is all about breathing and consciously repeating words to yourself to accompany the breathing. Since we breathe every day, it is indiscernible whether you are using this tool as you travel on the bus commuting home from work, in a conference room with your boss, or when you are feeling low and want to curl up in a ball and die.

Breathe

Pema explains in her book, when things get way too complicated; step back and breathe. When the force of the world, the politics of the U.S., Great Britain or Italy start weighing heavily on your mind, breathe. When you look at all the pain around you and feel powerless to do anything, breathe.

Pema explains, inhale and say silently to yourself breathe in the pain, then exhale and say breathe out relief. Then, inhale, and say silently to yourself breathe in the relief, and exhale and say breathe out the pain. I find I need about 15 minutes of conscious breathing in this way. After doing this, I find I have new energy or something else crosses my path to move me into a different space.

If I continue to be in that negative space of worry or feeling powerless, then absolutely nothing will be accomplished that day. I know we all have something to accomplish every day, whether it is just getting out of bed, taking a shower and brushing our teeth or running a Fortune 500 company, this exercise gets us from zero to ten in fifteen minutes. Chodron’s exercise moves me to the space I need to be in, so I can function. It is what I need.

So, I invite you to try this simple exercise…and remember…keep breathing.

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Alcoholics need detox care

Posted on October 29, 2015 by Melissa Killeen

Melissa Killeen

Melissa Killeen

Alcoholics are not receiving the care they need for detox. As a recovery coach, I have seen a disturbing practice develop within the medical community involving detoxing an individual in extreme alcohol withdrawal. Not everyone who walks into an emergency room in withdrawal from an addiction is transferred to an inpatient detox environment. Detoxing from drugs will last as long as it might take for a person to safely withdraw from a specific substance, often at least 5 days. Drug detoxification can take place in inpatient settings, and according to the National Survey of Substance Abuse Treatment Facilities, about 6.5 percent of inpatient treatment facilities and 4.8 percent of hospitals provide this kind of care. At an inpatient detox treatment program, people have around-the-clock medical supervision that can help them to avoid serious complications caused by withdrawal, and people also have a safe and sober place in which to recover from their addictions, so they aren’t tempted to relapse.

Alcoholics are not treated in the same manner. Alcohol detox could take the same 5 days during which patients may experience a wide range of symptoms depending on the severity of their alcohol dependence. Symptoms experienced during detox may be as mild as a headache and nausea or as severe as delirium tremens (DTs), marked by seizures and/or hallucinations. Emergency Room’s expect alcohol detox to take 24 hours for the physical withdrawal symptoms to disappear, aided by intravenous dosages of phenobarbital. But the mental withdrawal takes much longer.

Most alcoholics are sent home by hospital emergency room physicians, with a script for Diazepam (Valium), lorazepam (Ativan), or chlordiazepoxide (Librium), and asked to return to their family practitioner for a follow-up in two days. Sending an alcoholic client to detox at home is a cop-out on the part of the medical and hospital community.

 
ERs and the behavioral health departments in most major-market hospitals are not equipped, nor do they have the beds, to house clients that are in withdrawal or detox from alcohol. Many of these hospitals have closed their detox centers. A cost cutting practice called “reducing the length of stay” mandates that the ER discharges a client to go home, as it costs too much for them to stay in the hospital, waiting for an bed to become available at a detox center. The client is sent home to make their own plans to enter a detox and/or treatment center.

To complicate matters further, there are very few free or low-cost detox facilities. For example, in the state of New Jersey, only two hospitals can provide Medicaid-covered detox treatment: in Paramus, Bergen County, the Bergen Regional Medical Center  http://www.bergenregional.com/Evergreen/index.html ) and in Atlantic City, the AtlantiCare Regional Hospital (http://www.atlanticare.org/index.php/mission-health-care ). In the private for-profit detox centers, there will be a Medicaid or charity-care bed or two, but these beds have a long waiting list, giving the individual only one option: to detox at home.

Individuals who need help with withdrawing from their alcohol addiction don’t have the time to wait—they are withdrawing now! It is generally assumed by the ER staff that alcoholics will be able to detox at home, with minimal health risks. Detoxing at home poses a significant problem: the maximum likelihood that the client in withdrawal will pick up a drink in their home environment.

This is where a recovery coach can help.

 
As long as these individuals have a recovery coach with them at all times, a coach who can step up and step in if something goes wrong, and to help plan for admission to a treatment center, this can be a safe strategy to follow.

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