Tag Archives: drug 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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Substantial R.O.I. from Funding Recovery Programs

Posted on August 27, 2015 by Melissa Killeen

melissa-new-post

Melissa Killeen

“Most crucially, everyone must be aware of how logical and smart treatment is from a purely financial standpoint.” – Dr Richard Juman, president of the New York State Psychological Association

Can there be a substantial R.O.I. (return on investment) from government-funded recovery programs? How can funding recovery programs provide high returns on the funding investment when a new report from the CDC says opioid use is at epidemic proportions? When heroin deaths nearly quadrupled from 2000 to 2013? And the trend is worsening: heroin-related
deaths, grew a staggering 39.3% from 2012 to 2013. There were about 44,000 drug drug-addiction-9847058overdose deaths in the U.S. in 2013, more than 16,000 of them involving powerful prescription painkillers such as Vicodin and OxyContin. [i] Each day, 44 people in the United States die from overdose of prescription painkillers.[ii] How much funding can the government forecast to pump into this epidemic? Addressing the impact of substance use alone is estimated to cost hundreds of billions each year. Is there enough government money to make a dent? We have to, at least, try.

Substance abuse is costly to our nation, exacting over $600 billion annually in costs related to healthcare, lost work, lower productivity and crime. Research from the Massachusetts Opioid Task Force and Department of Public Health established that mental and substance use disorders are among the top conditions that result in significant costs to families, employers, and publicly funded health systems. In 2012, an estimated 23.1 million Americans aged 12 and older needed treatment for substance use. By 2020, mental and substance-use disorders will surpass all physical diseases as a major cause of disability worldwide. [iii]

In June 2006, the Washington State Institute for Public Policy, whose mission is to carry out practical, non-partisan research on issues of importance to Washington State, was directed by the Washington Legislature to estimate whether treatment for people with alcohol, drug, and mental health disorders offers economic advantages, or a R.O.I. (return on investment). By reviewing “what works,” literature, and estimating monetary value of benefits, they reached these conclusions:

  1. The average substance use treatment program can achieve roughly a 15 to 22 percent reduction in the incidence or severity of these disorders.
  2. Treatment of these disorders can achieve about $3.77 in benefits per dollar of treatment costs. This is equivalent to a 56 percent rate of return on investment.
  3. Estimated that a reasonably aggressive implementation policy could generate $1.5 billion in net benefits for people in Washington with $416 million in net taxpayer benefits, and the risk of losing money is small.[iv]

But still, state and federal legislators are hesitant to fund intervention, treatment, and recovery programs.

“Together we must challenge individuals, communities, cities, counties, regions, states, and the nation to be accountable for the outcomes of the justice systems at every level of government.”
— James Bell

Approximately one-quarter of those people held in U.S. prisons or jails have been convicted of a drug offense.[v] The United States incarcerates more people for drug offenses than any other country. With an estimated 6.8 million Americans struggling with drug abuse or dependence, the growth of the prison population continues to be driven largely by incarceration for drug offenses.[vi] Where does this spiral of incarceration instead of treatment stop?

For example, the average cost for a year of an offender treatment program is $5,000, whereas a year of imprisonment costs over $31,000, and far more in areas like New York City where the average annual cost per inmate was $167,731 in 2012. Court ordered addiction treatment programs can seriously reduce prison costs.[vii]

The Pennsylvania Commission on Crime and Delinquency (PCCD) examined the return-on-investment for seven programs (e.g. Big Brothers and Big Sisters, Strengthening Families, and Multisystemic Therapy programs) that are supported by the state’s Commission and Department of Public Welfare. It was concluded that these programs represent a potential $317 million return to the Commonwealth in terms of reduced correctional costs, lessened welfare and social services burden, and increased employment and tax revenue. The researchers estimated that the programs produced returns of $1 to $25, for every dollar invested, and could generate cost savings as great as $130 million for a single program.[viii] Are these facts overlooked by legislators in state and federal government?

Maryland voters believe by a five-to-one margin that the drug problem is getting worse. The same poll showed that voters believe by a two-to-one margin that there are too many people in prison, and 86% of respondents favor judges having the option to order drug treatment rather than prison for some offenders. [ix] Have the voters spoken?

“Recovery with justice allows us to bury the ghosts of the past and to live with ourselves in the present.” — William White

So in this election year, I urge you to contact your local state representatives, contact your state senators and congressmen/women and urge them to increase funding for substance-addiction treatment and implement reforms that will send addicts to treatment programs like Drug Court or COPS, (Office of Community Oriented Policing Services) versus prison.

William White just posted an excellent letter to our presidential candidates that outlines the impact opioid addiction has on individuals, families, and communities. White requests a policy statement by the candidates in the 2016 Presidential campaign. Copy this letter and send it to the candidates you support: http://www.williamwhitepapers.com/blog/

And remember:

There are 23 million people in long-term recovery, and we vote.

 

References used in this blog

[i] The American Association for the Treatment of Opioid Dependence (AATOD) March 18, 2015 10:51 AM, Accessed on August 23, 2015 at: http://finance.yahoo.com/news/only-1-9-substance-abuse-145129124.html

[ii] Understanding the Epidemic, Center for Disease Control, access on August 23, at: http://www.cdc.gov/drugoverdose/epidemic/index.html

[iii] Massachusetts Opioid Task Force and Department of Public Health Recommendations on Priorities for Investments in Prevention, Intervention, Treatment and Recovery, http://www.mass.gov/eohhs/docs/dph/substance-abuse/opioid/report-of-the-opioid-task-force-6-10-14.pdf  Accessed August 23, 2015

[iv] Washington State Institute for Public Policy, accessed on August 23, 2015 at: http://www.wsipp.wa.gov/ReportFile/945/Wsipp_Evidence-based-Treatment-of-Alcohol-Drug-and-Mental-Health-Disorders-Potential-Benefits-Costs-and-Fiscal-Impacts-for-Washington-State_Full-Report.pdf

[v] Number of people in federal or state prison for drug offenses: Harrison, Paige, and Allen J. Beck. Prisoners in 2005. Washington, DC: Bureau of Justice Statistics. Estimate of jail inmates held on drug offense derived from James, Doris J. 2004. Profile of jail inmates, 2002. Washington, DC: Bureau of Justice Statistics.

[vi] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2005 National Survey on Drug Use & Health: Detailed Tables. Table 5.1A Online at www.drugabusestatistics.samhsa.gov/NSDUH/2k5NSDUH/tabs/Sect5peTabs1to82.htm#Tab5.1A

[vii] The American Association for the Treatment of Opioid Dependence (AATOD)March 18, 2015 10:51 AM, Accessed on August 23, 2015 at: http://finance.yahoo.com/news/only-1-9-substance-abuse-145129124.html

[viii] EpisCenter, Penn State University, Cost-benefit Assessment of Pennsylvania’s Approach to Youth Crime Prevention Shows Dramatic Return on Investment access on August 23, 2015 at: http://www.episcenter.psu.edu/sites/default/files/Fact%20Sheet%20-%20Cost%20Benefit%20of%20PA%20Prevention.pdf

[ix] Justice Policy.org accessed on August 23, 2015 at: http://www.justicepolicy.org/uploads/justicepolicy/documents/04-01_rep_mdtreatmentorincarceration_ac-dp.pdf

[ix] Maryland Voter Survey. (December, 2003). Bethesda, Maryland: Potomac Incorporated.

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Faces and Voices of Recovery announces the 2015 America Honors Recovery Awards

Posted on May 23, 2015 by Melissa Killeen

Faces and Voices of Recovery Awards

Faces and Voices of Recovery announces the 2015 America Honors Recovery Awards.  America Honors Recovery is the addiction recovery community’s annual awards event to recognize the over 23.5 million Americans in recovery and recovery community organizations.

Sponsored by Faces & Voices of Recovery, the event highlights the extraordinary contributions of the country’s most influential recovery community leaders to the growing movement to promote the reality of recovery from addiction.

The recipients will be honored at the July 23, 2015 America Honors Recovery Awards Dinner, starting at 6:30, to be held at the  Hyatt Arlington at Washington’s Key Bridge 1325 Wilson Boulevard Arlington, VA 22209.  If you have any questions, please contact info@facesandvoicesofrecovery.org or call us at (202) 737-0690.  Tickets go on sale starting the week of May 26 at the Faces & Voices Website

America Honors Recovery salutes the legacies of three dynamic recovery trailblazers who dedicated their lives to removing barriers for individuals and families affected by addiction – Dr. Vernon E. Johnson and recovery advocates Joel Hernandez and Lisa Mojer-Torres.

The Vernon Johnson Award-

  • Melissa Killeen, Founder & Owner of Melissa Killeen Recovery Coaching, Ms Killeen resides in Laurel Springs, New Jersey
  • Honesty Liller, Chief Executive Officer of the The McShin Foundation, Ms Liller resides in Richmond, Virginia
  • Molly O’Neill, President & CEO of First Call Alcohol/Drug Prevention & Recovery, Ms. O’Neill resides in Kansas City, Missouri

The Joel Hernandez Award-

  • Utah Support Advocates for Recovery Awareness (USARA) Executive Director, Mary Jo McMillen Salt Lake City, Utah

The Lisa Mojer-Torres Award-

  • H. Westley Clark, M.D. CSAT

Director – Retired, University of California, Los Angeles

The Voice of Recovery Award-

  • Greg Williams

Director, The Anonymous People, Recovery Advocate

 The Distinguished Lifetime Achievement Award

  • William White

Author, Researcher and Recovery Historian

 

2015 America Honors Recovery Awards Dinner tickets go on sale starting the week of May 26 at the Faces & Voices Website

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