Meet the unicorns

unicorns-e1445611915468After yesterday’s post, we need a little hope and a reminder that people with opioid addiction can achieve full recovery.

Some local people in recovery from opioid addiction were growing frustrated with media representations of opioid addiction that suggest full abstinence-based recovery is not a realistic goal.

They decided to start The Unicorn Project and  I’ve helped them with a website.

Media reports and comments from “experts” give the impression that opioid addiction (heroin, vicodin, etc.) is a near hopeless condition and that the only hope is maintenance on other opioids (buprenorphine and methadone).

Some of these reports acknowledge that there are people who achieve drug-free recovery, but imply that they are extremely rare. It almost sounds like everyone’s heard of them, but no one’s seen one–like unicorns.

We know this isn’t true.

We want people to know that opioid addicts can achieve full recovery without opioid maintenance drugs. And, it’s not rare or unusual when people get the right kind of help.

We’re not here to argue that medications like buprenorphine and methadone are bad, or that our path to recovery or one form of treatment is better than another.

We just want people to know that drug-free recovery is a legitimate path to recovery, that many people already succeed with this path, and that more people could also succeed on this path—if they are offered the right kind of help.

Our evidence is us. We’re all in long-term recovery from opioid addiction.

All of us have been in full recovery for more than 5 years.

This is just a start. The current postings represent just a small fraction of the recovering opioid addicts in a single community. They have several more unicorns working on their stories.


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“heroin-assisted treatment, a science-based, compassionate approach”


A photo-essay (trigger warning) seeks to document heroin-assisted “treatment” (my quotes) and humanize heroin addiction.

The author explains his intent:

Throughout the project, I’d spoken with the subjects about the purpose of the photo essay – to challenge the stereotypes of drug genre photography and to help spread awareness about heroin-assisted treatment.

He also describes the reality of what he witnessed:

I often explained to them that their photos would likely be published on the Internet – that police, future employers and others could learn they are heroin users. Despite the risks, the three subjects reiterated that they wanted to take part in the project because they, too, wanted to tell others about heroin-assisted treatment.

I’d been told that after enrolling in the heroin-assisted treatment study, some participants had reconnected with family members, found stable housing and gotten jobs. I hoped that I’d be able to take photos of Marie, Cheryl and Johnny in these types of settings.

However, I quickly learned that this wouldn’t be easy. Two of the three subjects didn’t engage in many other activities beyond self-injecting at the Crosstown clinic three times a day. Outside the clinic, much of their time was spent acquiring and using drugs.

This meant the moments I was able to capture ended up being far less varied than I’d anticipated.

Still, there were revealing moments, like when I managed to photograph Marie traveled across the city by bus to try to find her mother. It was Thanksgiving and she hadn’t seen her mother in over two years. I thought these particular photos might help the viewer understand Marie in a new way: even if people weren’t able to fully understand the depth of Marie’s suffering or the roots of her addiction, everyone knows what it’s like to want to spend the holidays with loved ones.

The greatest challenge I faced was determining how to document two of the subjects’ ongoing drug use outside of the heroin-assisted treatment study. I simply couldn’t ignore it because it was a major part of their day-to-day lives.

The images are pretty rough and heartbreaking, but he suggests he avoided anything sensational.

When the time came to choose the final photographs, I deliberately left out images that I suspected could be viewed as the most sensational or degrading.

This is described as last resort “treatment”. One can’t help but wonder what kind of care these people have been provided. Did they ever get compassionate, comprehensive, high quality treatment of adequate duration and intensity? Were they ever helped by people who believe in their capacity to recover? Were they ever exposed to a community of people who have recovered and enjoying full, satisfying lives?

Is this treatment? Or, palliative care for a treatable condition?

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What does clinical humility look like?

Bill White recently put out a thought-provoking call for addiction professionals and institutions to engage in self inventory and practice professional humility:

The challenges for each of us who work in this special service ministry and for the specialized industry of addiction treatment include conducting a regular inventory of clinical and administrative policies and practices to identify areas of inadvertent harm, altering conditions linked to such harm, making amends for such injuries, and developing mechanisms to prevent such injuries in the future.

He highlights an example I’d been meaning to share:

Chris Budnick, an addictions professional in North Carolina and founding Board Chair for Recovery Communities of North Carolina, Inc. (RCNC), recently responded to that question by preparing a formal letter of amends to the individuals, families, and communities he has served.

Chris’s reading of his letter is in the video above. The text can be read in Bill’s post here.

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Oh my God, there is no way I’m going to be able to do this.


From MLive:

Emma Nagler had always dreamed her college years would be filled with wild parties, late nights and parents who would be none the wiser.

By the time she arrived on campus as a college freshman in Ann Arbor three years ago, her sentiment had shifted dramatically. The concerns about where she was going to party and how she was going to get high were replaced with fears about falling back into the habit of drinking and using drugs.

“At freshman orientation, everyone was talking about drinking and partying,” Nagler recalls. “I remember thinking ‘Oh my God, there is no way I’m going to be able to do this.'”

Emma did it. Read the rest of her story here.

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A great guy with a great story


From MLive:

The last time John Worthy attended a graduation ceremony with his daughter in 2007, he was in a much different place than he’ll be when the two reunite as he receives his master’s degree in social work from the University of Michigan.

Mired in a world revolved around drugs and alcohol and dealing with the aftermath of his third drug-related criminal charge, Worthy recalls a phone conversation with Sasha, who had moved to Atlanta with her mother – a watershed moment that convinced him to get clean.

“One day during (my daughter Sasha’s) senior year she called and asked if I was going to be able to attend her graduation,” said Worthy, who was 38 at the time. “I found that to be troubling that she asked me. The more I thought about it, I couldn’t determine if she asked me because she was afraid that I wasn’t (going) or afraid that I was. I really began to think about her and what impact all of this stuff had on her.”

Moments like that phone conversation are how Worthy measures his progress in recovery from drugs and alcohol in the years that followed as “symbols of change.”

Read the rest here.

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3 recent articles about AA

truman11Here’s a rundown of a few recent positive articles about 12 step recovery.

First, Meghan O’Gieblyn interrogates Gabrielle Glaser’s widely circulated takedown of AA:

Last April, the Atlantic published a feature-length takedown of America’s longest-standing mutual-aid fellowship. “The False Gospel of Alcoholics Anonymous” was the work of Gabrielle Glaser, who delivered the bad news in dry and dismal statistics. According to modern studies, AA’s success rate is between 5 and 8 percent. Glaser claimed she was surprised by the numbers (“I assumed as a journalist that AA worked”), though the article betrayed a longstanding skepticism. Over the past few years, Glaser has been advancing the message in major news organs that twelve-step programs are bad for everyone, including women (Wall Street Journal), teenagers (New York Times), heroin addicts (Daily Beast), South Africans (Marie Claire) and doctors (Daily Beast again). But at eight thousand words, the Atlantic article was longer and received far more attention than her earlier publications. It also offered the most complete formulation of her case. “The problem is that nothing about the 12-step approach draws on modern science,” Glaser wrote, “not the character building, not the tough love, not the 28-day rehab stay.” If alcoholism is truly a disease, why is the default treatment a spiritually oriented support group run by nonprofessionals?

Second, Jessica Gregg, M.D., Ph.D. encourages doctors to think twice before dismissing 12 step groups:

Addiction has long been medicine’s unwanted stepchild. Doctors didn’t understand it, didn’t know how to treat it and felt helpless in the face of the wreckage it brought to their patients’ lives. As a result, while providers addressed the consequences of addiction — endocarditis, liver failure, seizures, overdose — they rarely treated the disease itself. That mysterious task has been left to others: counselors, peers in recovery and 12-step programs.

Third, Tori Utley examines criticism of AA in the media:

In recent years, reports of the failures of Alcoholics Anonymous have continued, challenging the foundational programming of the 12 steps. With the majority of treatment programs being based on the methodology founded initially in the 1930s by Bill Wilson and Dr. Bob Smith in Akron, Ohio, many wonder why these programs are still followed and why we put any confidence in 12-step programs at all.

With conflict about the issue surfacing in the medical and clinical communities, numerous sources have arose to dispute the 12-step methodology.



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I really hope they are willing to listen to the evidence

If you spend much time following news about addiction treatment, you’ll start to notice a pattern.

There’s a lot of skepticism about addiction as a disease and abstinence-based treatment. Somehow, addiction treatment has become a front in the culture wars and articles that attack 12 step recovery (this particular article earned he writer an award) or promote maintenance treatments get a lot of press.

You also get enthusiastic stories on maintenance treatments that challenge conventional thinking.

This story focuses on the use of hydromorphone (Dilaudid) to “treat” addiction, presenting it as medication that doesn’t really produce euphoria, leaving out that Dilaudid is powerful and sought after by people with opioid addiction. [trigger warning]

2b8137819ce7132ada7acbbc3e7afa00A new study says the drug used by Max, hydromorphone, is a powerful tool that could helps thousands of other Canadians battling opioid addiction.

. . .

“I’m not getting stoned, I’m not getting that kind of effect from it.”

. . .

Addiction researcher Dr. Eugenia Oviedo-Joekes says this trial is the first of its kind in the world and she is urging an expansion of clinics modeled on Vancouver’s Crosstown.

. . .

She says addiction should not be treated as a “second class” illness because of the social stigma attached to it.

She says access to drugs such as hydromorphone or even the medical equivalent of heroin are now proven to be the best form of treatment. And she said supplying the medication to patients in a controlled setting does not encourage people to use drugs.

“I really hope the government is willing to listen to the evidence. I really hope some people stop playing to the fear of what it means.This treatment is for those we are leaving behind, the poorest, the most vulnerable.”

I couldn’t agree more. Socio-economic class should not determine one’s access to treatment, or the kind of treatment one gets offered. All people with addiction should have access to the best treatment available. And, we should not play to the public’s fears.

So then, what’s the very next sentence in the article?

Researchers also point to other benefits from the trial, showing participants were much less likely to get involved in crime because they no longer had to scramble to pay for heroin. They also spent less time in emergency wards and were not as costly to the criminal justice system.

Why lower the bar? And, why lower the bar in a manner that plays to the public’s fears of people with addiction rather than their hopes?

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