Recovery Rising Excerpt: Treatment Works? Taking on a Sacred Slogan
Sloganeering has a long history in the alcohol and other drug (AOD) problems arena as a means of promoting or stigmatizing drug use, advocating particular cultural policies toward drug use, and conveying particular definitions of the nature of AOD problems. The ideological and financial backlash against addiction treatment through the late 1980s and 1990s left treatment advocates on the defensive. It was in this climate that the slogan, Treatment Works, became the central organizing slogan of the addiction treatment industry. There was much to commend the slogan. It was short and catchy, celebrated those whose lives had been transformed by professional treatment, and honored treatment practitioners and their organizations. Something bothered me about the slogan, and it took some time to sort out the source of that discomfort.
In 2004 and early 2005, I posted and published a paper challenging the use of this slogan. I argued that the slogan 1) erroneously conveyed the existence of an entity called “treatment” that was consistent in character and quality across the United States, 2) perpetuated a single, professionally-directed pathway to AOD problem resolution, 3) failed to acknowledge individuals who resolve AOD problems without professional intervention or who are harmed by professional treatment, 4) justified the prevailing acute care model of intervention (analogous to treating a broken arm) that was unsuitable for most people with severe AOD problems, 5) misrepresented the highly variable and complex outcomes of addiction treatment, and 6) shifted the responsibility for recovery from the addicted/recovering person to the treatment professional.
I argued that the slogan Treatment Works should be abandoned and replaced by a cluster of messages that shifted the emphasis from the intervention (treatment) to the desired outcome (recovery), extolled the importance of personal choice and responsibility, celebrated multiple pathways of recovery, affirmed the supportive roles of family and community in the recovery process, and incorporated catalytic metaphors drawn from diverse medical, religious, spiritual, political, and cultural traditions.
I knew that this would not be the most popular article, but I knew that such an article could be best written by someone with a long history as a treatment advocate. Authored by someone outside the field, this article would have been discounted as one more “treatment-bashing” article. Authored by myself, I thought there was a chance to spark serious discussion inside the field on the central messages we need to convey to our local communities and the country about addiction treatment. This writing was a reaffirmation that our job is to tell the truth about treatment, not sell it as snake oil. And we must tell that truth to multiple parties: our own staff, patients and families, allied professionals, policymakers, and the public. History has taught me that any misrepresentation of fact to promote addiction treatment in the short run has the potential to mortally wound the field in the long run.