People addicted to alcohol and other drugs see the world differently. They SEE the world differently as a result of neurocognitive changes in perception that accelerate in tandem with increased tissue tolerance, increased intensity of cellular hunger (craving), and the resulting obsession with maintaining the drug relationship at all costs. As drug seeking, drug procurement,(……)

One of the benefits of working on multiple projects is that seemingly unconnected areas of study can create amazing synergies when they cross the same space. One such breakthrough in my career occurred in the 1990s. My organizational work had kindled an interest in how individuals sustained exemplary performance and health in high stress human(……)

The Engagement Dance The outreach workers of Project SAFE had a remarkable ability to engage women who were initially hostile or ambivalent about participating in professional treatment, but the outreach worker’s ability to eventually get these women to a treatment center did not necessarily mean that the clients then lived happily ever after. The on-going(……)

The explosive growth of nonclinical recovery support services (RSS) as an adjunct or alternative to professionally-directed addiction treatment and participation in recovery mutual aid societies raises three related questions: 1) What is the ideal organizational placement for the delivery RSS?, 2) What persons are best qualified to provide RSS?, and 3) Are RSS best provided(……)

A Rendezvous with Hope (Lessons from an Outreach Worker) Through my tenure in the addictions field, the question of readiness for treatment and recovery was thought of as a pain quotient. In the earliest years, we believed that people didn’t enter recovery until they had truly “hit bottom.” If a client didn’t fit that criterion(……)

Landmark life in recovery surveys have been recently conducted in the United States (Laudet; Kaskutas, Borkman, Laudet, et al.; Witbrodt, Kaskutas, & Grella), Canada (McQuaid, Malik, Moussouini, et al.), Australia (Best & Savic), and the UK (Best, Albertson, Irving, et al.).  These surveys provide retrospective confirmation of the improvements in physical/emotional/relational health and quality of(……)

The field of addiction treatment is facing a growing cultural backlash that threatens its future as a viable social institution. Cultural ownership of an intractable problem vacillates over time. Vague but passionate promises of a new approach always garner more hope than the known limitations of current efforts. And any industry that has attracted substantial(……)

Efforts are well underway to shift addiction treatment from models of ever-briefer acute care to models of sustained recovery management (RM) nested within larger recovery-oriented systems of care (ROSC). This shift involves extending the continuum of recovery support services across the stages of long-term recovery, but it also embraces a more activist stance in shaping(……)