On May 21, 2005, David Foster Wallace opened his commencement address at Kenyon College with the following story. There are these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says “Morning,  boys.  How’s the water?” And the two young fish swim on for(……)

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(……)

When a slave was drunk, the slave holder had no fear that he would plan an insurrection; no fear that he would escape to the north. It was the sober, thinking slave who was dangerous, and needed the vigilance of his master to keep him a slave. –Frederick Douglass, 1855. Addiction is influenced by personal(……)

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(……)