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The 2009 Annual Report of the Office of Substance Abuse Treatment Services (OSATS), formerly the Division of Addiction and Recovery Services, includes return-to-custody data on offenders who paroled in Fiscal Year 2005-06 for a one-year and a two-year period. The return to custody rate after one year for offenders completing both in-prison and community-based treatment in FY 2005-06 was 21.9 percent compared to 39.9 percent for all offenders. The return to custody rate after two years for offenders completing both in-prison and community-based treatment in FY 2005-06 was 35.3 percent compared to 54.2 percent for all offenders.

For male offenders, the return-to-custody rate after one year for those who completed both in-prison and community-based substance abuse treatment in FY 2005-06 was 25.4 percent compared to 41.2 percent of all male offenders. The return-to-prison rate after two years for male offenders who completed both in-prison and community-based substance abuse treatment in FY 2005-06 was 40.4 percent compared to 55.6 percent of all male offenders.

Female offenders were especially responsive to substance abuse treatment. After one year, only 8.8 percent of female offenders who completed both in-prison and community-based substance abuse treatment in FY 2005-06 were returned to custody compared to 30.1 percent of all female offenders. The return-to-prison rate after two years for female offenders who completed both in-prison and community-based substance abuse treatment in FY 2005-06 was 16.5 percent compared to 43.7 percent of all female offenders.

Very cool. Thanks Lighthouse!

For many students, moving to Ann Arbor to begin their careers at the University of Michigan is a time of excitement, curiosity and maybe a little bit of fear. But for School of Social Work graduate student Ivana Grahovac, the emotions were different.

As Grahovac prepared to start her time at the University, she was also recovering from a five-year addiction to heroin. Though she had been clean and sober for four-and-a-half years in her hometown of Bloomfield Hills, Mich., she wasn’t sure she could recreate that security in Ann Arbor.

Grahovac said coming to Ann Arbor was a “leap of faith” and that once she arrived, she felt her sobriety constantly threatened.

“I was constantly getting these e-mails about being invited to join people for keggers, drink night specials and pub-crawls,” she said. “There was just a real lack of understanding going on that maybe there are people for whom this would be a very bad choice and possibly cause some serious negative and tragic consequences to occur.”

It was in this environment that Grahovac decided to create Students for Recovery, a group aiming to support and provide provides information for students recovering from addiction. The group also helps students find sober programming as an alternative to the usual Friday night party filled with red Solo cups and alcohol.

Read the rest here.

I am completely in favour of helping people who use drugs to stop, if that is what they want. I assume that is what is meant by ‘recovery’. Working with anyone who has problems with drugs must start where the individual is and could involve a range of strategies. Harm reduction should permeate the services available to drug users, which should be used on the basis of evidence of effectiveness, including cost-effectiveness, and on the basis of allocating scarce resources in the most effective way on a population base.

I wonder about the evidence for his first statement. How many people has he or his organization helped achieve drug-free recovery? How many of the people they serve want drug-free recovery, and how many people can’t access services to achieve this goal? Do they track this information? Do they use it to advocate for more drug-free treatment services?

If so, great. We’re on the same side. If not, stop giving lip service to helping people who use drugs stop.

The recovery agenda is a dishonest political agenda, by which some treatment agencies are positioning themselves for a seamless transition to a Conservative government. It ignores evidence and relies on faith. It is becoming evangelistic. It is dishonest because it is completely undeliverable financially and it raises false hopes. It is not a public health approach.

Whoa! I’m not there to see for myself, so I don’t know if the U.K. recovery movement is a cabal of political conservatives or ideologues trying to exploit political conservatives. I see no political pandering on Wired in.

As a recovery advocate that is thousands of miles away, I see a frustrating parallel with discussions here. The HR advocates adopt a hyper-rational posture, denying that their values are reflected anywhere in their beliefs and practice while accusing recovery advocates of being close scientific cousins of intelligent design advocates.

What evidence do recovery advocates ignore? There is ample evidence that we can be as effective at treating addiction as we are with other chronic diseases like hypertension, diabetes and asthma. Should we reject the current treatments for those too?

Why is it undeliverable financially? Because the public doesn’t support it? Isn’t that the point of advocacy? Why quash advocacy work that is focused on improving the lives of the people you also advocate for? Why not collaborate to make sure a complete continuum is offered?

The basis of drugs work should always be harm reduction. It should always be public health-based and if it helps with public order that is fine with me.

Why is drug-free treatment incompatible with public health? I think it is, but it’s also important to keep in mind some of the limitations of public health models–tension between prevention and treatment is common in these arguments, Public health approaches always include the application of some values (even when we say they don’t), and they risk turning life and death decisions for entire classes of people into cold accounting exercises. For example, why do we cringe at a harm reduction/public health approach to female circumcision? (More here and here.)

One other observation. Mr. O’Hare did not the use of the word addiction or any its variants. Does that intimate something? It may be nothing (Really, I mean that.), but it make me wonder if he’s invested in framing as something other than a disease.

[hat tip: PeaPod]

Many people would argue that the UK treatment system, in main, is simply managing symptoms and accepting long-term disability or discomfort of people with serious substance use problems.

These same people would not argue against the value of treatment per se, rather it needs to be provided in a different way.

The recovery movement is first and foremost a civil rights movement. It is about helping disadvantaged people, people with problems, improve their well-being.

It is about helping people with substance use problems (and often many other problems) reclaiming or claiming their right to a safe, dignified, meaningful and gratifying life in the community, sometimes despite their problems.

A recovery oriented system of care places the person with the problem at the centre of the system. It does not just build places where people go and get ‘treatment’ – it builds forms of support theroughout the community.

It accepts that the struggles of the person are not just with what is going on within their own body and mind – it is about their social struggles, which they experience because of the prejudice, discrimination, stigma and marginalisation that occurs in society.

Based on the consistency of findings across the studies, the confounders controlled for, the dose response relationships, as well as the theoretical plausibility and experimental findings regarding the impact of media exposure and commercial communications, it can be concluded from the studies reviewed that alcohol marketing increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.

The problem with the methadone community is we have too many people who think methadone is a magic bullet for that disease—that recovery involves nothing more than taking methadone.

This view is reinforced by people who, with the best of intentions, proclaim, “Methadone is recovery.” Methadone is not recovery. Recovery is recovery. Methadone is a pathway, a road, a tool. Recovery is a life and a particular way of living your life. Saying that methadone is recovery let’s people think that, “Hey, you go up to the counter there, and you drink a cup of medication, and that’s it. You’re in recovery.” And of course, that’s nonsense. Too many people in the methadone field learn that opiate dependence is a brain disorder, and they think that that’s all there is to it. But just like any other chronic medical condition, it has a behavioral component that involves how you live your life and the daily decisions you make.

He bemoans the lack of recovery-oriented providers:

Bill: Do you see the methadone clinics in the United States developing more recovery-oriented philosophies in their service practices?

Walter: I wish I could say I did, but it’s a yes and no. I’ve been to all the AATOD conferences since 2001 and there are clearly people who are developing more recovery-oriented programs, but there are 1200 methadone programs in the U.S. How many are represented at the AATOD? 40? So yes, some of the programs are developing more recovery-oriented services, but many are not.

This will be a very interesting movement to watch. Read the rest here.

[via dailydose.net]

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