Tag Archives: California Drug Rehab

ERs Are Stepping Up to Help With Addiction

Addiction Treatment Centers

 

Leave it to California to take the lead when it comes to a group of hospitals trying a new way of helping those addicted to opioids—having ERs administer buprenorphine (aka Suboxone) when someone enters in the throes of withdrawal. (Lest anyone forget, buprenorphine is weaker than other opioids. It activates “the same receptors as other opioids, but doesn’t cause a high if taken as prescribed,” says the article in The New York Times.) A 2015 study by researchers at Yale-New Haven Hospital found that when ERs have done this, the people who get the buprenorphine are more likely (twice as likely, in fact) to be in treatment after a month than people who were only given an informational packet that included phone numbers related to treatment. As a result of the study, an ER specialist who heads the buprenorphine program at Highland Hospital in Oakland convinced the California Health Care Foundation to give his hospital a grant to try the novel method.

 

ER Departments

Out of the box idea? Sure. But it seems to be working. Now ER doctors are calling the lead author of the study every week, she said in August, and ER departments in Camden, NJ, Brunswick, Maine, Philadelphia, New York, Syracuse, and Boston are also offering buprenorphine.The doctors need training to prescribe the medication, as well as a license from the DEA to prescribe it unless someone is in withdrawal, so ER doctors are in a good position to treat those patients. “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” the lead author of the study said. “They’re beyond thinking they can just be a revolving door.”

 

Detox Centers in Northern California

 

Treatment in the ER

It’s a rare opportunity to meet people where they need help and get them started on medication for their addiction, the article notes. In some places of the country, it’s not easy to find a doctor who takes insurance AND prescribes buprenorphine. After their ER visit, ideally a person will follow a “wheel and spoke” approach, where they first go to a treatment clinic (the hub), adjust to the medication, and then see a doctor in a primary practice (the spoke). Treatment in the ER involves buprenorphine under the tongue, and usually, a prescription for Suboxone, in the form of strips that will dissolve in the mouth and thus are harder to abuse. Then the person is directed to meet with the head of the addiction program in his clinic, where he’s available one day a week.

 

Detox Centers

 

Even signs posted in the waiting area of Highland ER reaching out to those suffering from opioid use disorder are helping. A woman there for a respiratory infection saw one and told her brother about the signs, and he decided to enter the program. Recently released from prison, he was hoping to stay clean, especially because he had a job offer. Now he had “a stable source of treatment.” California was willing to provide the grants to have this program flourish. Two-thirds of Highland Hospital’s 375 patients in withdrawal accepted the medication and had an initial appointment at its addiction clinic. Not only that, but California has started to require detox centers and residential centers to allow residents to take either buprenorphine or methadone, medication-assisted treatment, which has had a history of controversy. That’s also ground-breaking.

 

For more information or to contact our Detox Centers in the Bay Area call (866) 596-9391.

 

72,000 Deaths

Can the news from the Centers for Disease Control about 2017 drug overdoses BE any bleaker? The years 2016-2017 saw a record number of people dying from overdoses, which was more deaths than from guns, car crashes, or H.I.V.

Someone has done an analysis. Drugs are deadlier now (often due to mixing them with other substances besides the main drug), and more people are using. The good news is that where the deadlier drugs arrived earliest, such as in New England, some states are seeing the number of overdoses drop. Could that be from diligent public health campaigns and offering more addiction treatment, which they were hitting the problem with? 

However, the writer reminds readers that you can’t totally trust the numbers. With an epidemic like the Zika virus, an infectious disease, people sought help, and public health officials moved, quickly. But with addiction, there’s that pesky STIGMA (detailed in an earlier post on this site this month), so that drug users may not have been truthful about their drug use when polled. Also, some drug users don’t have telephones or are hard to reach, and some deaths take longer to be researched and reported than others.

Deaths from Drug Addiction

As mentioned earlier, another reason for the astronomical number of deaths is that the drug supply is changing, as noted by an associate professor at the Brown University of Public Health. Fentanyl is being added to heroin, methamphetamine and cocaine, and even anti-anxiety medicines known as benzos, or benzodiazepines. (Stay tuned for a post on older people mixing benzos with opioids.) That’s especially bad news for “older, urban black Americans; those who used heroin before the recent changes to the drug supply might be unprepared for the strength of the new mixtures,” according to the article.

The East seems to be in a better position than the Midwest relative to this one part of the epidemic, because heroin that makes it way to the West is usually “processed into a form known as black tar that is difficult to mix with synthetic drugs.” The East, however, usually has a white powder that combines well with fentanyl.

Let’s hope that Dayton, Ohio, which has been in the news as a “hot spot” for opioid use, is the way of the future for other states. The county has a new emergency response strategy, is utilizing federal and state grants to combat drug use, and has reduced opioid prescribing and provided addiction treatment to prisoners in jails.

drug addiction treatment centers

Drug Addiction Treatment Centers

There are other hopeful signs: Congress may step in with bills that mandate reductions in prescribing opioids, among other things, and along the same lines, experts are reminding people that we need more funding of public health programs.

There’s yet another action that might help which requires no funding and little effort. A behavioral economist at the University of California and the Chief Medical Examiner-Coroner for Los Angeles County wrote an opinion column to suggest that medical examiners and coroners tell doctors when their patients die of overdoses. They wrote that they believe that more careful prescribing would result if doctors were told, and they even set up a trial in San Diego County in 2015 to test their thesis.

They had a letter sent to half the doctors in the study who had prescribed opioids about that doctor’s patient’s death after each one happened. The letter wasn’t threatening “and gave the clinician a path toward safer prescribing.” The results of the study indicated doctors did reduce their prescribing and started fewer patients on opioids.

Every little bit helps, or at least people are trying.

For more information on our drug addiction treatment centers contact our rehab in California, Summit Estate, by calling (866) 569-9391

CA, NY, and Safe Injection Sites

Substance Abuse and Treatment

There is a lot that’s controversial about substance abuse and treatment, such as various issues related to marijuana and whether medication-assisted treatment is the best way to go. For example, one of the more polarizing questions is whether or not people suffering from opioid addiction should be offered safe injection sites, where they would find clean needles and be supervised. These sites are not a new idea; CNN reports that in addition to Canada, Australia and some European countries already have them. In 2017, a California bill proposing safe injection sites in eight counties and certain cities such as Los Angeles failed to pass the state Senate. Had it passed, the state would have been the first in the nation to have them. San Francisco was hoping to start one modeled after the one in Vancouver. One senator said they’d be “shooting galleries for street heroin,” yet another implied they centers would be a heck of a lot better in helping people “get off drugs and lead healthy, successful lives” than what’s happening now.

 Supervised Consumption Facilities 

Yet this year it looks as if cities are taking matters into their own hands, according to the CNN article. In February, The San Francisco Department of Public Health “unanimously endorsed a task force’s recommendation” to open a center. About 22,000 people have overdosed in the city, and in 2017, 100 people died of an overdose there. The mayor said that the sites aren’t ideal, but they’re a necessity with the current opioid epidemic. Two are scheduled to open in San Francisco in July. For people wanting statistics on the likelihood of these centers’ “success,” the article has this: “More than 100 peer-reviewed studies on safe injection sites — otherwise known as supervised consumption facilities — have consistently shown them to be effective at reducing overdose deaths, preventing transmission of HIV and viral hepatitis, reducing street-based drug use and linking people to drug treatment and other services.They can also save cities money, which is not to say they’re a good solution to an overwhelming problem.

 top rehab center in California

Injection Sites 

The video accompanying the CNN article showed an overdose victim being revived with Narcan. It was rewarding to see her “come to,” but on the other hand, it was quite upsetting to see her so out of it initially. The video also explained (and showed) what happens to your body during an overdose, which makes a viewer wish that those hooked on opioids would watch it and consider rehab. New York is having its own its own problems trying to get injection sites, as this headline indicates: De Blasio’s Plan for Safe Drug Injection Sites Faces Substantial Hurdles. The mayor would like four initially, but according to the articles, the federal government may determine that the plan “violate(s) the nation’s drug laws.” A spokesperson pointed to what happened in Vermont, where the U.S. Attorney for the state cautioned officials who want the centers about legal repercussions  (see below).

Rehab Centers in California 

Besides New York, other cities such as Seattle and Baltimore, are moving toward opening sites. Philadelphia has publicly announced that they’d like private companies to set up shop in their city. The Vermont federal prosecutor decreed that using illicit narcotics and managing and maintaining sites on which drugs are used and distributed, is illegal, and would expose workers and drug users to criminal charges. Not only that, but the properties where the centers were located could also be forfeited. De Blasio practically pleaded for the centers, saying they would save lives (and prevent up to 130 overdoses a year). (Last year, the city had over 1,400 overdose deaths.) Around the same time as he appeared on TV, a woman reported that she got clean with the help of a safe injection site but didn’t go into detail. It’s difficult to fully understand the politics, or the weight different government bodies hold in the dispute. How could California try to pass a bill in favor of the sites, when the federal government would likely swoop in as it did in Vermont? And how are cities inviting the centers in when they likely would be stomping on federal law, too? You wonder, as the opioid epidemic rages on, what will happen. For more information contact our top rehab center in California at  (866) 569-9391.

Autism, Asperger’s and Addiction in the High-Tech Industry

 Illustration with word cloud on disease AutismIllustration with word cloud on disease AutismA February post postulated that substance abuse may be more prevalent in the high-tech industry in Silicon Valley than is generally known. Anecdotal evidence from Silicon Valley addiction experts who treat a number of clients from the industry suggested that this is true. Why? The stress involved in working in such a competitive environment — trying to be the first to launch a product.

Those with normal and above-average intelligence are said to have high-functioning autism. Asperger’s syndrome is closely related.” The Autism Society explains that people with Asperger’s exhibit “less severe symptoms and the absence of language delays [in childhood]”. WebMD also holds that high-functioning autistic people as well as people with Asperger’s are “good fits for technically demanding jobs. Not only does the internet downplay autistic social deficits, but the language of computers also allows some people with autism to give full expression to their exceptional abilities.”

Perhaps you’ve known or seen someone on the spectrum who seems intensely interested in how things work. One of the experts WebMD quoted said that these people’s brains are wired differently. They “pick out patterns in information and to discern the logical rules that govern systems. That means people with Asperger’s and high-functioning autism often have great talents for creating and analyzing mechanical systems, such as engines, or abstract systems, like mathematics and computer programs.” Gawker reported that “cases of Asperger’s and autism … exploded in Silicon Valley over the past 20 years, according to state-funded outreach workers — an assertion that will come as no shock to users familiar with pedantic, apathetic, tight-lipped and self-serving tech companies.”

To be fair, Silicon Valley isn’t the only area cited as having a high incidence of these conditions. There’s Redmond, Washington, where Microsoft is located, and the northwest Rochester, where IBM is located, is also mentioned as a possibility. Gawker also noted that there are no statistics surrounding the number of programmers and engineers, for example, that are on the spectrum, but “popular belief holds that places like NASA and Silicon Valley are havens for them.” Even Computerworld, one of the industry bibles, has weighed in, with an article titled “Asperger’s: the IT industry’s dark secret,” in which several techies on the spectrum commented. Temple Grandin, who has Asperger’s, says we wouldn’t even have computers without techies with Asperger’s. So where does substance abuse and recovery come in, you might ask. Do people on the spectrum have substance abuse problems like others?

Maia Szalivitz, a “neuroscience journalist” who often writes about addiction, details her thoughts in an article in The Atlantic (which originally appeared in a publication called Spectrum). It opens with the story of a man addicted to heroin who finally got clean. Afterward he was diagnosed with autism, although the signs were there all along. Szalivitz says that for years, the commonly held belief was that addiction among people with autism is rare, since they follow rules and are usually isolated from their peers, for example. But a study in Sweden found the opposite to be true — people on the higher end of the spectrum are “more than twice as likely to become addicted,” and it’s worse if they also have ADHA. Experts in the article say that people on the spectrum find that alcohol eases social anxiety, and they may become addicted. The same holds true of marijuana. Impulsive behaviors in this population are also a problem and can lead to gambling or internet shopping addiction. An article about autism and addiction in Psychology Today by a person who runs a California treatment center included research from the Washington University School of Medicine, where experts studied Australian twins. The findings were that “people with autistic traits were no more likely to drink or use marijuana than people without these traits, but that people with autistic traits who drank or smoked pot were more likely to become addicted to or otherwise abuse these substances.” The writer noted the difference between a person exhibiting autistic symptoms and actually having a diagnosis, however. He posits that “a diagnosis is likely to accompany a more extreme form of the disorder. And it seems from this research as if a more extreme form of the disorder may keep autistic people from even experimenting with substances.” A psychiatrist he interviewed said “it could be that some traits related to autism are protective, while others elevate the risk for alcohol and substance-abuse problems.” If anything, the information in these articles shows a need for more study between autism and addiction.

Nutrition and Recovery

When people suffering from addiction enter treatment and stop using, they often develop a more intense interest in food – often sugary, high-carb, or high-fat choices like doughnuts or mac and cheese. Usually, before they know it, they’re packing on the pounds. Those who have abused alcohol and other drugs likely had a poor relationship with food at the same time, eating whatever pleased them, and some were malnourished. Addiction experts know that what these people are really doing is substituting one drug for another. Both substances make the brain’s pleasure and reward centers light up, which explains why food takes on added importance for them. Many treatment centers promote the idea of healthy eating, and treating people with substance use disorders holistically, but it’s an integral part of the program at Summit Estate Recovery Center. Angela Goncalves, Director of Operations at Summit, even brought a cookbook targeted to those in recovery from her former center, Malibu Beach Recovery Center, to Summit. “I was the Director of Operations at [the former] Malibu Beach Recovery Center from September 2007 to September 2014,” she says. “I saw how effective our diet was for clients struggling to recover from drugs and alcohol. The food was not only delicious, but it boosted dopamine levels.  When I became Director of Operations at Summit Estate Recovery Center in the Silicon Valley, I immediately distributed copies of our cookbook, then known as Dopamine for Dinner, to the chef and staff. It’s the basis of the wonderful meals we serve, and our clients look and feel super healthy.” The basis of the cookbook is the approach to food taken by a French executive in the pharmaceutical industry who developed a diet for himself based on low-glycemic foods. It’s noteworthy that even the chefs who cook the recipes — and contributed to the book — noticed how much healthier the clients look since consuming the foods in the book. There’s this from the Introduction: “….[A]ddicts of all sorts (illicit drugs, prescription drugs and/or alcohol), can recover more easily by following a version of [this diet]. The goal was not weight loss, but regaining emotional balance and health, restoring chronically low dopamine levels and expediting brain repair. The diet also makes recovery more probable for diabetics.” and “Although we call this a ‘diet,’ his is not a diet in the traditional sense. There are no calories to count, and we don’t ask that our clients memorize the values of the Glycemic Index. There are no long lists of forbidden ingredients. Rather the recipes are based on an abundance of allowable products that will enrich and enhance culinary possibilities, and may introduce ingredients that had not been a habitual staple in their nutritional habits.” The cookbook is also for alumni of the two programs (MBRC and Summit), and the “hundreds of thousands of Americans just like them – alcoholics and addicts seeking to achieve long-term recovery through a lifestyle change.” Note: The Barnes and Noble version of Dopamine for Dinner (now called the Malibu Beach Recovery Diet Cookbook by Joan Borsten) can be purchased from Amazon at this link: https://tinyurl.com/ydafq33h

 

 

Choosing a Bay Area Rehabilitation Center

For those that are struggling with addiction or have a loved one caught up in drug abuse or alcohol abuse, finding a rehab center to turn to for help can be one of the most important decisions you make in your life. Selecting the right rehab center can be the difference for you between a long and successful recovery or falling back and deeper into addiction and abuse. It is worth the time and effort to consider facilities that provide the best care possible, and when you are choosing a Bay Area rehabilitation center, there are important factors to consider that can help you make the best choice.

Look at the Staff at the Center

An important factor in selecting a center for treatment is to know something about the staff available at the center. Many centers today find themselves understaffed, with a very high client to staff ratio. You want a location that offers a lower ratio so that you know you or your loved one is going to get the attention and support that is needed. Look to see what the staff is like, the type of professionals that are available to provide medical care, therapy and the like so you can determine if they can offer you the level of care needed.

Choosing a Bay Area Rehabilitation Center

Look at the Treatment Plans of the Center

When choosing any Bay area rehabilitation center, you want to take a close look to see what type of treatment plans are available to clients. You want to select a location that offers varied and personalized treatment plans so you can be sure you or your loved one get the best help possible. Different facilities offer different treatments, with some only offering outpatient or inpatient programs, while others offer a selection.

The Bay Area Center to Consider

If you are seeking a Bay Area rehabilitation center to help with addiction, consider contacting us here at Summit Estate Recovery Center. We offer one of the finest facilities in Northern California and have the experienced, caring staff and the treatment programs that can provide the specialized care that clients need. You can find out more about us by reading about our facilities and programs here on our website, or you can give us a call at 866-569-9391 and speak with a team member who can answer your questions and provide you with the assistance you need to get you started.

 

What Makes for Effective Rehab in California

Before agreeing to take part in any rehabilitation program or treatment center for alcohol or drug addiction, it is important that you know what you should expect from the chosen program or facility. Not every program is identical and offers the same level of care, experienced staff, therapy styles, or amenities. There are some programs that you find may be very basic in their approach, and perhaps they will not offer you the effective treatment you need most. It is good to know what makes for effective rehab in California today, so you know what to look for and expect.

Comfort with Rehab Programs

Looking at the programs offered by a facility is critical to see if this facility will be ideal for you and your needs. Different facilities take different approaches to treatment and provide different programs, so understanding what is offered is important. You want to select a place that offers programs that you will be comfortable attending. If the only program offered involves group therapy sessions, and you are not comfortable with that approach, treatment will not be effective for you. Look closely to see that they offer treatment options best suited to your needs.

effective rehab in California

Consider the Methods of Rehab

Effective rehab in California will offer different methods for rehabilitation. You want a place that can help you from start to finish and beyond, provide you with the medical care for detox, the inpatient or outpatient treatment sessions for addiction or dual diagnosis treatment, and give you the aftercare needed to help you sustain your recovery and succeed. Programs that offer specialized and personalized care may offer you greater options and methods so you can get the care that is best for you.

Effective Rehab for You is Here

When you are seeking a rehab facility in California to help yourself or a loved one, look at what we have to offer here at Summit Estate Recovery Center. We are one of the top programs in Northern California and can offer you and are committed to helping you overcome your alcohol or substance addiction so that you can turn your life around and have a bright future. You can find out more about us and our services when you look at the pages here on our website, but you may also phone us at 866-569-9391 at any time so you can speak with us and make arrangements to get on the path to recovery.

The Help Available at the Summit Rehab Center

Drug or alcohol addiction destroys lives and families each day. The longer you or a loved one suffer from an addiction, the harder it may become to overcome the problem and reclaim what has been lost in life. If you or someone you care about it is struggling with an addiction, you know the devastation it can cause, and you want to do whatever you can to get the person you love the help they need. It is important for you to know that help is available here at our Summit Rehab Center, where we work with individuals dealing with addiction in a highly effective manner.

Providing Personalized Care at Our Center

Here at Summit Rehab Center, we are the best drug and alcohol treatment center available in Northern California. We understand that each person deals with addiction differently and that there is no “cookie cutter” approach to treatment that works for everyone. We craft a personalized treatment plan for each individual and have a high staff to client ratio so that you are sure to get the attention you need and deserve for your treatment. This approach for much greater success in treatment and recovery.

The Help Available at the Summit Rehab Center

Care That Goes Beyond the Standards

The care we provide for each client at Summit Estate Recovery Center goes beyond the norm that you may find at other treatment facilities. We start working with our clients from the time that an intervention may be necessary. From that time forward, through admission, detox treatments, and therapy sessions, right through the necessary aftercare, we will be there for you to help you so that you can have the best chance at a successful recovery. We offer several program options, including outpatient treatment and a residential rehab facility, so that you have the options before you that work best for your situation.

Talk to Us about Our Rehab Center

If you would like to learn more about us at Summit Estate Recovery Center and see how our Summit Rehab Center can help you or a loved one, please take the time to review our website and take a visual tour of our facility. If you have any questions or need any help, we have staff available to speak with you 24 hours a day, seven days a week so you can get the help you need. You can phone us at 866-569-9391 to begin the process and learn what we can do to help you.

Inpatient and Outpatient Alcohol Treatment Programs in the Bay Area

Alcohol is something socially accepted and available everywhere. Maybe for this reason, it’s one of the most abused substances in the U.S. Unfortunately, sometimes it’s even glamorized or encouraged through media. For this reason, many people don’t fully understand the danger that comes along with alcohol abuse.

Summit Estate Recovery Center offers inpatient and outpatient alcohol treatment programs in the Bay Area. Their highly trained experts use tried and true methods in the treatment of alcoholism. The institution offers luxurious locations in order to provide their patients a comfortable, private environment. Such beautiful locations, along with the proper treatment, gives them enough encouragement and stimulation to finally beat the bottle.

inpatient and outpatient alcohol treatment programs in the Bay Area

Different kind of alcohol abuse treatments

People looking for inpatient and outpatient alcohol treatment programs in the Bay Area can find the proper aid at Summit Estate Recovery Center. After admission, the residential alcoholism treatment program starts with a full evaluation. In this evaluation, doctors try to find any co-occurring disorders like anxiety or depression. In those cases, a dual diagnosis treatment is recommended.

After this evaluation, patients receive a medically supervised detoxification. The comfort and safety of Summit Estate Recovery Center’s facilities are very helpful on this matter. Afterwards, patient meet with the clinical staff to create an individualized plan that best suits them. They can also assist to additional, helpful activities like yoga, massage, acupuncture, among others. Inpatient programs might last up to 90 days.

Summit Estate Recovery Center also offers outpatient treatments to fit your schedule. This facility is located in Saratoga, California. In this place, patients can participate in discussion dinners specially coked by an onsite chef. Saratoga’s location also offers one-on-one, family and couples therapy sessions or groups.

Some patients that already went through the inpatient treatment are encouraged to follow outpatient treatment after their 30 or 60 days of therapy. In these cases, it’s necessary the authorization of Summit Estate Recovery Center’s medical staff and substance abuse counselors.

The help you need is a phone call away

Either if you or a beloved one is going through an alcohol addiction, you can receive the help you need at Summit Estate Recovery Center. Its luxurious facilities and expert staff provide the right environment and inpatient and outpatient alcohol treatment programs in the Bay Area. Call at 866-569-9391 to receive more information and talk more about what you’re going through.

Defining Recovery: Reconciling Mental Illness and Positive Mental Health

mental health A curious and dynamic dance revolves around the definition of recovery from mental health disorders in the 21st century. On the one hand, consumers of mental health services tend to define recovery as the presence of positive behaviors and mental states – known as the salutogenic model – while members of the scientific and medical communities tend to define recovery as the absence of disease and negative mental states – known as the pathogenic model. In order to reconcile and synthesize these two disparate points of view into a workable, useful, and inclusive definition, a group of researchers, spearheaded by Helene Provencher of Laval University (Quebec City, Quebec, Canada) and Corey L.M. Keyes of Emory University (Atlanta, Georgia, USA) propose a comprehensive definition of recovery under the label complete mental health. First explored in the 2005 article “Mental illness and/or mental health? Investigating Axioms of the Complete State Model of Health” and expanded over the course of the past decade in close to a dozen related, follow-up studies, the idea of complete mental health – and its relationship to recovery from mental health disorders – is novel in that it recognizes the following:

  1. The absence of the symptoms mental illness does not automatically mean positive mental health.
  2. Positive mental health does not require the total absence of the symptoms of mental illness.

Instead of viewing positive mental health and mental illness as mutually exclusive states of being, Provencher and Keyes consider them as “two separate continua rather than the opposite ends of a separate continuum.” It’s important to note that while these initial studies focus on mental health disorders such as depression, schizophrenia, PTSD, and mood disorders, the value of the complete mental health model applies with equal validity to recovery from addiction and substance abuse disorders. Professor James Jackson (University of Michigan) elucidates the transfer of this Provencher/Keyes model to include recovery from addiction and substance abuse disorders in the 2016 publication Measuring Recovery from Substance Use or Mental Disorders: “…one commonality between substance abuse and mental disorders…is that people with substance abuse problems often have cravings that could be described as conceptually similar to symptoms. In both cases, such a craving may be fine as long as the person is not acting on it.” Both professional substance abuse counselors and individuals in active recovery from substance abuse disorders know cravings are not the only persistent symptom-like phenomenon challenging successful recovery. Counter-productive psychological coping mechanisms such as denial, anger, and rationalizing not only contribute to continued substance abuse prior to recovery, but also follow the recovering addict throughout life and often lead to relapse. Recovery does not mean the total absence of these life-interrupting coping mechanisms; rather, recovery means having the awareness, self-efficacy, and practical tools to identify and counter these mechanisms as they recur over time.

Substance Abuse Recovery: Process and Outcome

Recovery from addiction and substance abuse disorders is complex. It’s tempting to measure recovery with a single, yes/no criterion wherein abstinence signifies recovery and indulgence in intoxicants signifies non-recovery or abuse. However, substance abuse counselors and individuals in recovery alike identify this black-and-white approach as a reductive oversimplification that ignores the subtleties and nuanced challenges involved in creating a life free of substance abuse. Relapse is a reality, yet relapse does not always mean a total collapse of the recovery effort. Nor does it mean a return to square one. The functional truth is that recovery is a non-linear process filled with advances, setbacks, successes, and failures. It includes in-between periods that are neither highs nor lows. The lifelong process of recovery happens on a dynamic continuum, and the precise location of an individual in recovery on that continuum rarely remains fixed. A recovering individual responds to the stresses and gifts of daily life with relative degrees of efficiency. Hard days are as much a part of recovery of good days. Navigating the extremes while maintaining a commitment to the process is the hallmark of a sustainable approach, as opposed to a static mindset that relegates an individual to a restrictive binary with sobriety on one side and substance abuse on the other.

An Multi-Faceted, Inclusive Model of Recovery

The complete mental health model advocated by Provencher and Keyes allows for the non-linear nature of recovery from addiction and substance abuse, and accommodates the formation of an analog for the two features of complete mental health previously described:

  1. Abstinence alone does not automatically mean complete recovery.
  2. Recovery does not require the absence of addiction-related symptoms.

Abstinence is, of course, the ultimate measure of sobriety, yet for individuals struggling with addiction, recovery means more than abstinence. It means the restoration – or in some instances, the discovery – of a way of life that supports happiness, health, and well-being. The model designed by Provencher and Keyes integrates a pre-existing model of mental illness described by Liberman and Koplewicz with their own model of positive mental health. The combination of these two models results in a multi-dimensional rubric containing six states of relative and interconnected positive mental health and disruptive mental illness, ranging from an initial state of being non-recovered from mental illness and languishing to a final state of being recovered from mental illness and flourishing:

  1. Non-recovered and languishing. This phase is characterized by severe impairments in mental health and extreme symptoms of mental illness.
  2. Non-recovered and moderately mentally healthy. This phase is characterized by fewer symptoms of mental illness combined with moderate levels of positive mental health.
  3. Non-recovered from mental illness and flourishing. This phase is characterized by the significantly reduced presence of the symptoms of mental illness, combined with concrete and identifiable attributes associated with positive mental health and flourishing.
  4. Recovered from mental illness and languishing. This phase is characterized by the absence of the symptoms of mental illness, combined with an absence of the attributes of positive mental health.
  5. Recovered from mental illness and moderately mentally healthy. This phase is characterized by the absence of the symptoms of mental illness, combined with moderate levels of positive mental health.
  6. Recovered from mental illness and flourishing. This phase is characterized by the absence of the symptoms of mental illness, combined with high levels of positive mental health.

[For the purposes of this article, the states are described here in sequence, whereas the rubric created by Provencher and Keyes situates them on an x/y axis, with the x axis representing the mental health continuum, and the y axis representing the mental illness continuum] Substance abuse therapists and individuals struggling with substance abuse will immediately recognize the value of this expanded view of recovery. It asks both to understand that the process of recovery – the goal of which is complete mental health – is neither wholly salutogenic nor wholly pathogenic, but a combination of the two. It also asks those therapists and individuals to understand that recovery is neither solely a process nor solely an outcome, but again, a combination of the two. It gives therapists the tools to identify a client who’s abstinent, yet displaying mental health behaviors that may lead to relapse, and provides the vocabulary to discuss what they see with their client. It gives individuals in recovery the means to understand that it’s possible to be sober, abstinent, and diligently following a recovery program, yet still experience negative emotions and signs of poor mental health.

The Intersection of Theory and Practice

The Provencher/Keyes model gives treatment professionals the groundwork for situating traditional and complementary therapeutic modes side-by-side in pursuit of a greater whole: complete mental health. Awareness and application of the model particularly benefits individuals with co-occurring disorders, in that an array of therapies can be deployed – with the six states of recovery as a guide – to address both addiction and mental health disorders simultaneously. For many therapists and individuals in recovery, the Provencher/Keyes model verifies what they know already: recovery can be a messy process, filled with peaks and valleys. What works for one individual might not work for another, and what works one day for one individual might not work the next day for the same individual. The ability to bolster a recovery plan in one area, ease off in another, and stay steady in still another is something experienced practitioners and those in recovery have cultivated for decades. Until recently, however, these types of tweaks, and the insights that instigate them, have been a matter of instinct and the result of experiential knowledge – not the result of standard prescriptive practice. The introduction and adoption of a model that integrates the salutogenic and pathogenic theories of recovery into an adaptive, holistic, inclusive, and seamless whole unites theory and practice in a way that gives individuals in recovery a greater chance of therapeutic success, and ultimately, more options on the path to personal well-being and total mental health.