When we were planning a new blog for the rehab clinic I work for we had an interesting discussion about "recovery" - a word that sums up our approach to addiction treatment.
Millions of people all over the world follow the 12 Steps of Alcoholics Anonymous, as well as other self-help groups like Narcotics, Cocaine, Gamblers and Sex Addicts Anonymous. These people are "in recovery".
The 12 Step concept is simple - addicts must admit powerlessness over their drug of choice, deal with their issues and live a life of abstinence. They say the programme works if you work the programme and it takes a lot of bloody minded determination to stay on the straight and narrow. It's simple but it's not easy.
One of the many things that people on the outside don't understand about our type of "recovery" is that an alcoholic or drug addict is never "cured" of his/her addiction. Even if someone has been abstinent for 25 years he/she needs to be wary of taking just one sip of alcohol (or the drug equivalent) as any contact with it could send them over the edge. In AA they say "one drink is too many but a thousand are not enough." Some alcoholics relapse by simply walking past a pub.
To those of us on the inside the word "recovery" makes perfect sense. When someone says "I'm in recovery" I know immediately that they've been through hell, have faced their demons and is dealing with life "a day at a time" - another of AA's many useful aphorisms.
But far too many people on the outside have never heard of the term "recovery" when it comes to addiction treatment. And why should they? There are very few residential rehab clinics in the UK, the media tend to mock AA and the 12 Steps and the NHS prefer to distribute methadone than send people into residential addiction treatment.
To prove to my colleagues that the term "recovery" means something else to people in Britain, I wrote the term "AA recovery" into Google. All the top entries were links to another organisation called AA - the Automobile Association (theaa.com) - and their roadside "recovery" service for broken down cars.
What's the problem with that? You might ask. Every industry has jargon, or technical, terms which are used internally but not understood by anyone outside that sector. It's part of organisational culture.
The problem is actually a lot deeper than misunderstandings about the word "recovery". The issue is that this whole approach to addiction treatment (residential, long term, psychological) is more or less ignored by government and the medical profession - even though it works so well (as proven by this American investigation that took 8 years, covered various sites and cost $27 million).
As a result of this misunderstanding, millions of alcoholics and drug addicts don't get access to the kind of treatment that can really help them to recover. All that is on offer to addicts in Britain today are products like methadone, in other words a legal form of addiction courtesy of the drugs industry.
The Betty Ford Institute, America's leading rehab clinic, sponsored a study in 2007 which proposed a standard definition of the term "recovery". In the study's introduction they write "Individuals who are 'in recovery' know what it means to them and how important it is in their life. They do not need a formal definition. However, recovery is not clear to the public, to those who research and evaluate addiction treatments, and to those who make policies about addiction...
"A commonly accepted and operationally defined measure of recovery could lead to improved research and understanding in the addiction field." In other words if the term was properly defined, understood and accepted by policy makers and the public more would be done to make residential "recovery" services available to those who need them.
The other problem with this lack of understanding of the term, and concept, or "recovery, is that family doctors and other concerned people often don't know how to deal with those who are suffering from addiction: "we have little to tell families, employers, schools, payers, and policymakers about how they can support and extend the recovery process...Without a consensus definition of recovery that will permit systematic measurement, there will likely be no research to inform these issues."
The Betty Ford report was published almost 8 years ago and I don't think much progress has been made since then in terms of getting a definition of "recovery" into the public domain. In my view this is because it is not in the interest of the powerful drugs industry.
But it is worth noting the definition of "recovery" that the Betty Ford Institute came up with: "Recovery from substance dependence is a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship."