UNDERSTANDING RECOVERY SUPPORT SERVICES RECOVERY SUPPORT 101 2020

UNDERSTANDING RECOVERY SUPPORT SERVICES: RECOVERY SUPPORT 101 2020 UVU CONFERENCE ON ADDICTION DEB DETTOR, M. S. MARCH 13, 2020

ADDICTION AS A LONG-TERM CONDITION o Treatment as short term; acute care model o 1984: my training from NYS Dept of Substance Abuse Services o separate NYS Division of Alcohol Services o By the late 1990’s: Connecticut was leading the way toward Recovery Oriented Systems of Care o 2004: I became a Recovery Advocate in new recovery advocacy movement

PROMOTING LONG-TERM RECOVERY BECAME THE GOAL By late 1990 s, two different approaches were underway in US: The New Recovery Advocacy Movement* was emerging with people in recovery assuming leadership roles and SAMHSA and national funders began to direct funding toward recovery initiatives: RCSP grants *term coined by William White, MA 2000 author of Slaying the Dragon

FOR THIS PRESENTATION Two resource handouts from the August 2018 TEP that was held in Washington, DC 1) SAMHSA Recovery Research and Evaluation Technical Expert Panel Summary Report (August 2018) 2) Reports of Findings from a Systematic Review of the Scientific Literature on Recovery Support Services in the United States (August 2017) both by Dr. John Kelly, Director, Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School

6 DOMAINS OF RECOVERY SUPPORT SERVICES q Mutual Help Organizations q Clinical Treatment Models q Peer Based Recovery Support Models q Recovery Community Centers q Recovery Residences q Educational Based Recovery Support

MUTUAL HELP ORGANIZATIONS 12 Step Meetings Moderation Management SMART Recovery Refuge Recovery Life. Ring Wellbriety Support In The Rooms Women for Sobriety

ABOUT MUTUAL HELP o These are the oldest: beginning with AA 1935 (Oxford Group) o 12 Step Groups are the most studied and most widely available model o Evaluation of mutual help demonstrates strong research response: large number of good quality studies have been conducted that indicate mutual help formats to be highly effective in promoting long-term recovery

CLINICAL TREATMENT/CONTINUING CARE MODELS • These are treatment interventions that occur after the acute care treatment phase • These can last months to years; usually dependent on adequate payment sources Evaluation reflects a large quantity of published studies, and the quality of this evidence was deemed strong. There was moderate evidence about the effectiveness of implementation of recovery management check ups

PEER BASED RECOVERY SUPPORT o Recovery advocates did not use this language when concept was forged o Advocates pushed for these models to be developed by people in recovery o Who ARE the experts about recovery o Recovery support facilitates development of RECOVERY CAPITAL

ABOUT PEER BASED RECOVERY SUPPORT History of this model: twelve step mentorship and MH peer mentorship (NAMI) Who decides what we call it? recovery coaches or peer recovery support specialists Training curricula vary from state to state; certification processes vary, as do supervisory models or practices Sites where these services are available vary widely: RCOs, traditional treatment settings, medical/hospital settings, correctional facilities, street outreach, recovery houses Evaluation: small – medium quantity of studies with moderate design quality yielding moderate information about efficacy

ABOUT RECOVERY COMMUNITY CENTERS Elements of these programs: o Recovery visibility on Main St. of your town o Safe sanctuary for recovery with open hours – alcohol and drug free o Represent many pathways of recovery o Menu of offerings to build RECOVERY CAPITAL: support meetings; employment help; peer mentorship; volunteer opportunities; access to community resources

RECOVERY COMMUNITY CENTERS (RCC) Evaluation: small number of studies have been done with weak to moderate design yielding weak to moderate information 2015 study began with 32 RCCs NE and NYS: New kid on the block: An investigation of the physical, operational, personnel, and service characteristics of recovery community centers in the United States (John F. Kelly, � , Nilofar Fallah-Sohy, Corrie Vilsaint, Lauren A. Hoffman, Leonard A. Jason, Robert L. Stout, Julie B. Cristello, Bettina B. Hoeppner (Journal of Substance Abuse Treatment 111 (2020) 1 -10) There are close to 50 RCCs now in New England New York!

RECOVERY RESIDENCES Sober House model: 1830’s created as ‘dry hotels’ – not treatment based Many models exist with different elements related to: - payment and eviction - house rules and oversight - use of alcohol and drugs - overdose deaths many miracles have been accomplished; many problems exist

RECOVERY RESIDENCES 2011 National Association of Recovery Residences (NARR) was born to : ‘promote a recovery-oriented continuum of support for those with substance use disorders by credentialing recovery residences that implement empirically based recovery principles and practice standards’ Challenge of bringing order to chaos Evaluation: medium quantity of research studies with moderate to strong qualitative designs have yielded moderate to strong support for this model

HISTORY OF COLLEGIATE RECOVERY PROGRAMS • 1977: Brown University (RI) Dr. Bruce Donovan, Dean of Chemical Dependency, extended recovery support to students • 1983: Rutgers University (NJ) had first on-campus housing for recovering students • 1986: Center for Collegiate Recovery Communities, at Texas Tech. • 1997: Step Up program was created at Augsburg College in Minneapolis, Minnesota. Their housing program opened in 1999 Association of Recovery in Higher Education reports just 8 years ago, there were 14 member schools; today there are more than 140!

HISTORY OF RECOVERY HIGH SCHOOLS • First there were recovery support services in random high schools • Ecole Nouvelle (now Sobriety High) in Minnesota was established in 1986 and opened in a community center with four students and one teacher in 1987 • 2003: Archway Academy in Houston Texas – chronicled in 2016 documentary Generation Found Currently, there are 43 of them registered with National Association of Recovery Schools!

EDUCATION BASED RECOVERY SUPPORT Evaluation: small number of studies with weak to moderate quality leading to weak to moderate level of support in these models *More research is needed for these models

WHY RESEARCH MATTERS o Data drives the funding bus o It helps to develop effective support strategies to sustain long-term recovery o Justifies creation of the programs we want to develop WE MUST ALL BE RECOVERY ADVOCATES!

SOME OF TOP RECOVERY RESEARCHERS IN U. S. John Kelly, Ph. D - Recovery Research Institute: Harvard Medical Center William White, MA - Chestnut Hill (Williamwhitepapers. com) Keith Humphreys, Ph. D Alexandre Laudet, Ph. D Tom Mc. Clellan, Ph. D

QUESTIONS AND ANSWERS Thank you! Deb Dettor dettor 808@outlook. com