Approaching Addiction as a Community

  1. Community Access and The Stigma of Addiction
  2. Community Solutions to the Stigma of Addiction

Narrowing on the Individual

A brief review of media coverage reveals increased attention to addiction issues; however, these are usually paired with celebrity confessions and criminal indictments. As William White points out in his 2014 white paper, Waiting For Breaking Good: The Media and Addiction Recovery, "The media seeks to make the personal recovery story as dramatic as possible," and helps create an impression that addiction is highly individualized and that entering treatment is the end of the story. Viewing addiction as a "personal problem" insulates us from the reality of its community roots, impact, and responsibility.
Narrowing on the Individual

Community Access and The Stigma of Addiction

There is a familiar saying that "every addict impacts six other people in their addiction." However, if this saying is true, it would also be true that every recovering addict would affect six other people in their sobriety. This would mean that recovery is possible through connection to others in the community, including the services provided by the larger whole.

Access to treatment services, however, has historically not been a community funding priority. People, still, continue to resist entering treatment and recovery even when services are made available. This resistance often lies in stigma and beliefs about addiction, which removes the focus from the community and places it solely on the individual.

Here are some common beliefs about addiction that keep it confined to an individual problem:

  • Morality: Addiction is a result of a personal weakness or character problem. The solution is increased willpower and a stronger character.
  • Biology: Addiction is a result of a physical differences in addicts- differences in their neurology and physiology, most likely a result of genetics. The solution will be medications or nutritional changes to alter the body.
  • Psychology: Addiction is an attempt to "self-medicate" trauma or another undiagnosed mental health issue. The solution is to treat the trauma or depression, and the person will no longer need to drink or use drugs.
  • Sociology: Addiction is a result of family dynamics, usually several generations of drug and alcohol use. Very often these families have additional community issues such as poverty, crime, or neighborhood drug use that increases the problem. The solution is to change the family dynamics that support addiction, address social problems, and find a connection with a healthier support group with prosocial values.
  • Spiritually: Addiction is a result of feelings of alienation, a "hole in the soul" that leads the person to feel isolated and lack direction. The solution is to help the person connect with something greater than themselves and develop a greater sense of purpose.

Most treatment professionals agree that addiction is a "Bio-Psycho-Socio-Spiritual Disease," recognizing that ALL of these possible explanations for addiction can play a role in various ways. Addressing all of these areas increases the chance for successful, long-term sobriety.

Many of these factors involve community and family changes, so community ownership of addiction and treatment are vital in making long-term recovery appear to be a viable reality. Because we are social creatures and live within the layers of a connected society, it is difficult to heal in the confined space of individuality; treatment embedded within a community has a greater chance at addressing the Bio-Psycho-Socio-Spiritual nature of addiction.

Community Solutions to the Stigma of Addiction

Fear-Based Approaches

Traditional approaches were founded in scare tactics. These programs, such as DARE and Scared Straight, have been demonstrated to have little to no long term impact on a young person's decision to use alcohol and drugs. Utilizing social marketing with images of "your brain on drugs" and people in hand-cuffs will not change the long term recovery rates. My students and I often joke that people in early recovery don't makes good "posters" for non-profit sympathy the way big-eyed children and pregnant mothers do. Nonetheless, the effects of these radical marketing images are still not well supported.

Crisis-Based and Mandatory Treatment

I have watched thousands of people enter the recovery process through interventions, criminal charges, medical crisis, job threats, custody battles, and divorce ultimatums over the years. Fear is a powerful motivator to temporarily interrupt someone's using, and research shows that mandated treatment clients have a better treatment completion rate than "self-referred" clients. This flies in the face of the commonly held belief that you have to "want" to get clean. Almost no-one "wants" to get clean; they are avoiding the consequences of using most of the time! Crisis-based entry into recovery is an invaluable tool of the recovery process, but crisis will not keep someone clean and sober over the long-term.

Social Marketing

In the 1970's, the field of Social Marketing began to shift the traditional consumer-focused marketing strategies from selling products to selling ideas and services that enhance the health of the general community.

  • Examples of this include commercials and billboards encouraging pre-natal care, discouraging smoking, and safety-belts.
  • This approach has been effective in changing community conversation about smoking and drunk driving, as well as drinking while pregnant.

Social Marketing could be the key to moving the recovery dialogue from an acute, "get this person through treatment quickly" emphasis to social awareness that addiction is a chronic condition requiring longer-term support from a variety of sources. Social marketing could be a powerful ally in offering up images of successful long term sobriety. Social marketing can challenge the stigma - dramatic pictures of low-bottomed addicts and alcoholics - and turn instead to the benefits of sobriety.

  • I often focus on what a client will "get" if they get clean and sober, not on what they will avoid. They get families, careers, children, stable homes, long-term relationships, physical health, and interests.
  • The Big Book of Alcoholics Anonymous recognizes this in "The Promises" of recovery. Addiction is a chronic condition, and managing the full bio-psycho-socio-spiritual components of the disease with individualized plans of recovery makes long-term healing for both the individual and community possible.

We need people with long term sobriety to "come out" and demonstrate that recovery is not just possible, but probable, with the right individualized self-care plan and support from the community. I'll go first:

My name is Mary, and I am a person in long-term sobriety for 26 years. Because of sobriety I have long-term relationships, have assisted thousands of individuals and families in recovery, have trained thousands of alcohol and drug counselors through San Jose City College, and have avoided the physical consequences of addiction that haunt my family. I didn't get sober alone, and haven't stayed sober without professional and community support. Recovery is not just possible, but probable with the right self-care plan.