“Whether or not you use today, your focus should be on safety.”
For most people, recovery means abstinence from the use of alcohol or other drugs.
I think this is true of most drug treatment providers. And I think it is true of most family members and friends of people who have a history of opiate use. It is even true of most people who are currently using, or who consider themselves to be in recovery.
As a result, the focus of recovery is on not using. The measure of recovery success becomes whether or not a person uses. And time itself becomes measured in days sober. Had a relapse? Reset the recovery clock back to zero!
But shouldn’t our real focus be on safety?
Think of what it would be like to say to someone you care about, “whether or not you use today, our focus should be on safety.”
How would that feel? What would that mean?
Focus is a powerful thing. That one change in focus has great transformational power.
For the person in recovery, changing the focus of recovery from use/non-use to safety has the power to transform their relationship with recovery. For family and friends, it has the power to transform their relationship with the person they love. For doctors, counselors, probation officers and other professionals, it has the power to transform and improve their life’s work. Even more, the change to a focus on safety has the power to save lives.
Take a look at the traditional ways we talk about the focus of recovery:
Traditional Focus of Recovery
sobriety/relapse
abstinence/non-abstinence
use/non-use
dirty/clean
Now consider a new focus:
New and Improved Focus of Recovery
safety
sustainability
It’s not that abstinence is not a worthwhile goal. It’s just that abstinence is really only a means to an end: safety from harm.
All too often, in focusing on the means (abstinence), we lose sight of the ends (safety from harm). It’s a case of not seeing the forest for the trees. And the sad truth is that devastating harm often results.
“Abstinence is really only the means to an end: safety from harm.”
Click on any post’s headline to read or post comments. Thanks!
{ 9 comments… read them below or add one }
Yes, safety first. But THEN, hopefully, recovery. Not sure I can survive, let alone my 30 yo addict daughter, a life time of heroin use.
My professional background is microbiology and public health – so, I have some expertise regarding needle use and aseptic techniques. Are you aware of ‘junkies” methods for treating their own abscesses? My daughter referred briefly to well known/accepted ‘home’ techniques that involved milk and maybe vinegar. I’m curious as to the details of these. treatments.
Tom – your posts are very provocative to ‘us’ – parents, non-addicts, the general public. You do force me to consider new ideas and ways of thinking. What is your background? Are you a former addict? Do you work for an agency/professional group? I struggle with ‘acceptance’, regarding my heroin addict daughter, and thereby, ‘condoning’, or enabling her behavior. How active do you think I should be in communicating with her?
Hi Peggy,
The home remedies for treatment of abcesses are not familiar to me, and don’t sound safe. You can find better information about how to treat abcesses here. Abcesses can be serious, and it would be best to seek medical attention.
Many people don’t access medical attention because they don’t want to be “red flagged” as an opiate in their medical records. Or because they fear (often with reason) that they won’t be treated with respect and compassion by ER or other medical staff.
As far as my background, I started and still run a program for people with opiate dependence at a large mental health/drug treatment agency. My education/professional background is in journalism, law and counseling. I don’t have a personal history with addiction. I do have over ten years of experience working full time solely with people who are opiate dependent and their families.
I try not to give advice about particular people, because I’m not in a position to fully assess the situation. This blog is intended to provide information and education (and for me to learn from other people), and I can’t provide professional advice in this setting.
From a general perspective, a parent should communicate with their child to the extent that it is healthy for the parent and the child. Withholding healthy communication is not an effective way to support recovery. Participating in healthy communication between a parent and child does not perpetuate addiction.
Hope this was helpful,
Tom
Peggy,
I forgot to respond to your first comment!
The idea is not to focus on safety then recovery. But to focus on safety and sustainability during recovery. Part of this is recognizing that the recovery process includes periods of use and non-use, and both are part of the recovery process for most people.
Tom
What is being presented here is very refreshing to me. I’m a recovering Heroin/Cocaine addict and I can say from personal experience that 2 of my friends would still be alive today if the focus was on safety first. My best friend died of a heroin overdose in a relapse situation. He was clean for a little over a month before his sudden and tragic death. It was so avoidable! There was someone there that could have saved him, but they chose to leave him passed out in his car, and die, rather then call emergency services! They claim that they were afraid of getting arrested! I can personally say that they should have been afraid of the beating that we as the victims friends gave him later, but that would not bring my friend back. SAFETY! WE NEED MORE OF IT!
Pressing The Issue
Tom, I realize this is an old thread but am hoping you catch this response to it nonetheless. You stated on 1/15/10, “Withholding healthy communication is not an effective way to support recovery. Participating in healthy communication between a parent and child does not perpetuate addiction.” I hope I am not taking anything you’ve said out of context. I agree with your comment. Why is it then that so many rehabs place their residents on restriction–using the first 30 days? My son’s been on restriction waaaaay more than that. I do understand why it’s in his best interest to keep him from the streets; I do not understand why it’s supposedly in his best interests to keep him from seeing me on their premises. I don’t drink, have never used any illicit drugs, and have never been arrested. He can’t see me, but he’s in residence with hard-core users and convicted felons. Any insight on this one?
Hi Suz, I get an automatic notification of all new comments, so don’t worry about how old the post is, I will still see any comment and appreciate all comments.
I wasn’t specifically talking about the rehab context. But I still stand by my statement, including in the rehab context. The key words though are “healthy communication.”
I think the positive motive of most rehabs that have a rule limiting contact is that they want the patient/client to experience a break from their previous social environment, and focus on the treatment. I’m afraid most rehabs have probably been burned more than a few times by family members who did NOT communicate in healthy ways. The sad truth is that some family members intentionally or unintentionally sabotage the recovery process. For the most part, rehabs are short on flexibility (and staff laziness is not uncommon either) (I’m just being honest), and I think they aren’t taking the time to sort out which contact would actually be helpful and which contact would be harmful.
I know my calls to clients in rehab are always appreciated by clients. They seem to like to hear from someone familiar with words of praise and support. I think it helps with retention in treatment. I think the same would be true of calls from most parents.
I think the negative motive of some rehabs is both laziness and an aversion to being held accountable (if you can’t hear what is happening, you can’t complain).
I think harm reduction is the only way to deal with todays substance abusers; the concept of non use is a long shot for people who are sick without being able to use. As a lifelong heroin user I can say that the frist step is to get these people safe. Getting clean is a long process, no two people are going to get better at the same rate
I agree with you Don. Recovery is a process. The process usually includes periods of use and non-use. And it’s important to help people stay safe throughout the entire process from active use to long term recovery. Thanks for your comment!