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SAMHSA's recovery definition: Old wine in a new bottle or just the American way?

January 4, 2012
by Terry L. Stawar, Ed.D.
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After a year-long collaborative effort, on Dec. 22, 2011 the federal Substance Abuse and Mental Health Services Administration (SAMHSA) released its new definition of “recovery." According to SAMHSA administrator Pamela S. Hyde it is "a significant milestone in promoting greater public awareness and appreciation for the importance of recovery, and widespread support for the services that can make it a reality for millions of Americans." 

I applaud SAMHSA’s in this regard. Ever since “recovery’ entered the more general behavioral healthcare lexicon, it has confused many people, who may associate it exclusively with substance abuse treatment or 12-step programs.
 
I especially admire how the definition, below, relates recovery (consciously or unconsciously) to the three basic American values found in the United States Declaration of Independence.
 
"A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
 
“improve their health and wellness” = Life
“live a self-directed life” = Liberty
“strive to reach their full potential” = Pursuit of happiness
 
These values can even be used to establish service priorities. First priority would be services such as crisis stabilization that prevent homicides and suicides. Second would be services that promote the use of the least restrictive environment and least intrusive services, and finally services that allow consumers to participate in society to the fullest extent possible.
 
Some may see this definition as nothing new, but of course, everything is derivative to some extent. And I think these associations are very positive features. It also has an honorable history. Back in the 1970’s the “Balanced Service System” (The Balanced Service System A Model of Personal and Social Integration by Ronald J. Gerhard, Richard E. Dorgan, and Donald G. Miles) elegantly used these three values to underpin the development of the first set of accreditation standards for community mental health centers for the Joint Commission on Accreditation of Hospitals
 
And of course, one can always do worse than paraphrasing Thomas Jefferson.
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Comments

Good Afternoon Dr. Stawar

This new SAMSHA definition “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential” greatly reinforces my fear and concern about the mentalhealth-ification of addictive disease. As I'm sure you know these two, mental disorders and addictive Disease, are separate and distinct diseases with different etiology, progression, treatment requirements, and outcomes - even though they both occur in the same location of the body, the brain, - lung cancer and pneumonia both occur in the same location, the lungs, but are very recognizable as separate and distinct diseases. The recovery for these diseases looks very different from one to the other - in the same way that recovery from melanoma, a disease occurring in the skin, looks and is very different from recovery from ringworm, a disease also occurring in the skin. I'm sure SAMSHA is aware of the distinctions between the two and I'm hoping that someone can help me to understand why SAMSHA is nationally disseminating information that could be very easily interpreted to the contrary.

Isn't not including abstinence from mind altering chemicals in the definition of recovery from addictive disease as negligent as not including abstain from products containing peanuts in the definition of recovery for individuals with a severe allergic reaction to peanuts or abstain from eating seafood in the definition of recovery for someone with a anaphylactic reaction to seafood?

Here is the basis of my fear and concern: As a recovering individual (thirty years abstinent and practicing 12 step recovery), as well as a licensed counselor with a degree in Addiction Studies, I know that if I drink or use other mind altering drugs, I die, and that I'm not that unique from other chemically dependant (not abuser) human beings. This new definition and trend really scares me for those who do not understand what I, and I hope you, understand about this primary, progressive, chronic, and fatal, if left untreated, disease.

Isn’t this "recovery definition", along with the new DSM V criteria, simply more effort toward the "mental health-ification" of addictive disease? And, is there anything we (people in recovery from addictive disease and addiction counselors) can do to halt and possibly reverse this dangerous and harmful trend?

Glenn Richardson LCDC CCS CPS

I think its an awesome idea but i crnatiely can see problems and issues where it starts and stopsAs for areas of improvement I think we need an outreach in each county to have a youth center/coffee shop type thing for youth with mental health needs interact with others who may or may not have mental health needs as well

Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar

@tstawar

planetterry.wordpress.com

Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...