Alcohol is the most common principal drug of concern for people accessing treatment, according to the Australian Institute of Health and Welfare (AIHW’s) new report.
a) Almost two in five (37%) treatment episodes for people accessing support for themselves were for alcohol, followed by b) amphetamines (24 %), c) cannabis (19 %) and d) heroin (4.6 %).
Between 2011–12 and 2020–21, alcohol was the most common principal drug of concern in treatment episodes provided to people for their drug use. This number has increased by 24 per cent, from approximately 67,000 episodes in 2011–12 to approximately 83,000 episodes in 2020–21
(What is Needed, What It Will Take, and the Overwhelming Realization That Prevention is Better Than Cure)
The emphasis in the recovery literature has tended toward an exploration of recovery capital (the accrual of positive strengths, resources, and assets), therefore this paper will explore the pains of recovery alongside strengths, resources and assets (pull factors) to permit a more comprehensive insight into the recovery journey.
The recovery journey is experienced in both positive and negative ways and as such this paper attempts to integrate the ‘pains of desistance’ approach into a recovery capital framework (Nugent and Schinkel 2016). The ‘pains’ of recovery are defined here as negative factors and forces that act either as barriers that impede a person’s capacity to overcome substance misuse problems (or negative factors and forces that are used by the individual as a means or motivation to make positive change).
Therefore, we will firstly identify which pains of recovery (push factors) are present, and which strengths, resources and assets (pull factors) are present, within the three domains (of personal, social and community recovery capital), at two phases of the recovery journey (early and stable recovery). Given that the likelihood of relapse reduces from the early recovery phase to the stable recovery phase (Best 2019), we are keen to observe what recovery capital looks like in these two phases of recovery, by exploring what happens to the number and nature of both the pull factors and the pains of recovery in each phase and how the pains of recovery are managed and overcome from the early phase to the later phase. Secondly, we will explore which push and pull factors and forces either promote the growth of recovery capital in the three domains or impede it. Of interest here will be an exploration of whether the pain of recovery act as a push factor for positive change.
The Three Domains of Capital
Personal capital: overcoming and managing adversity (All five themes relating to personal capital in early recovery were identified as pains of recovery._
The pains of uncovering unresolved Trauma
The pains of low self-esteem
The pains of uncovering alternative addictions
The unexpected pains of sobriety
Pains of purposeless and hopelessness
Social capital (Two of the three themes relating to social capital in early recovery were identified as pains of recovery and a pull factor was also identified.)
The pains of family relationships and dysfunction
The pains of leaving old social and friendship networks
Mutual aid groups: gaining new friendships and tools for recovery
Community capital (All four themes relating to community capital in early recovery were identified as pains of recovery.)
The pains of housing transitions
The pains of securing meaningful employment opportunities and managing their recovery around work
The pains of negative professional experiences
The pains of stigma as negative community capital
2. Stable recovery: the ongoing successes and challenges
Personal capital (There were three pains of recovery and two pull factors for the personal capital domain in stable recovery.)
Living a life beyond what was envisioned
The ongoing pains of self-esteem
The ongoing pains of mental health
The pains of relapse
Post recovery identities: front doors and good exits
Social capital (Two of the three themes relating to social capital in stable recovery were identified as pains of recovery and two were identified as pull factors. Family provoked mixed responses in that it continued to be a source of dysfunction and therefore a pain of recovery but for many it was now a stabilizing form of recovery capital.)
The pains of social events
Romantic relationships
Family reconciliation and the pains of ongoing trauma
Community capital (Both themes relating to community capital in stable recovery were identified as pull factors.)
(Dalgarno Institute Comment: Drug Use Exiting Therapeutic communities are key resources in addressing all of these areas I.e. Fresh Start’s P.H.R.E.E. project has had these elements in play for decades…
The staggering amount of resources necessary to walk a substance user out of the tyranny of addiction even to a baseline of ‘normalcy’ is staggering. To monetize the above resources alone is staggering. #Prevention and #Demand Reduction must be the imperative of drug policy, not just to merely curtail the crippling financial costs, but much more, spare the pain to the drug user and their families and communities.)
According to this model of addiction, some people may find it harder to resist developing addictions than others, and those with addictive personalities are inherently more likely to have an addiction than the rest of the population.
However, the concept is controversial, and many addiction experts argue it is harmful.
No major health organization recognizes addictive personality as a medical diagnosis.
What the research says
While health organizations do not endorse the idea of addictive personalities, there is some evidence that certain traits may make addiction more likely.
A 2018 study of 109 mostly male participants found that impulsive behaviors correlated with a higher risk of addiction. Impulsivity may increase a person’s likelihood of taking risks or using substances, thereby elevating their risk of becoming addicted.
A 2019 paper also highlights some other traits and behaviors that researchers have linked to addiction, including sensation seeking, nonconformity, and tolerance of behavior that breaks social rules.
However, the 2019 paper also emphasizes that most researchers oppose the idea of addictive personalities because it is deterministic. In reality, addiction is a complex, multifaceted illness related to many factors.
For example, there is also an association between addiction and temporary emotional states, such as feeling stressed or alienated. People not having the opportunity to learn healthier coping skills for dealing with these emotions may also play a role.
A 2021 study of 94 people with addictions aged 14–32 living in Switzerland, France, and Quebec observed similar trends. Participants often reported alienation, discomfort in social situations, anxiety, or depression.
An insecure attachment style was also common in this group. This occurs when a person does not develop a secure attachment with their main parental figure during childhood, which then affects their relationships and ways of coping with adversity throughout life.
(Dalgarno Institute Comments: You will note the repetition of the entrenched definitions of addiction as an ‘illness’ that are the presuppositions of this article.
It is interesting that substance dependency/addiction is one of the only ‘illnesses’ that behaviour change can end. Yes, indeed, it is a complex maelstrom of factors, that involve much more than mere biochemical interactions and disrupted brain anatomy.
You will notice that all the factors that may contribute to this psuedo-medical condition are behavioural issues. All behaviours are learned, so they can be unlearned. Of course, once psychotropic toxins are part of the mix they may only add to or amplify, poor impulse control, inability to delay gratification and the externalizing of blame that can also all spring from selfishness, laziness, pride and other egocentricities – all character flaws that does make walking back out of this mess more difficult, but not ‘incurable’ (to stay with the disease motif).
If we are to remove stigma properly, then we must empower agency and capacity again in the whole person – Body, Mind and Soul.
‘Illness’ models, we now understand only disempower the former humanity enhancing aspects and lead to a further capitulation, not rejuvenation. Better health and well-being require not mere triage and damage management, but a full anthropologically based suite of human recalibration process.
A broader scope of understanding is needed and drug use exiting vehicles, and their attending capacity building measures are key not simply to ‘managing a sickness’ but exiting a disorder that no longer has to have dominion over the individual.)
"British Columbia's prison system has become a health and addiction system of last resort, according to a new study from SFU , which found that three-quarters of people admitted to B.C. prisons in 2017 suffered from addiction or mental health issues — up from 61 per cent in 2009. Complex care cases — people with a combination of addiction and mental health needs — more than doubled in the same time period, from 15 to 32 per cent. That’s approximately 10 times the national average, estimated at between two and four per cent."
“This is a multiple systems failure that we’re seeing,” said Amanda Butler, lead author of the study. “I think a lot of these folks have been failed by every other service system before they come into contact with the criminal justice system.”
Damning indictments indeed, but it’s the Why, and the Wherefore that must be investigated, if we are going to attempt to remedy this growing, and seemingly, uncontrollable mess.
Many interpretations will be gleaned from this very concerning emergence, and depending on one’s confirmation bias metric, finger pointing will go in many directions.
One perspective we'd like to bring to this, is one that is all too often quickly buried by the pro-drug hijackers of 'Harm Reduction' models.
As we have written time and time again on this issue, Harm Reduction (an important pillar in drug policy) is supposed to be about minimising short- and long-term harms to the drug user, WHILST enabling, equipping, and empowering them to EXIT drug use! Hmmmm? Since the sector charged with reducing the harms of drug use (including not just the 'harms' to the drug user) have stopped focusing on drug use exiting, the harms have only increased.
One of the foundational causes of this ever burgeoning chaos, is of course, DRUG USE. If one doesn’t use drugs, the harms do NOT occur!
Ah, but I hear the vociferous objections of the stakeholders in this failing misuse of policy; 'That's over simplifying the situation, the reasons behind drug use are complex'.
There is no argument from us that there may be many catalysts for initial uptake, but once drug using starts, the substance then becomes one of the key drivers to drug seeking behaviour, if not the sole one, once dependency presents.
A ‘circuit breaker’ in the drug use/seeking behaviour is an imperative. If ‘Harm Reduction’ mechanisms, do not have a ‘circuit breaker’ in its arsenal in the fight against this individual and community destroying behaviour, then it continues to fight this insidious foe with one hand tied behind it’s back.
‘Liquid handcuffs’ (substance substitute options) https://nobrainer.org.au/index.php/search-our-site?q=liquid+handcuffs&Search= can be part of a ‘circuit breaker’, if and ONLY if, the clear and scheduled cessation of drug use is the immovable goal. Yet, all too often, we see this potential vehicle for exiting drug use only become another individual undermining chemical dependence.
So, when all the syringes have been handed out. All the drug consumption rooms have been engaged. All the free chemical substitutes have been administered… and drug use continues, and grows, then where does a community go in the longing to free these slaves to substances, and the heart broken casualties that are their family, friends, and colleagues?
The failed misused policy ends up where British Columbia finds itself. The only ‘circuit breaker’ remaining is ‘secure welfare’ – which in almost all cases is interpreted as the prison system.
Sadly, the incarceration is not just the exasperated last resort for the recalcitrant drug user, it’s also what the drug use has led to, that so often facilitates criminal proceedings. Everything from acquisitional crime to violence, public nuisance or other society impacting ripple effects from this distressing behaviour.
When you’re dealing with a (more often than not) intractable life controlling issue, coercive vehicles are needed to start the change process. To quote the now famous recovering addict, Actor Robert Downy Jnr, “It’s not that difficult to overcome these seemingly ghastly problems [drug addiction]… what’s hard is to decide to do it.”
Pity, it is said looks at a problem superficially and throws a token ‘kindness’ at the issue and walks away. Compassion, however, insists on restoration, not just ‘recalibration’, and therefore cannot condone a ‘kindness’ that doesn’t only not end the grief, but adds to it.
Yet, there is perhaps still one more unfolding in this sad saga – and an arguably cynical one at that, but bear with us.
What if the agenda of the gatekeepers of the ‘harm reduction’ policy have little to no regard for the cessation of drug use? Instead, they seek only to sanitize and normalise drug use? Create a tsunami of substance use behaviour that simply can’t be ‘managed’ by criminal justice, or now even ‘health policy’. It can only be allowed to exist un-impugned, simply tolerated.
Sadly, we have dealt with such stakeholders and their well-masked agenda.
When a society becomes enamoured with the pursuit of pleasure, that it now perceives even ‘failed entitlements to ‘happiness’, normal vicissitudes of life, or even emotional inconveniences, as trauma that need to be ‘medicated away’ with the ‘buzz of the gear’, you know that public health and well-being policy is in trouble – as is the community and its families it is charged to serve.
(#RecoveryIsPossible from #liquidhandcuffs if effective chemical free rehabilitation is applied) The ‘damage management’ and short-sighted approach of Opiate Substitute Treatments, cares little for the rehabilitation of the addicted individual, if there is no ‘sunset clause’ on the process. Medically Assisted Treatments, may be useful only as an initial circuit-breaker to dependency, but is not a long-term health benefiting option. (Some people are now going to Narcotics Anonymous to get off Methadone, after being heroin free for 14 years)