People in recovery are an oppressed population who are stigmatized, denied access to quality services, and objectified. Furthermore, this population contains microcosmic elements of privilege and dominance.
As a person who has recovered from a substance use disorder and who now provides services to others in recovery, I have witnessed our oppression firsthand. In the course of my addiction, I was reduced from a privileged white male to a ward of the state; I was labeled, stigmatized, and assigned a lower status. In order to escape a long prison sentence, I submitted to court supervision and mandated treatment, giving up my rights to confidentiality and autonomy. Even after successful completion of the court program, I was saddled with a felony record. The stigma attached to people with substance use disorders not only negatively affects our social status and autonomy: it also impacts our ability to access services, including treatment for our disorders. Insurance companies deny coverage for those with substance use disorders in spite of parity laws, in part because treatment plans contain non-clinical components such as spirituality that don’t jibe with medical models. (Allen, 2015)
In our media, people with substance use disorders are depicted as miserable, broken wraiths; their posture is slumped over, with heads hung low. The backdrops are bleak; the lighting is shadowed and ominous. Journalistic coverage of these people and their tribulations is sensationalized by photos of needles and spoons full of syrupy opiates; ant hills of white powder and razor blades; multi-colored mosaics of pills and capsules. The reports never fail to miss a celebrity’s public fall and subsequent admission to treatment; but positive portrayals of successful people in recovery are conspicuously absent. People in recovery are referred to as “addicts” or worse, even after we have stopped using substances. We are also objectified as sources of inspiration, simply because we are in recovery. We are congratulated, and taught to congratulate ourselves, on simply making it through 24 hours without using substances.
When I entered recovery, I was told a story; a single story that weaves throughout the world of addiction and recovery; the miraculous transformation of the hopeless, wretched addict into a respectable and productive, if somewhat grizzled, member of society through adherence to a spiritual “program” which requires abandonment of the ego and mistrust of the self. I was taught that I was powerless over my affliction and that my circumstances were the result of my foolish attempts to manage my own life. I was taught that my only chance for success lay in turning over my life to a higher power, and surrendering my very will on a daily basis. I was taught to silence, or at least lower, my voice; that, because my recovery amounted to grace, I must be humble. This story is so pervasive that it shapes the very experience of addiction; presaging the treatment and recovery experience. (Pols and Smart, 2012)
The quality of services offered to people in recovery is limited by content steeped in turn-of-the-20th-century folk wisdom and the esoteric ramblings of two depression-era alcoholics, despite advances in psychology and medicine that offer much higher rates of success. This is often due to dogmatic adherence to abstinence-only models, which harken to the Temperance movement of the late 19th century and which are the basis for the twelve-step programs. In this sense, there exists a privileged group within the recovery population. The twelve-step paradigm and the concepts therein dominate any conversation about recovery, and it takes a concerted effort to think outside of this construct. Those who wish to propose alternative theories of addiction or recovery are up against generations of self-referential popular science; a virtual monolith of recovery thought that crowds out any competing ideas. These archaic treatment methods contradict and undermine other proven methods, limiting their success and often resulting in death. (Peele, 2014 and Cherkis, 2015) Even with the advent of medication-assisted therapy, only about half of the people who need life-saving medications are receiving it due to prescribing limits. These limits were imposed because the medication is commonly viewed as a drug of abuse rather than a medication; and due to a dearth of physician training about addiction medicine. (Vestal, 2016)
“Just as with other oppressed groups, a fierce sense of identity and distinction has existed alongside our fight for equality and acceptance; and as with the others, these two are not mutually exclusive. Being treated like everyone else does not mean that we have to be like everyone else. By the same token, recovery must not be an albatross on our necks. We do not have to exist in a bubble in order to preserve who we are and where we came from. As we orient more of our systems towards recovery and it increasingly resembles the generalized concepts of health and wellness, it will become necessary for us to be fluent and proficient in the larger context. The delineation between us and “earthlings” or “normies” must be erased. Recovery, ultimately, is not apprenticeship, but mastery. The full recovery experience is unfettered and takes place out in the open, surrounded not by an insular layer of fellow recovering people but by people. The real recovery community is the community. Recovery is not a consolation prize, an approximation or a microcosm of life, it is about rejoining the human race as a full participant and contender for life’s biggest prizes. Recovery must not be in vitro; true recovery is in vivo. Recovery is nothing less than life itself.” (Sledd, 2014)
Allen, B. (2015, August 16). When Rehab Might Help An Addict – But Insurance Won’t Cover It. Retrieved September 3, 2015, fromhttp://www.npr.org/sections/health-shots/2015/08/16/430437514/when-rehab-might-help-an-addict-but-insurance-wont-cover-it
Cherkis, J. (2015, January 28). There’s A Treatment For Heroin Addiction That Actually Works. Why Aren’t We Using It? Retrieved September 3, 2015, from http://projects.huffingtonpost.com/dying-to-be-free-heroin-treatment?fb_ref=Default
Peele, S. (2014, May 20). Can We All Stop Pretending That Motivational Interviewing Is Compatible With the 12 Steps? – Substance.com. Retrieved September 3, 2015, from http://www.substance.com/can-we-all-stop-pretending-that-motivational-interviewing-is-compatible-with-the-12-steps/5988/
Pols, H., & Smart, G. (2012, November 14). Curing addiction: Twelve Steps or fixing the brain? Retrieved September 3, 2015, from http://theconversation.com/curing-addiction-twelve-steps-or-fixing-the-brain-10557
Sledd, A. (2015, April 23) Recovery In Vivo. Retrieved from https://www.adamsledd.com/recovery-in-vivo
Vestal, C. (2016, February 11). Waiting Lists Grow For Medicine To Fight Opioid Addiction. Retrieved from http://www.huffingtonpost.com/entry/opioid-addiction-treatment_us_56bcb1a5e4b08ffac1241b63