Substance Abuse Organization Releases New Definition of 'Recovery' CME News Author: Deborah rauser CME Author: !

aurie arclay" MD CME Release#: $%&$'&($%() *ali# for cre#it through $%&$'&($%+ Clinical Conte,t -he Substance Abuse an# Mental .ealth Services A#/inistration 0SAM.SA1 has issue# a new wor2ing #efinition of 3recovery3 fro/ /ental #isor#ers an# substance use #isor#ers4 5ro/ August %( to (6" ($%%" SAM.SA ran several 7ublic fee#bac2 foru/s an# a blog87ost allowing sta2ehol#ers to co//ent on the wor2ing #efinition an# relate# gui#ing 7rinci7les4 9n total" /ore than %$$$ 7artici7ants 7rovi#e# nearly :$$ i#eas" an# /ore than ;:$$ votes e,7resse# su77ort of the i#eas on the foru/s4 SAM.SA reviewe# an# consi#ere# these i#eas as it issue# the final #efinition an# 7rinci7les4 A 7rea/ble to the #efinition an# 7rinci7les now stresses the variety of in#ivi#ualize# 7athways to recovery" an# the re7ort now focuses on the vital role of ho7e in sti/ulating a recovery4 -he new #efinition an# 7rinci7les target 7olicy/a2ers" syste/s a#/inistrators" 7rovi#ers" 7ractitioners" consu/ers" 7eers" fa/ily /e/bers" a#vocates" an# others4 -heir ai/ is to facilitate #esign" /easure/ent" an# rei/burse/ent of services an# su77orts to /eet the 7atient8s7ecific nee#s of those with /ental #isor#ers an# substance use #isor#ers4 Stu#y Syno7sis an# <ers7ective After consi#ering /ore than %"=$$ co//ents #uring a 7ublic fee#bac2 7erio# this su//er" SAM.SA has release# a new wor2ing #efinition of 3recovery3 fro/ /ental #isor#ers an# substance use #isor#ers4 -he organization began consulting /e/bers of the behavioral healthcare co//unity /ore than % year ago to #evelo7 both /a>or gui#ing 7rinci7les an# a #efinition that woul# ca7ture 3the essential" co//on e,7eriences of those recovering"3 they write4 -he new #efinition" which was 7ublishe# on SAM.SA's ?eb site on Dece/ber ((" now states that recovery is a 37rocess of change through which in#ivi#uals i/7rove their health an# wellness" live a self8#irecte# life" an# strive to reach their full 7otential43 3Over the years it has beco/e increasingly a77arent that a 7ractical" co/7rehensive wor2ing #efinition of recovery woul# enable 7olicy /a2ers" 7rovi#ers" an# others to better #esign" #eliver" an# /easure integrate# an# holistic services to those in nee#"3 <a/ela S4 .y#e" SAM.SA a#/inistrator" sai# in a news release4 39 believe SAM.SA has achieve# a significant /ilestone in 7ro/oting greater 7ublic awareness an# a77reciation for the i/7ortance of recovery" an# wi#es7rea# su77ort for the services that can /a2e it a reality for /illions of A/ericans"3 a##e# Ms4 .y#e4

<ublic 5ee#bac2 9n August ($%$" SAM.SA invite# 3/ental health consu/ers an# in#ivi#uals in a##iction recovery3 to a /eeting to #iscuss the nee# for a new #efinition of recovery as 7art of its Recovery Su77ort Strategic 9nitiative4 -here" the 7artici7ants #evelo7e# the first #raft of a #efinition as well as a #raft of gui#ing 7rinci7les of recovery4 Over the following %( /onths" SAM.SA wor2e# with other 7artici7ants at /eetings an# conferences to clarify an# revise the #rafts4 -he first official wor2ing #efinition an# 7rinci7les were then 7oste# on a ?eb site blog in August ($%%" along with an invitation for 7ublic fee#bac24 -he initial blog 7ost receive# (;@ co//ents" with /ore than %"($$ a##itional co//ents left on SAM.SA's 5ee#bac2 5oru/s4 Altogether" %"$$$ 7artici7ants left co//ents) the 7artici7ants inclu#e# re7resentatives fro/ organizations such as the National Alliance on Mental 9llness 0NAM91 an# the National Association of State Alcohol an# Drug Abuse Directors 0NASADAD14 NAM9 an# NASADAD Res7on# 3SAM.SA's %$ 'Aui#ing <rinci7les of Recovery' are lau#able as a vision to as7ire to"3 Michael B4 5itz7atric2" e,ecutive #irector of NAM9" wrote at that ti/e in one of the blog's co//ents4 3Cnfortunately" these 7rinci7les fail to ac2nowle#ge that so/e 7eo7le living with the /ost serious /ental illnesses are so/eti/es li/ite# or unable to e,ercise self8 #eter/ination43 .e a##e# that neglect or lac2 of treat/ent can lea# to 3horren#ous conseDuences"3 inclu#ing large nu/bers of those with /ental illnesses being incarcerate# in >ails an# 7risons" 3boar#e#3 in e/ergency #e7art/ents" or beco/ing ho/eless4 3-he solution to these 7roble/s is a syste/ that is in#ivi#ualize#" res7ectful" allows 7eo7le to e,ercise 7ersonal choice an# autono/y whenever 7ossible" but also has the ca7acity to intervene an# 7rovi#e hu/ane" co/7assionate assistance to 7eo7le when they /ost nee# it"3 wrote Mr4 5itz7atric24 .e also suggeste# that the i/7ortant role fa/ilies 7lay in hel7ing a#ults living with /ental illness shoul# be ac2nowle#ge# an# that the gui#elines shoul# e/7hasize that recovery /eans #ifferent things for #ifferent 7eo7le4 Robert 94 !4 Morrison" e,ecutive #irector of NASADAD" wrote in his co//ents that /ore wor2 shoul# be #one in un#erstan#ing current state8fun#e# recovery services an# that SAM.SA shoul# #raw fro/ states' e,7eriences with the various Access to Recovery /o#els alrea#y i/7le/ente#4

39n a##ition" we agree there are co//onalities between recovery fro/ /ental an# substance use #isor#ers that are i/7ortant to un#erstan#" 7articularly in the conte,t of rei/burse/ent strategies"3 wrote Mr4 Morrison4 .e a##e# that it shoul# also be ac2nowle#ge# that recovery e,7eriences /ay be #ifferent for these 7eo7le4 SAMS.A note# that /any of these co//ents have been incor7orate# into the current wor2ing #efinition an# 7rinci7les4 3-he res7onse to our reDuest for fee#bac2 was tre/en#ous an# clearly #e/onstrate# the fiel#'s interest an# concern on this i/7ortant issue4 Over ;":$$ votes were also cast in su77ort of the i#eas on the foru/s"3 they write4 New Aui#elines -he new gui#ing 7rinci7les now state that recovery: Ee/erges fro/ ho7e) Eis 7erson8#riven) Eoccurs through /any 7athways) Eis holistic) Eis su77orte# by 7eers an# allies) Eis su77orte# through relationshi7s an# social networ2s) Eis culturally base#) Eis su77orte# by a##ressing trau/a) Einvolves the in#ivi#ual" fa/ily" an# co//unity) an# Eis base# on res7ect4 Along with the #efinition an# 7rinci7les" SAM.SA has also create# 3= /a>or #i/ensions that su77ort a life in recovery"3 consisting of health" ho/e" 7ur7ose" an# co//unity4 5urther" they a##e# a 7rea/ble e/7hasizing that 3there are /any #ifferent 7athways to recovery" an# each in#ivi#ual #eter/ines his or her own way43 SAM.SA notes that although several effective /o#els e,ist for 7ro/oting recovery" /ore wor2 is nee#e# to /a2e sure services an# syste/s are 7ut into 7lace in every state4 3Drawing on research" 7ractice" an# 7ersonal e,7erience of recovering in#ivi#uals" within the conte,t of health refor/" SAM.SA will lea# efforts to a#vance the un#erstan#ing of recovery an# ensure that vital recovery su77orts an# services are available an# accessible to all who nee# an# want the/43 -he full re7ort was 7ublishe# online Dece/ber (( on SAM.SA's ?eb site4 Stu#y .ighlights

ESAM.SA #efines 3recovery3 fro/ /ental #isor#ers an# substance use #isor#ers as a 7rocess of change through which in#ivi#uals i/7rove their health an# wellness" live a self8#irecte# life" an# strive to reach their full 7otential4 E-he Recovery Su77ort Strategic 9nitiative has i#entifie# = /a>or #i/ensions that su77ort a life in recovery: health" ho/e" 7ur7ose" an# co//unity4 E.ealth is #efine# as overco/ing or /anaging the #isease an# living in a way that 7ro/otes 7hysical an# e/otional health4 E.o/e is #efine# as a stable an# safe 7lace to live4 E<ur7ose refers to /eaningful #aily activities" such as wor2" school" volunteering" fa/ily caregiving" or creative 7ursuits" acco/7anie# by the in#e7en#ence" inco/e" an# resources to 7artici7ate in society4 ECo//unity refers to relationshi7s an# social networ2s offering su77ort" frien#shi7" love" an# ho7e4 EAui#ing 7rinci7les of recovery inclu#e the following: FRecovery ste/s fro/ ho7e" which is internalize# an# can be encourage# by 7eers" fa/ilies" 7rovi#ers" allies" an# others4 FRecovery is 7erson #riven" base# on self8#eter/ination" self8#irection" #efinition of 7atients' own life goals" an# #esign of their own uniDue 7ath0s1 to attain these goals4 O7ti/izing 7atient autono/y an# in#e7en#ence e/7owers 7atients an# gives the/ the resources to /a2e infor/e# #ecisions" begin recovery" buil# on their strengths" an# gain or regain control of their lives4 FRecovery occurs via /any 7athways" base# on each in#ivi#ual's uniDue nee#s" strengths" 7references" goals" culture" bac2groun#s" an# trau/a e,7eriences4 <athways /ay inclu#e 7rofessional clinical treat/ent) /e#ications) su77ort of fa/ily" school" an# 7eers) faith8 base# a77roaches) an# abstinence for those with substance use #isor#ers4 FRecovery is holistic" involving /in#" bo#y" s7irit" an# co//unity" an# integrating self8 care 7ractices" fa/ily" housing" e/7loy/ent" e#ucation" clinical treat/ent" faith" s7irituality" creativity" social networ2s" trans7ortation" an# co//unity 7artici7ation4 F<eers an# allies su77ort recovery through /utual su77ort an# /utual ai# grou7s" as #o 7rofessionals by 7rovi#ing clinical treat/ent an# other services4 FRelationshi7 an# social networ2s su77ort recovery by allowing the 7atient to leave behin# unhealthy an#&or unfulfilling life roles an# to engage in new roles" such as 7artner" caregiver" frien#" stu#ent" or e/7loyee4 FRecovery is culturally base# an# influence#" with values" tra#itions" an# beliefs #eter/ining a 7erson's >ourney an# uniDue 7athway to recovery4 Services shoul# be culturally groun#e# an# 7ersonalize#4 FA##ressing trau/a G inclu#ing 7hysical or se,ual abuse" #o/estic violence" war" an# #isaster G su77orts recovery" as these for/s of trau/a often 7rece#e or are associate# with alcohol an# #rug use" /ental health 7roble/s" an# relate# issues4 FRecovery involves in#ivi#ual" fa/ily" an# co//unity strengths) an# res7onsibility4 FRecovery is base# on res7ect an# reDuires 7rotecting 7atient rights an# eli/inating #iscri/ination4 All concerne# shoul# ac2nowle#ge that ta2ing ste7s towar#s recovery /ay reDuire great courage4 Self8acce7tance an# a 7ositive sense of i#entity 7ro/ote recovery4 Clinical 9/7lications

ESAM.SA #efines 3recovery3 fro/ /ental #isor#ers an# substance use #isor#ers as a 7rocess of change through which in#ivi#uals i/7rove their health an# wellness" live a self8#irecte# life" an# strive to reach their full 7otential4 .ealth" ho/e" 7ur7ose" an# co//unity are = /a>or #i/ensions that su77ort a life in recovery4 EAui#ing 7rinci7les of recovery inclu#e recovery e/erging fro/ ho7e) being 7erson8 #riven an# holistic) occurring via /any 7athways) an# su77orte# by 7eers" allies" relationshi7s" an# social networ2s4 9t is culturally base#) /ust a##ress trau/a) is base# on res7ect) an# involves in#ivi#ual" fa/ily" an# co//unity strengths an# res7onsibility4