Sunday, June 15, 2008

A very U.K. definition of recovery

‘The process of recovery from problematic substance use is characterised by voluntary sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.’
A definition only a committee could love. Seriously though, it's good that England is re-examining its treatment system, trying to be more client centered, and trying to develop a vision of recovery. Also, I recognize how difficult the task is. Agreeing on a definition of recovery in an organization would be difficult, let alone across organizations and systems.

Two things leap out at me. The word maximize seems to hedge and leave some room for clinical pessimism. The other thing I found striking is the use of the phrase "sustained control". It's hard to imagine an American consensus statement with that phrase. In fact, one of the participants stated, "very uneasy with the words recovery and sobriety – it all sounded very American", bu that they are "words everyone understands." The concepts of powerlessness from 12 step groups, and loss of control from the DSM are pretty widely accepted here. It's worth noting that sustained control could mean abstinence or non-problematic use.

It seems to me that an important determinant of the definition of recovery would be the definition of the problem. My impression is that the disease concept is not widely accepted and drug problems are thought to be lifestyle choices.

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