After 10 years of being clean and sober, AIDS activist Mike Shriver relapsed into crystal meth use. “I went from being San Francisco’s youngest ever Health Commissioner and Willie Brown’s AIDS czar to literally living in my closet. I couldn’t leave the house unless I was high.”

He credits the Castro Country Club – a clean and sober coffee house and 12-step meeting space in the heart of the Castro’s bar scene – as the impetus for him to stop using in 2010. “They invited me to curate an exhibit of my hummingbird photographs. That’s what got me in the door: a place that told me, ‘you have value’.” Indeed, a safe and welcoming community is critical for a successful recovery.

Mike long ago returned to advocacy, but you’ll still find him at the Club most days. He volunteers behind the coffee bar, works with other individuals in recovery, attends meetings, and sits on their board. “In 1987, I thought the Castro Country Club was a cool place to hang out. In 1990 it was a place to send my clients. In 2010 it saved my life.”

Photo courtesy of Mike Shriver

“Hope...is the foundation of recovery,” notes the U.S. Substance Abuse and Mental Health Services Administration. Yet, recovery is rarely possible just through determination - people also need a stable and safe place to live, a sense of purpose, meaningful activities, supportive relationships and social networks to create and sustain hope.

The bottom line is that addiction can be managed successfully, over the long term. Relapse is a natural part of recovery: between 40 and 60% of people in abstinence-based recovery re-initiate use at least once, similar to rates of relapse for other chronic diseases such as hypertension or diabetes.

Importantly, substance use disorders can’t be treated in a vacuum. Drug use is often a symptom of an underlying issue – especially trauma and mental health disorders. About half of people who experience a mental health disorder will also experience a substance use disorder at some point in their lives, and the numbers are even higher for people with anxiety disorders or PTSD.

“WHAT ARE YOU IN RECOVERY FROM? POVERTY? PHYSICAL OR EMOTIONAL ABUSE? DRUG USE IS USUALLY NOT THE CAUSE; IT'S THE THING PEOPLE USE TO COPE WITH THE CAUSES.”

ALEX KRAL
RTI INTERNATIONAL

Our Approach

If someone in your life is in recovery, be a champion. Support of family and friends is crucial. At the same time, take care of yourself: it can be stressful and there's a lot of anger, fear, anxiety, and grief that comes with dealing with problematic substance use.

Many environmental issues impact people’s recovery – most notably unemployment and homelessness. If people are forced to choose between going into rehab or keeping their apartment, they are unlikely to choose treatment. Someone living on the streets or worrying about where they’ll spend the next few nights is less likely to prioritize their recovery, and more likely to use again as a coping mechanism.

There is a huge overlap between homelessness and substance use, some of which is highlighted in Battery Powered’s Homelessness Issue Brief.

Battery Powered’s approach to recovery focuses on programs that provide support and healing to those seeking to reduce or eliminate their substance use. We are especially interested in efforts that involve collaboration between clinical providers and organizations that provide supportive services to build home, purpose and community.

Peer support programs. Many types of peer-based support programs have been shown to substantially support recovery, including peer recovery coaches and other peer mentors, peer-based support groups, and peer navigators, who can assist with linkage to care, follow-through with treatment or advocacy with providers. For those seeking abstinence, 12-step programs (and some of their more secular alternatives) are also peer-based solutions that have been shown to work. Even more formal is a recovery community organization, a self-organized, self-directed community run by people in recovery, to help them mobilize, organize, and support each other.

While many of these types of peer-based resources have been shown to have a positive impact on people in recovery, Medi-Cal does not fund any of these types of services, making them difficult to sustain without other support.

“i wish I could just prescribe a friend.”

marlene martin, MD
zuckerberg SF general hospital

Mental health treatment. Extensive research shows that integrating treatment for substance use and mental health disorders is superior for people with both challenges, compared with separate treatment of each. Integration works because it’s easier for people, but also because it better reflects their experience – drug use and mental illness are frequently intertwined, with one feeding the other. Integration of mental health treatment into substance use recovery services often requires a focus on the person rather than the disorder. Often these services are best when they are also integrated with primary care services, rather than being seen only as specialty care.

Healing trauma. A commonly-heard buzzword these days is “trauma-informed” – services that promote resilience for people who have experienced trauma. Trauma-informed services are designed to recognize the widespread impacts of trauma in people’s lives, and fully integrate that recognition into services in ways that resist re-traumatizing people.

Trauma-informed substance use treatment and recovery services create a safe and respectful environment in which people can disclose past traumas, and receive help in overcoming the effects of those traumas. Innovative recovery programs that incorporate a trauma-informed approach are desperately needed to improve options for people who use substance use as a coping mechanism, making it difficult to reduce or stop use.

RESOURCES

Recovery

Our Approach