For an indiscernible reason, the New York Times front-paged a story on “recovery communities” today-- looking at how some recovering addicts and alcoholics move to particular cities and neighborhoods to support each other in a drug-free lifestyle. But can these communities be improved, based on the latest addiction research?
Studies find both pros and cons in this approach-- the positive aspects relate to the fact that social support is essential to overcoming addiction and other people with the same problem are often good at giving that support to each other. But one downside, as the article notes, is that living in an isolated cocoon where identity is derived from one’s addiction can be a trap, preventing further progress and achievement by relentlessly focusing on recovery and constantly emphasizing the danger of relapse.
As the Times also points out, for many people with severe addictions, simply attaining that is an important achievement-- asking more may be too much.
There are ways to improve recovery communities, however. For example, education about the complexities of addiction could be a great help-- myths about recovery still circulate widely and are reinforced in many self help groups. One is the notion that 12-step programs are essential to recovery; another is that medications like methadone or even antidepressants aren’t “really” recovery, even if there is no other drug use and full functioning.
Also, the Times notes that there is a high prevalence of overdose in many such communities. Since most overdoses involve a combination of opioid drugs like heroin or Oxycontin and alcohol and/or benzodiazepines, distribution of the opioid-blocker naloxone should be instituted in these areas, as I argued in that paper here. The blocker causes withdrawal, not a high and is otherwise safe, and is usually enough to reverse the deadly respiratory depression that kills in these cases. New York, Chicago, London and several other cities already have naloxone distribution programs and early data suggests that it can prevent many deaths.
Many recovering addicts in 12-step programs aren’t inclined to such “harm reduction” approaches-- but, as they used to say in ACT UP, dead addicts don’t recover.
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