Adolescent Substance Abuse Treatment: Help SAMHSA Define Recovery!

The Substance Abuse and Mental Health Services Administration (SAMHSA) is asking for our help to define recovery. Here's some food for thought.
William White, et.al., in "The Recovery Revolution: Will it include children, adolescents and transition age youth?" discuss the appropriateness of 'recovery' when applied to children and adolescents:

The concern is that most of what we know about recovery is derived from studies of adults. We know very little about the prevalence pathways, processes and stages of long-term recovery for adolescents with substance use disorders.

And: 

Many adolescents mature out of substance-related problems in the transition into adult role responsibilities; for other adolescents, substance-related problems evolve into a chronic, debilitating disorder.
 
Adolescents who mature out of substance-related problems often do so without conceptualizing these problems and their resolution within an addiction/recovery framework.

"The Recovery Revolution" asks many other penetrating questions, some of which I have selected below: 

• Do the existing concepts such as "system of care" and "positive youth development" currently serve as adequate organizing frameworks for youth?
• Is the concept of recovery misapplied to children because of its meaning of returning to  a previous level of functioning;brings with it the social stigma attached to addiction;lacks a holistic developmental perspective because of its "disease" trappings and only works if integrated with the concept of resilience?>
• What roles if any do harm reduction (eg needle exchange programs and risk reduction (DUI programs) play with in  a recovery oriented system of care?

I also recommend looking at "Designing a Recovery-Oriented Care Model for Adolescents and Transition Age Youth with Substance Use or Co-Occurring Mental Health Disorders," a report from the "CSAT/CMHS/SAMHSA Consultative Session" held November 13-14, 2008 and prepared by a group led by Doreen Cavanaugh, Ph.D. of the Georgetown University Health Policy Institute. 
Table 5 summarizes how participants of this meeting defined the critical characteristics of a recovery-oriented system of care (ROSC) for youth:

1. Family-focused/family driven
2. Age appropriate/developmental approach
3. Promotes resilience
4. Empowers youth
5. Acknowledges non-linear nature of recovery
6. Strengths-based
7. Addresses recovery capital
8. Individualized
9. Promotes hope
10. Broad array of services and supports
11. Culturally competent
12. Accessible
13. Provides choices
14. Promotes personal responsibility
15. Integrated
16. Ecological/systems perspective
17. Continuity of care
18. Engaging
19. Non-discriminatory
20. Collaborative
21. Cost-effective
22. Authenticity (honesty, integrity, fun, respect, trust, tolerance, patience)
23. Evidence-based
24. Focuses on quality of life
25. Flexible
26. Promotes accountability (outcomes)
27. Realistic
28. Statewide-level of organization
 

>>Follow the link to leave your comments about adolescent recovery from alcohol and drug abuse for SAMHSA. Comments close August 26, 2011, so hurry!
 
 

Paul Savery is the Adolescent Substance Abuse Treatment Coordinator for the North Carolina Divsion of Mental Health, Developmental Disabilities and Substance Abuse Services.
 
 
 
 
 
 
Photo at top: Benjamin Chambers, under Creative Commons license.