What Is Recovery? (Part II)

In October 2019, Nora Volkow, director of the NIDA (National Institute on Drug Abuse) since 2003, made a site visit to one of the killing grounds of our current opioids crisis, the Kensington neighborhood of Philadelphia. (I grew up in Philadelphia. My father had a shoe store in Kensington at which I worked.)

Volkow came away with a strong impression. Indeed, it seems that she received an earful, which she described in a blog at the NIDA web site titled: “Addressing the Socioeconomic Complexities of Addiction—Lessons From the Kensington Neighborhood in Philadelphia.”

First, the director noted:

Philadelphia’s rate of overdose deaths skyrocketed this past decade, tripling the city’s number of homicide deaths and greatly exceeding the peak number of deaths from AIDS in 1994.

Volkow then went on to reveal her takeaway lesson:

Whenever I ask people on the front lines of America’s drug crisis what more we can do to support and help their work, they remind me how essential it is to address the basic needs of individuals with addiction, such as stable and safe housing, food, basic medical care, and an opportunity for employment. In the addiction field, we have recognized the importance of addressing these basic needs as part of recovery support. Yet, it is crucial to realize that these needs have to be met even before a person is in stable recovery in order to facilitate them getting to recovery at all. People cannot recover from addiction if they are homeless, isolated, and struggling to find food and safety.

Indeed, we might question Volkow’s conceiving of these elements—housing, medical care, a safe community, and education and employment—as preconditions for recovery, rather than comprising recovery itself. In particular, another government agency, SAMHSA (Substance Abuse and Mental Health Services Administration), specifically redefined recovery in 2012 based on these keynotes: health, home, purpose (work and education), and community. In other words, recovery is a matter of having a safe home and supportive community, being healthy, and pursuing a purpose in life.

Thankfully, the director of the NIDA has seemingly come to this substantive meaning of recovery herself (albeit a bit belatedly), rather than defining recovery as abstaining from alcohol or drugs.

Thank goodness we are now all on the same page.