I have recently been editing films and writing summaries for Wulf’s conversation with David Best, one of the leading recovery advocates and researchers worldwide. [David is away at the moment, so this content won’t be added to the Recovery Voices website for a little while yet.]
I was not surprised to hear David talk about the strong impact that William L White (Bill White) had on him personally and on his research. Tim Leighton has expressed similar feelings and gratitude in relation to Bill. And, as some of you know, Tim introduced me to Bill’s work way back in 2005 and this had a huge impact on me and my work.
Bill was very critical of the fact that the treatment system in the US and elsewhere, including the UK, was based on an acute care model. It resulted in what we called the ‘revolving door of treatment’—people making multiple entries into and then out treatment. Here is what Bill had to say at a Recovery Oriented Systems of Care Workshop in Atlanta, Georgia in 2009 , revealed in this film clip:
‘Because what I want to tell you as a historian of this field is the acute care model of addiction treatment in the United States, as we have evolved it over 40 years, is politically and scientifically not sustainable.
Can everybody hear me? As a cultural institution, addiction treatment is on probation. We simply became an alternative to the revolving doors of jails and drunk tanks and emergency rooms of general hospitals. And we promised them we would end that revolving door. And we had great promises of what we would do by way of recovery.
And we have done some amazing things. Agree? We have people whose lives have been absolutely transformed through this thing we call addiction treatment. We have people who don’t have enough words in their language to express the gratitude of what addiction treatment has meant for them and their families.
But we are going to do, particularly early this afternoon, a fearless and searching moral inventory of addiction treatment as a system of care, looking at performance data, and what I’m going to tell you is with that performance data compared to what we promised the community in this country what we can do with addiction treatment, the gap is so great it is unsustainable.
How long do you think it will be, or are we already at a point, where almost everyone in this country knows someone for whom addiction treatment did not work? What do you think a family who’s about to readmit their addicted family member for the fifth time feels when they hear the slogan ‘Treatment Works’? What do you think a family hears when they hear the slogan ‘Treatment Works’ who buried their child from an overdose after four very expensive episodes of what they were told was the best addiction treatment in the country.
We’re going to talk about addiction treatment works. It has effects. But what we’re going to talk about is this simple point. We are putting people in interventions in the United States whose problem severity and complexity is so great, whose recovery capital is so low, we’re putting them in interventions so brief, so weak, it has little probability of success.
And when they fail, what do we do with them? We punish them, because we say he or she had their chance. As family members, we divorce them. We extrude them from our households. We send them to prison. We fire them from our places of employment. We take their babies from them because they had their chance. And what I’m going to argue with you throughout the day, is that was not a chance… that was a setup.
That was not a personal failure, that was a systems failure. Are you with me?’
The situation was the same in the UK. The UK government copied from the US the slogan ‘Treatment Works’. Yet, for the majority of people, this was not the case. The government and the treatment system were in denial to the ‘revolving door of treatment’ which was evident to so many of us.
Bill had similar words to say to the above when he gave a talk in London on 18 March 2009 at a conference organised by Action on Addiction and my organisation Wired In. Tim Leighton and I were the two other speakers at that conference. Here is a short clip:
