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SAMHSA News - September/October 2004, Volume 12, Number 5

Peer-to-Peer Program Promotes Recovery (Part 1)

For many people, the story that follows illustrates perfectly the philosophy of the Recovery Community Services Program at SAMHSA's Center for Substance Abuse Treatment (CSAT).

A man falls into a hole so deep he can't get out. A doctor walks by, and the man calls for help. The doctor writes a prescription, tosses it into the hole, and walks on. A priest walks by, and the man tries again. The priest writes a prayer, tosses it into the hole, and walks on. Finally a friend walks by, and again the man asks for help. To his surprise, the friend jumps in with him. "Why did you do that?" the man asks. "Now we're both in the hole." "Yes," the friend responds. "But I've been in this hole before, and I know the way out."

Launched in 2002, the Program promotes the idea that people who have already recovered from alcohol or substance abuse disorders can do a lot to help their peers initiate or sustain their own recovery.

Today, 30 grantees around the Nation are providing peer-to-peer recovery support services to individuals at every stage of recovery, their family members, and other allies. Directed by Catherine D. Nugent, M.S., the Program has three ultimate goals—to prevent relapse, promote recovery, and improve participants' quality of life.

"The recovery community has become a key player in the addiction, treatment, and recovery fields," said CSAT Director H. Westley Clark, M.D., J.D., M.P.H., noting that peer support complements professional treatment. "Recovery Community Services Program projects are paving the way to concrete improvements in the systems that serve people addicted to alcohol and other drugs. This is an exciting time," Dr. Clark said.

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A Long History

The concept of peer support has a long history within the alcohol and substance abuse treatment field. [For information about the parallel history of self-help within the mental health treatment field, see SAMHSA News, Spring 1997, "SAMHSA Responds to Growth of the Consumer Movement."]

Since its founding in 1935, for example, Alcoholics Anonymous has brought together millions of people who help each other attain and maintain sobriety. Narcotics Anonymous and similar groups have followed suit. Once the exclusive domain of highly trained professionals, the substance abuse treatment field now embraces self-help groups as a valuable option available to those who need help recovering from alcohol or substance abuse.

"Spending time with others helps create and strengthen those meaningful relationships that are part of our definition of recovery," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "Our vision is based on the precept that all people deserve the opportunity for life that includes a job, a home, education, and meaningful relationships with family and friends—in short, a life in the community for everyone. That vision really is the antidote to the emptiness, isolation, and loneliness that weigh heavily on the hearts of people who suffer from addiction."

Underlying the Recovery Community Services Program and other peer-to-peer recovery support efforts is a conceptual framework based on three primary ideas. First, holistic, community-based support services play an important role in helping people sustain long-term recovery from chronic conditions such as alcoholism and substance use disorders. Second, recovery occurs along a "change continuum," and peers can help people move along the continuum by offering hope, motivation, and living proof that treatment works and recovery is possible. Third, social support—in the form of demonstrations of caring, offers of information, concrete assistance, or simple companionship—is important.

"Recovery is a life-long endeavor, but treatment programs end," explained Ms. Nugent, Senior Public Health Advisor in CSAT's Practice Improvement Branch. "People often need more support than they get from aftercare services or 12-step programs. By drawing on the abilities of people in recovery—and their desire to give something back—we can extend the continuum of recovery services available in the community."

For individuals seeking help, self-help groups offer support, information, and role models in a non-threatening, non-judgmental environment. But participation also helps people who have already recovered, Ms. Nugent stressed. "If you're acting as a role model for recovery, that's a relapse prevention strategy in and of itself," she said.

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