This week’s post looks at how my understanding of addiction and recovery continues to widen. I reflect on a recent four-day visit to the Hazelden Betty Ford Foundation’s treatment center in Center City, MN, and my preparation for an upcoming recovery event in the Washington, DC, and Baltimore areas: Two Lives, One Legacy.

I traveled to Hazelden Betty Ford for two purposes: to research in its library and archives how attention to and practices of family recovery have evolved, and to participate in a program hosted by the president of its Graduate School, which provides master’s degrees in substance use and mental health counseling.

I joined 80 enthusiastic graduate students and faculty members for an on-site educational program. As part of that experience, I participated in a President’s Lecture Focused Symposium, hosted by School President Kevin Doyle, on the topic Evolution and Opportunities in Family Treatment and Recovery.

Dr. Matthew Glowiak, a faculty professor, moderated the event, which included brief remarks from me and a presentation led by Jenni Scott, Clinical Director of Family and Children Services, on Hazelden Betty Ford’s ambitious plans to expand its family recovery services. The organization was one of the first to develop a family program many decades ago and is now in the midst of expanding beyond a single program to an array of integrated services provided in parallel to patient care and also available to families who do not have loved ones in treatment. 

Ms. Scott summed up her presentation this way: “Family recovery is an essential part of effective addiction treatment—not an adjunct to the patient’s care.” She explained that a family systems approach is supported by evidence and is not a one-time check-in, but an ongoing service. Hazelden Betty Ford’s long-term direction is whole-family care.

Her co-presenter, Lydia Burr, Executive Director of Hazelden Betty Ford’s Center for Teens, Young Adults and Families in Plymouth, MN, emphasized the challenges of asking parents to help overcome younger family members’ resistance to seeking recovery, particularly in residential settings. Working with families takes time and patience.

I made this trip because my involvement in writing and talking about A Marriage that Changed the World has convinced me that one of the most important messages from the Wilsons’ marriage was their commitment to recovery for both individuals and families.

While this commitment was central from the founding and continued over many decades, for many reasons attention to family recovery has remained the stepchild of addiction treatment—less well known and less widely practiced. Without greater attention to family recovery, there will be no slowing the intergenerational passing on of addictions. The effects on children and their children are often overlooked, yet they can shorten lives and unnecessarily increase anxiety and fear.

My visit led me to revisit some of my basic beliefs about addiction and recovery:

Stigma and shame: I was reminded that stigma and shame continue to get in the way of recovery for individuals and families. Education about the complex nature of addiction remains limited. While there was a period of progress when doctors increasingly recognized substance use disorders as illnesses, more recent surveys show a return to the belief that addiction is a personal weakness rather than a disease.

Substance use as an illness: Brain science makes clear that the brain of a person with a substance use disorder changes, creating the compulsion and obsession to drink or use. Science also shows us how much more powerful alcohol and other drugs are today, and how stronger substances further change the brain and make recovery more difficult. Returns to drinking or drug use are influenced by these brain changes, the strength of the substances, and the length of time they have been used—not by personal weakness.

Recovery paths: For almost forty years, most of what I learned about my problems with alcohol and other substances came from attending Twelve Step meetings and reading. It was through researching A Marriage that Changed the World that I learned about multiple pathways to recovery.

Treatment providers like Hazelden Betty Ford and Ashley Addiction Treatment offer a wide range of approaches, including Twelve Step meetings as part of treatment. Other programs focus on harm reduction through prescribed medications and counseling. Within the mutual aid and support world, there are also numerous alternatives to Twelve Step programs. Unfortunately, it can be difficult for the lay consumer to access unbiased, results-based information about these many pathways.

Bridging individual and family recovery: Changes in insurance coverage have increased access to treatment for alcohol and other drug use disorders. Treatment is no longer available only to those wealthy enough to pay out of pocket. A visit to a treatment provider like Hazelden Betty Ford makes this clear.

What is equally and painfully obvious is that insurance coverage for recovery services for the families of those seeking individual treatment remains limited.

Historically, family recovery was viewed as important primarily because it increased the likelihood of sustained sobriety for the person with a substance use disorder. Today, research shows that family treatment is essential for the health of family members, the functioning of the family system, and the support of the person recovering from addiction.

Next steps: The more I learn about the complexity of treating addiction and advancing recovery, the more I believe we all need to keep learning if we hope to slow and ultimately stop the growth of addiction. Brain changes can limit and destroy lives and families. We need to broaden our understanding of what recovery can mean and what is possible.

Join me in sharing your journey of learning how to offer hope to families affected by substance use disorders and other addictions, and in broadening our thinking about what is possible.