I recently came across SAMHSA’s (Substance Abuse and Mental Health Services Administration) Working Definition of Recovery: 10 Guiding Principles of Recovery: https://library.samhsa.gov/sites/default/files/pep12-recdef.pdf
As I was reading it, I was struck by how similar recovery and prevention are in terms of definitions, concepts and principles.
The issues and elements constituting what we call recovery parallel those associated with the prevention of substance use.
While recovery and prevention are often viewed as separate fields with differing goals and practices, I believe reflecting upon one can help inform and enlighten us regarding the other.
Specifically, I think substance use disorder recovery holds important lessons for substance use prevention. Let’s explore some examples below.
Definition of Recovery & Prevention
The working definition of recovery in the SAMHSA document is: “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
Similarly, alcohol and drug use prevention can be viewed as a process of healthy development and behavioral change aimed at improving young people’s wellbeing, positive self-image, self-efficacy and self-management toward reaching their full potential.
Notice this definition of prevention, like that of recovery, is much broader than our sometimes-narrow practice of providing information or education about risk behaviors or targeting only risk factors for substance use.
A broader definition of prevention reflecting that of recovery aims to promote protective factors necessary for healthy development and creating resiliency among young people.
Major Dimensions of Recovery & Prevention
SAMHSA identifies four dimensions of recovery which can also be considered key components of prevention. These include health, home, purpose and community.
While health in recovery terms means “Overcoming or managing one’s disease(s) or symptoms,” it also includes “making informed, healthy choices that support physical and emotional wellbeing.”
This later aspect of health, as it relates to recovery, is key to successful prevention as well. Prevention should promote informed healthy decisions and decision-making among youths and young adults, leading to improved health and wellness.
Home is another dimension of recovery referring to “a stable and safe place to live” necessary not only for those in recovery, but also for the prevention of substance use and mental health problems.
In addition, parents and caregivers at home are perhaps the most important influence in a young person’s choosing to live a healthy lifestyle including avoiding substance use.
Purpose is another dimension of recovery that has immense implications for prevention and refers to “meaningful daily activities.”
Pro-social structured activities, as opposed to unstructured time, are critical to a young person’s healthy development and reaching their full potential, as well as avoiding substance use and addiction.
Daily meaningful activities can include sports, volunteering, school, work, art, music, time spent in nature, hobbies, creative activities, etc., as long as they are adult supervised.
Lastly, community refers to “Relationships and social networks that provide support, friendship, love, and hope” is as important to the prevention of substance use and mental health problems as it is to successful recovery from addiction.
The only caveat is that friendships that support a young person’s healthy development are key to creating hope and providing love, while social networks that encourage risky or unhealthy behaviors most often harm one’s health and positive development.
Guiding Principles of Recovery & Prevention
Like the definition of recovery and its major dimensions, perhaps all the 10 principles of recovery are also applicable in one way or another to drug use prevention.
These 10 principles of recovery include: hope, person-driven, many pathways, holistic, peer support, relational, culture, addresses trauma, strengths/responsibility, and respect.
Let’s look briefly at just two of these guiding principles of recovery and how they relate to prevention: holistic and addresses trauma.
Like recovery, prevention is also most effective if it stays true to the principle that individuals are multi-dimensional and therefore prevention requires a whole-person and whole-health strategy rather than one narrowly focused only on substance use avoidance.
In other words, inclusive prevention that encompasses a young person’s whole existence, including “mind, body, spirit, and community” will be more efficacious and result in broader positive outcomes than exclusive prevention.
Prevention that does not target the whole-person and addresses only the risks of substance use is too exclusive, like recovery that only targets selective symptoms of addiction.
Rather, whole-health and whole-life prevention should address substance use avoidance along with the promotion of healthy lifestyles that protect and improve mental and physical health, performance and happiness of young people.
Holistic prevention also suggests the broadest range of services, resources and life experiences for youths to help them develop into well-rounded, grounded and competent individuals.
Secondly, the principle of addressing trauma, whether physical, psychological, emotional, sexual or others, is essential not only for successful recovery but also for preventing youth substance use, addiction and mental health problems.
Youth who have experienced trauma must be prioritized for receipt of evidence-based substance use prevention, intervention and treatment and provided with services and support offering love and trust building to promote healing from physical and emotional harm.
Prevention for young people who’ve experienced trauma must also be more holistic, empowering and positive than just providing risk-based messages.
Conclusion
In conclusion, addiction recovery and substance use prevention are not self-contained, freestanding concepts as some of us may think.
Rather, recovery and prevention may be thought of as two fields of practice on the same continuum or if you will, two sides of the same coin. That is probably why there are so many similarities between recovery and prevention.
For that reason, looking more closely at addiction recovery can help inform prevention provides with insights and lessons for more efficacious prevention concepts and strategies.