As Vermont attempts to reckon with the national scourge of opioid addiction, it is evident that key areas include prevention and recovery. (As emphasized by Governor Scott’s Opioid Coordination Council). There is growing need for “recovery coaches” — people who do not counsel or treat the drug-dependent, but serve to support those in recovery as they strive to maintain sobriety and rebuild their lives. Recovery coaches help break the cycle of a return to environmental circumstances that increase the risk of relapse, by supporting people in recovery positively with existing resources. Vermont certifies recovery coaches, through an intensive and humbling one-week training course.
As a certified recovery coach, I have sought to find people and organizations whom I can help. Ironically, when I expressed interest in a recovery coach job position in Barre last year, I received the following email response:
“Thanks for your inquiry. If you saw one of our job postings, then you know that these are “peer recovery coach” positions. Thus, we require applicants to have personal experience with a substance use disorder and at least 2 years of continuous recovery from it.”
I am not a “peer” recovery coach, as I am not myself in opioid addiction or alcohol recovery. To put this another way: I am not qualified for this government job because I have not suffered from a substance use disorder. What’s more, recovery coaches who are themselves undergoing “Medically Assisted Treatment” (MAT), and thus regularly taking suboxone or another pharmaceutical, are qualified.
I raise this strange situation to highlight a number of important recovery-related issues. Reducing the stigma that attaches to addiction is vitally important for all of us, and this is especially true for those in recovery.
When a person initially overcomes their addiction and is drug free (or in MAT), they are extremely vulnerable to relapse as they try to create new thought and behavior patterns to return to a more “normal” life. Diet, employment, housing, transportation, relationships, negative past peer influences — all of these must be managed while a person strengthens on the road to recovery.
And this is where “peer” recovery coaches are infinitely more qualified than non-peers — they have been through the Hell. They truly relate to the agony of withdrawal, and the brain-altered cravings. They have succeeded in escaping the cycle. I have no more business sitting as a recovery coach with people in early recovery than I do as a civilian advising combat veterans how to wage a guerilla war. This is why the Vermont recovery coach program states that “…A coach should be an individual who demonstrates a strong and stable personal program of recovery and possesses a recommended minimum time of one year in recovery. A potential coach needs to have demonstrated progress in the recovery process.”
This is not to say that “unqualified” recovery coaches like me do not have an important role in our society’s effort to heal this plague. But we must humbly respect the limitations in our ability to fully comprehend what these people have endured, or how much they may condemn themselves for it. What’s more, I submit that when those of us who have not become “qualified” by way of substance abuse dependency properly defer to and respect the much higher authority of those who have, that we elevate them to the place of respect they merit. We pay homage to what they have endured, like war veterans to be honored — the reverse of stigma.
We must do this because society must instill hope and desire in those in addiction to themselves join the ranks of the leaders who survived an addiction boot camp worse than Parris Island. Right now, in Vermont and across the nation, it is former substance abuse disorder sufferers who man the front lines in our clinics, recovery centers, and treatment facilities. It is from those in addiction that we must distill those in recovery, from whom we recruit the future leaders in reversing this cycle.
And the proof of the truth of everything I have just said is that there are almost no recovery coaches who lack the qualification of being in recovery. (I’m a rare exception). Where are you, noble, straight, never-been-a-druggie people? It’s like an ebola epidemic, where only that small fraction who have survived the disease dare approach the actively ill and care for them. Only, we sober people have no such excuse because we can’t “catch” addiction — to the contrary, working with those in addiction will strengthen our immunity!
What of those “in recovery” who are involved in “medically assisted therapy” (MAT)? This is a huge rift in the recovery community — for instance, many people in recovery from alcohol do not regard those who are taking suboxone to be “in recovery” because they are still dependent. But recovery coaches simply do not make those moral judgments. If a person is on suboxone, they are very unlikely to overdose — and with illicit fentanyl now present in most street heroin, this is becoming paramount. We must meet people where they are in recovery, and praise and acknowledge their progress so that we compassionately nurture them back into community. It is from that reversal of stigma and alienation that they will indeed wean from MAT treatment also, if they choose.
In a war, one does not condemn the dead and wounded for their failure. In a war against addiction instead of a war on drugs (as with a war on mental illness rather than a war on guns), it does not avail society to blame individuals for their circumstances. It may have been a lack of personal responsibility that led to someone’s downfall, but hindsight is unhelpful — it will be personal responsibility that helps them rejoin society and their families. And that is what those in the recovery community seek to reinforce and instill.
The argument that people “must hit bottom first” is a frightening deception (and justification of apathy), because many of these people will “hit bottom” in death. Alcoholics or others may have surmounted their addictions, but generally they did not have to worry that a bottle of Jose Cuervo would be laced with carfentanyl and kill them in minutes, before they had a chance to “hit rock bottom” (and rejoin society in order to condemn others for not having yet hit rock bottom…).
The role of recovery coaches is really society’s role, as reflected in the Vermont Recovery Coach Professional Oath:
“I will do no harm. I will celebrate and support all paths to recovery. I will abide by the ethical codes of recovery coaching. I will listen, motivate, and support others in their recovery and their plans for their future. My work as a recovery coach is about addressing the needs and developing the strengths of those I am lucky enough to serve.”
We are all better off with expanding recovery resources. Volunteer coaches cost nothing in tax dollars aside from one week of training. The opioid/heroin/fentanyl crisis continues to worsen, and indirectly harms exponentially more people than those suffering from drug dependency. Whether or not we are qualified or certified, we are all called to be recovery coaches. Truly, Vermonters, our communities must recruit more unqualified volunteers to serve in this field. It isn’t fair, or sustainable, to leave only the sick to care for the sick.