is thinking about it to really jump on the bandwagon. it is looking beautiful. when i came here this morning, i was notified that taggers were there last night, but fortunately, they did not touch our building. >> to check out the mural in person, stop by 65 polk road. in addition to being a street smarts artist, he has been teaching students about the value for public space and creating public art for the communities through a program called where art lives. for a full list of other in your locations and to learn more about the efforts to combat vandalism, visit i've been clean four years! fifty-six ys! i've been in long-term recovery for 23 years. i've been in recovery for six months and love it! i've been in recovery for over 15 years!

every september, people gather all across the country to celebrate recovery from addiction. i am so grateful for 19 years of recovery. it's changed my life, changed my children's lives. for information or for events near you, visit recoverymonth.gov get involved and join the voices for recovery. (music) hello, i'm ivette torres, and welcome to another edition of the road to recovery. today, we'll be talking about providing a continuum of care and improving collaboration among services.

joining us in our panel today are dr. thomas kirk, jr., commissioner, connecticut department of mental health and addiction services; paul molloy, ceo and founder, oxford house incorporated; george williams, director, community partnerships, treatment alternatives for safe communities in illinois; lonnetta albright, director, great lakes addiction technology transfer center, university of illinois at chicago, jane adams college of social work. each year, about 40 million debilitating illness or injuries occur to americans as a result of substance use disorders. dr. kirk, what have we learned recently about the science of addiction? a few points are very, very clear.

one of them is that substance abuse disorders, whether its substance abuse or substance dependence, it involves changing the chemistry of the brain. and those changes impact on behavior as well as our physical activities. i think it's very, very clear from the evidence, also, that people who develop these serious disorders have lifetime conditions or chronic conditions like any other disease, diabetes and so on. and our challenge is to delay the age of first use of these - use, and secondly, view alcohol and drug dependence as chronic conditions for which recovery management is a solution. and george, thinking of definitions, when is someone considered to be in recovery? you know, that's a very good question. i think that at the point that when a person have accessed treatment services and he or she understand what all that means now, and then they

make a commitment, and then they go out and seek support services as well as make that commitment that they want to change their lives. i think for me, at that point in time, recovery starts then. it started for me then. i thought when i made that commitment to change my life. and so i say that at that point, when you make that innate internal commitment and then you take the steps, you seek treatment services and then you make a commitment to what all that entails, the group services, the individual services, the family talk and so forth and so on. i think that that, for me, engages the process of recovery. other thoughts on recovery, paul? one of the problems, from the standpoint of an alcoholic or a drug addict, is that as an individual who's addicted, you become, or i became, absolutely convinced i needed that alcohol or drug in order to exist.

i didn't think i could do a thing without canadian club and budweiser. and so the first big problem is that most of us who are alcoholics and drug addicts don't wake up some morning and say, well, i think i'm going to go into treatment. instead, what happens is we've caused somebody some problems, either a wife, kids, parents, work, school. somehow, we've gotten in trouble. maybe even the police have intervened. so the first thing that happens to most of us who are alcoholics or drug addicts is some sort of intervention. and that's because we can't convince ourselves that hey, we should change, but society says we can't tolerate your behavior because as an alcoholic and a drug addict, i couldn't predict what my behavior was. and so that intervention happens. how did someone, paul, since you've given such a good example, how did your journey

engage you into a state of sobriety? well, i had many false starts. and unfortunately, things began to happen to me that got me into trouble. and finally, one of the things that got me into big trouble was that i had a wife who got sick of being threatened, then, of being killed every time i got drunk. and so she called the police and they took me to a mental hospital. and that was a big step along the way. and my wife also said i don't want anything to do with this guy anymore because she had been tortured by this tremendous unpredictability when i was intoxicated. i think as part of as i listen to paul talk about his journey, i'm reminded of my dad's journey as a recovering alcoholic, who when we say many pathways to recovery dr. kirk, he never went through treatment,

and similar experiences for him that he found himself in a ditch, and that said he said his first prayer in his life since a child that said if you just let me get home to my children, i will never take another drink. and 40, 50 years later, never took another drink. so i think there are many pathways here, and wellness and health and resiliency, i think, has to be a part of the discussion. dr. kirk, going back to the examples that have been given, i know that you absolutely pondered the whole notion of when an individual is in recovery versus what the system itself considers recovery, and so on. tell us about the journey that you had in terms of really help us to understand a recovery-oriented system. what is that? i think one of the most significant challenges

is that to the average individual, when someone talks about recovery, that means cure. and it's clear that when you talk about this particular condition, just like other serious conditions, cure is not the right word. i like to think of what i call recovery zone. what recovery refers to is the individual path that a person takes as they experience and manage their "illness," and then they go onto reclaim their life. most of us at this table have probably had some serious event occur to us, whether it's a divorce, whether it's a death of someone close to us, whatever it is, and it just knocked us back on our heels. but we responded to whatever it is that we found in ourselves to get back on our feet and have what i call a new beginning. well, people in recovery from substance use conditions, they have many new beginnings but what it

comes down to is that helping them to learn to have respect for themselves, see themselves as being resilient individuals, and renewing. and so to me, recovery involves three rs, respect, resilience, and renewal. now, i think the more we can, if you will, normalize that in a larger healthcare field or discussion, then the choir, if you will, is going to get bigger so that people will not say well, those people are addicts, those people are this, as compared to the diabetic, as compared to someone who has cholesterol difficulties. these are healthcare conditions like any other, and i think the sooner we treat them that way, so much the better. i think one of the secrets in recovery is that the addict or the alcoholic has to be comfortable enough in sobriety to avoid relapse. and sobriety is total abstinence. you somehow have to con yourself into saying, i can't take one drink, i can't pick up one fix because one's not enough, thousand's not enough.

once you start, you're back into the compulsive use. so i think that it really is a difficult job for the recovering alcoholic or drug addict to make that transition into becoming comfortable enough with sobriety not to relapse. i think one of the things that you're hearing among the group here, the person is responsible for managing their own recovery. and so a person such as myself, that operate a state system for care for people with mental illness and substance abuse, my job is to give them the tool, so they can choose to use because for some, one particular tool is going to work well. for another, something else. for some people, it's spirituality. for some people, it's aa. some people, it's na. any number of things but you play off the strengths of people because people weren't born with these conditions. and so when they finally develop, the person has a life before that. so when paul talks about his situation or any at this table,

we had lives before these conditions occur. how do you find those things? so one of the questions that i know our staff often ask when they're working with a person, what worked for you before? what worked for you? you play off those strengths. so moving away from diagnosis and weaknesses and deficits, and play off the strengths of the individual so they feel a sense of well-being or confidence that i can back on my feet. when we come back, we're going to be taking a look at exactly those types of systems and how does our healthcare delivery systems respond to an individual's need to make their own decisions and to have that continuum of care available to them. we'll be right back. people trapped by drug or alcohol addiction often feel like there's no hope, no way out. but for every lock, there's a key.

and if you have a problem, it's good to know there are real solutions to help you get free. for drug or alcohol treatment referral for you or someone you know, call 1-800-662-help. brought to you by the u.s. department of health and human services. people who suffer from drug or alcohol addiction sometimes say hurtful things. they drive the people who love them most away. if you know someone who suffers from drug or alcohol addiction, listen. try to hear what they are really saying. know that there is hope, and help them find their voice again. for drug or alcohol treatment referral for you or someone you know, call 1-800-662-help. brought to you by the u.s. department of health and human services. (music)

one of the things that we recognize in any continuum of care model is that people need different services depending upon their unique situation. everybody gets an individualized treatment plan. if you have mild to moderate conditions, you may need one series of services. if you've got moderate to severe, you may need another series of services. it's clear that people in the moderate to severe spectrum have also had problems, may have problems with the law, child welfare, their job, their family, their mental health, their physical health. well, the traditional specialty delivery system doesn't provide all the services necessary in the moderate to severe spectrum. you may have to be dealing with child welfare. you may have to be dealing with a probation or parole officer. you may have to be dealing with the employer's eap program. so what we want to make sure is that there's a case manager of sorts, particularly in the

moderate to severe spectrum, so that that person cannot get overwhelmed by the multiple demands. (music) one of the great things about being in recovery, other than getting away from the absolute hell of leading a life as an addict, is that you meet wonderful people. back in my drinking days, i used to justify spending my time in bars because i said, that's where all the interesting people are. well, guess what? just like me, they've all gotten into sobriety and they're now in aa and na. and so that's the first good news about recovery is you meet interesting people. the second good news is you're able to control your behavior. (music)

the mission of nora is to prevent the use of alcohol, tobacco, and other drugs to diverse communities in northeast ohio. we're going to start with the serenity prayer. what makes nora different from other treatment and recovery programs is that we get a lot of calls from individuals in recovery who want to give back, and they come to our organization to support us. they want to be a part of a system that is really helping individuals to retain their recovery over a long period of time. nora's existence these last few years, i think, have reminded people of truly what the value is in that very simplistic reality of if i help you, that's indirectly helping me. and of course, if i've helped you and i'm in need, you're in a position to help me. i became a volunteer for nora because i always dreamed of helping others and i knew this was a recovery agency. and i wanted to be a part of helping because i know

some of the life things that i've been through would be able to help others as in the same situation that i have been in. the most difficult part was probably getting the word out and convincing our target audience that it wasn't another fly-by night creation, that we were really sincere about what we wanted to do for the recovery community. and once they found out that we were sincere and that our hearts were in it, we didn't have a problem with getting volunteers at all. let's let mommy try. we're going to start with one. let mommy try. if you can find a woman who is in need of treatment and her children, and treat the entire family, then we're going to reduce the cost of services and maybe burdening the public system over time because it's better to treat a family than it is an individual. when people started sending over their daughters or their sons and started knocking on the door

and saying, can you help us? can you help my daughter? can you help my niece? can you help my cousin? we started developing 12-step meetings. the kids, they started coming over and we had teens, things on the weekend. when school was out, the kids would come over and they would come for winter break, summer break. we had food, we would feed them lunch, take them on picnics. we did a play. it is and was a wonderful program. i think over the last five years, we've seen a great momentum of individuals who were mobilized, who came together to really support treatment and recovery and to give back. so i'm really happy that i think now, it's a big difference in terms of what you see individuals are really stepping up, saying i'm a person in recovery. and they're proud of that. so dr. kirk, we've talked a little bit about the recovery for the individual. let's talk systems now. when you began your journey as commissioner in connecticut,

what did you find about the system that you wanted to change? a couple things. one of them is that the people with whom i interact and who fund the system believe that persons who develop these conditions never get better, so just put enough money to keep a cap on it. another point, that we looked at all the monies we were spending, and it appeared that we were spending 80 percent of our resources on 20 percent of the people. why is that? because they were going in and out of detox, expensive types of care. not because now, those care components were important but we had the money, we didn't view it as a sustained approach. and so how do you sustain the person in recovery? the outcome measures that we were using were problematic. and so we tried to go about it in such a way that what are the services that would really engage people in care? paul mentioned before about how do you engage? one quick example.

why is it that women do not come into treatment at the same rate in september? it's their children going to school. so one of the things that one of our research pointed out is that, and we've done this every year since then, if you give a woman with children, if you make sure her youngster has a backpack to go to school, maybe a decent pair of clothes to go to school the first day, that is more effective in getting that woman into care than saying, i'm going to give you an appointment next wednesday at two o'clock. that's not on her agenda. the fact that you reflect your interest in her as a person is more effective than the traditional systems. as any number of persons in recovery would probably say, there's a certain point when i'm ready and don't tell me next week. you need to be able to make something available to me that - so a part of our work was what are those differences that make a difference? i'm sure george will talk about, from a criminal justice point of view, one of the things we found there, give the person some temporary support for housing

and transportation, dollars for a month. personal care, shaving, whatever. those simple things. those are not evidence-based treatments, they're simply things to engage the person into care. they're common sense. yes. absolutely. george? as you speak about the systems, the systems today are real different than it was i came out of treatment 25 years ago, in that there's more availability of systems willing to allow you to access services, employment and church-based services and faith-based services and so forth. and in our program is that we have the client advocate, the case management component that help the client move along the systems and help them to understand the systems, to help them to navigate those systems, and sometimes to negotiate them. how do i negotiate with the criminal justice systems? that can be very complex for the individual as well as for the family member, as well. and for us, it's about citizenship.

how do we start the conversation around what i'm doing now in recovery is helping me to restore and to establish being a citizen, a normal george citizen, and accessing those things that help me in that journey. and that is employment and support services. and the whole faith-based piece as well have been very integral because i can go to a self-help meeting and get what i need there, but then i can go over here and have another conversation that's very different, that's very supportive in that system as well. so i see that as being very integral and very important is to that whole continuum of services. see, the great thing that tom and george mentioned is a transition that's taken place over the last 30 years in america. yes. we had more professionals and we had more opportunity to get people on the right track to recovery and to provide opportunities along the way so they stay on the track. thirty, 40 years ago it was viewed much differently.

it was saying let's get the guy off the street into detox, three or four days to get him off the physical dependence, then he should be better. well, then the 28-day model came up. hazeldon, betty ford, and so on. let's send the guy away for 28 days and really shape him up. over the last 20 years, professionals have learned much more is needed. absolutely. lonnetta, what are some of those components of the continuum of care? if i had a problem and come to you, what should a system, if i come to you and it's a state-funded program, what should a system - what should i expect? well, as in attc, workforce development is one of our major focus areas, and within this recovery-oriented systems of care systems changing and helping groups and counties and state systems understand what we mean by a system of care. we look at dr. kirk's work in connecticut and dr. evan's work in philadelphia as models.

and when we look at the components of the system, i think one of the key things related to access is recovery happens in the community, and what is appropriate and effective for those individuals within their given communities. and all of the supports that exist in that community, not just treatment providers but the school systems. we're working with a group, a big system in detroit, and the drug courts are there, the schools are there, mental health is there, the jails are there, treatment's there, the recovery provider organizations are there, the state supporting this, and all of these systems coming together, regulatory, financing structures, and how we describe that system, i think, is critical. i think it's going to be critical as we continue

looking at recovery and a recovery-oriented system of care, particularly within the context of healthcare reform and what does that mean and how we're going to roll this out and look at a continuum. i want to go back to tom. before, when you came in and you were describing what the old system looked like, and then you intervened and you began to set forth policies to attempt to integrate both the addiction treatment and the mental health, and to really get people in the community who were providing services to start working together on behalf of this person versus in their own little niche. is that what happened? yeah. a couple things. one of them is that one of the most interesting exchanges i had in my early days in connecticut was with the governor's chief of staff. and i asked this person, how can i ever make mental health or addictions be the agenda?

and he said, it will never be the agenda. your challenge is to show how it's part of every other agenda. so education, healthcare, the criminal justice system. how is it part of every other agenda? so it actually came from the policy of the governor's office? this was just an exchange i had with him. the second piece is that if you go back and you ask what is it a person wants when they come into care? paul may mention this and george may mention also, never underestimate the power of the substance. and so you better show me somebody who used the methods that you're telling me about and got better. because as bad as the alcohol and drugs were to me, they worked, at least for certain pieces. it kept me medicated. yes. but then that's why the other aspect is go to the recovery community, ask them what they want. what's going to work for them? and so one of the things we did, actually at the beginning, took people in the mental health advocacy community, and groups such as ccar, and said, tell us what you want.

tell us what the system would look like. and that was back in 2000. i occasionally go back and look at it. i should look at it more frequently. the values that they put on the table, the direction they want, no wrong door and these other kinds of things, they're as true today in 2009 as they were in 2000. isn't that what any of us, when we go to a healthcare provider, we have certain expectations. same for those folks. and they know what's best that's going to work for them. the good news is there is a tremendous grassroots movement in the country. faces and voices of recovery had thousands of gatherings, whether walking across the bridge or having or a cookout or something else, where recovering people were taking a lead in saying hey look, it works. i'm in recovery. oxford house, as we speak, there are 10,000 beds across the country, all done by the recovery community itself. when we come back, i want to hear from george, exactly what is the tasc program and how does it get incorporated into this concept of the continuum of care?

we'll be right back. (music) everyone with alcohol and drug addiction is in the same boat. (music) with treatment, you can find solid ground. for drug and alcohol information and treatment referral for you or someone you know, call 1-800-662-help. i'm a sophomore in college this year. man, if you had known me when i was a sophomore in high school, nobody could tell me anything. i gave all my teachers a bad time. they all gave up on me, except my english teacher.

eight years teaching high school english, 10 years in recovery for alcohol addiction. to be or not to be. i got help. that's it right there. when you get help, who knows just who you'll help along the way. for drug and alcohol information and treatment referral for you or someone you know, call 1-800-662-help. (music) i decided that as part of my recovery experience, i wanted to one, become a counselor. and so i went and i got certified as an addiction counselor and i started volunteering. first, i started volunteering in different organizations and then, i decided to go to school and i wanted to be an addictions counselor.

and so i did that. and so i probably started talking to my family members. my family members started coming to me with their problems. well, george, you did it. how can i do it? and i let them know that my journey was my journey but you can have your journey. and all you have to do is just make this commitment. (music) sanctuary is a private, nonprofit organization that is committed to helping young people and their families help themselves. so we have a full continuum of services to provide support through adolescence and to help families and communities help support young people. we are the only emergency shelter for youth on guam and in micronesia.