o advocate for. so faces and voices of recovery has used the training as an opportunity create a video, a dvd, that can be you know sent around the country, can be put on the internet, can really be used in trainings and in workshops around the country so that more people have the terminology that's necessary to communicate our, our message to the broadest possible audience. there are three major sections of the dvd. the first is a 90- minute training video which takes you through faces and voices of recovery's media and message training, the actual core training itself. the second part of the dvd is a section called, "keys to successful interviews". that section really is helpful for people who are going to be going into an interview situation and they need to brush up on some basic skills. and the third section of the dvd contains all the

materials, the powerpoint materials, our message training, our tips on successful media interviews, that folks can use to further their skills as they go along through this training. you have recently gotten involved with faces and voices of recovery, laura, tell me why you got involved with faces and voices of recovery and why you, what brought you to this work? i am so thrilled to be part of this organization, i'm really proud to be part of it. they have a message that is very near and dear to my heart, which is sharing the message of hope and recovery, to having a new way of life. i took away from the messaging that i attended last fall, that there are right words to use and, and not so good words to use. for example, we want to talk about recovery, we don't want to talk about addiction. addiction is where people are stuck in the problem. recovery is where people get into the solution and that's what it's all about, giving people hope and healing and a new way of life. some of the main questions that we receive is, what kind of training is this, you know?

and when you say, media message training, that means that if the media... put a microphone and camera to my face and say, joe, i heard that you used drugs and alcohol before. and who are you? and how do i respond to the media and how do i respond to where the community and the public can know that the benefits of long-term recovery? i think the main message there is that people in long-term recovery can move onto advocate for people with addictions and people to also get long-term recovery like they did. the message is real clear that the benefits of recovery, it works, and that's a reality for many people that's in recovery today. lureen you wanted to comment. yeah, i really wanted to comment on something that, that carlos said and connected to what john was saying. carlos talked about the confusion around the language and john talked about the research that

really showed how using strength-based language, how it impacts the person. and i think that there is this flavor of the day language. i mean we, you know, chemical dependency, it's always something different. but i think there's an opportunity here for us to really show the leadership because i think the difference is, is that this language that we want to promote, is actually something that's going to help people, it is the right thing to do. so i think rather than it being this floating, flavor of the day, that we actually have to take the leadership and make sure that people are using language that is going to promote this culture of recovery. but particularly now, i think with the healthcare reform, daphne, do we have an opportunity here in order to, to really turn things around? we have a huge opportunity here. the country is talking about healthcare reform, the country is talking about health and this is time to take this, this issue out of the crime

pages and into the health pages. this is a health issue and when we begin to understand that, fundamentally in our own hearts from the, from academia to clinicians to the folks working in our prisons and jails, to understand that we are talking about individual health. this is a gigantic opportunity and it's, it's a wonderful opportunity because this changes the way people see themselves. when you come, a lot of people who have suffered with addiction, suffer from just horrible feelings of, of inadequacy...shame. ...shame, isolation and so forth. and when you learn that this is actually something that you have an ability to begin to treat, that other people have overcome themselves, that this is about health. and when you can move from saying, i feel sick to i feel well, as opposed to i, going from i feel you know i'm a bad person to a good person.

we're talking about moving from sickness to health. so yeah, it's a great opportunity. and i'd, i'd like to mirror daphne's comments. i'm really, really excited about national healthcare reform, but i also feel that it's wrought with pitfalls because i believe we're going to interject a whole new set of language into the conversation, if you will. did a lot of organizing around the parity act and making sure that substance abuse was included in the language and the wellstone... substance abuse? yes, because it was the wellstone mental health parity act, so...substance abuse? am i hearing, substance abuse? yes ma'am, yes ma'am, yes ma'am. and, and you know daphne has, has quoted bill white quite a bit and, and he's truly prolific writer and agree with the title that folks had given him, the dean of recovery. but he was saying that three ways to deal with social stigma, stigmatations stigma, stigma if you will. one is to protest stigma and discrimination are illegal and you need to protest, protest that and

bring it to the forefront and hold the folks that are doing it, accountable. but there also is an educational component he talks about. and then there's a contact component. and this this is not new. i got this from a 2009 paper that he did with arthur evans. and so i think you had suggested it, we need a multi-prong approach where stigma is alive and well and where folks are comfortable with that, we need to hold them accountable. but we need to do some education as well, within the field as well as outside the field. and then i think we need to look at establishing new contexts and reaching out to non-traditional groups if you will, the recovering community. i believe that we could do more in reaching out to them. and i think that is, that is i tell you, i have been through national alcohol and drug addiction recovery month and its events and the testimonials that we see from individuals in recovery. and it's almost painful to see what daphne was saying in terms of a shamed-based approach to, to their recovery.

and it, it really, i think it's, it's an area where folks in recovery are going to have to work with other folks in recovery to, to bring them along to a comfort level where individuals can then be free of that self-perception, in order for them to change their language. do you agree, john? i do, i do, absolutely. i think this issue of stigma which is directly obviously connected to the terms that we use, is, is very important. i was just thinking about the, the world health movement, this is a not a us phenomenon either, it's, it's cross-national. the world health organization did a study in, in the late '90s across 14 different countries, looking at 18 of the most stigmatized conditions, including drug and alcohol addiction. so they had things like being homeless, being a criminal, being hiv- positive, all these very heavily stigmatized conditions.

and what they found, cross-nationally, drug addiction was number one, alcohol addiction was number four, so two of the top four were the most stigmatized conditions cross-nationally. and stigma, and, and that surprised me. i mean obviously we all know that these conditions are very stigmatized, just how stigmatized, i didn't realize, that they, they would come top of that list. so that was very surprising to me. so what we're dealing with is possibly and probably the most stigmatized of all social problems, if you frame them, put it in that framework. and i think importantly, there were two factors that i see moderate stigma. one is cause and the other is controllability. cause being, it's their fault. controllability, they can't help it. so it is those two factors. and i think that science now has contributed to our understanding that people with a substance use disorder, they may have had the initial choice to

pick up alcohol or another substance, but it's not their fault that they become addicted. and this is something that's been, been around for a long time. but it eludes most of us, i think, most of the time. and the other thing is controllability. science is now, as i mentioned earlier, helped our understanding in, in terms of people's inability, the impaired control which we know is an essential, perhaps the essential characteristic of addiction, is this inability to control, this impaired control over, over use despite harmful consequences. and so this issue of cause and controllability and the science that's, that's really informed that, have really helped i think to de-stigmatize. and we need to get that message out that these are health problems to, that they are treatable. they are probably the most, have the best prognosis of any mental disorder on the severe end of the spectrum. most people eventually recover from a substance use disorder and these are the kinds of messages

because i think out there, there's a lot of kind of negative thinking and nihilism regarding the, the prognosis for individuals with addiction, they're, they're hopeless. there's no chance, we can't help them and, and they lie all the time and, and these kinds of very biased statements which sorry you were going to say? it was fine. i just wanted to say that when we come back, i want to get into the, the notion of how do we sustain a, a conversation of holding folks to be responsible in a way that doesn't stigmatize or doesn't discriminate? because if we, if we need to look at things differently, then we need to substitute that which we think now, with something more positive and, and we need to learn how to do that. we'll be right back. for more information on national

alcohol and drug addiction recovery month events in your town, and how you can get involved, visit the recovery month website at recoverymonth.gov. [music] 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] hi, i'm michele monroe with the road to recovery and we're here today in maryland getting some opinions on what people think about different languages used in the substance abuse and mental health arena. if i said that somebody had a drug and alcohol addiction what would you think that that means? i think the person has a... a certainly health issue problem that needs to be, needs to be attended to. i would think of people struggling in difficult circumstances... with certain underlying issues that, that lead them to feel that they need to use those things as an outlet.

i think of a illness, i think of a sickness that's hard to overcome. and i think that the person needs support, as much support as possible. i think about people who needs help and they need to find help as soon as possible. so what if i said alcohol and drug problem? what do you feel about that? it's a problem that needs to be fixed, that's what i start thinking, you know, and you need to fix it, you need to find a way to fix it. if there needs to be out there more programs for these people, more resources where they can get to as soon as possible, you know, where they can speak their languages cause alcohol doesn't have any color or any face, any language. it comes in any, it can be anybody. and then problems sounds like, you just, you can deal with it if you seek for help, then addiction sounds more like you are in serious problem. i think it's the same thing, i mean i think that if you have an addiction, you have a problem.

you know, if you have a problem, you could possibly have an addiction. so the same thing goes you know, they need help, they have an illness and they need support. if i told you i was in recovery, what does recovery mean to you? i, i think you're really trying to get, get back on the right track and, and i would certainly pray for you and hope that you could stay there and get better because recovery is very difficult you, first of all you have to admit that you need the recovery. and then when you recover, it takes, it's a long process. i think when a person says that they are in recovery and they're trying to get over their addiction, one must give them a chance and believe them. recovery to me is a first step, just because you're in recovery, that doesn't that mean that you're going to be recovered completely. so, but it's the first step for you to get to where you need to get to be able to say, i used to be that. if, if you're telling me that you're in recovery, i'd say that you are trying to get your life together and that you have a serious problem and that you're, you care about becoming a better person.

somebody was trying to get into recovery and needed treatment and needed help. do you have a role in their recovery? and if you have a role, what role do you think you would need to play? i've been taught that that the whole family as well as the community plays a role in your recovery, so. i think you really have to love them and help them through it and don't prosecute them and make them think that they're doing something wrong and, and give them support. if the person is open to letting you help them, just really being there to support them, you know, give them that emotional support that they need. i do have a role, i think people whose, you know, seeking for help, they do need support from others because obviously they cannot cope by themselves with the issues they may have. so i guess my role will be like just be there and supportive and try to be a friend and understand what they are going through.

i'd probably just want to like speak into their life as much as possible and try to encourage them that i think realization for them is the most important to realize that they have an addiction problem and then to go about trying to help them through recovery and being as supportive as possible in the process. do you think recovery is possible and that people can make a change? it would be hard, it's very hard, but it's possible. anything's possible. i absolutely think recovery is possible and it's, it's something different for each person, but it it's probably a long process and will take a lot for them to be able to recover. recovery is definitely possible, where there's a will, there's a way, so everybody who really wants to recover, i believe they can recover, but they just have to really try. yeah, i think you can recover. i mean, like a lot of it depends on environment, like you got to get away from what you're doing and, and you know if you want to, if you want to do it, you can. so daphne, how do we change the paradigm? how do we begin to use positive language,

person-centered, people- first type of language? we begin by being conscious of the words that we're using and there are a number of words and papers and reports and so forth out there that promote words like health and recovery and person-centered and mutual support and so forth. and so there's a, there's a model that talks about going from unconscious incompetence at something, where you, where you do something and it's not what you want to do but you're not even aware of it, to conscious incompetence where you begin to be aware that these aren't the terms i want to use, to conscious competence and we're starting to be more aware of the terminology we're using to unconscious competence. and i think that's what we want to do as a field, is move to a point where we're automatically speaking in positive, person-centered, health-centered approaches. you two folks are in recovery.

now they're going to be folks out there that are going to say, alright, based on what john was saying, how do you then hold the person responsible for their need to keep themselves in the straight and narrow, even thought they may have had a, a recurring need for treatment? how do we then begin to reshape that to still not be offensive but to get our...a point across? well i, i really connected to what you're saying, i really want to comment on what daphne was saying. i think that we have to demand that people begin using the right language and there's a very simple and easy and concrete way to do that. one of the things that i've noticed is that people are not adapting the new language, but they're still being supported in certain ways. whenever someone has to write an rfp for something, they need to be using the correct language. i, i've seen rfps that have been written and

i can see by the language that's being used, that they are not, they're not moved to this whole framework of recovery, but they're still being awarded. so we need to help people to begin to use, and if we do that, they're going to pick it up immediately because people need, organizations need funding. i believe samhsa has done a great job in, in laying the framework for, if you will, for the type of discussion that i think needs to happen. and i think it's around recovery in a system of care model that's person-centered and it's based more on the holistic approach. that it's, it's person-driven if you will. and i, i think we just to build upon that. i think that's the way we begin to have the kind of conversations where all of a sudden, instead of 200,000 recovery advocates, you're making greater head roads into the 20 million people in recovery that miss hyde talks about. so instead of reaching less then 3 million and

providing services, we make inroads into the 22-and-a-half million that still need that. our message isn't resonating with multiple groups and so as a field, i think we want to look at our message and i think to have that universal language is going to mean that we can't view non-traditional groups as still target populations, if you will, from a deficit perspective. but then we begin to view them as key informants, that they have valuable information that can add to this discussion. and until we begin to do that, it's our, our whole efforts are going to be based around self-serving. we need this particular language to protect our funding stream, we need this particular language to add value to the work that we do versus our primary purpose is to provide the services and the help for people that are struggling with substance abuse or addiction and any of the other issues that they present to us with. well we need the language whereby i can recognize

where i need to do additional work and it's not going to be, belittling me or diminishing my worth, but that i can pick up the pieces and move forward again in that path to recovery because i think one of the things that we learned early on with the recovery-oriented system of care notion, was that particularly thomas kirk's model in connecticut is that the person is considered to be in recovery the second they have that aha moment. that they realize that they need treatment for their illness and, and from then on they still consider themselves in, in recovery. would that work, i mean in other sectors? i think that, i think that that's very, very important and one of the things i want to say is that, in terms of the development of the recovery or system of care, the focus on language has not been something that i've seen. and i think that everything we do,

if we're, if we're doing a conference, whatever we do, there needs to be a component in there on language. we really need to push this because it's, it's something that we can do that doesn't cost a lot of money, but it's key, it's key in how we define and how we build our systems. well i believe very strongly that the work that, that csat has done and cathy nugent within one of our branches, with the addiction technology transfer centers, is beginning to do that quite a bit. i think that it is a very conscious effort at you know, we're, we're struggling internally and, and working at it. and so you know the process is, it's almost like eating an elephant, you know, how do you begin to eat an elephant, it's going to be one bite at a time. so we, we are beginning to make inroads into that area, particularly with the materials from, that are being developed within the attc.

certainly the planning partners for recovery month, right daphne? yes indeed, that's been such a valuable group to move the conversation forward throughout the year, not just in september during recovery month, but throughout the year, to keep this issue elevated. so the question is, is what type of system is somebody coming into? i think it's a system that needs to be all encompassing, that can provide services wherever, whichever doorway the person chooses. and i'm, i'm just really grateful to the, the initiatives that samhsa and, and the federal government have supported around the access to recovery program, the recovery community support programs, that foster this peer-to-peer interaction where they're non-traditional approaches, but that, creating that peer-to-peer interaction, i think is just so critical. now it's not a slight on the academics or the, the clinical or the treatment professional, but there's that empathy factor between one person that has experienced this helping another person.

and i think we need to promote more of that. so i'm, i'm a big believer that money isn't the answer to everything, but i believe that samhsa hit on something when they were funding those type of programs. and in doing so, those individuals that are helping each other, maybe they can help each other on the language front as well as how do they view themselves...absolutely. ...and how do i want to go back to john, john, talk to me about some of the articles where people can access more information, if i wanted to learn more about this. you mentioned that you had authored some articles that may be helpful. well yeah the, you know the question is, is which terms? if we're not going to use certain terms, what terms should we recommend and then advocate for? i know daphne has written a lot about this and, and also bill white. i published a paper in 2004 in the treatment, alcoholism treatment quarterly, which actually talks a lot about the issue of terminology and how it may affect, how it's imprecise.

for example, we use the term abuse, generically, but also it's a diagnostic label, it's actually a, a dsm diagnostic label, which creates a lot of confusion when you see it written. are they referring to the more generic issue, you know, regarding the whole range of problems versus a particular diagnosis, that has specific meaning? so it's imprecisely used and this is a problem, of course, in communication. so one of the things that i think we need to, we need to have a term that describes these problems generically... and the institute of medicine has tried to deal with that, have they not? yes and the world health organization too, so in the 1970's they were advocating against using the term abuse, even though the american psychiatric association adopted that term which is unfortunate because then that gives rise to the term abuser, naturally. and that was the warning actually, back in the '70's that was saying, this is what's going to happen is that you're going to you're going to

generate this term by using that term. so what do we replace that with? so there are, there are a couple of things that i see i, i wrote about in that paper and papers since then, is to use, for example, if someone has a diagnosable substance abuse disorder, to use that term, substance abuse disorder. if we're talking about it generically, we might refer to individuals with a substance-related problem or substance- related condition. another term in other countries that have been used is substance misuse. so the misuse of a particular drug or alcohol. and so these are three ter substance-related problem or substance-related condition, again, person first, it's an individual with a substance-related problem or a substance- related condition. substance misuse as opposed to abuse, then that doesn't give rise to that negative connotation regarding abuser. and then substance use disorder, as i mentioned before, eating, eating disorders, no problem. everybody refers to them as eating disorders, not as food abusers and i think we should do the

same with substance use disorders. very good. well i've certainly enjoyed dealing with this subject matter today and i want to remind folks that national alcohol and drug addiction recovery month, does work to reduce the discrimination associated with individuals in recovery and those that need to go into treatment. it's celebrated every september. we certainly hope that you have learned that during this month, we not only have to use the right language, but we have to embrace the whole concept of support for those in recovery and those who need treatment and their families within their community. so i want to thank you for being here, it's been a terrific show. thank you. for a copy of this program or other programs in the road to recovery series, call samhsa, at 1-800-662-help or order online at recoverymonth.gov and click multimedia.

[music] every september, national alcohol and drug addiction recovery month provides an opportunity for communities like yours, to raise awareness of alcohol and drug use disorders and highlight the effectiveness of treatment. in order to help you plan events and activities in commemoration of this year's recovery month observance, the free recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources. to obtain your copy of this year's recovery month kit and gain access to other free publications and materials related to addiction treatment and recovery issues, visit the recovery month website at www.recoverymonth.gov, or call 1-800-662-help.

it's important that everyone become involved because addiction is our nation's number one health problem and treatment is our best tool to address it. [music]