Lifespan Recovery Management LRM
Lifespan Recovery Management
By: Michael Weiner, Ph.D., MCAP
www.lifespanrecoverymanagement.com
Contact: 561 398-8696
The way that we have been treating people with addiction is not nearly as effective as we would like it to be. Isn’t it time to stop treating a chronic condition as though it was a series of acute episodes?
We’ve been treating people with addiction in short-term residential settings, frequently far away from home and family, and spending little time on what happens back in the real world.
Should the symptoms of addiction become active again we do the same thing over again. It’s the patient’s fault that the condition became active, probably didn’t go to enough meetings or use a sponsor well.
Every time this occurs shame accumulates.
I’ve developed“Lifespan Recovery Management (LRM) as a strategy that treats addiction close to home and over the course of time. “Close to home” means that families can participate and services that may be needed are easily accessible.
The process starts with an assessment. An assessment is needed to determine what is needed to get well. It’s a process that could start with managing withdrawal from substances and residential care. This is because the risk of continued use could be high.
There are also occasions when an assessment indicates that a less intense level of care, such as intensive outpatient, can be effective.
As symptoms become less severe and risks are lowered treatment becomes less intense. The perception that treatment is ongoing and lifelong is very important.
In general, people with substance use disorders do well while they are in treatment. So do people with diabetes and hypertension. When a person stops treating their chronic disease symptoms become active: blood sugar becomes unstable, blood pressures rise, substance use disorders become active.
“LRM” removes the stigma from treatment and recovery. It can be built upon a cognitive behavioral (SMART) or a “spiritual (12-step) approach to wellness. Cognitions and language are intertwined; each has an impact on the other. It follows that:
It is not possible to eliminate the stigma that exists around addiction, and apply a chronic care model, without changing the language that we use on a daily basis.
To bring about a chronic care model and to eliminate stigma we need to:
Change From/Change To:
Change From: Relapse / Change To: Recurrence
Change From: Relapse Prevention / Change To: Recovery Management
Change From: Aftercare/Primary Care
Change To: Continued Care/Ongoing Care/ Anything to indicate that all levels of care are equally important). Eliminate the term “primary care”
“I’ve been to treatment Once a person has engaged in treatment it is
“x” number of times” continuous. Abstinence dates may change.
“I’ve been to treatment 3 times,” means “I’ve
failed 3 times.”
“How many times have you been to treatment?”
means “how many times have you failed?”
Simply ask for a treatment history.
Remove labels.
A person is not just “an alcoholic’ or “an addict.” “My name is Michael, I’m an alcoholic” becomes “My name is Michael; I have a substance use disorder.” Or possibly, “an alcohol use disorder.” One would never say, “My name is Michael, I’m a cold.” One would say “I have a cold.”
Denial
“Ambivalence” is actually what a patient is feeling. Most patients have at least a glimmer that using is a problem. “Ambivalence” also gives a therapist something to work with.
Clean/Dirty
Anything other than “clean/dirty.” “Positive” or “Negative” might work. Does a diabetic’s blood ever come back “clean” or “dirty?”
The word “treatment” applies to the entire, continuous process, not just to residential.
We build upon “success,” not “failure.”
Change takes diligence, practice, and time. Let’s begin.
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