1. Building Recovery-oriented Systems of Care for Drug Court Participants Laura Griffith Director of Programs April 15, 2014

2. What Is Recovery? There are over 23 million American adults in long-term recovery – no longer have a problem with alcohol or other drugs.

3. Definitions of Recovery J. F. Kelly & Hoeppner, 2012

4. Snapshot of Life in Recovery 4 LIFE IN ADDICTIONLIFE IN RECOVERY Measured average length of time in addiction – 18 years. Measured average age of recovery – 36 years old. Measured in 3 stages. Stage 1: < 3 years Stage 2: 3 to 10 years Stage 3: 10+ years FINANCES 70% experienced financial problems FINANCES Healthy financial circumstance improved as recovery progressed. Paying bills on time and paying back personal debt doubled. Fifty percent more people in recovery pay their taxes. MENTAL HEALTH PROBLEMS Two-thirds had untreated mental health problems MENTAL HEALTH PROBLEMS Untreated mental health problems decreased fourfold CRIMINAL JUSTICE INVOLVEMENT  Over half (53%) reported one arrest; 1/3 experienced more than 1 incarceration  35% had had their driver’s license revoked CRIMINAL JUSTICE INVOLVEMENT  Involvement with the criminal justice system decreased tenfold  Restoration of driving privileges EMPLOYMENT AND EDUCATION  Half had been fired or suspended from work; 61% frequently missed work or school 33% had dropped out of school EMPLOYMENT AND EDUCATION  10% reported employment problems; 83% are steadily employed, and 28% have started their own business  78% have furthered their education or training CIVIC/FAMILY ENGAGEMENT  Two-thirds participated in family activities  Volunteerism was at 31% and 61% voted CIVIC/FAMILY ENGAGEMENT  Participation in family activities increased by almost half (46%) to 95%  Volunteerism was 84% (more than doubled) and voting increased to 86% (an increase of 41%)

5. Why is it important? What does it mean?  Recovery is associated with dramatic improvements in all areas of life  Life keeps getting better as recovery progresses.  Policies, systems, services, and supports are needed to help more people initiate and sustain recovery  Additional research is necessary to identify effective and cost-effective recovery-promoting policies and services – to build recovery- oriented systems of care

6.  Established 2011  Over 95 member organizations (35 states) with local, state, national, and international focus  Building infrastructure and capacity to provide: Public education Advocacy Peer recovery support services ARCO

7. Focus: Recovery and Wellness Shifting from a crisis-oriented, professionally-directed, acute-care approach with its emphasis on discrete treatment episodes…. …to a person-directed, recovery management approach that provides long-term supports and recognizes the many pathways to health and wellness.

8. Recovery-oriented Systems of Care Mobilizing resources to:  Build the capacity of communities, organizations and institutions to support recovery  Build on the strengths and resilience of individuals, families and communities to promote recovery, health, and wellness.  Expand the menu of services and supports across the entire recovery continuum  Ensure people in or seeking recovery receive dignity and respect  Lift discriminatory policies and barriers to recovery

9. Recovery-oriented Systems of Care  Mobilizing all of the resources in our communities to:  Accord people in or seeking recovery dignity and respect  “Recovery capital” of Drug Court participants  Build the capacity of institutions that Drug Court teams have relationships with to support recovery

10. Building Connections to Family and Community JOBS/EDUCATION/CIVIC ENGAGEMENT  Recovery GED programs, high schools and colleges  Employment discrimination against people in recovery with criminal justice history  Restrictions on voting rights for people with criminal justice history  Opportunities to volunteer and build work histories

11. Recovery-oriented Systems of Care RCOs Recovery Community Centers Recovery Homes Recovery Schools Recovery Industries Recovery Ministries Recovery Cafes

12. What is Needed: Recovery Capital  Physical : includes health (access to care), financial assets, food/clothing/shelter, transportation  Human: includes culture, values, knowledge, education, inner- and interpersonal skills, judgment, and other capacities  Social: includes connectedness to social supports and resources, intimate/family/kinship relationships, and bonds to community and social institutions Recovery Capital is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from addiction. (Granfield and Cloud, 1999, 2004; White, 2006)

13. Consequences of Addiction Can Deplete Recovery Capital  Limited education  Minimal or spotty work history  Low or no income  Criminal background  Poor rental history  Bad credit  Accrued debt and/or back taxes  Unstable family history  Inadequate access to health care

14. Creating and Reinforcing Recovery Capital  Safe and affordable place to live  Steady employment and job readiness  Education and vocational skills  Life and recovery skills  Health and wellness  Sober social support networks  Sense of belonging and purpose  Connection to family and community

15.  Services to help individuals and families initiate, stabilize, and sustain recovery  Provided by individuals with “lived experience” of addiction and recovery  Non-professional and non-clinical  Distinct from mutual aid support, such as 12-step groups  Provide links to professional treatment, health and social services, and support resources in communities Peer Recovery Support Services

16. What Makes Peer Work Effective?  Focuses on establishing trust and building relationship  Builds on a person’s strengths to improve Recovery Capital  Promotes recovery choices and goals through a self-directed Recovery Plan  Utilizes recovery community resources and assets  Provides entry and navigation to health and social service systems  Models the benefits of a life in recovery and elevates recovery as an expectation

17.  Effective outreach, engagement, and portability  Manage recovery as a chronic condition  Stage-appropriate  Cost-effective  Reduce relapse and promote rapid recovery reengagement  Facilitate reentry and reduces recidivism  Reduce emergency room visits  Create stronger and accountable communities Benefits of Peer Recovery Support Services

18. When Are PRSS Delivered? Across the full continuum of the recovery process:  Prior to treatment  During treatment  Post treatment  In lieu of treatment  Peer services are designed and delivered to be responsive and appropriate to all stages of recovery.

19. Where Are PRSS Delivered?  Recovery community centers  Faith and community-based organizations  Emergency departments and primary care settings  Addiction and mental health treatment  Criminal justice systems  HIV/AIDs and other health and social service agencies  Children, youth, and family service agencies  Recovery high schools and colleges  Recovery residences and Oxford Houses

20. Peer Recovery Coach  Personal guide and mentor for individuals seeking to achieve or sustain long-term recovery from addiction, regardless of pathway to recovery  Connecto r to instrumental recovery- supportive resources, including housing, employment, and other services  Liaison to formal and informal community supports, resources, and recovery-supporting activities

21. NOT Just Recovery Coaches…  Peer telephone continuing support  Peer-facilitated educational and support groups  Peer-connected and –navigated health and community supports  Peer-operated recovery residences  Peer-operated recovery community centers

22. Recovery Community Centers  Vision: creating a community institution like a Senior Center  Provides public and visible space for recovery to flourish in community: Recovery on Main Street  Serves as a “community organizing engine” for civic engagement and advocacy  Operates as a “hub” for PRSS and recovery activities  Includes participation of family members  Provides volunteer, service, and leadership opportunities  Positions the recovery community as a key stakeholder with the greater community

23. Drug Court participants can complete their community service hours at USARA’s recovery community center. A USARA Family Resource Facilitator works with families who are involved in the Family Drug Court program in the Juvenile Courts. Example

24. PRO-ACT (Pennsylvania Recovery Organization – Achieving Community Together) works with its Drug Courts by providing a Certified Recovery Specialist (CRS) to each Drug Court participant. They assess Recovery Capital and develop Recovery Plans in order to help participants enhance and strengthen their recovery. CRS’s provide ongoing support thru each level of the Drug Court process either face- to-face or thru the use of telephonic recovery support. Example

25. In Vermont, the Chittenden County Drug Court refers many people to the Turning Point Center of Chittenden County, a peer-run recovery community center. All new drug court participants take part in a six-session “Making Recovery Easier” group, funded by the Court Administrator’s Office.

26. Faces & Voices of Recovery