We find ourselves living through one of the darkest chapters in America’s failed drug war. Story after story of an ever-worsening public health crisis make it all too easy to despair. The fact that we all know the scale of this problem was brought on and continues to be perpetuated by the seemingly untouchable “legal” American opioid cartel adds insult to injury. Entire communities are buckling under the weight of this crisis, and the number of those devastated communities, along with the rate at which we’re dying is only moving in one direction—up. America needs a big win and we need it badly. Fortunately, one major city appears poised to deliver a large-scale victory. It’s not the biggest or wealthiest of the major cities, but it’s about achieve something that we’ve never seen in the entire history of the drug war. Philadelphia is on the brink of becoming America’s first major collegiate recovery city.
For the entire history of the drug war we’ve known two irrefutable facts. The first is that supply reduction, as the primary approach, is a failed policy. We have never once been successful in stopping the flow of drugs into our country (a.k.a. the largest single market for drugs on earth). The second, is that demand reduction is both more effective and a whole lot cheaper. This is not to say that we shouldn’t continue to try and stop massive shipments of narcotics into the country by any means, but when the cartels we’re fighting to the south are being outsold and out marketed by the “legal” opioid cartel we let take power here at home—the deck is very much stacked against law enforcement and against the American people. We’re going to need lawyers not helicopters for the war at home, but that’s a fight for tomorrow. Today, we’re fighting on the demand reduction side and we’ve got a front row seat to the making of history.
When we talk about the treatment and support of people with substance use disorders, the easiest place to start is with the desired outcomes. There are basically three positive outcomes (I know people have very strong opinions about which of these three outcomes is the best, but let’s just agree that moving toward wellness and improving quality of life is better than a coffin or long-term incarceration). People successfully implementing one of these outcomes are collectively referred to as the recovery community. This over simplification is problematic in and of itself as it’s actually a coalition of three distinct communities (each with numerous sub-communities of their own) rather than a single homogeneous population, but that’s a separate topic for a separate conversation. The first two outcomes are successful long-term medication maintenance and successful long-term harm reduction. These are both fairly self-explanatory and the overwhelming majority of people practicing them don’t self-identify as being in “recovery” irrespective of how badly many of my fellow coalition members would like them to. They both have value, both have improved the quality of life of countless individuals, and both have prevented deaths.
The third category, and the one I actively practice in my own life, is abstinence based recovery. Also, fairly self-explanatory (individuals abstain from using drugs and alcohol as part of their recovery). For decades, there is one subcategory of individuals seeking abstinence based recovery which has been statistically much more probable to achieve long-term recovery than others. That subgroup is impaired professionals. If you want to get a basic framework of how we should be treating everyone with a substance use disorder, you need look no further than how the medical community treats its own. It starts with, “you’re a human being and we’re going to help you.” It’s acute care as needed and a ton of subacute support for years from there. No one does it more effectively. Long-term peer support brought to scale post-acute care is a winning recipe for other traumatic diseases, and it’s how they treat this one in their own population.
Which brings us both to collegiate recovery and the city of Philadelphia. For the past several decades, a few universities have effectively created the equivalent of the long-term, subacute, portion of an impaired professionals program for non-professional students on their campuses. Individuals with substance use disorders attending these collegiate recovery communities maintain their recovery at a much, much greater rate than their non-professional peers who do not receive the benefits of this long-term, institutionally backed support infrastructure. In the past ten years, the number of colleges and universities with collegiate recovery programs and collegiate recovery efforts has increased exponentially. It’s very clear to absolutely everyone looking at this phenomenon that this movement is part of the brightest future of long-term support for emerging adults with substance use disorders in our country. We need, not only to expand collegiate recovery within the four-year university system, but to replicate it within our community colleges, trade schools, and apprentice programs.
And that’s exactly what’s happening right now in Philadelphia. Philadelphia is already recovery friendly as major cities go, with projections of over 30,000 pro-recovery advocates marching in PRO-ACT’s upcoming recovery walk on September 23 www.recoverywalks.org (up from 26,000 at last year’s walk), state funded and community support for their recovery high school, www.thebridgewayschool.org, and a pro-recovery mayor. This though—this is unprecedented. With more and more academic institutions like Temple, St. Joseph’s, Drexel, Penn, West Chester, Villanova, and the Community College of Philadelphia (to name a few) starting or continuing to build their individual collegiate recovery communities, we are witnessing the final approach toward a tipping point. We are witnessing the formation of a collegiate recovery coalition the likes of which has never been seen. There are over 100 schools within 50 miles of Philadelphia, which is also roughly the current number of schools with institutionally supported collegiate recovery efforts in the entire United States—including the schools with existing collegiate recovery communities in Philly. Even at under 20% of the Philadelphia schools actively developing collegiate recovery communities, the entire environment is starting to shift. When that number hits 50% and the early adopters are more established, the whole landscape of how we treat emerging adults with substance use disorders will change on a systemic level.
When Philadelphia becomes America’s first major collegiate recovery city, two things will happen. The first is that we will finally see an impaired professionals program for emerging adults in recovery from substance use disorder brought to scale. The second is that every major city in America will follow suit and establish collegiate recovery coalitions of their own. Like all large scale systemic changes, it won’t happen overnight and it will require a lot of effort from countless individuals to truly make the shift. That said, the shift will happen because the residents of those other cities will demand large scale collegiate recovery for a generation which has been, until now, largely left to fend for themselves on streets that grow more merciless with each passing year.