MADISON RECOVERS: Building a Community for Recovery

Note: Over the next month, we'll be looking at Madison's recovery community, including the increase in opiate abuse in Dane County, local treatment options for those in recovery, and growing initiatives aimed at combatting substance abuse in and around Madison. The first installment looked at the growing problem of opiate use in Madison [1].

Across Madison, new bridges and apartment buildings are taking shape, but as the physical framework of the city grows, the human infrastructure is under increasing strain. According to the Wisconsin Department of Health Services [2], Wisconsin “has consistently high rates of adult alcoholism and binge drinking compared to other states and the U.S. as a whole” the state's suicide rate [3] is four times the homicide rate, and heroin overdose rates [4] have more than doubled since 2002.

Young adults in Wisconsin struggle with substance abuse and alcoholism at an earlier-than-average age [5]. The struggle with substance abuse and mental disorders are leaving many in a lurch, and leaders in the medical and the substance abuse treatment community are calling for more support in the recovery community in Madison.

“We can create a culture and a society of people who are aware of what needs to be done in order to have health and wellbeing, but it takes a really concerted community effort,” said Amy Margulies, a senior counselor with UW-Madison's University Health Services. “The vast majority of people who deal with anxiety, depression and substance abuse go to the physician before they'll ever go to a mental health provider. We need to be able to address those issues, and not just say to our physicians, 'hurry up.'”

As mental health becomes a priority, groups around Madison are looking to mitigate the misinformation surrounding addiction and to address substance abuse issues with multi-faceted responses. “Holistic” approaches, or treatment options that take outside factors like stress and psychological resilience into account, “can help the body cope better, heal more quickly and maintain health,” according to Lucy Waletzky and Marsha Handel of the American Holistic Health Association.

“Many programs are put together with only AODA certification,” said Norman Briggs, Director of AODA Services at ARC Community Services. “We're certified to treat both mental health and substance abuse. Holistic approaches to recovery may be in short supply, but they are critical to communities' long term success in the struggle against drug abuse.”

Addiction is a disease that manifests itself in many different ways, and holistic treatment allows clinicians to handle each patient as a person, rather than a collection of symptoms.

“It's pretty unlikely that someone is only going to be struggling with substance abuse,” Margulies said. "We look at the whole person and try to figure out what's going to be the best thing for them. Often someone will come in to address anxiety and depression, and we discover that underneath there's a pattern of substance abuse.”

Today, complementary and alternative medicine, or CAM, is being used in different ways all over the city. UHS uses a system of integrated counseling that allows mental health and medical analyses to be administered side by side. Connections Counseling has meditative counseling groups and supportive mentor groups.

“99 percent of the people we work with have a severe history of sexual and emotional abuse. We try to get them in the door first and then deal with all of their issues,” Briggs said. “We’re going to have to be increasingly efficient with co-occurring mental and substance issues, and we're going to have to look at addiction holistically. All agencies ought to be offering more services for the person as a whole.”

Regardless of the strategy, holistic approaches to substance abuse treatment are concerted, long-term efforts that need community support. A patient's recovery isn't just physical, it's also emotional and economic. Relapse rates for patients in recovery are high, falling between 40 and 60 percent according to the National Institute on Drug Abuse.

Those rates decline drastically after one or two years of sobriety. If someone is able to address their physical and emotional issues but can't find a job or a safe place to live, they will be at risk of relapse. With the right community support for the first few years of recovery treatment, patients have a better chance of staying healthy and sober.

“Recovery is not something that's an easy fix. It's something you have to keep an eye on and work on,” ARC Program Manager Laura Fabick said. “A lot of areas that women can afford (to live in) are in really bad, drug infested neighborhoods. We also need employers that are willing to work with women in recovery with families and high needs.”

These challenges mean that true, sustained substance abuse treatment and success has to come from a community level. The stigma surrounding substance abuse, and a lack of understanding of the disease of addiction.

Changing the discussion on substance abuse will not be easy. It will involve destigmatizing the struggle against substance abuse and a greater public understanding of the disease of addiction. But with a flourishing medical community, a growing arts scene and access to an array of stunning natural escapes like the UW-Madison Arboretum, Madison is well placed to develop a thriving recovery community.

“I wish I could say that there's been a notable shift in culture,” Margulies said. “There are some standards that have been recognized nationally that really make a difference. This is where we define who we are as a culture.”