Building a Science of Recovery: The Pinnacle ATTC Achievement?

November 6, 2018

Mike Flaherty, PhD
Founder, Institute for Research, Education, and Training in the Addictions
Former Director, Northeast ATTC

In 25 years of service to our nation, providers, and the public, the Addiction Technology Transfer Center Network (ATTC) has achieved many accomplishments capable of being referred to as its “pinnacle” achievement. Indeed, reaching 25 years itself via SAMHSA support and guidance as a “model” to bring science into adopted practice, while building workforce development, advancing innovation in prevention and more recently mental health could each be peak accomplishments. The ATTCs, regional beacons of “what works” taken to those who “need to know”and “can do something with it” are without parallel in any other nation of the world. Universities and institutions of higher learning would do well to emulate them.

The ATTC Network Role in Recovery

By braiding scientific understanding of the illness with the proven recovery and wellness experience, science advanced.  

As the 20th century was coming to an end, addiction was treated systemically as an acute, self-inflicted illness with a limited number of covered treatment episodes—or in jail—or on your own. In 2001, the Institute of Medicine (IOM) resolved “the American health care delivery system is in need of fundamental change” and that under-addressing chronic illness was both the major cost and life shortening. Experts in addiction (McLellan et al., 2000; White et al., 2002) were quick to add that in lieu of the existing acute care model, addiction was best understood and treated as a chronic illness.

 The ATTCs collectively studied this message (Flaherty et al., 2006) and while keeping best science firmly in mind, looked to learn from those in recovery as to how treatment (and prevention) should be updated and made more relevant to each person and community. The ATTCs conducted a qualitative analysis of their own perceptions and the concerns in each region. Amidst unique geographical responses, all agreed that considering those in recovery and their shared experience and knowledge was the path to ultimate knowledge adoption—and health. In that day’s ATTC meeting, Mary Beth Johnson, then head of the ATTC National Office, proclaimed with a tear in her eye, “those in recovery are being welcomed back into the tent.” The ATTC role in recovery was born. A paradigm shift occurred. Person-centered care was defined. Science evolved.

Advancing the Science of Treatment and Recovery 

Immediately all the ATTCs, with SAMHSA CSAT support, expanded their focus by adding to the dissemination of the science of the illness and best medical treatment of it, the many pathways of recovery and linkages to community supports that existed and that continue to emerge to enhance recovery, e.g., the peer workforce, building recovery capital, medication-assisted recovery, etc. By braiding scientific understanding of the illness with the proven recovery and wellness experience, science advanced. One giving the best knowledge of the illness and its treatment; the other the personal and community practices that helped to prevent the illness or attain recovery from it.

Mike Flaherty, Lonnetta Albright, and Bill White

Nine translational science topical monographs soon followed under the leadership of the Great Lakes ATTC, Northeast ATTC, Philadelphia Department of Behavioral disAbility and William White, and other recovery leaders. Recovery focused treatment guidelines followed from Connecticut, Philadelphia, Pittsburgh and the American Society of Addiction Medicine (ASAM). An ATTC recovery bibliography located 300 existing studies and books worldwide on recovery. Conferences were facilitated in Chicago, Philadelphia—and eventually 45 states!

Repositories for this information and its emerging science were developed by William White (www.williamwhitepapers.com), John Kelly (www.RecoveryAnswers.org) at Harvard, and SAMHSA (www.samhsa.gov/recovery). To anchor this course, earlier visionary work (e.g., DeLeon, Kurtz, White, Moos, Valliant, et al.) was linked to a first ever and still evolving definition of recovery.

Science evolved. Illness built its recovery. The ATTCs, by creating this tipping point, found their pinnacle moment – to date.


References

Institute of Medicine. (2001) Crossing the Quality Chasm: A New Health System for the 21stCentury. Washington, D.C.: National Academy Press

Flaherty, M.T. (2006). Special Report: A Unified Vision for the Prevention and Management of Substance Use Disorders: Building resiliency, wellness and recovery – A shift from an Acute Care to a sustained care recovery management model. National consensus statement compiled by Institute for Research, Education and Training in the Addictions and Northeast Addiction Technology Center. Pittsburgh, Pa.

McLellan AT, Lewis, DC, O’Brien CP, Kleber HD, (2000) Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284:1689-95.

White W, Boyle M. & Loveland D. (2002). Alcoholism/Addiction as a Chronic Disease: From rhetoric to clinical reality, Alcoholism Treatment Quarterly, 20(?3/4), 107-30.v


About our Guest Blogger

Dr. Flaherty is a clinical psychologist with more than 30 years experience in the prevention, intervention, treatment, research and policy development related to substance use, addiction and recovery. Prior to founding the Institute for Research, Education and Training in the Addictions in 1999 and becoming the Principle Investigator of its SAMHSA/CSAT funded Northeast ATTC, Dr. Flaherty was the Vice President of the St. Francis Health System and Director of its Institute for Psychiatry and Addiction Services, the then largest such facility in Pennsylvania. He has authored and overseen over 20 Federal and Foundational grants, more than 50 articles and books on topics ranging from pregnancy and addiction to the chronic disease understanding of addiction; how prevention is the cornerstone of wellness and recovery; and the need for a unified vision for prevention/intervention/ treatment, wellness and recovery in America. He regularly consults on the central role of prevention, wellness and recovery in addressing substance use. While currently dedicating himself to clinical practice he still leads key projects, prepares clinical monographs and researches the importance of understanding further the components of personal recovery. Dr. Flaherty is also committed to translating this knowledge into building a better work force through the building of skilled workers at all levels and in all disciplines addressing the prevention and treatment of substance use.