What is Lifespan Recovery Management?
In 2011, an article written by Dr. John Kelly and William White was published in a volume
titled “Addiction Recovery Management”. The title of the article was also a question:
Recovery Management: What if we Really Believed that Addiction is a Chronic Disease?”
The answer may be that we would be providing care for our patients over the course of a
lifetime. Hopefully, there would be long periods of stability that would require only
monitoring. However, symptoms of a chronic disease tend to recur. At those times,
interventions could be rapid and the intensity of the intervention would depend upon the
severity of the symptoms and the level of risk.
For clarity, as I refer to “symptoms” and “risk” I’m referring to those for a substance use
disorder (sud) as stated in the 2013 ASAM Criteria and in the DSM-5. What we have been
doing is treating a series of episodic occurrences as though one episode was totally
unrelated to the other. I frequently hear people in the process of recovery say something
like “I’ve been to treatment three times.” That perception is understandable. If a person
has been admitted on multiple occasions to residential treatment for substance use
disorders (suds) each treatment was likely to look the same, e.g. another 1st step, another
story, etc. There’s an assumption that a person needs to start from scratch.
Every time this happens shame accumulates.
Lifespan Recovery Management, on the other hand, treats a chronic substance use
disorder over the course of time. The intensity of care would always match the severity of
symptoms and the level of risk. The critical factor is that even when symptoms are
inactive, the disorder is monitored. The lowest level of care would be an annual recovery
check-up (White, 2014). Sounds a lot like any other chronic disorder, doesn’t it?
Initially, residential care is likely to make sense. As a culture we tend not to recognize the
severity of suds