Medication Assisted Recovery: Advancing from Attitudes of Tolerance and Acceptance to Nurturance

For the majority of us involved in the recovery advocacy movement, the concept of accepting that there are multiple pathways to recovery is a familiar one. The idea that there are many roads to recovery has increasingly become more widely understood. We have come to recognize that often times the pathway we utilized in our own personal recovery journey may very well not be the same one that will work best for others. We have come to a greater awareness of the diversity of options an individual and their family seeking recovery has at their disposal. We have collectively come to a place of tolerance and acceptance regarding there not being one single “right way” to recover.

While widespread tolerance and acceptance of multiple pathways to recovery is great and was in itself once a lofty aspiration, the time has come for us to move beyond the zone of tolerance and acceptance and into the zone of nurturance. For guidance around what this means exactly, we can turn our attention to another social justice movement - the LGBTQ movement.

The “Riddle Scale” has long been used in the LGBTQ equality movement as an assessment tool to measure attitudes toward homosexuality. The scale offers a range of attitudes with the lowest of end of attitudes being “repulsion” and the highest end of attitudes being “nurturance.” While the scale refers to attitudes toward homosexuality, we can easily transfer its use from attitudes toward homosexuality to attitudes toward medication assisted recovery.

“Tolerance,” closer to the lower end of the Riddle Scale, is described as seeing homosexuality as “just a phase” that “many people go through and most people grow out of." For some of us, practicing tolerance of medication assisted recovery is often demonstrated by an attitude that medication ought to be used for a finite period of time with the goal of quickly tapering off in order to ‘truly be in recovery.” We are tolerant of the fact that medication is utilized by some people but still very much see it as “less-than” abstinence-based, medication-free recovery. While tolerance is far greater than repulsion, this is still extraordinarily far below the mark of where we ought to be.

“Acceptance,” while often used as a positive term in recovery, is actually closer to the lower end of the Riddle Scale as well. On this scale, the attitude of acceptance is described as “still implying there is something to accept” and ignoring “the pain of invisibility” as well as the “stress of being in the closet.” Furthermore, acceptance fails to “acknowledge that another’s identity may be of the same value as their own.” When we apply this description of acceptance to the attitude toward medication assisted recovery, I am certain that an honest self-assessment would yield that many of us still dwell in the land of acceptance. We fail to affirm the stigma and challenges associated with utilizing medication assisted recovery, and we certainly still fall short of affirming this style of recovery as just as valid as abstinence-based, medication-free recovery.

“Nurturance”, on the other hand, at the highest end of attitudes on the Riddle Scale, is described as seeing individuals as “an indispensable part of society.” Past the attitudes of tolerance, acceptance, support, admiration and appreciation, nurturance is an attitude that embraces the extraordinary value of the individual. When we think of the evidence-based fact that medication assisted recovery saves lives, and if we view each individual life as an indispensable part of society, it is quite feasible that we can all move to an attitude of nurturance regarding medication assisted recovery.

The next evolution of the recovery advocacy movement requires us all moving to this attitude of nurturance. Tolerance and acceptance of multiple pathways to recovery has served us well, but the time has come for us to truly see each possible pathway as equally indispensable to allowing opportunities for wellness and recovery. Rather than tolerating and accepting medication assisted recovery, we must actively practice an attitude of nurturance and see it as an indispensable tool for indispensable lives.

Originally posted on Faces & Voices of Recovery’s RecoveryBlog. Faces & Voices of Recovery is dedicated to organizing and mobilizing the over 23 million Americans in recovery from addiction to alcohol and other drugs, our families, friends and allies into recovery community organizations and networks, to promote the right and resources to recover through advocacy, education and demonstrating the power and proof of long-term recovery.

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