What Happens When Addiction Counselors Relapse?
What Happens When Addiction Counselors Relapse?
AA began with “one alcoholic talking to another.” Bill W. at his darkest moment was only able to stay sober by talking with another drunk, Dr. Bob. The message is simple: if addicts want to stay clean, they must help others to sobriety.
That was 74 years ago, when AA was the only support available to most substance abusers. Since then, the recovery movement has become has become a billion-dollarvocation. These days, close to 100,000 people in the United States work in recovery-related jobs, earning their living as drug counselors, "techs" or social workers at hospital treatment programs or at thousands of rehabs across the country. In general, most people who enter the field of chemical dependency have some kind of personal connection with the problem—many have friends or family members who are or were addicts. But according to recent studies, well over 50 percent of the social workers, counselors, therapists, administrators and others who help addicts achieve sobriety were once addicts themselves—a strange twist on the famous Hunter S. Thompson quote, “When the going get weird, the weird turn pro.”
While this personal connection to their clients tends to mean addiction professionals are incredibly passionate and dedicated, there is a down side as well. It's no secret that many addicts, even those with significant sober time under their belts, relapse. And when addicts or alcoholics working in recovery stumble, the consequences are often more dire than for the pedestrian—that is, non-professional—drunk.
Addiction professionals often hide a slip for fear of losing their job or license, and thus their use can continue to escalate untreated.
John Leonard, the Director of Marketing at The Retreat, an exceptional, low-cost residential recovery program on Lake Minnetonka, relapsed over three years ago but shame still bubbles to the surface when he speaks of how he drank after he’d been sober for almost eight years and worked in the recovery field for five. His voice quiets. “You can go so far as to say the drugs and alcohol were God,” he admits.
Leonard was one of the lucky ones—he found sobriety again and after 40 days of therapy, was even able to get his old position back. But his experience, sadly, is the exception, as most addiction specialists do not get either back. Cynthia Moreno Tuohy, the Executive Director of the National Association of Alcoholism and Drug Abuse Counselors (NAADAC), puts a rather fine point on it. “We [chemical dependency professionals] do very well treating clients in general,” she says. “We don’t do so well for the professional in recovery. We tend to blame the victim—we say you have a disease but we are not recognizing that relapse is part of that disease cycle. Why would we not do for addiction counselors what we do for everyone else?”
Most graduate programs in chemical dependency require applicants to have significant time free—typically a year or two—from chemical use and in most states, licensing boards require similar amounts of clean time from professionals who are also in recovery. When a clinician relapses, they violate this condition of their licensure and typically lose that license in addition to being fired. The climb back to their pre-relapse lives tends to be steep.
While the damage to reputation may make some employers reticent about bringing back those who have relapsed, the much bigger concern is client safety—particularly those who are in the early days of recovery and heavily influenced by their recovery counselors. But it’s not just that a rehab tech or group leader could make a beer or snort look good or that clients may assume that treatment doesn’t work if even the counselors can’t even stay sober. The fact is that when people go back to toxic, selfish thinking, they may begin to cross boundaries as casually as if they were crossing streets. It’s doubtful that a specialist in the throws of his or her own addiction can keep a patients’ best interest always at the fore.
Judi Hanson, who is the Director of Community and Family Outreach at Sobriety High and has toiled for decades in the recovery field, remembers when one popular counselor at a facility where she worked relapsed. Without warning, the counselor came clean about his drinking in a group meeting setting. “That was pretty devastating to a lot of the clients,” Hanson recalls.
Chuck Rice, an attorney and instructor at a nationally recognized graduate school of addiction studies, said that typically patients aren’t told about staff relapses. “The counselor would just be gone.” While most treatment facilities have procedures in place to manage the fallout when one of their own relapses, human resource departments at both the Betty Ford Clinic and Hazelden were reticent to discuss the particulars beyond confidentiality concerns. The Retreat, which is an AA based program, deals with employee relapse much the way any AA group works to help their members. As John Leonard says, “Our policy is we believe treatment works and we believe in supporting people and so we take them back if they are successful.”
While relapse of a counselor or other addiction professional poses dangers to patients, the biggest threat is actually to the person who relapses. “Anecdotally, the recovery rate for people who work in the field that relapse is abysmal,” says Rice. Leonard, who drank for three months before “heading south,” says, “They were really tough on me and told me the outcomes were not good. We’ve had a number of clinicians and counselors come through The Retreat, and they’re difficult to work with because they tend to be in a lot of denial.”
Leonard understands this viscerally. “When I went back to treatment where I knew everyone, I felt I had lost credibility. My identity was wrapped up with my work and then that identity was shattered with lots of shame, confusion and everything around that.”
Yet perhaps the greatest challenge for those in Leonard’s situation is financial—addiction professionals often hide a slip for fear of losing their job or license, and thus their use can continue to escalate untreated. When friends, co-workers or others finally recognize what’s going on, the person is often far, far down the rabbit hole and therefore what might have been a simple slip for someone else has become a full blown crisis.
Many people who make their living in the recovery field complain that over time, it can become easy for professionals to blur the lines between the demands of personal recovery and the demands of their jobs. Given the relatively low success rates at many rehabs and treatment programs, burnout is a major issue. “When you work in the field,” says Leonard, “the last thing you want to do when you get off work is go to a meeting.” Furthermore, recovery professionals get used to being the one with the answers, the experience, and the credibility. It is easy to confuse the work they do, the sessions they attend and the group meetings they run with their own personal recovery programs.
Chuck Rice is upfront with his students about the special challenges facing a person in recovery who decides to make a career in chemical dependency. “I tell them that their job is not a substitute for a program of recovery.” Still, it is sometimes difficult for counselors who attend 12 step meetings since they will eventually find themselves sitting beside a current or past client. It is one thing to run or facilitate a group meeting for addicts, and another to be one of the members of a recovery group themselves. “I encourage them to consider what they will say when they bump into a client or past client in the rooms,” says Rice.
To combat all of this, Touhy strongly recommends that those who toil in the field have support programs outside the job. As a recovering addict who works as a chemical dependency professional, she’s a testament to the fact that this can work—and work well. “I am lucky because I am so accountable—people see me every day, often in evening meetings,” she says. “If I relapsed, someone would notice it right away.”
The irony is that the support and safety nets that exist for other professionals who fall victim to alcoholism and addiction does not really exist for people who work in the field. Most professional organizations and licensing boards have monitoring systems to help members deal with addiction issues. Health care professionals like pharmacists, doctors and nurses are monitored, so a chemical dependency issue would go to the monitoring board first and not to the licensing board. “Sobriety rates of monitored professionals exceeds 90%,” says Rice—a rate far above the average of the general population.