Since getting sober 18 years ago, Tracey Helton Mitchell has had a miscarriage, mourned the loss of both parents and discovered that her cat is dying of cancer. But that is nowhere close to the problems she had when she was using drugs. Her experience as a heroin addict is chronicled in her new book The Big Fix and details several of her “rock bottoms” such as living in alleyways, selling her body for drugs, to shooting up in the soles of her feet in a broken down motel. Today, Mitchell is a married mother of three and runs a peer-based mental health program that helps individuals re-enter the workforce and, having spent an extensive amount of time in the system, has plenty to say about the recovery industry.
We spoke to her about the direction that treatment should be headed. Here are 5 things Mitchell believes should change in the way we’re approaching recovery today.
1. Offer more options.
It’s no news that much of treatment offered today is based around the 12-step model. Though Mitchell is in abstinence-based recovery herself, she believes that we need to expand our options. “I think that when you think of the treatment system right now, it kind of has a one-size-fits-all approach,” she says. “And what we want to look for is people having a variety of choices.” The opportunities are far and wide, according to Mitchell. “There’s Life Ring, there’s SMART recovery, there’s seeing a therapist, there’s spirituality if that’s what you’re into, there’s meditation. Just having one alternative doesn’t necessarily make for a good treatment outcome—and I don’t think that the rehab system should be afraid to try other stuff.”
2. Provide longer stays.
Things have changed quite a bit since Mitchell was in rehab 18 years ago. Back then, the average stay was 90 days to 6 months, but today she says a person is lucky if they can get 90 days. “There’s so much emphasis on whatever the insurance will pay for which is less and less,” she says. “You used to be able to just stay in rehab for an extended period of time until you get yourself together, but that’s not really an option for people anymore. That’s almost like the junkie unicorn—it doesn’t exist.” As far as 28-day rehabs? Mitchell says that people in her industry refer to them as “spin-dries” because of the repeated cycle of people that have to return again time after time.
3. Allow a smoother transition from rehab to sober living.
Lengthier stays at a rehab isn’t of much use if there’s no supportive period afterwards. “There used to be a transitional piece in rehab where at the very end, people would look for a job or they would return from work and still live in the rehab facility,” Mitchell says. “And a lot of that has gone out the window. So having some middle options where people can still continue to work but live in a rehab would be something that I would like to see brought back.” Mitchell recalls her own experience of working her first job after treatment. Being able to live at the rehab facility at the time was crucial to her recovery because it provided a safe place for her to talk to people through the process. Even though some people envision that space to be in sober living homes, she says that “there’s such a stark transition from rehab to sober living now that there’s no sort of soft landing anymore.”
4. Support people around relapse.
Mitchell credits San Francisco’s naloxone program in the late 90s as an important step towards addressing fatal overdoses. As mentioned in her interview on NPR’s Fresh Air with Terry Gross, she promptly states, “You can’t get clean if you’re dead.” She stands by a mechanism that can support people who aren’t necessarily able to be completely abstinent and believes that it should be a part of the alternatives offered by the government, sober living providers and rehabs. She says, “There’s a stopgap right now of at least 900,000 to 1 million people who are interested in getting some form of treatment but cannot.” Having an exit strategy after rehab and discussing harm reduction—instead of just allowing people to fall off a cliff when they leave—is one way she believes we can start rebooting the system.
5. Be transparent with the struggles of recovery.
Though things aren’t nearly as hard as they were when she was using, Mitchell by no means paints recovery as a rosy walk in the park. “I think the recovery community does a huge disservice by not presenting the real-life struggles that go on in recovery,” she says. “For instance, some people don’t even have that initial phase where they feel great—some people have struggles from the very beginning. And that’s okay.” Like any toxic relationship, breaking up for good can be a struggle and and often requires building yourself back from the ground up. These are things that take time and may, realistically, always be challenging. “Your extended adolescence using drugs doesn’t give you any kind of life tools of how you’re going to resolve issues [in life],” Mitchell says. “So that’s part of recovery—actually rebooting your life or just learning the tools to where drugs or alcohol are not an option.
You can purchase Tracey Helton Mitchell's book, The Big Fix: Hope After Heroin, today at Amazon and bookstores.