Allopathy, recovery and rehabilitation

As a historian cum anthropologist cum criminologist, it will come as little surprise that I am drawn to historical perspectives of the development of behaviours, cultures, norms, attitudes, practices and policies as much as I am to the behaviour, culture, norm, attitude, practice or policy, itself. The journey to the endpoint is almost always a fascinating combination of factors that are wholly revealing about why we – as a society – are in the predicament we are, especially when we investigate issues of addiction and recovery or crime and rehabilitation; the focus of this blog.

Notwithstanding the range of important events and developments that have had a significant impact on these areas, lately I’ve been interested in how allopathy and allopathic models have shaped, and continue to shape, the conventional wisdom that underpins how we think about and address addiction and recovery and crime and rehabilitation. This is something that John McKnight looks at in The Careless Society in relation to ‘rehabilitation services’ and which, although the language is different, Bruce Alexander points to in The Globalization of Addiction.

Allopathic medicine emerged as the primary Western medical model in the mid to late nineteenth century as scientific progress gathered pace and produced a number of vaccines for particular diseases. Its basic premise, as McKnight points out, is that ‘the malady is in the person and the cure is achieved by professional intrusion into that person’; that the problem is within the person and needs to be treated by an expert, with medicine and / or some kind of treatment.

This ideology was a comfortable bed-fellow of the prevailing social, cultural and political interests that defined the ‘late-modern’ era, with politically charged drives for greater individual responsibility and a smaller state towards a globalised free-market economy. And it is this ideology that has led us for so long, to look to professionals, services and systems for a cure or a solution to what are now, politically charged issues of crime and addiction.

But times are a-changing and the conventional wisdom no longer fits as comfortably as it once did. There isn’t the money to be pumped into systems – which are ultimately failing – to keep them afloat. And the importance of strong positive networks in vibrant communities is once again at fore of almost every agenda, from tackling poverty to mental health, addiction and recovery and crime and rehabilitation.

The challenge is that, whether you’re looking at addiction and recovery or crime and rehabilitation, we are all still struggling as ‘allopathic captives’ and even as our understanding about what works develops, we will find it difficult to move beyond the deeply entrenched systems or the false dichotomies (e.g. is addiction a ‘medical’ or ‘criminal’ problem; are people who commit crime ‘out of control’ or ‘acting of their own free will’ etc. etc.) that are ‘irresolvable debates that dissipate intellectual energy, hindering progress towards the paradigm shift that is needed’.

‘Despite the increased focus on recovery in recent years, the evidence remains patchy around what works best, at what points and for who. Combined with this, addiction is still largely considered and treated as a health and criminal issue with allopathic responses seen as the primary solution. Even with the broad understanding of recovery as a social process, this places the fundamental challenge on the individual’s shoulders, focussing on a ‘malady within’ and seeks to bring ‘recovery capital’ to bear in mending the problem. It does little to identify and address the deeply entrenched socio-economic and political conditions that may have led to the substance use in the first place.’ An extract from our new Recovery & ABCD Training Brochure

What we need is something transformational that can navigate the limitations of the allopathic ideology and its consequences. We believe ABCD offers just that. Since the beginning of the year we have been developing a training package* for those involved in the recovery sector, in particular, who are interested in finding out what ABCD could do in their neighbourhoods, for all those affected by addiction and recovery in their communities and through the services on offer. We want to help to build a strong evidence base about what can be achieved together through ABCD and be part of the movement that shifts us all away from a careless and dislocated society.

*Training packages will shortly be available for those interested in Policing, Prisons, and the wider Criminal Justice System.

Download the Recovery & ABCD Training Brochure.

Rebecca Daddow