Sweeping social change often begins as a ripple in quiet places: conversations around the kitchen table, in church basements, on school campuses, and the like. For the recovery movement, conversations between concerned family members, teachers, rehab counselors, emergency medical technicians and street medics, and many others who are part of recovery community organizations are helping undertake a massive shift in the perception of addiction in the U.S.
Recovery community organizations (RCOs) are independent, non-profit organizations led and governed by representatives of communities of recovery. RCOs organize recovery-focused activities, carry out recovery-focused community education and outreach programs, and/or provide recovery support services.
As people who work with RCOs, we have seen firsthand how these organizations are the main drivers of the recovery movement yet rarely get credit — or funding — for the work they do. To heal families and communities from the devastating impact of addiction, federal and state governments need to support people who have been on the front lines of the addiction epidemic and the kind of meaningful mutual aid they provide that has been saving lives for years.
RCOs stop overdose deaths
The U.S. is finally coming to understand the depths of long-standing addiction that has only worsened during the Covid-19 pandemic. Overdose deaths accounted for more than 100,000 lives lost in 2020. Mental health issues, including addiction, continue to worsen as people cope with unprecedented levels of instability, illness, unemployment, and isolation.
While addiction is a costly challenge in resources and lives, 85% of people who reach five years of recovery remain that way for the rest of their lives. That’s why the recovery community has been quietly working to move recovery out of the shadows and into the public eye.
The focus of these organizations on long-term recovery, building relationships, and empowering people by offering resources nestled within the community is a dramatic departure from treatment models that use 30-day rehabs, incarceration, or three-strikes rules.
In these mutual aid networks, people with lived experience in recovery are valued leaders. Community care helps shift demand from overburdened professional services to community-initiated care. Unlike government-funded grant programs, RCOs offer unlimited care. They look at long-term results like sustained recovery and offer recovery community-based programming to provide innovative services that aim to keep people safe and healthy over time.
Finding funding for these programs is a perpetual challenge. The Substance Abuse Prevention and Treatment Block Grant (SABG) program is the funding foundation of states’ substance abuse prevention and treatment systems, accounting for treatment for 1.5 million Americans. These block grants are based on a congressionally mandated formula administered by the federal Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Prevention and Center for Substance Abuse Treatment. Yet this grant shuts out recovery community organizations when it should be putting them first.
Although state governments pour tens of millions of dollars every year into mental health service programs, RCOs and recovery support receive only a small fraction of this funding. Essential supports provided by RCOs, such as housing, peer support, employment services, legal aid, enforcement of mental health parity with insurance companies, and on-demand treatment needs get overlooked even though addiction is a mental health disorder.
Every dollar spent on recovery services frees up $7 in government budgets. Yet leaders are more willing to invest in overpolicing marginalized communities and beefing up the criminal justice system than they are in investing in recovery services. The result is more sick people, more overdose deaths, more fractured communities, and more need than ever for recovery community organizations.
RCOs deserve better than bake sales
Funding for recovery community organizations is a patchwork affair. There has never been an established, stable funding mechanism to support them. Some are funded through time-limited grants, some through block grants to the states, and others rely on grassroots funding drives.
Recovery community organizations are the first groups to help individuals struggling with addiction, but the last to receive funding that translates into healthier communities. They are a huge part of the solution, but can accomplish only so much with self-funding.
Until these organizations are treated with the same respect as other mental health resources, and funded in proportion to their results, overdose deaths will continue to rise. Their reach will remain limited, as will their ability to hire peer workers with lived experience to help people sustain their recovery and enrich their communities.
Leaders and elected officials must think beyond in-patient treatment or detox centers and create policies that support recovery community organizations, whose work is part of the sea change transforming the way Americans think about recovery. When given the proper tools, they can also help heal communities fractured by addiction and those in which addiction runs stealthily below the surface.
Instead of competing for grants or spending precious resources fundraising, recovery community organizations should be supported by permanent, guaranteed funding. One way to do this is for Congress to mandate that 10% of block grants be reserved for RCOs so they can continue to do their essential work. Better data collection and analysis are also needed to determine the effectiveness of money spent on recovery programs and improve outcomes. Too much money is wasted on resources that aren’t accessible to people who need help, that don’t include the needs of marginalized communities, or that are limited to treatment and prevention but offer nothing for sustaining recovery.
On shoestring budgets, much of which they raise themselves, recovery community organizations have transformed the way recovery is approached in the U.S. But they need more than grassroots fundraising like bake sales and GoFundMe campaigns to sustain the vital work they do.