Disruptive innovation, a term coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.
The worlds of addiction treatment and recovery mutual aid are on the brink of being radically disrupted and transformed. New recovery support institutions and bold innovations in how, when, and where recovery supports are delivered will pose unprecedented threats and opportunities for established players within the treatment and mutual aid arenas.
Making predictions about the future is fraught with considerable peril. Sensible people refrain from such folly to avoid making fools of themselves, but carefully reading one's environment and projecting how emerging trends may coalesce to revolutionize or displace existing industries can be helpful in making sense of the present and shaping an otherwise unknowable and threatening future.
With full awareness of such perils and benefits, below are the first five of ten predictions about the future of addiction recovery support in the United States offered by two self-confessed recovery nerds.
1. Transformative innovations in recovery support will encompass high and low tech platforms and a dramatically broadened menu of products, services, and support activities.
Small scale innovations in recovery support will be integrated into larger more sophisticated platforms whose content and import will increase exponentially as the market grows. Such market growth will be influenced by a greater focus on low and moderate levels of alcohol and other drug (AOD) problem severity, growing recognition and perceived legitimacy of multiple pathways and styles of long-term recovery, recovery across the life cycle, and increased attention to family recovery (including the healing of those who have lost someone to addiction).
2. An ecumenical culture of recovery will spread through new recovery support institutions. People who once framed their identities in terms of affiliation with a recovery mutual aid society (e.g., as a member, of AA, NA, CA, WFS, SOS, SMART Recovery, LifeRing, Celebrate Recovery, etc.) will increasingly embrace a larger identity (e.g., as a person in long-term recovery). People who once experienced but no longer experience a significant problem with alcohol and/or other drugs who in the past had not embraced a recovery identity will increasingly see themselves within this recovery rubric, as recovery without mutual aid or professional treatment involvement is recognized as a common and legitimate recovery pathway.
The emergence of this larger recovery identity will allow people representing diverse pathways and styles of AOD problem resolution to see themselves as "a people" with shared needs, interests, and aspirations. This will fuel expansion of a culture of recovery with its own eclectic history, language, values, symbols, rituals, literature, art, and social institutions. The current expansion of recovery support institutions will continue to grow exponentially (recovery community organizations, recovery community centers, recovery celebration and advocacy events, recovery residences, recovery high schools and collegiate recovery programs, recovery industries, recovery ministries, recovery cafes, recovery-focused music venues, recovery-focused athletic activities, etc.). As recovery becomes a more visible lifestyle, new products and service institutions will rise to support that lifestyle.
3. Addiction treatment as a professional and business endeavor will face intensified challenges to its legitimacy as a cultural institution, due in great part to its own excesses, e.g., misrepresentation of outcomes and other unethical marketing practices, problems of accessibility and affordability, low rates of treatment completion and high recidivism rates, expos's of fraud and patient exploitation, etc. Such challenges will open opportunities for new approaches to addiction treatment and recovery support. Without radical changes in the acute care model of addiction treatment, existing and new peer-based recovery support institutions will move from adjuncts (superficial appendages) of addiction treatment to fully-developed alternatives to professionally-directed addiction treatment.
4. Responding to this crisis, addiction treatment institutions will attempt to colonize new recovery support competitors and will pioneer new service menus and new technologies of service delivery. A day is coming when going through a fixed "treatment program" will be replaced by an ever-expanding menu of clinical and recovery support options that will be uniquely combined and sequenced for each individual/family seeking help. A day is rapidly approaching when "going to treatment" as a physical place will give way to "treatment without walls"--addiction medicine, addiction counseling, and linked recovery support services delivered within one's natural environment through one's watch, cell phone, television, computer, notebook, or other devices not yet conceived. Electronic technologies will be married to advances in artificial intelligence creating androids that listen and learn about their hosts and tailor recovery support responses to fit their unique needs. The Siris and Alexas of tomorrow will offer AI-facilitated recovery guidance.
The current limited use of electronic technologies for marketing and continuing care will expand to include delivery of a full spectrum of e-treatment and e-recovery support services. This will be spawned in part by the parallel growth of e-medicine and e-therapy within allied fields of service. Small online and home service Ma and pa? recovery support shops will expand and compete to become theAmazon of recovery support services.
5. Formal membership in 12-Step groups (as measured by membership surveys) will slowly decline but rate of attrition in groups such as AA will be offset by attraction of new members through non-traditional routes of entrance and the growing secular and religious wings of AA.
Twelve-Step influence will grow culturally even as its membership numbers decline due to non-traditional styles of using AA principles and practices (e.g., use of literature, Steps, service activities, etc. without meeting attendance or formal sponsorship). Secular and religious alternatives to 12-Step groups will grow, even as the boundaries between secular, religious, and spiritual frameworks of recovery become increasingly blurred and dual citizenship in recovery and ecumenical recovery support groups (e.g., All Recovery) become increasingly common.
The responding fundamentalist movements rising in response to these trends will not reverse the long-term momentum of these changes. Twelve-Step recovery will move culturally from THE pathway of recovery support to one of many pathways, while remaining the most established pathway of recovery initiation and maintenance in the U.S.
Coming Next: Five more predictions and a sampling of websites, social media accounts, apps, and online mutual aid societies that point to this brave new future.