It Takes A Village

A Practical Guide to Building Recovery Ready Communities

Healing a Village Q&A – Mark Lefebvre

What is the author’s inspiration?

The author is a person with lived experience in active addiction and works in the recovery field. When he was discharged from the behavioral health unit of Portsmouth Regional Hospital in 2012, there were very few resources in New Hampshire to assist in his recovery journey. Today, the state offers a wide range prevention, treatment, and recovery resources. His work to help raise the recovery capacity within his community inspired this book.

What was the author’s writing process and research?

The author has interwoven his own candid personal experiences in active addiction and recovery work throughout the book as examples of addiction being a community disease. He researched and has referenced hundreds of articles and books on the topic, and conducted interviews with leading authors, academic experts, family members and professional colleagues.

What are the book’s themes and messages?

The book’s overarching theme is about hope for individuals, families, and communities that there IS a solution to addiction at the community level. Since this book is a blueprint on how to build a Recovery Ready Community, communities do not need to start from scratch. The case studies and examples allow the reader to benefit from other community efforts.

What challenges did the author face?

The biggest challenge facing the author was knowing when to stop researching and begin writing. The arc of the narrative became evident early in the process given his lived and professional experience. However, the subject matter is vast, and the risk was to get lost in the research.

The author purposely avoided writing an academic narrative. There are countless other books written by authors with a lot of professional letters after their name. Rather, the author sought to make this book personal and relatable. And most importantly, useful.

What is the author’s personal connection to the subject matter?

The content of this book is deeply personal for the author being in recovery for nearly 13 years at the publishing date following over 40 years of active addiction. His recovery experience is also personal as he and his wife Vivian are co-founders of Safe Harbor Recovery Center in Portsmouth. He previously has served on then Govern Chris Sununu’s Recovery Task Force, and as New Hampshire’s statewide director of the NH Works for Recovery program. He brought the Recovery Friendly Workplace initiative to the state of Maine. He led the Greater Portsmouth Recovery Community coalition during its first 3 years of operation and has consulted with several communities in Maine in their efforts to bring recovery to their communities. He has produced nearly 50 podcast episodes on subject of addiction and recovery.

What is this book about?

This book is about hope. There are solutions to address addiction at the community level. This book provides a systematic and practical guide to becoming a Recovery Ready Community. It provides evidence-based information on the science of addiction and its roots in childhood trauma. Referencing examples such as the Greater Portsmouth Recovery Coalition (New Hampshire), Strafford County Addiction Task Force (New Hampshire), Lewiston-Auburn Area Recovery Collaborative (Maine), and other community coalitions, readers will learn how to build a community coalition, sustain the coalition over the long term, and deliver outcomes that benefit individuals, families, and communities alike.

What is a Recovery Ready Community?

Well, it depends. there cannot be a single numerical standard for designating a community as “recovery ready.” Yes, there are common elements of what constitutes a so-called Recovery Ready Community, but there are also many variables including community culture, government structure, socioeconomic status, diversity (or lack thereof), geographical location, and many other nuances that define a community’s identity.

Recovery readiness to a large extent, is what a community says it is. Recovery readiness is what that community decides for itself in the form of a common vision and measurable outcomes. Recovery readiness is about the journey, not the destination. Communities that are self-aware, that are working on community issues, and that are bringing different stakeholders together to address the impact of addiction in their community may be sufficient for that community’s level of readiness.

For whom is this book written?

The book is intended for community leaders from all sectors, service providers, community-based organizations, academic institutions, individuals, and families. From this book, readers will understand the challenges facing communities across the United States in addressing the local impact of the epidemic of drug abuse, including public safety, public health, the local economy, and the social fabric that makes up the identity of the community.

Why now?

In a word, urgency. Lefebvre was fortunate as his cycle of addiction occurred before fentanyl and its deadly derivatives became readily available and occupied a ubiquitous presence in today’s illicit drug supply. According to the New York Times, nearly 110,000 Americans died in 2022 of drug overdoses, “representing a plateau after two years of sharp increases.” Overdose deaths had climbed by 30 percent in 2020 and 17 percent in 2020, according to the Times.

The good news is that recovery is working. The CDC reported a nearly 24% decline in drug overdose deaths from October 2023 to September 2024. Provisional data shows about 87,000 drug overdose deaths that period, down from around 114,000 the previous year which means that 27,000 American had another chance to be with their families and move forward with their lives. This is the fewest overdose deaths in any 12-month period since June 2020

What is addiction so misunderstood and stigmatized?

Sometimes people don’t know what they don’t know. Stigma can range from an innocent lack of understanding about the facts surrounding addiction to generations carrying the same stereotypes and tropes learned from our family. Education and conversation can address a lack of understanding. When the stigma of addiction impacts our rightful access to basic needs such as housing or employment, the prospects of a person in recovery maintaining that recovery over the long term are diminished. But when stigma impacts our children or other loved ones, it can create a crisis.

What is the impact of addiction on the family?

For every individual having a substance use disorder, several others including family members, friends, and fellow workers are also impacted. An individual’s substance use disorder sends ripples through families and communities, and ignoring these ripples can cause long-lasting consequences. Based on studies cited in this book, there are eight million children in the United States living in a household with at least one parent with a substance use disorder. The impact can include disrupted lives, problems in schools, trauma, and the potential accidental use of drugs in the home by children and family pets.

What is the impact of addiction on the community?

Substance use in the United States has had a devastating impact to the community, affecting public health (transmission of infectious diseases, discarded needles), public safety (crime, housing insecurity), and the local economy (absenteeism, disability). The opioid crisis in particular has put pressure on the healthcare system with overdoses, overdose reversals through naloxone administration, increased emergency room visits and EMS calls.

What is recovery?

SAMHSA (Substance Abuse and Mental Health Administration) defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. A recovery ready framework needs to address the entire continuum of care of prevention, harm reduction, treatment, and recovery support, including re-entry into the community.

What is a recovery continuum of care?

SAMHSA defines a Recovery-Oriented System of Care (ROSC) as a “coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families, and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems.

Why is a community approach to addiction so important?

Because addiction poses a public safety, public health, and economic threat to a community, the solution to address the impact of must come from within the community.

Why is it implementing a community coalition so difficult?

Barriers to implementing a community coalition to address addiction include stigma, a lack of common understanding of the problem, where to begin, denial that there is a SUD problem in the first place, the lack of funding, and the lack of coordination. For some coalitions that did get off the ground, they were not sustained due to lack of ongoing financial support over multiple years. Others have floundered because of the lack of decision makers participating in the coalition.

How has the author’s lived experience informed the book?

The author speaks as a person with lived experience, both as a person in long-term recovery from drug addiction and alcoholism, and as a professional in the recovery field. This experience informs the reader from both a recipient and provider of recovery services and offers a unique perspective from both.

Testimonials

“Well-written, full of practical advice and, most importantly, teeming with hope—Mark Lefebvre's "Healing a Village" is exactly the book to help the nation turn back its addiction crisis. It answers the toughest questions, the ones I most often get when I talk about the epidemic: What should I do to help my loved one? How can my community offer love and evidence-based care to those most in need?” - Beth Macy, author of Dopesick and Raising Lazarus.

"Healing from addiction begins at home in the community where connections are made, and we feel safe. Healing a Village offers a profound message of hope through community recovery. If you're looking for a blueprint on how to get there, then this book is for you." - Seth Kaplan, author of Fragile Neighborhoods.

“As communities try to address and heal from endemic addiction problems, well-meaning but siloed community stakeholder groups can be oblivious to the fact that they may actually be undermining each other’s best efforts or even worsening the problems they are hoping to solve. In Healing a Village, Mark Lefebvre, does us all a huge service by diagnosing the exact nature of these kinds of common problems creating and demonstrating the successful enactment of a treatment plan with “community as patient.” Integrating clinical and public health frameworks and concepts while documenting successful real-world implementation examples and lessons learned, Mr. Lefebvre has produced a book that is both a compelling story and a highly accessible instruction manual. Inspirational and motivational, it is a cue to action with the potential to foster more united and sustained coalitions to facilitate healing and enhanced community resilience.” -John F. Kelly, PhD, ABAP, Elizabeth R. Spallin Professor of psychiatry in Addiction Medicine, Harvard Medical School; Founder and Director, Recovery Research Institute and National Center for Youth Prevention, Treatment, and Recovery, Massachusetts General Hospital, Boston, USA.

“Lefebvre has produced an inspirational story of building recovery communities through drive, passion, and commitment to partnership. ‘Healing a village’ is a wonderful account of that journey that should motivate and drive others to follow in the footsteps. For many years now, we have recognized that recovery is a journey over time. As Mark Lefebvre illustrates in Healing a Village the same is true for communities where partnership, trust and commitment between key stakeholders are an essential component of building a Recovery Ready Community. In essence, what Lefebvre describes is the process of transforming communities to create the conditions that maximizes the likelihood of personal change. The learning set out in the book provides a roadmap for building partnerships and alliances based on hope and shared belief that will pave the way for community transformation across the US and beyond. This book captures the ‘essential elements’ of building a Recovery Ready Community full of insight and inspiration” - Professor David Best, BA, MSc, PhD; Director, Centre for Addiction Recovery Research (CARR), Leeds Trinity University

“Whether you are a government leader, healthcare provider, or community advocate, this book will provide you with the insights you need to bring recovery-ready principles to life in your own community. As Lefebvre’s work has shown us, when we build a coalition that centers on dignity and support, we are not just healing individuals—we are healing the entire village.” - Deaglan McEachern, Mayor of the City of Portsmouth

“Healing a Village is a must read for anyone wishing to help a loved one struggling with substance use disorder or hoping to help heal their community and by doing so help repair their state and nation. Only a person with lived experience who in recovery spent decades in this work could prepare such a comprehensive step-by-step manual. I thoroughly enjoyed every page of this book.” - Gordon Smith, J.D., Director of Opioid Response, State of Maine

“Healing A Village is a guide for our times! Through relatable stories and an accessible integration of the science and process of community building, Mark Lefebvre inspires and provides a roadmap for on the ground leaders to spark action and the healing of our society one individual, neighborhood, and city at a time. Inspiring, hopeful, and practical, this guide will fast-track leaders at all levels to build recovery ready communities and restore out innate capacity to heal and thrive through difficult times.“ – Dr. Christina Bethell, PhD, MBA, MPH Professor, Johns Hopkins University

“Mark Lefebvre’s book, Healing a Village: A Practical Guide to Building Recovery Ready Communities, is essential reading for local and state decisionmakers across the country who are looking for ways to address the consequences of addiction on their communities. Healing a Village is a how-to guide that provides practical steps communities can take based on proven coalition strategies, recovery research, and lived experience to improve not only the lives of people in recovery, but the life of the whole community. The book addresses underlying causes of addiction and includes detailed descriptions of programs and interventions in the areas of prevention, treatment, and recovery supports. Following the steps laid out in this book, communities can move from being recovery deserts to areas rich in recovery capital. Healing a Village fills a gap in the literature by drawing on examples of community actions in rural areas, small towns, and cities, as well as strategies for supporting recovery in the workplace. Healing a Village is a welcome addition to our knowledge of recovery by getting at the heart of addiction as a community disease and recovery as a journey everyone in the community takes together to create a healing space.” – Alison Jones Webb, author of Recovery Allies

“Substance use disorder is a chronic disorder that is too often mismatched with acute, abstinence-only treatment. The resulting treatment gap drives the more than 100,000 annual overdose fatalities in the US. There is a critical need for more extensive, inclusive models of care, such as Recovery Ready Communities. In Healing a Village: A Practical Guide to Building Recovery Ready Communities, Lefebvre combines lived experiences with the latest scientific understanding of addiction and recovery to highlight meaningful opportunities for communities to address substance use disorder. Indeed, as Lefebvre writes, this book is about hope.” - Alex Elswick, PhD Assistant Extension Professor Substance Use Prevention & Recovery. University of Kentucky

“As a 36 year veteran of law enforcement and a public safety career spanning more than four decades I am so excited and relieved to see Healing A Village become available as a guide for communities to come together to save lives. This is also personal for me as I am an affected other, with three adult children who have had their struggles with substance use disorder. It not only takes a village to raise a child, it takes a village to save lives. Lefebvre has thoughtfully and strategically put all the pieces in place for community success in order to give our loved ones the best chance to recover by way of Healing a Village.” – Chief Robert MacKenzie, Kennebunk (ME) Chief of Police.

“This comprehensive guide provides a practical blueprint for any group seeking to build a Recovery Ready Community to address addiction at a local level. Drawing from his personal experience in both recovery and his professional work developing coalitions, Mark Lefebvre presents a clear-eyed view of the human impact of addiction and an evidence-based approach for community response. The book expertly weaves together the science of addiction, trauma-informed care principles, and proven strategies for building sustainable community coalitions. Using the Greater Portsmouth Recovery Coalition as a detailed case study, Lefebvre ably demonstrates how communities can coordinate prevention, treatment, and recovery support services while breaking down silos between stakeholders. He addresses common barriers to implementation and provides concrete solutions for everything from coalition building to measuring outcomes. What sets this book apart is its emphasis on meeting communities where they are - acknowledging that there's no one-size-fits-all approach to becoming "recovery ready." Written with both compassion and pragmatism, this guide offers actionable insights for community leaders, healthcare providers, and anyone working to build local capacity for addiction recovery services.” - Alan Gold, Co-founder, Greater Portsmouth Recovery Coalition, President, Pinetree Institute Board of Trustees

“Healing a Village” lays out an easy-to-follow guide for building various components in a community to address the substance use crisis from a multitude of angles. When considering how to make your community “recovery ready,” skip the ocean that is the Internet, and start at the thoughtfully curated “lake” that is Mark Lefebvre’s Healing a Village.” – Eliza Zarka, Director National Recovery Friendly Workplace Institute

“This important book offers a clear guide to a community in recovery. This important book offers a clear guide to a community in recovery. Substance use is a disease of isolation and treatment requires human connection. Working from the inside out, recovery is an individual journey dependent on ever widening circles of community. Mark has eloquently applied those same principals to the healing of a community, building from the inside out. We are all in this together, no exceptions.” – Margo Walsh, Founder, MaineWorks.

"Since 2018 Pinetree Institute has been engaged in developing trauma-responsive solutions to pressing social needs. One major focus of that work has been community-based approaches to addressing addiction and recovery. Mark Lefebvre has been an integral part of that work. He has brought his leadership skills, community networking capacity and his own personal lived experience with recovery to bear on engaging communities to address these issues. We are very excited that he has been able to document this work in this clear and compelling narrative. We share with Lefebvre the deep hope that this book can serve as a guide to individuals, organizations and community leaders who wish to expand on this work and create robust recovery ready communities in their own localities. Thank you Mark for laying out a roadmap that we hope many communities can follow" - Larry McCullough, Ed.D., Executive Director, Pinetree Institute

“Mark, Lefebvre’s Healing a Recovery Village, A Practical Guide to Building Recovery Communities is a timely publication with real world useful resources to building recovery capital at the community level. Healing from substance use conditions is a whole community process as highlighted throughout. This is a must-read book for groups working to establish communities of hope, purpose, and connection.” – William Stauffer, Executive Director, Pennsylvania Recovery Organization Alliance

In Healing a Village, Mark Lefebvre delivers an impactful message on building recovery capital in our communities by blending hands-on experience, evidence-based practices, and his own lived experience. “More than a guide, it sets a benchmark for reducing stigma, coordinating resources, and engaging stakeholders to foster a supportive environment where municipalities and their constituents can tackle addiction with empathy and collaboration.” – David Martinak, Recovery Friendly Workplace of New Jersey

“Healing A Village: A Practical Guide to Building Recovery-Ready Communities delivers just what is promised in a relatable, simple to understand fashion. Examples from communities that have undertaken this set of challenges help to illustrate the author’s ideas and suggestions, but Mark bravely goes one step further: he identifies challenges and threats to development and implementation that can arise to help organizers see a complete picture. Often guidebooks may ignore the difficult realities to sell a specific idea or model, but he paints a complete picture of process. If you work in any facet of this field, from prevention to harm reduction, from treatment to recovery support, from client services to administration, this is a must read!” – Jeffrey Quamme, CEO, Connecticut Certification Board.

“Mark Lefebvre provides an amazingly comprehensive, detailed, practical, and easy-to-read overview of the contemporary substance use disorder problem in the USA. And in doing so he outlines methods for developing and actively sustaining community-level solutions. I can strongly recommend this book to anyone desiring to build, support, and guide community collaborations as a resource for, and response to, serious substance use problems. Brian Coon, MA, LCAS, CCS, MAC, Chief Clinical Officer, Pavillon Treatment Center.” – Brian Coon, Chief Clinical Officer, Pavillon