There is no shortage of misconceptions and hurt feelings swirling about when it comes to 12-step based recovery versus recovery from other substances such as opiates that extols the virtues of medication-assisted therapy (MAT). It doesn’t take but a few minutes of perusing the internet to find people who have strong opinions: hate verses wide-spread approval in both camps, and then there’s those who spew vitriol or shout praises without much investigation of either side.
It takes a lot of energy to judge another’s recovery; energy that could be better spent working and rebuilding our lives or helping another to restore their life, because there’s only one thing that matters about any recovery journey: Does the recovery mode that you choose/chose facilitate change to you as a person?
I’ve been in recovery rooms for thirty years, and I’ve always felt loved and supported, but I’ve made a point to stay away from the people who were not serious about recovery. It’s not hard to sniff them out. There are people who have been around recovery rooms for years, but I don’t want what they have: men and women who prey on the newcomers; people who are five years into their recovery and they’re still playing the blame game; chronic relapser’s who have no intention of quitting; people who gripe and complain about everything in the world but do nothing at all to make it a better place. But, you know what—so what. People are people, no matter where you go. We all know that there’s no shortage of A-holes on the planet, and that includes recovery rooms.
Early in my sobriety, I listened to the old-timers who told me to “stick with the winners.” I took that advice to heart. I stayed out of the gossip ring. I wasn’t looking for a boyfriend or a new husband. I had a single purpose and that was to get sober and stay sober. I’ve made many wonderful, lasting friends, and I can’t recall ever being entangled in drama. Recovery rooms are filled with people from every demographic—and most of us are there to get well and stay well.
I think we need to be careful about attacking any one way to get sober and stay sober. I am disheartened when I read blog posts that bash the 12-steps, as well as those that bash medically assisted therapy (MAT) such as Buprenorphine, the drug that grabs onto opiate receptors. A much better mantra would be: Hey, whatever works for you, go for it!
We miss the point entirely when we attack any modality that may work for some and not for others. One of the perplexing things about the disease of addiction and alcoholism is that it’s not a cookie-cutter disease; it knows no demographics—so why would we think there could be a cookie-cutter solution?
Let me just say, my family, including my extended family, has had or we still have an eclectic variety of addicts and/or alcoholics that one can imagine: We have everything from surgeons to strippers. Some are still drinking their heads off—functional alcoholics—great people who hold full-time jobs but they’re a hot mess at home, to a former heroin addict, to a former meth-head, to prescription opiate and benzo addict, to a former crack head. Did I miss anyone? Please, refrain from saying I don’t understand because I get it. This addiction business is complicated and messy.
Most of my family members (the ones that are in recovery) have found lasting sobriety through the 12-steps, but we have a variety there too: One found recovery, initially, through the 12-steps but then he decided that it wasn’t for him and he joined a nondenominational church. He does a lot of service work there; he fixes cars for single mothers. He works full time. This year he married a woman with two children and became an instant dad. He’s stepped-up to the challenge—sans resentments, and with a smile on his face and love in his heart. He’s changed in every way. He’s no longer the fearful, selfish heroin addict that he used to be; he’s grown into a loving husband and father. Another extended family member quit smoking crack and using other drugs by calling on God. Another stopped using by white-knuckling it for a while then they jumped on the opportunity for medication-assisted therapy. Each one who wanted recovery more than they wanted to use, found their way.
There are no absolutes. Addiction is a complicated disease for complicated people. Why all the angst about which way is best? Any modality that can help us change our thinking and stay clean is the right answer. It’s truly that simple. We don’t need to disparage one as being far superior to the other. I have my preference—but that’s all it is—a preference. It’s far more productive to assist others in recovery when we can move away from judgment and move closer to acceptance for each person’s journey.
The only must to recovery that I see is that somehow, someway, if we want to live sober productive lives—we have to change. Even the respected Substance Abuse and Mental Health Services Administration (SAMHSA) points out that all medication-assisted treatments should include “counseling and participation in social support programs.” You can’t hand someone a prescription and say, here ya go. Take this pill and change your life—it’s not that easy. Medication-assisted therapy may be a God-send to help people stay clean long enough for them to work on their underlying emotional issues, but used alone, medication-assisted therapy is not a panacea for addiction.
The person that I was would use again, so I had to change. Of course I’m still me, but my thinking had to change. My reactions to life had to change. My perspectives had to change. My behaviors had to change. I had to learn healthy coping skills.
The one family member that went from white-knuckle sobriety to medication-assisted recovery moved on to abstinence. She’s been drug-free for a number of years, but her behavior hasn’t changed all that much. According to her mother, her daughter is still dancing in the strip club. She says she’s immature—actually, her words were “She acts like a baby.” Mom reported that her daughter’s house is a revolving door of visitors and boyfriends. She had multiple children with multiple men. Mom said, “She spends far too much time experimenting with eyeliner,” and whittles away hours putting on make-up. Mom wants to know, “Why is she like this?” I told her mother, perhaps it’s because her daughter is dry—not sober. She has remained the same person but doesn’t use drugs anymore. She never grew up. She never assumed an adult role because emotionally, she’s still fourteen.
The difference between dry and sober is the behavior—it must change.
I believe it’s not enough to be drug or alcohol-free. We have to do the work in order to experience emotional growth. The particular woman in question never surrounded herself with good role models. She never learned how to adjust her life to living sober, assuming adult responsibilities, and moving past the person that she used to be.
If we want to stay sober and be happy, we have to grow; we have to delve into the emotional baggage that drove our using behavior in the first place: low self-esteem, feelings of not belonging, selfishness, fear, the list can be quite long. We need to learn how to get our feelings out of the way and not allow them to stick out so far. We have to quit being so thin-skinned.
Most of us can’t do this alone. We need help in the form of other people to guide us toward those reset buttons that will help change our thinking, help us glean new perspectives, and teach us to take ownership of our part in the addiction equation. We need a community of sorts: friends we can be honest with about what’s really going on in our lives, and more importantly, in our heads. It helps to have people who have walked in our shoes to understand how difficult the journey can be. I’ve learned so much from others by watching how they live their lives, how they dealt with their struggles, and how they overcame erroneous thinking patterns. Do these people have to be in recovery? Not necessarily, but I’m not sure someone who wasn’t an addict or alcoholic would understand the insanity that can set-up shop in one’s head.
My take on medication-assisted therapy is this: it’s life-saving for many, but alone, it won’t bring about a significant enough change in the person’s behavior. As previously stated, MAT works best in conjunction with intensive therapy, peer support, 12-steps…, a person needs additional avenues to help them change their behavior, and it matters little which one they choose, as long as they can find success. What matters is that person changes enough so that they don’t revert back to their old thinking patterns and old habits that drove them into addiction.
I know a woman who works the 12-steps. She’s been sober for thirty-five years. We recently had a conversation about medication-assisted therapy. She too knows plenty of people in recovery rooms who have been using medication-assisted therapy for six, seven, ten, fifteen years. They pick up their chip like everyone else; I’ve never heard of anyone in recovery rooms lecture them or begrudge their journey. The difference is those people did the inside work. They’re sober, not just dry. They didn’t just slap a bandage over the gaping wounds that were their bleeding hearts and raw emotions. If a person feels more secure, and believes they need medication-assisted help in order not to relapse—it’s a personal choice that I don’t believe anyone should condemn.
I like the 12-steps because, for me, it broke recovery down into manageable bites: the whole one day at a time theory was manageable. As for medication assistance, there too, a person has to realize that it may be a long-term commitment. Will a person be okay with going to the doctor every month to get a new prescription? Are they willing to work on changing their emotional responses to life?
If a person has found a way to live a happy productive life, isn’t that more to the point than to argue about how they accomplished that herculean task? There is no right or wrong answer in the recovery arena. Remember Shakespeare said it first, “To thine own self be true.” Whatever solution a person chooses that works for them—is the right one. Who are any of us to judge another’s journey, or belittle the programs that work for millions? Two trite but true 12-step sayings that make sense right here and right now: Live and let live; But for the grace of God, there go I.
Lisa Boucher is the award-winning author of “Raising The Bottom: Making Mindful Choices in Drinking Culture.” She has contributed to notable publications such as Shape Magazine, U.S. News & World Report, The Fix, and is a frequent guest on numerous syndicated radio and podcast shows where she talks about addiction, alcoholism, childhood trauma, and how we can heal. She is highly intuitive and has assisted hundreds of people in healing from substance abuse, depression, and anxiety. A recovering alcoholic, she has been sober for thirty years and understands the complex nature of addiction and how childhood trauma is often at the root of what ails us. A registered nurse, Lisa believes that traditional healthcare does little to incorporate the mind-body connection, nor does our current healthcare system appreciate the healing power of nature.