Options in Addiction Recovery
There have been huge, seismic shifts in the field of addiction recovery over the last 15 years, greater than has happened in the last 100 prior to that. Finally, people have been able to get across that people with addictions are not
So, when talking about options, we need a super-brief word about the trends over time in looking at addiction. AA came about in the 30’s, and was viewed as largely the only vehicle for help.
It has much to recommend it. It was free, religious, but unaffiliated with any particular church, it had an appeal to the working-man, the middle-class, and became a pathway by which people could get treatment and be assessed as ready to rejoin society. The measure was they couldn’t drink, and the assumption was that anyone who didn’t have success by surrendering to god just didn’t want to get better. That presumes that everyone agrees on how that looks.
Certainly making major changes in life can be easier if a large dose of religion
There are more options than ever available to those with addiction issues. In the last 10 to 20 years, options and awareness that there are “Many pathways,” , is almost cliche -- finally! For a long time, “AA is the only way” was accepted and articulated widely.
In addition, people have come to accept that there is room for medicine (people are often tired and strung out and weakened when they are in a position of having to quit), some can use medication to great advantage to make a smoother transition and to address other illnesses being masked by substance abuse.
Doctors are slowly beginning to see some of the nuance involved in addiction and to learn more on their own, and addiction services through state and federal systems have widely disseminated information and standards.
A ridiculously large number of people have fallen on corrections systems to house and treat until they can ship them off elsewhere. Arguably the WORST setting for someone with mental or emotional problems to be, untreated. For those with addiction issues, it is hardly therapeutic. It further desensitizes a population that already feels they’ve run out of options.
However, there has been much progress lately in ways in which criminal justice and corrections systems have stepped into the forefront of addiction treatment, even though I adamantly feel that people should be diverted into facilities that address mental health and addiction issues immediately rather than after incarcerating them, initially, by default.
Treatment has begun to incorporate good mental health practices, and the public has been seeing addiction and treatment from a more realistic perspective. People aren’t locked away and shamed, and they’re not treated as moral reprobates. There’s also been a mandate to treat addiction as we would other illnesses, and despite my refusal to call addiction a disease, I appreciate that it can be treated via the medical system, and I wish that we had better processes to incorporate it into other mental health care programs.
From my point of view, addiction, like any other issue, choice, decision, benefits from thinking about and planning realistic steps, based on a reality-based assessment of what’s going on. I don’t think we need to treat everything as an emergency, but we don’t want to Practically speaking, there are a number of options these days, and I’m going to attempt a non-exhaustive overview to give people an idea of what they might look for and expect at a high level.
Self-help and Peer Support
First, if you have a decent doctor go and get an overall health assessment -- or even a clinic or emergency room can give you a good baseline for your overall health. Get some blood work, mention anything that’s worrying you, and if at all possible, mention to them that you’re a little worried about your drinking. Now, I realize this may be different for other substances and for non-substance related issues, so let’s just start here and we can adapt from there. For eating disorders, for instance, that’s very important. Even for gambling, things like stress and sleeplessness show up in our physical well-being.
What If I Don’t Want to Stop?
Totally legitimate. Most people don’t -- want to stop, or to quit all of a sudden entirely just like that. I think it probably depends on the level of damage that it is doing to your life and how urgent that is at the moment. If you can keep that damage to a minimum, well that can definitely feel worth it especially from a short-term perspective.
That’s a good question to ask:
What is an acceptable amount of damage to my life, or
How often do I want to allow for damage to my life
I was not able to sustain drinking without that part of it, so that became a choice. Some people have a clearer picture of what healthy drinking looks like and can go back to drinking a glass of wine or a beer once in a while without needing to orient every minute of daily life around it the way I really wanted to.
Moderation is a serious consideration. I tend to feel that it’s difficult for many, and definitely too hard for myself, so I don’t talk as much about that, although I’m not against it, and I’m envious of those who seem to be able to reset better than I can. I’m better with food on that front than I am with drinking or drugs, and I accept that! If I’m relegated to coffee, then so be it. :) I’ll talk more about moderation. I find it very interesting, and I think many people DO successfully moderate for often long, long periods of time.
I would encourage self-honesty and careful tracking. I tend to feel a brief period of sobriety can be helpful, but many people are not quite ready to approach that way, so that’s fine and understood.
AA can be a great place to start. They emphasize religious/spirituality and following a specific model for acknowledgment and redress and a pledge to a Higher Power. Meetings are free, and everyone is welcome at most of them. They are plentiful, and you can find regular meetings almost everywhere. Contact AA directly for information or local meetings. As with almost anything, give them a chance. If you don’t immediately like the format or the vibe, try a couple of different meetings. Support is a good thing. More support is better, even if your primary choice of support is different.
NA meetings also follow a 12-step program/philosophy but adapted to narcotics (and there are other XA models following this structure.
There is some room to enjoy aspects of the program -- camaraderie, something to do with our time, good realistic thinking, real-life examples, peer support, vivid reminders, etc. -- without following the “Program” full-on. That would be my preference, but then others find a devotion to the whole program life-changing and I know all kinds of ways that people have incorporated 12-step help and then gone on to live their lives with and without that constant contact. They generally have friends they can reach out to, though, at any time.
For people who don’t find AA resonant or who are not religious, there are some alternatives.
SMART Recovery is solidly positioned as the 2nd largest peer support organization. It has a fraction of the number of meetings, but it has grown, and there are meetings in most metropolitan areas. There are online meetings and resources as well.
There are others, including Women for Sobriety, Lifering and many wonderful local groups through Health and Human Services, community groups, the medical and mental health communities, linkages with corrections and treatment … Many arms are reaching out these days, and that’s wonderful to see.
I also see a lot of respect for sister organizations and the shared goal of helping people get and stay sober. I see that more and more, and I think it’s a great trend. :)
I think ultimately, we want to start to build links outside of help groups, and that’s one of the reasons I find the psychology-based approach of SMART and Dr. Peele so appealing. They’re designed to lead you towards living a better life, in your own real life, wherever you’re starting out. Eliminating substance, helped me see ways I could actually improve, instead of just trying to frantically cover up my flaws all the time. It was a happy approach for me, and that’s the one I’m equipped to share a little bit about.
This is on the support side of recovery. Treatment options are shifting as well, and there is good news as well as bad news there, too!
Great Handout about recovery pathways and options from SAMHSA