Excuses for not going to 12-step meetings:

Some people collect stamps. I collect reasons for not going to 12-step meetings:

I’m too busy.

I don’t have a car.

I don’t have a license to drive my car.

Gas is too expensive.

I hate cigarette smoke.

I can’t smoke at meetings.

I don’t have childcare.

I won’t know anyone.

I might know someone.

I hear that it’s really a cult.

I’d have to drive too far.

All they talk about is drinking.

They sell drugs at the meetings.

The meetings are too depressing.

The people at meetings are too happy.

I get my recovery at your church.

Meetings are too far away.

Meetings are too close and I’ll know people there.

My probation officer won’t let me go because of my curfew.

Going to meetings makes me want to drink or use drugs.

I have social phobia and don’t feel comfortable in groups.

I don’t need to hear a bunch of other people’s problems.

I don’t want to tell a bunch of strangers my personal business.

The only time I ever think about drugs or alcohol is when I’m at a meeting.

The people there are a bunch of fakes, lying about being clean/sober.

The last time I went, the men wanted to hook up with me sexually.

The last time I went, the women wanted to hook up with me sexually.

I got into recovery to have a life, and going to meetings just interferes with that.

And…my all-time favorite: I don’t want to get addicted to meetings. I just love that excuse…you may be snorting dangerous pills, alienated your friends and family, be nearing financial ruin, but none of that bothers you as much as the possibility you may get addicted to going to recovery meetings.

I’m not unreasonable. I know some of these excuses have some merit, like lack of childcare. But I also know there’s usually a way to overcome these barriers. People in active addiction often overcome great challenges to continue to getting their drugs. They create clever and imaginative solutions. Similarly, people can get to meetings if they want to do so.

I’d rather hear real reasons for not going: it’s scary and humiliating to admit you are addicted. It takes tremendous courage to walk into a 12-step recovery meeting for the first time, and it takes courage to continue to go to meetings. Meetings aren’t always pleasant or convenient.

But this form of recovery has worked for millions of people in a few hundred countries. It’s been around for seventy-seven years. What other drug addiction recovery programs have been in existence for that long? Twelve- step recovery isn’t a flash in the pan, and it has multiple clinical studies to show that it works.  And it’s the best deal in town, since it’s free. So even though it can be intimidating to start going to meetings, the benefits are worth the effort.

Is it possible to recover without going to 12-step meetings? I believe so, yes. But I think it’s harder and takes more time and energy. I imagine the difference to be like hacking your way through a dense forest rather than taking a wide and well-worn path through the forest.

Twelve step programs aren’t the only recovery option and may not work for everyone, but please don’t tell me it doesn’t work for you until you’ve tried it.

 

Twelve step meetings aren’t group therapy.

The Differences Between Group Therapy and 12-step Meetings

 Before I actually went to some open 12-step meetings, I thought they would be like group therapy meetings. However, 12-step meetings have basic differences from group therapy meetings.

 Twelve-step meetings are free. Most group therapy costs some amount of money.

 Members don’t give advice to each other. Or at least, experienced members of Narcotics Anonymous and Alcoholics Anonymous don’t tend to give advice to each other. Instead, members share their own experiences. They tell about what worked for them, and what didn’t work.  The topic is often about how to get through situations without using drugs or alcohol, but may also be about how to live with difficult life situations, and still retain one’s serenity.

 In group therapy, members are encouraged to give advice, or feedback, to other members. Some treatment centers believe that alcoholics and addicts must be confronted, so that denial can be broken through. Twelve-step meetings don’t take this stance. Instead, members offer their own experience, freely and without expectations. It’s a subtle difference, but important. Other 12-step members don’t assume they know what another person should do about life decisions; they simply offer their own experiences.

 In 12-step meetings, there’s no therapist or counselor in charge of the meeting. Instead, there’s a chairperson, a member of the 12-step program who opens and closes the meeting. This person is in charge only in the sense that she guides, rather than controls, the meeting. Some chairpersons guide more than others. For example, some chairpersons will interrupt a member who’s sharing something that can be harmful to the group. This could mean interrupting a “drunkalog” (long pointless sharing that glamorizes drinking or using drugs). Other chairpersons let the meeting run its course, believing that a Higher Power is always in control. The chairperson is responsible for starting and ending the meeting on time.

 No record of attendance is kept at 12-step meetings. A person is considered to be a member of Narcotics Anonymous when that person says they are a member. The only requirement for membership is a desire to stop using drugs.

 Twelve step meetings are held in slightly different ways in different areas of the country. In some places, meetings range from fifty minutes to an hour and a half.  At “speaker” meetings, one person tells their story of addiction and recovery for the whole hour, traditionally telling “what it was like, what happened, and what it’s like now.” At other types of meetings, all persons present are offered a chance to share or pass to the next person. In some meetings, members who wish to share raise their hands and are called on by the meeting chairperson. In group therapy, all members are usually expected to say something during the session, but at NA or AA, no one is coerced to speak.

 I tell my patients about these differences, because many people who really need the guidance and support that 12-step meetings don’t go, because of their mistaken opinions about meetings.

 They think they will be made to speak at an NA or AA meeting, and don’t want to go for that reason. Other patients say if they hear people talking about drugs it will make them want to use drugs. Other people say they “don’t want to hear everybody else’s problems.”

 Problems are shared at meetings, but the emphasis is on solutions. Most good meetings don’t allow the meeting to become a dumping ground for negative experience.  I explain that in most meetings, sharing about specific drugs is discouraged. NA members are encouraged to share about what they are feeling, and what kind of help they need to remain abstinent from all drugs.

 Overall, the mood of 12-step meetings is one of humbleness, where one recovering addict shares what worked for her with the rest of the group, without expectations and with humility. By contrast, in group therapy, feedback or advice is usually given by other group members. But an addict’s tendency with such an approach is to ask, “Who are you to be telling me what to do?” Narcotics Anonymous meetings recognize that advice and feedback often grates on addicts, and their meetings are constructed differently. Other member’s experiences are offered as learning opportunities.

 Twelve step members aren’t perfect, to say the least. Many members are wrestling with serious mental and emotional problems. Sometimes members do lapse into advice-giving and preaching, but nearly always lose this tendency to try to control others as they progress in their own recovery.

 There’s a reason 12-step recovery has been around for seventy-five years. Many other recovery methods have attained a brief popularity, only to fade away within ten or twenty years. Twelve step recovery has helped millions of people worldwide, continues to grow, and will be with us for a long time to come.

Is Your Recovery Portable?

Today I listened to a friend talk about the difficulties of keeping her recovery program going after she moved to a new area.

 From what my patients tell me, this is a common problem. Last week I had yet another patient say that her relapse started when she moved to this area from another state. She had more than eight years of good recovery, but when she moved to North Carolina, she stopped doing all the things that previously made up her recovery program: 12-step meetings, calling a sponsor, and helping other addicts. Gradually, staying clean off alcohol and other drugs lost its priority, and addiction was a distant memory. She listened to the old lie of addiction: she could use drugs now, and it would be different. Her disease told her she’d been clean so long, she knew how to keep from going back to active addiction.

 This was, of course, not true. I saw this patient shortly after she lost her job because of intravenous opioid addiction.

 Why does moving to a new area seem to begin a downward slide toward relapse for some people?

 My friend in recovery who just moved was able to describe it to me. She says it’s a starting over process, and she feels like she’s on the outside. She feels like she did when she was a newcomer to meetings. She misses the feeling of being at home in meetings, surrounded by people she knows who love her. She says getting involved in meetings in a new area is the hardest thing she’s ever done, more difficult than coming to meetings for the first time.

 She says, “I’ve done this before, and I think to myself this should be easy. It took me by surprise. The loneliness is super-dangerous. I have these dangerous feelings, like I don’t belong. It’s just like my first few months of recovery, except now I keep thinking that it should be easier, and I shouldn’t be having these feelings. In early recovery, I had that gift of desperation. I was acutely aware that the drugs brought me to that point and I had to come to meetings to stay clean. I had willingness to do whatever it took. Now I don’t feel that desperate, and have a hard time making myself go to meetings. It’s hard as hell.”

 “Plus, I don’t know who in these new meetings is working a program of recovery, and whose life is just full of drama. I don’t know who the winners are. And the formats are different, though I like them. They have topic meetings and everyone who shares stays on the topic!”

 My friend seems to be doing better than she’s feeling. The last I saw her, she was surrounding by laughter and hugs. She says she’s getting through this difficult time by sharing about her feelings, and listening to the experience of other recovering people who have moved to a new area and new meetings. She stays in touch with her old friends from previous meetings, and travels the four hours to visit these friends once or twice per month during her transition.

 I think my friend will be fine, so long as she continues to do what she needs to. Going to new meetings is difficult and staying at home would be easier, but not in the long run. Given the havoc addiction has caused in her life, she’s not willing to risk a relapse with all the heartache it brings.

Going to 12- step meetings on methadone (or Suboxone)

I really do push patients to go to 12-step recovery meetings: either AA (Alcoholics Anonymous) or NA (Narcotics Anonymous). I do this because 12-step meetings work, they are free, and can be found in nearly every community.

What’s not to love?

But patients on medication-assisted treatments with methadone and buprenorphine (Suboxone)
often have bad experiences if they share that they are taking these medications. Patients may be given bad advice, or treated with distain by other members.

NA literature (Bulletin #29) makes it clear that although NA has no opinion about methadone maintenance as a treatment method, NA considers abstinence to mean abstinence from maintenance medications as well as drugs. However, NA also makes clear in Bulletin #29 that because the only requirement for membership in NA is a “desire to stop using,” people on maintenance medications who have that desire have as much right to come to NA and enjoy its benefits as anyone. They should be made to feel welcome by NA members.

Most of the patients I see do have a desire to be completely off methadone and buprenorphine at some point, and going to NA can help them learn tools not only to help them get off these medications, but also prevent relapses. NA can help them build relationships with people who become a support network.

When I ask a patient to go to NA for the first time, I shoot a prayer skyward that the NA members he encounters will be kind and welcoming.

Often, patients on maintenance medications say they feel more comfortable going to Alcoholics Anonymous, because that fellowship focuses only on sobriety from alcohol. I tell patients they should go where they feel the most comfortable, understood, and accepted. Recovery blooms in both of these wonderful fellowships, and if my patient feels welcomed, she is likely to return, and be helped.