Tiny Candle of Hope



Every Friday at 6 pm at the Crossfire Biker’s church in North Wilkesboro, NC, people gather to attend a tiny meeting of Narcotics Anonymous, called the Brushy Mountain Group.

It’s not a large meeting; only six to eight people are there on any given Friday. It’s not an old and established meeting; it only started three months ago. But this meeting’s impact could be massive because it has the potential to change the lives of the participants.

This meeting was started with the intention of giving all people seeking recovery a place to get well. Applying the spiritual principles of acceptance and unconditional love, this NA meeting welcomes every person who wishes to recover from the disease of addiction.

This meeting makes no distinction between members who are prescribed methadone, buprenorphine, anti-depressants, stimulants, or other medications. Everyone is welcome to attend and everyone is welcome to share their experience, strength and hope. The recovering people who happen to be prescribed methadone and buprenorphine are treated as full members.

For critics who say Narcotics Anonymous is meant to be a program of complete abstinence from all drugs, people at this meeting have no issue with this statement. They know there is a difference between using drugs and taking medication. Surely the founders of NA never meant for members to be completely abstinent from all medications!

These members know the Third Tradition of Narcotics Anonymous says, “The only requirement for membership is the desire to stop using.” The assumption is that this means using drugs, not medications. At this meeting, members make their own decisions about their “clean date.” For most, the clean date is the day after their last illicit drug use.

At this meeting, the Fifth Tradition of Narcotics Anonymous is felt to be of the upmost importance, and should be a main guiding principle of every meeting: “Each group has but one primary purpose: to carry the message to the addict who still suffers.” No clean time distinctions are made. This still-suffering addict may be a newcomer, or it may be a member with twenty years of recovery. Suffering is suffering, and the group is there to support suffering members.

If a participant shares about taking medication, no one clutches at their pearls and gasps. No one  tut-tuts and asks them to shut up and talk to someone after the meeting. These people are given the same esteem as all other members. The others listen in respectful silence, and sharing continues after that person is finished.

Participants don’t often share about medication, except in passing. Most share about how they are feeling and how their emotions affect their recovery. They talk about situations that could cause a relapse, and they share gratitude for achievements big and small. They talk about how to handle the guilt from their actions in active addiction, or about how they want to do a better job raising the children.

In other words, an observer couldn’t tell this meeting was any different from any other NA meeting where recovery is underway.

This meeting is a tiny candle, spreading just a flicker of light into a small corner of one community darkened by the opioid use disorder epidemic.

But what if this light spread…what if more 12-step meetings welcomed people on methadone or buprenorphine with open arms, with hugs and unconditional love instead of judgment and put-downs?

Then 12-step recovery could be ablaze with the light of changing lives.

That’s my prayer.


19 responses to this post.

  1. Beautifully put. Thank you.


  2. Posted by Mary Anne Hughes on May 23, 2018 at 1:49 am

    I just copied to post at my treatment center. “This little light of mine, I’m gonna let it shine!” Thanks, Jana. I’ll make it one of my prayers, too.


  3. NA is WAY!!!!!! behind the time on MAT — Betty Ford Hazelton has been using MAT now for over 4 years with great results.The have copyrighted the CORE12 program using MAT and 12 steps. Abstinence is a great ideal , but not worth dying over.


  4. Posted by Eric M on May 27, 2018 at 5:40 am

    I’d hope that most NA meetings emphasize harm reduction over being chemical free as I definitely know people who need maintenance. Most I go to here in Chicago (I’ve probably been to 45 or so NA meetings at a half-dozen locations), seem to idealize being chemical free, and think that the spiritual changes in users will enable them to taper off eventually, but will accept people where they’re at.

    Either way, it still seems to be a sensitive subject that doesn’t get talked about much during the meetings themselves.

    For myself, I elected to not remain on maintenance, only using Suboxone to taper through withdrawals. But I’d never criticize anyone who made a different choice as my circumstances can’t be applied to everyone.


  5. Posted by Don H on May 31, 2018 at 7:51 pm

    From the Hazelden website:

    “Integrating the Twelve Steps with Medication-Assisted Treatment for Opioid
    Use Disorder provides step-by-step guidance on how to implement COR-12™ at
    your organization. With COR-12™, you can help patients:

    – Stay engaged in treatment longer in order to establish a solid Twelve Step

    – Discontinue medication when appropriate to achieve ultimate abstinence
    and lifelong recovery”

    They just can’t bring themselves to admit and state that MAT is recovery from addiction! It’s like they are going into MAT kicking and screaming – and only because they now pretty much HAVE TO! What a crock stop medication to “Achieve ultimate abstinence” Evidently I don’t have ultimate abstinence then? I must be at the “basic abstinence” level I guess.


    • Yes, it is annoying.
      It’s very hard to change an ingrained way of thinking.
      I have patients on buprenorphine for more than ten years who do not plan to taper off of it. I’m fine with that. They are doing so well in life that it’s hard to see how getting off this medication would help them have a better life. Well, except for the time spent coming to see me and the expense of the treatment. But I only ask to see them every other month when they are doing so well.


  6. Posted by Sean McKinnon on June 3, 2018 at 10:47 pm

    Dr. Burson can you point us to any evidence based studies that show the benefit of 12 step groups or 12 step groups combined with MAT?


    • yes, here’s a list of the ones I already had references for – there may be many more that I don’t have. You’ll note none specifically addressing 12-step recovery in patients on MAT. I don’t believe I’ve ever seen any study of this type. For obvious reasons, that would be a really hard group to study.

      1. Tonigan, J. Scott, “Alcoholics Anonymous Outcomes and Benefits,” in Recent Developments in Alcoholics, Volume 18, Research on Alcoholics Anonymous and Spirituality in Addiction Recovery, edited by Marc Galanter and Lee Ann Kaskutas. P 357-372.
      2. McKeller J, Stewart E., Humphreys k, “Alcoholics Anonymous and positive alcohol-related outcomes: cause, consequence, or just a correlate?” Journal of Clinical Psychology, 2003, April, 71 (2) p 302-308.
      3. Emrick CD, “Alcholics Anonymous: affiliation processes and effectiveness as treatment,” Alcohol clin Exp Res, 1987 Octo 11(5): 416-423.
      a. Abstract: Recent findings from the empirical literature on Alcoholics Anonymous (AA) suggest that no clear exclusionary criteria for this organization exist, except that alcohol-dependent individuals who become nonproblem drinkers appear to be less likely to affiliate with or maintain involvement in AA. Of those alcoholics who become long term, active AA members, about 40 to 50% enjoy several years of total abstinence, with about 60 to 68% improving to some extent, drinking less or not at all during their participation. Those who combine AA with other forms of treatment seem to do as well as or better than those who go to AA alone. More active AA participants do as well as or better than those who participate less actively. Compared to professionally treated alcoholics, AA members seem to achieve abstinence at a higher rate. Consideration is given to the apparent unsuitability of AA for problem drinkers who choose the goal of non-problem drinking.
      4. Gossop, M., Stewart, D. and Marsden, J. (2008), Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up study. Addiction, 103: 119–125. doi: 10.1111/j.1360-0443.2007.02050. Conclusions: NA/AA can support and supplement residential addiction treatment as an aftercare resource. In view of the generally poor alcohol use outcomes achieved by drug-dependent patients after treatment, the improved alcohol outcomes of NA/AA attenders suggests that the effectiveness of existing treatment services may be improved by initiatives that lead to increased involvement and engagement with such groups.
      5. Moos, RH and Moos BS, “Participation in Treatment and Alcoholics Anonymous: Initially Untreated Individuals,” Journal of Clinical Psychology, 62(6): 735-750.
      Abstract: This study focused on the duration of participation in professional treatment and Alcoholics Anonymous (AA) for previously untreated individuals with alcohol use disorders. These individuals were surveyed at baseline and 1 year, 3 years, 8 years, and 16 years later. Compared with individuals who remained untreated, individuals who obtained 27 weeks or more of treatment in the first year after seeking help had better 16-year alcohol-related outcomes. Similarly, individuals who participated in AA for 27 weeks or more had better 16-year outcomes. Subsequent AA involvement was also associated with better 16-year outcomes, but this was not true of subsequent treatment. Some of the association between treatment and long-term alcohol-related outcomes appears to be due to participation in AA.*


  7. Posted by Chenoa Brown on September 19, 2018 at 8:18 am

    Absolutely LOVE this!!


  8. Posted by Fellow on January 18, 2019 at 11:39 pm

    I would have still been on mind and mood altering chemicals if my sponsor didn’t asked me to think about it. I used 18 years antidepressants and was sure I couldn’t live without because that’s what all the professionals told me – anyway i’m now 10 months and 7 days free from this medication and I changed my clean date from a little under 4 years to 10 months because of this. Miracles happen and I don’t feel any longer there is some reservation between me and my higher power.
    Off course I took a long time to slowly come down and I was in close contact with 2 psychiatric doctors.


    • I’m glad it worked well for you. However, most members of 12-step groups would not have considered anti-depressants as a relapse. Many chemicals are mind and mood altering without being particularly addictive or destructive. Caffeine, for example, is both mind and mood altering, but rarely causes significant problems. And you can get a strong cup of coffee at most all AA or NA groups! At any rate, I’m happy you feel better!


  9. Posted by Bill on January 19, 2019 at 1:14 am

    I guess they do believe in total absentee’s Promoting drugs , Manipulating the 12 traditions to justify not being clean and the rehabilitation world applauds that We do welcome everyone however we do not celebrate being clean being on drugs . naws inc and the rehabilitation centers are in bed with trying to change our philosophy of total absentees of being clean . I also knew Jimmy and some of the founding Members and they meant being totality clean from all mood changing substance and mind alerting chemicals
    In Loving Service .


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