Posts Tagged ‘12-step recovery’

“We will not regret, nor wish to shut the door on it.”

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“We will not regret, nor wish to shut the door on it.”

This was a tough blog to write. I want to thread the needle; I want to relate some solid help from 12-step recovery sources without angering some of my faithful readers who become angry with any mention of 12 step recovery.

So you’ve been warned.

I know 12-step recovery isn’t for everyone. Some people tell of bad experiences with 12-step groups. And I know millions of people have been helped by these groups, too. So take what you like from this blog entry, leave the rest, and if you read something helpful, I’ll be happy. If not, try again next week because my topics fluctuate.

I talk to many recovering addicts who voice regrets about their past. The stories vary; the patients’ main theme is regret for behavior during active addiction. I understand those feelings, and feel tempted to tell patients how to deal with these feelings… but I don’t say anything, for fear that I’ll sound too “preachy.” Who am I to tell someone that they can examine past regrets, learn from previous mistakes, make amends when needed, and face the future with a clean slate? Isn’t that a conversation for a priest, imam, rabbi, or pastor?

Yes, it is. And yet, this person is in my office. Many times my patients tell me they feel unworthy to join or rejoin a religious community, and feel judged by such groups. Some of my patients’ perceptions could be colored by their own shame, but I fear many of them are accurate in their perceptions. Addiction is still regarded as a sin by some religious groups. Other groups know addiction isn’t a sin but a disease, which can cause us to do and say things we regret, which are contrary to our values

Twelve step groups like Alcoholics Anonymous and Narcotics Anonymous have mechanisms for dealing with past regrets and ruptured relationships. These groups didn’t invent anything new. They use the same approach as other spiritual and religious groups, which are also sound psychological advice. However, the twelve steps provide a handy framework for handling regrets.

First, in Step 4, the recovering person assesses past behavior, called a “moral inventory” in recovery parlance.  That inventory is shared with themselves (ending denial), another trusted person, and the god of their understanding. Patterns of behavior emerge, giving information to be used in steps 6 and 7, where the person becomes willing to give up old behavior and ask the god of their understanding for help with this.

In step 8, the recovering person lists the people he has harmed while in active addiction. With the aid of a sponsor or trusted spiritual advisor, in Step 9 the recovering person makes plans for how best to make up for past behavior.

Amends can be as simple as saying, “I’m sorry,” to someone for past bad behavior, or amends can be more extended, like resolving to be fully emotionally present for loved ones.

Sometimes direct amends aren’t possible, if the person has moved away, died, or unable to be located. A more general amends can be made instead. For example, if a person shoplifted to support their addiction, it may be impossible to remember where and what was stolen. Part of the amends process is not to repeat the old behavior, but a more general amends may involve volunteering in the same community to help society in some way, like donating to a food bank or giving time to help a child in need.

If the recovering person feels guilty about stealing money, amends may include apologizing for the past behavior, and making a plan of re-payment. For example, I know a person in recovery now for over 16 years who sends a check for $25 each month to a governmental agency to whom he owned money after a criminal conviction. He may never get the full amount paid off, but he’s taking action to fix what he broke.

Addiction taught harsh lessons that came at exorbitant prices, so we should learn from past mistakes. Recovering people can move forward by planning amends for past actions, but also should consult a sponsor or spiritual guide for help. For example, if an addict stole money from a drug dealer, it should not be paid back, especially if it puts the recovering addict at risk. In some situations, the best amends may mean having no contact with the other person.

Some recovering addicts have long lists of bad behavior to make amends for, and other recovering addicts’ lists may contain only a few people. Many addicts harmed only their immediate family, by not being completely emotionally available to their spouses or children during their addiction. Some recovering people feel just as bad about that as others feel about committing armed robbery for drug money.

The point of amends isn’t how bad the behavior was, but how the recovering person feels, and how he can leave behind guilt and shame and move forward.

Addiction, like some other diseases, affects behavior. Rather than living with regrets, recovery means facing regrets, learning from them, fixing what we can, and then moving on. It doesn’t matter what you call it: making amends, cleaning your side of the street, getting right with the god of your understanding, or some other term.

 

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Story of a Recovering Addict

Following is an interview that I did with a recovering addict. He now has over 13 years in recovery, and has a master’s degree in addiction counseling.  His history demonstrates how NA can help an addict, and illustrates some of the main tenants of 12-step recovery.

JB: What kinds of drugs did you use?

ML: Everything. I shot cocaine, Dilaudids, heroin, quarter-grain morphine tablets, and always alcohol. Alcohol and marijuana were just a given. They were daily.

JB: Can opioid addicts get clean just using NA?

ML: Yeah. My sponsor did, and other people [have].

JB: What percentage of people in NA used opioids?

ML: Back in1982, when I entered recovery, it seemed like seventy-five percent of people in NA used opiates. Then in the 1980s, more people addicted to crack came into NA, so now I’d estimate about fifty percent or less. But there’s no numbers [statistics kept by NA].

JB: How else has NA changed?

ML: Back in the early days of NA, most addicts hit a low bottom, before coming to NA, but now, with the growth of treatment centers, drug courts, information on the internet…when my father told me I had to leave the house unless I got help, I looked in the phone book and there were only two numbers to call for help. I called the Council on Alcoholism and got directed to AA. There’s been such a growth in [addiction treatment resources]. Every family has had experience with some kind of addiction. There’s more acceptance and knowledge now. People get to NA before they hit the kind of bottom that I did. That’s a good thing.

JB: How effective is NA? Some people say that only two percent of people who go to a twelve step meeting stay clean. What do you say to that?

ML: (laughs) I’d like to know where they got their numbers.

A lot of people get their start in NA and find other means to recover…other fellowships, churchs,…it’s an individual thing. It depends on what kind of living situation the individual is in, how willing the individual is [to get clean], and what kind of recovery the people at those [NA] meetings have. It depends on how deeply they get involved in that fellowship [NA].

In my case, I went to meetings for more than a year, but I didn’t work any steps. But I stayed clean, by going to meetings and getting support from the people at the meetings. Then I moved away and didn’t have that support. It didn’t take long for me to relapse. I was around old friends I used with, old sights and sounds…It takes more than just going to meetings to be successful. There are always exceptions, though. Some people have stayed clean for years that way.

In my case, the seed was planted. I wasn’t at a point where I could honestly look at my situation. So after I skinned my ass up [experienced consequences from using drugs], I went to inpatient treatment and then a halfway house. Plus meetings [Narcotics Anonymous and Alcoholics Anonymous]. I had a little more honesty, a little more willingness. But that second time, I didn’t work all the steps. I had three and a half years clean, got to the fourth step, and I relapsed. That relapse happened when my priorities shifted from going to meetings five or six times per week to relationships, working twelve hour days, hunting and fishing. Looking back, being surrounded by people in recovery was carrying me along.

It wasn’t long. I hadn’t experienced the change that comes from working all of the steps. It was only a matter of time before the self-deception set in. How in the hell could I talk myself into thinking I could sell dope, without using it? I was dissatisfied with my job, went traveling, and met “X.” He knew I’d hauled dope out of Florida in the past, for my brother in law. He asked about my connections and asked if I could help him move some kilos. I told him I still knew a few people, but I can’t be handling the stuff. I talked myself into believing I could sell that stuff and not use it. Insane.

That led to two and a half years in state prison. This put me in a controlled environment. I knew enough about recovery and the twelve steps and the change that can happen. I’d heard enough about it that I reached out and asked people I knew in NA to get me some [recovery reading] material. That was in 1988. They didn’t have as many 12-step meetings or substance abuse programs [in jail] then like they have now. I had to reach out and ask for help. I paid “Y” [an inmate] a candy bar so he would allow me to have an NA meeting in his cell, because it was the biggest. I paid a candy bar to him each meeting. He’d never been to a meeting in his life. This was in the county jail.

When we both got to state prison, they had NA meetings there. He got real involved. He got clean and is still clean today! He has twenty-one years in recovery, works in construction, and travels the world. I went to an AA meeting a few years ago, when I was visiting a town in Alabama, and it turned out he was speaking that night. He pointed to me and said, “That man is one of the reasons I’m here.” (At this point, ML tears up and takes a pause).

I had regular correspondence with friends, who sent me recovery literature. There was a “black market” step working guide. I used it and that’s the first time I did a “fearless and searching moral inventory” of myself. I didn’t have anyone to do my fifth step with [this is the step where the addict admits to God, himself, and another human being the exact nature of his wrongs].

At this point, I was in the county jail, about to go to state prison. This guy from Minnesota was in jail for thirty days for old warrants. It turns out he had a few years of recovery. He heard my fifth step and guided me through step seven. He mentioned his dad got [was sentenced to] forty years for murder. In the late 1970’s, when I was bringing cocaine out of Miami, the guy who set me up with the Columbians was named “Z”. I would meet him in a field [to exchange drugs] and he had a young boy with him. The guy who heard my fifth step was his son!

I’d been going in the front door of this state prison for six years, as an NA member, bringing meetings to the prisoners. Now I was in that prison. I progressed on through the steps, and experienced a change in my being…a real deep change that I can’t put into words. I recognized it was the beginning of a change that would continue to occur over a lifetime.

I relapsed once more, after nearly ten years clean. I got away from people in recovery, quit doing all the things I’d done on a regular basis, like prayer and meditation, meetings, contact with people in recovery. That relapse lasted a year. I was rescued by the Macon County Sheriff’s Office. I knew I was going to die. I was waiting for the overdose, the gunshot, whatever. I had no hope.

An addict always has the potential for relapse. I don’t care who they are, where they are, how long they’ve been clean or whatever. But once I experienced change on a deep level, mentally, emotionally, spiritually, and then used drugs again…you’re not the same addict. You don’t have the hustle. You can’t be as thoughtless, selfish, and solely self-focused as you were, before you experienced that change. I knew I couldn’t use drugs successfully, and I knew it was going to kill me. But when I lost that support, when I pushed away that foundation, that God of my understanding…That allows self-deception. It might be only momentarily, but you forget. You forget who you are, and if you’re where substances are available, you’re deceived.

JB: How’s your recovery now?

ML: Awesome. If you’d asked me in 1999 how I’d be doing now, I wouldn’t have gotten close. My life today is better than it’s ever been. I’m extremely blessed and grateful to be where I’m at today. I’m blessed to have the work, the people, a wonderful fiancée … I’m blessed to be able to share my life with the people I have in my life.

JB: What kind of work do you do?

ML: I work as a counselor. I work in a jail’s substance abuse treatment program. Looking at what they have available in jails now…fully staffed treatment programs, right in the county jail! From having to pay a candy bar to hold a meeting to where they have whole dorms in the county jail to treat addiction…the change has been awesome to see.

            This addict, ML,  described how his recovery progressed over time, and how he had setbacks and relapses. Obviously, given the morbidity and mortality of active addiction, treatment professionals and addicts prefer relapse-free recovery, but for many, relapse is part of the recovery process. Many fortunate addicts are able to get back into recovery, before catastrophe occurs.

ML is also a good example of how 12-step recovery meetings can help. Addiction treatment professionals should always inform addicts seeking recovery about these meetings, and encourage addicts to go to at least a half-dozen meetings, before deciding if 12-step recovery is right for them or not.

There are many recovering opioid addicts who used 12-step resources or other counseling to become completely opioid free and were able to get through both the acute physical opioid withdrawal and the more prolonged post-acute opioid withdrawal. Therefore, it does appear that drug-free recovery may be a reasonable goal for some opioid addicts who are motivated to do the work of recovery. For addicts who find the spiritual theme of 12-step recovery unacceptable, secular recovery groups are available.

            12-step recovery is free, widely available, and proven to work. It’s still the best deal in town.

Suboxone Patient’s Success Story, continued

XYZ:My brother had enough faith in me that it was worth the risk of starting this business [that he has now] together. I spent hours setting up a company in a ten foot by twenty foot room above my house. My wife and I started on EBay, making and selling [his product], and slowly grew it to the point that, three years later, I’m going to do over two million dollars in sales this year, I’ve got [large company] as a client, I’ve got [large company] as a client, I’m doing stuff locally, in the community now, and can actually give things back to the community.
JB: And you employ people in recovery?
XYZ: Oh, yeah. I employ other addicts I know I can trust. I’ve helped some people out who have been very, very successful and have stayed clean, and I’ve helped some people out who came and went, but at the same time, I gave them a chance. You can only do so much for somebody. They have to kind of want to do it themselves too, right?
JB: Have you ever had any bad experiences in the rooms of Narcotics Anonymous, as far as being on Suboxone, or do you just not talk to anybody about it?
XYZ: To be honest, I don’t broadcast it, obviously, and the only other people I would talk to about it would be somebody else who was an opioid addict, who was struggling, who was in utter misery. The whole withdrawal process…not only does it take a little while, but all that depression, the body [feels bad]. So I’ve shared with those I’ve known fairly well. I share my experience with them. I won’t necessarily tell people I don’t know well that I’m taking buprenorphine, but I will let them know about the medication. Even though the information is on the internet, a lot of it is contradictory.
It’s been great [speaking of Suboxone] for someone like me, who’s been able to put a life back together in recovery. I’d tell anybody, who’s even considering taking Suboxone, if they’re a true opioid pill addict, (I don’t know about heroin, I haven’t been there), once you get to the right level [meaning dose], it took away all of that withdrawal. And if you combine it with going to meetings, you’ll fix your head at the same time. Really. I didn’t have a job, unemployable, my family was…for a white collar guy, I was about as low as I could go, without being on the street.
Fortunately I came from a family that probably wouldn’t let that happen, at that point, but who knows, down the road… I had gotten to my low. And that’s about it, that’s about as much as I could have taken.
It [Suboxone] truly and honestly gave me my entire life back, because it took that away.
JB: What do you say to treatment centers that say, if you’re still taking methadone or Suboxone, you’re not in “real” recovery? What would you say to those people?
XYZ: To me, I look at taking Suboxone like I look at taking high blood pressure medicine, OK? It’s not mind altering, it’s not giving me a buzz, it’s not making…it’s simply fixing something I broke in my body, by abusing the hell out of it, by taking all those pain pills.
I know it’s hard for an average person, who thinks about addicts, “You did it to yourself, too bad, you shouldn’t have done that in the first place,” to be open minded. But you would think the treatment centers, by now, have seen enough damage that people have done to themselves to say, “Here’s something that we have proof that works…..”
I function normally. I get up early in the morning. I have a relationship with my wife now, after all of this, and she trusts me again. Financially, I’ve fixed all my problems, and have gotten better. I have a relationship with my kids. My wife and I were talking about it the other day. If I had to do it all over again, would I do it the way I did it? And the answer is, absolutely yes. As much as it sucked and as bad as it was, I would have still been a nine to five drone out there in corporate America, and never had the chance to do what I do. I go to work…this is dressy for me [indicating that he’s dressed in shorts and a tee shirt]
JB: So life is better now than it was before the addiction?
XYZ: It really is. Tenfold! I’m home for my kids. I wouldn’t have had the courage to have left a hundred thousand dollar a year job to start up a tee-shirt business. I had to do something. Fortunately, I was feeling good enough because of it [Suboxone], to work really hard at it, like I would have if I started it as a kid. At forty years old, to go out and do something like that…
JB: Like a second career.
XYZ: It’s almost like two lives for me. And if you’re happy, nothing else matters. I would have been a miserable, full time manager, out there working for other people and reaping the benefits for them and getting my little paycheck every week and traveling, and not seeing my wife and kids, and not living as well as I do now.
I joke, and say that I work part time now, because when I don’t want to work, I don’t have to work. And when I want to work, I do work. And there are weeks that I do a lot. But then, on Saturday, we’re going to the beach. I rented a beach house Monday through Saturday, with just me and my wife and our two kids. I can spend all my time with them. I could never have taken a vacation with them like that before.
JB: Do you have anything you’d like to tell the people who make drug addiction treatment policy decisions in this nation? Anything you want them to know?
XYZ: I think it’s a really good thing they increased the amount of patients you [meaning doctors prescribing Suboxone] can take on. I’d tell the people who make the laws to find out from the doctors…how did you come up with the one hundred patient limit? What should that number be? And get it to that number, so it could help more people. And if there’s a way to get it cheaper, because the average person can’t afford it.
The main thing I’d tell them is I know it works. I’m pretty proud of what I’ve achieved. And I wouldn’t have been able to do that, had I not had the help of Suboxone. It took me a little while to get over thinking it was a crutch. But at this point, knowing that I’ve got everybody in my corner, they’re understanding what’s going on…it’s a non-issue. It’s like I said, it’s like getting up and taking a high blood pressure medicine.