An Indictment

     Recently, several of my close associates have gone back out. People with time measured in years, not months. People who were doing all the stuff that people in recovery are told that we must do in order to keep on keeping on. People who were working steps, had service commitments, went to meetings, used their sponsors, read the literature, took care of themselves, lived up to their responsibilities, had deeply held religious beliefs and practices to match.

     So far, they were all lucky enough to make it back into the rooms of recovery. So far, they are all staying in. So far, so good. 

     They all have said it is a struggle to remain clean now. More of a struggle than before. They have had various consequences for their relapses. What those consequences are is of no importance to anyone reading this blog post. None of them "got away with it."

     I had my lapsing and relapsing during the first nine months of my attendance at x.a. meetings. Then I began to understand that I had to quit all of it and not just the drugs that I perceived of as having been or helped to create the biggest problems in my life. So I did. I got honest. [Unlike my buddies, I was not honest about what drugs I was still taking during those first nine months]. I started over.  Starting over was tough. Staying away from all of the drugs was much more difficult for me than staying away from some drugs.

     There is something here I've been thinking about a lot. We-- at least here in the United States-- really do not know enough about how to treat addicts in the throes of their addiction. Most of the addiction treatment industry organizations here are heavily dominated by twelve step approaches and philosophy with bits of pop psychology and pseudo-religion thrown in.

     The stats from the rehabs that are honest about the results of treatment via long-term follow-up are dismal. I've heard various percentages ranging from ten percent on up through thirty-three percent. One in three down to one in ten will remain abstinent. The other figure I've heard tossed around is one in four will relapse some percentage of the time and therefore are declared to be "improved."

     These figures ought to be unacceptable. They certainly are unacceptable to me.

     The best that professionals in our country can offer is "Well, some of you will be dead. Some will bounce in and out. A very few of you will remain clean." 


     But meanwhile, 

...if you relapsed, then your program or the way that you worked the program sucked or wasn't good enough.

...if you relapsed, then you quit going to meetings or didn't go to enough meetings or got disconnected from meetings even if you were going to meetings.

...if you relapsed and killed yourself, then you weren't working the program and forget all the foolishness about whether or not you had a separate disorder that has suicidal ideation as a prominent feature.


     Furthermore, your relapse had nothing to do with 

...our treatment protocol, 

...our failure to give you culturally competent treatment, 

...our failure to screen you for other disorders, 

...our failure to help you determine what support systems you want to use in order to not use again after you leave us, 

...our failure to recognize that x.a. programs may not be the best way to go for everyone,

...our failure to lobby for more research into the best ways to treat people with addiction, especially if some of those ways just might include stuff other than a twelve step philosophy.


     Beside that,

...One quasi-religious group is heavily involved in the addictions treatment industry for adults as well as in prevention programs for school kids. The adults are treated with mega-doses of certain vitamins and exposure to the group's ideology. The kids pledge not to use drugs and are also given links to certain websites where they too will be exposed to the group's ideology.

...a certain troubled teen industry group whose founder and staff are predominantly of a certain religion are heavily involved in the addictions treatment industry for teens. Those teens are lumped in with all the other "troubled teens" in their residential schools hell pits of torture.

I am not a fan of the quasi-religious group nor am I a fan of those places where staff go beating on kids and throwing them into extended periods of isolation and otherwise severely mistreating them.


     We are at a crossroads and we don't even know it.


sapphoq itching for another coffee says: People are complex. The etiologies behind addictions are multi-factorial. By subscribing to total immersion into the twelve steps and x.a. culture, the majority of the organizations involved in the addictions treatment industry are failing to recognize that more ways of treating addicts seeking relief from active addiction need to be researched and developed.
     By failing to do so, other organizations which are not noted for their honesty or humane practices will step in to fill the void. These other organizations claim to have better outcomes. We don't call them on their dishonest stats for fear of litigation or because we figure they are the experts or perhaps we've learned we ought not to criticize those agencies which are religious in nature.
     Because we fail to broaden our scope and we fail to demand ethical research into other more efficient ways to treat addicts in order to yield more successful outcomes, addicts will die. Addicts who could have been saved if only we knew more about how to treat them. Period.