Unity or Uniformity

     Twelve step programs-- although very much retaining the monopoly on what the majority of American treatment and rehabs offer in terms of how to maintain abstinence-- may not be the best fit for every patient or client or participant seeking to get free from addiction. This is something that we often ignore while bemoaning those who have darkened the doorways of 'our' meetings [and 'our' treatment facilities, if we happen to be staff at one of them] who went back out or continued to use. We are so fond of claiming that various addictions are now a disease of some sort. 

     What kind of people are we when we blame the patient for failing to gain or regain health after one or more bouts with a disease?

     When a cancer patient gets sicker and dies in spite of the chemo or radiation, do we blame the patient?

     When someone gripped in the natural course of a non-reversible dementia progresses and dies in spite of medical interventions, do we blame the patient?

     And yet, the addict seeking help is blamed for his or her return to active addiction. [I use addict to also include those who are addicted to alcohol]. What gives? Maybe we don't really believe in the disease concept. [Okay, I don't. I don't claim acceptance of the disease concept which seems to have swept the addiction treatment industry by storm].

     The problem does not lay in how we define addiction. Whether it is a medical condition with multiple etiologies and a disease-like progression, an actual disease, something else entirely, or a combination of these things is not something that I am taking issue with in this particular blog post. 

     While how we define addiction certainly does determine whether or not insurance companies will pay for treatment, it is not really at the crux of the problem. The problem is the low success rate ascribed to addicts seeking recovery. When making a decision related to my health, I seek out more than one option. And when the success rate for an option presented to me is described as anywhere from ten percent to just under thirty-four percent, I certainly do my research. I want the odds to be in my favor. In cases of severe and/or chronic and/or terminal diseases or conditions, there may not be better odds or very many viable options. Science offers us the opportunity to discover and describe best practices in medicine.

     In the United States, I think what we are suffering from is a lack of rigorous research into the multiple causes of addiction, treatment options, and how to determine the best fit for each client or patient. Twelve step programs have aided many of us in changing our lives thereby enabling us to become and remain abstinent. Yet, some percentage of people fail out of meetings with or without adjunct professional help. Not every human being is able to find a new way of life within the current structure of treatment and maintenance of abstinence. 

     There is no one way to recover. Yet, one way to recover utilizing the twelve steps of various Anonymous programs is what is pushed by the addictions treatment industry.

     We have today other ways to develop social support systems-- there is Celebrate Recovery [for Christians], Secular Organizations for Sobriety [or s.o.s. for non-theists, and for those who may be religious but wish to separate their religious practices from their recovery program], the Red Road [for Native Americans], Women For Sobriety [for women], Double Trouble and Dual Recovery Anonymous [both organizations are for those who also have mental health diagnoses], Rational Recovery [for rational people], Drug Courts [for non-violent offenders-- which include may include attendance at support groups and rehabs and/or a residential program] and more. Some of the programs utilize re-written forms of the twelve steps. Others do not. And some people do maintain abstinence via their religious practices and no attendance at any sort of program.

     Some of us discover that a twelve step program is the only program available to us. Even if we are able to travel some distance to attend a meeting that is not X.A., non-X.A. meetings may not be held as often as we may like.  And yet, there are a number of people for whom a twelve step program is not sufficient, adequate, or appropriate. Fortunately, within the Interwebz, we can find others who are thriving outside of the 12 step rooms.

     The sorry state of treatment programs today does not allow for options other than the twelve steps. People are not told that there are other options or ways to recover. And as far as truly personalizing treatment to the individual addict, that does not usually exist. A few addicts may be lucky enough to land in a program that recognizes that medication-assisted recovery, concurrent mental health treatment, or harm-reduction strategies may be better suited for certain patients but that is not, generally speaking, the experience of many addicts who have sought treatment. And we just don't know enough of how to figure out which addicts will do best in which options. We need more research and more development of alternate resources for those seeking recovery today.

     The thing is, none of us practice recovery in the specific ways it was described in the Big Book of Alcoholics Anonymous. There are scattered groups of individuals who are attempting a return to A.A.'s early times. And that's cool.

     For some of us, that sort of thing is not appropriate or useful. We don't fit. We need the stuff that we resonate with, whether it is participation in X.A. as it has evolved in these times or some other form of social supports. And some addicts do not resonate with X.A. 

     We do not have to be addicts kept in uniforms lined up against the wall waiting for lunch to begin, as if we were still in a regimented high school. The unity of a healthy twelve step meeting is truly a wonder to behold. A healthy group acknowledges that we can practice our unity in spite of our differences.

     We are not all the same. Some addicts need something else in order to recover. So let's quit blaming them for failing out of what we have to offer. Treatment providers need to learn how to fit treatment to each individual addict rather than fitting each addict to their brand of treatment.

     I envision a place where the characteristics of each individual patient is respected and where patients are offered more than one way to recover. Someday, we will know enough to stop blaming those who fail out of the system and instead invest in research that will truly illuminate best practices in addiction treatment. Until then, more of us will die. 

sapphoq badly needing a coffee says: I count myself fortunate that I have been able to make a life for myself within the recovery landscape as it exists today in my geographical location. My hope is that all of us who seek a way out will indeed be able to discover a way out. But that isn't the way it is YET.

     
For information on how an atheist can remain abstinent in a twelve-step program, buy my e-book "Another Atheist in Recovery." If you aren't an atheist, then buy my e-book "Up the Rebels" which is a hacker/slacker kind of a novel.
http://www.barnesandnoble.com/s/SpikedUp-Frog?store=allproducts&keyword=SpikedUp+Frog
Neither e-book has DRM. They are written in ePub format which can be read on many readers and also on your computer via Calibre or other reading program [but not Adobe tm].
I support the torrents so if someone wants to make my e-books available to others for free, that would be really cool-- and supported by the Creative Commons license that I used.

These Truths I Hold: part 3

These truths I hold to be self-evident, in no particular order: Part 3:

50.  Atheism rocks.
51.  Believing in something just because it "feels" good or right or comfortable is not enough of a reason to believe.
52.  Believing in something just because others believe in it is not enough of a reason to believe.
53.  Evidence, evidence, evidence.
54.  Which god?
55.  Which collection of literature?
56.  Rewriting history does not change what actually happened.
57.  Science saves lives.
58.  Funny how I didn't spot the unicorn in Isaiah when I was a fundy.  I was willing to deal with a talking snake and a talking donkey.  I don't know what I would have done with a unicorn.
59.  Evolution is not something to believe in.  It is something that you accept or reject totally or in part.  There is a common misuse of the word "theory" as in "only a theory" when the word "theorem" might be better suited.

60.  Homosexuality does occur in nature.  Ask any farmer who has had experience with a bull that turned out to be homosexual.
61.  Strawberry plants, blue-green lizards in Arizona.
62.  Adults can be heterosexual, homosexual, bisexual, or asexual.  Sexuality is fluid, not static.
63.  Insisting that "we are born that way" cheapens the fight for civil rights for all civilians.  Some folks may have been "born that way" but we do not really know yet what makes people straight or not straight.  It's a science thang, not a morality/sinner thang.
64.  Adults can identify as male, female, androgenous.  It's called gender identification and it too is not a morality/sinner thang.
65.  Some babies are born with an intersexed state-- which means they may have the genitalia of both sexes present at birth.  
66.  Babies who have A.I.S. [Androgen Insufficiency Syndrome] are genetically male.  Because their bodies do not respond to androgen, they are by necessity raised as female.  100% of A.I.S. female adults are either bisexual or lesbian.
67.  Transfolks who take hormones in the process of correcting their gender to correlate with their perceived gender will sometimes have an un-looked for change in sexual orientation.  The basis for wanting what is referred to as a "sex change" in the vernacular is NOT sexual orientation, as was commonly supposed in the sixties and is still supposed in some circles now.  A genetically male transfolk who is attracted to women may find that she is attracted to men, or both women and men after she begins hormone treatments. 
68.  The majority of cross-dressers [who are not interested in "correcting their gender"] are heterosexual males.
69.  I am not interested in being "tolerated," "toleration", or "tolerance."  If you cannot celebrate me for who I am and I cannot celebrate you for who you are, then it might be wiser for each of us to not engage each other.  Celebrate Diversity.

sapphoq itching for a coffee says:  Whether or not the United States was started as a Christian nation, we are now multi-cultural.  As a nation of many peoples and cultures and backgrounds, we are not all fundamentalist Christians.  Religion ought not dictate politics.  The public arena should remain secular-- including city, state, county, and national government; public schools [if you want your kids to pray in school then please send them to a religious school of your choosing...]; federal lands; courtrooms; any place that accepts public funding should be bound by secular public laws.  The laws that govern us all should not enslave us.  Not all of us are believers.  Even among believers there are differences.  Please get out of my vagina.  Don't dictate to me who I love or what I do and I will have the courtesy and respect to allow you to love who you love and do what you do.