I don’t feel that (AA or NA) works for me; any suggestions?


Q. I don't that feel (AA or NA) works for me; any suggestions?

Rather than answering the question directly, let me ask you a few questions. You only have to answer them for yourself. What your reply to me might be is completely immaterial.

1.   Did you go to a meeting every day, or did you find excuses to stay away?
2.   Did you talk to people, or did you arrive late and leave early, avoiding contact?
3.   Did you sit up front and pay attention, or did you sit in the back and keep track of all the things in the meeting that you didn’t approve of?
4.   Did you share — at least your name — or did you keep quiet and try to look cool so people wouldn’t know you were a newcomer?
5.   Did you get a Big Book or Basic Text (and read it)?
6.   Did you get a sponsor?
7.   Did you talk to your sponsor and get to know him or her?
8.   Did you do any work on the Steps?
9.   Did you become involved with service: putting away chairs, making coffee, cleaning up, greeting people (especially other newcomers) to make them feel at home?
10.  Did you get to know people who would include you in their activities outside of meetings, like going for coffee, picnics, and the many other things that program people to do have fun?
11.  Did you keep coming back, even when you didn’t feel like it?
12.  Did you want to believe the group could help, or did you look for things that were wrong with it — things to be offended by; reasons to disapprove?

The program won’t work for you — unless you work for it.  If you’ll think about your answers, you’ll discover the suggestions.


If I’m On A Suboxone Or Methadone Program, Am I Clean?

Q. Is being prescribed methadone or suboxone considered being clean, even though they are addictive, abusable substances?

You’ll get different answers to this question from different people.  Generally the division lies between those who are on maintenance drugs and those who are not.  Both sides of the discussion have their valid points.  However, I believe you answered your own question when you used the expression “addictive, abusable substances.”

The consensus among most professionals and recovering addicts is that “clean”, when used in the context of recovery, means drug-free.  Having all mood-altering substances out of our systems is necessary before the changes that addiction creates in our brains can be repaired.  As long as drugs that modify the reward system (which includes all recreational drugs) are in our bodies, repair and normalization cannot begin.  When we are on Suboxone or methadone maintenance, we are still addicted¹, and our brains are essentially in the same condition as when we were actively using other opioid drugs.  It would seem to be pushing things to call us clean.

That is not to say that there are no benefits to drug maintenance programs.  To the extent that they allow people to cease other drug use and begin to take care of themselves and fulfill their responsibilities, they have some validity.  The problem is that the addiction remains in full force, and relapse — whether to other drugs or simply recreational doses of the maintenance drugs — is only a hair’s breadth away.  Adherence to maintenance programs rests squarely on our willingness to continue to follow them.  That is an extremely dangerous place for an addict to be.

Here at Sunrise, we believe that the proper uses of these drugs are as short-term substitutes for the drugs being abused, with a relatively rapid taper to a completely drug-free condition.  If we wanted, we could easily become licensed to provide maintenance services.  However, we do not believe that is in the best interest of our patients, their families, and the other people in their lives.
¹If you don’t think we remain addicted on maintenance doses of opioid substitutes, just try quitting.  Both Suboxone (when used for long periods) and methadone have withdrawal syndromes that are worse than the drugs for which they’re being substituted.  Truth.

How long am I required to stay in rehab?

Q. How long am I required to stay in rehab?

Assuming that you have not been court-mandated into treatment, you are usually free to leave rehab at any time — against professional advice.  Assuming that you use good sense and stay, the answer varies depending on a variety of factors.

Getting the alcohol and/or other drugs out of our system is only the first of many things that need to happen in order for us to have a decent shot at long-term sobriety. Getting clean and sober (and staying that way) requires time.

I’ve written here often about the physical changes in our brains that cause us to be unable to function without drugs. Until our brains have had time to heal themselves, we are at great danger of relapse, because cravings can return at any time. Along with that danger goes the issue of how we feel physically and emotionally while the repairs are taking place. Post-acute withdrawal can be a bear, and it can last for quite a while. Without a plan and good support, that alone can make us uncomfortable enough to want to use again.

Psychological and emotional damage from our period of active addiction — and perhaps even before we first used, need to be addressed. Getting clean does nothing to deal with those issues, and ignoring them puts us at great risk of using simply to make the bad feelings go away again.

There are social and legal issues to be considered. Getting clean does not prepare us to go back to work immediately, repair damaged relationships with family, friends and perhaps employers, clear up financial and legal problems, and deal with the other situations surrounding our addictions. Only time, along with some support and work on our part, can prepare us to deal adequately with those things.  One of the prime targets of rehab is to help clients develop a plan, a support system, and learn how to use them.

Some help and support for family members and significant others is needed. Therapy, or at least a support group, is highly desirable for them because living with an addict is traumatizing. This is easier to arrange if we are under the guidance of people who know how to help our families and friends begin to heal too, because us telling our family that we think they need help is pretty much a non-starter.

Finally, we get to the addict behavior that we need to change. When we used, we developed behavior that protected our addictions.  Over time it became ingrained. (I like to use the example of putting Kobe Bryant in a basketball game, but telling him he can do anything he would normally do except try to score. How long would it take Kobe to blow that assignment, after spending most of his life working to do nothing but score? His instinct to shoot when the opportunity arises would trip him up, sure as taxes.) The point is, until we develop habits of thinking and responding to the world like a sober person, we are likely to respond to stressful situations just as we did in the past. More than one addict has come back saying, “I don’t know what happened — one day it seemed like a good idea and I just picked up!”

So there’s no way, really, to give a simple answer to this question. A safe one would be “Stay in rehab as long as possible.” Of course we all know that other factors can stymie a plan like that. Best answer: consult with the experts who are handling your rehab, and take their advice if possible. More rehab can’t hurt.  There are very few problems that can be solved if we don't have the skills to tackle them, and if we relapse — well, let’s just say that’s not the best way to remain out of rehab.

What if someone I knew in rehab relapses?

When I was in treatment, I was convinced that all of our little group of roughly 40 would grow old together in recovery.  By the end of three months I had lost track of most of them, and at least one was dead. Twenty-two years later, I know of five who I'm sure are sober, and at least one of those relapsed but made it back.

At a minimum, three-quarters of us in treatment at any given time will drink or use drugs again.  Most of us will do so in the first three months.  That doesn’t mean that rehab doesn't work, or that we won’t eventually get clean and sober, but it does mean that many from a given group won’t make it that time.  Addiction is a chronic disease, and its most obvious symptom is relapse.  However, the things we learn in rehab are not lost, and they help to build the foundation of sobriety.

There is one thing that can’t be overemphasized: no matter what Junior Therapist qualifications we think we got in rehab, we are in no way qualified to get anyone else clean! Someone a few weeks sober trying to “twelve step” a buddy is a well-intentioned trip back into insanity.  Hundreds of thousands of alcoholics and other addicts who failed to believe that fact have themselves joined their friends back “out there.”

The important questions are, first, how do I stay clean and sober, and how can I help the ones who didn’t.  We’ve covered how to stay sober in these pages more times than I care to count.  We stay sober by utilizing all the tools available to us, honestly, thoroughly and to the best of our ability.  We go to aftercare if it’s available.  We live in halfway houses if we are advised to.  We go to lots of meetings.  We get sponsors.  We do service work, hang out with sober friends, and learn to live a sober life.  Hanging out with someone who’s drinking isn’t service, it’s suicide.  (That goes for anyone who’s drinking, not just people we know from rehab.)

We can most help that buddy from rehab by telling him or her we’ll see them at a meeting.  If our sponsor is willing to go with us, we might pick them up and take them to a meeting — once.  We never go alone!  We don't loan them money, spend a lot of time on the phone with them, let them crash on our couch, or do anything else that will make it easier for them to avoid their bottom.  If they get clean again, we follow the advice of those with more sober time about hanging out.  If they don’t become abstinent, we say we’ll see them at a meeting, that we’ll be glad to support them in recovery, but that we can’t afford to hang around with people who are using.

That’s what we do when someone we meet in rehab relapses.  Remember: we have to take care of ourselves first, or we won’t be able to help anyone else when the time comes.  When we’re newcomers ourselves, it ain’t time yet.



I Don’t Like Identifying Myself As An Addict At Meetings — Do I Have To?

Q.  I do not like identifying myself as an addict. I feel it is something I have, not something I am, and saying it constantly just reinforces the mistake, in my opinion, that we are addicts rather than that we have an addiction. Is it appropriate to abstain from identifying myself that way in AA or NA meetings?

A.  I have diabetes, so I’m a diabetic.  That’s not all of what I am.  I am many other things: a writer, a father, a husband, a photographer, a recovering person, a brother, a geek, a lover of nature, a birdwatcher, a friend, a person who attempts to sustain a spiritual life, and so forth.  However, if I forget that I am a diabetic, I’m in trouble.  If I fail to practice the behavior appropriate to my condition, then the quality of my life will be far less, and its length substantially shortened.

The reasons we in the 12-step fellowships have evolved the tradition of identifying as alcoholics, addicts, or what have you, are several.  We do it to let others in the meeting know that we belong there.  We do it because humans love ritual, and little rituals like that build cohesion in the fellowship, as do others like reading How It Works in AA, the several excerpts from the Basic Text that are read at NA meetings, and similar customs at other fellowships.  We do it because it shows a willingness to identify ourselves as one of the group.  But the most important reason is precisely the one that you allude to above as being an undesirable thing: we do it because it reinforces the self-knowledge that we are addicted — a fact that, should we forget it or begin to question it, could kill us.  It is one more defense against the denial that comes along with addictions of all kinds.

By nit-picking at little details, we distract ourselves from the initially uncomfortable fact that we are, in the most important respects, just like the other people in the room.  We make pious statements about “labeling,” when in fact if we were — for example — a PhD, we would have little resistance to labeling ourselves at the drop of a hat.  So, if saying I'm an addict makes me uncomfortable, I have to ask myself why. Is it because I’m “different?”  Is it because I’m still not convinced that I have a chronic disease?  Is it because, deep down, I don’t want to be associated with “those people” because of pride?

As our denial lessens, and as we begin to identify with the reality of our dilemma and realize the safest path out of it, we become less resistant to calling a spade a spade.  In the meantime, if we need to be just a little bit different, we can identify as a person who “desires to stop drinking,” or is “addicted to smack,” or something that we believe suitable.  They will serve the purpose.

But let’s not kid ourselves about why we’re doing it.

How do you separate yourself from friends and family who are using? They’re the only friends I have!

Café Terrace at Night - Vincent van Gogh

Imagine that we are sitting at a sidewalk cafe in Paris, enjoying a cup of great coffee and a croissant.  Most of the folks around us are speaking French, and since we don’t, it’s not very interesting until we hear some folks speaking English a couple of tables away.  Immediately we’re like, “Where are you from?  How long have you been in Paris?  Where were you before?  Where are you going next?  Oh, me too!  Do you know so and so?”  Perfectly natural.  These are our people and they speak our language.

If a person was looking for a sure thing, as far as relapse is concerned, he couldn’t go wrong by hanging around with active addicts, especially family members.  As addicts we thought in predictable ways, behaved in predictable ways, and we even spoke in ways that identified us — to ourselves and others — as members of “the club.”  In early recovery those are, to a degree still “our people.”  They speak our language, and we’re still trying to learn the language of recovery.  They can get us into a world of trouble.

The old people, places and things are big triggers, and smart people avoid them even when they’re no longer beginners.  Old friends — and especially family members — are the ones who wired our buttons, and they can play us like a barroom piano.  It’s the way we’ve always interacted with them, and they can’t help it.  Nor can we help reacting when they do it.  Add familiar circumstances and places — maybe the local pool hall and bar — to the interpersonal stuff, and even an addict with quite a lot of clean time can be in trouble.

Family is hard to deal with.  Those who use have a vested interest in seeing us get high again, and even the sober ones may find the “new” us a little hard to take.  Sort of a “better the devil you know than the devil you don’t” thing.  If they start the same old stuff, we probably will too, and it’s a sure way to end up relapsing — when we start speaking and thinking in that language again.  That’s why we recommend halfway houses, sober houses and other lodging away from home for beginners, places where the folks around us know where we’re coming from.  When we attend family functions, we make sure we bring a sober person with us.  What host is going to turn down our friend for Thanksgiving dinner?  Then the two of us can sit there and watch the drunks, giving each other an occasional knowing look, and split when things get really rowdy.  “Gee, I’m sorry Mom, but Joe has to go and I need to give him a ride.”

You know how everyone is always talking about developing a support system, going to meetings, getting a sponsor, getting involved in service, and so forth?  That’s because we need to find new people, places and things.  That’s where we meet the sober people, make new friends and hang out with our recovery family.  Then we branch out and have fun in other places, but always with one or more of our new friends.

Sober people do a lot of things besides sit in smoky meeting rooms, drinking coffee, and talking about the program.  Most of us end up having more fun than we did when we were using.  We go scuba diving.  We ride motorcycles in sober motorcycle clubs.  We organize and put on dances, and attend those organized by other sober groups.  Sober cruises are fairly common, and every cruise ship has a meeting (just check the activity boards for “Friends of Bill”).  There is quite literally nothing that we can do loaded that we can’t do sober — except get high.

So, the answer to the question in the title is simple.  We don’t separate, we just back off.  Chances are that we make our old buds nervous anyway, and they’re not likely to pursue us very hard.  We hang with our new friends in recovery, and that takes care of the second part.  Our using friends are no longer our only friends, and it’s a safe bet that our new, sober, friends will become just as important in our lives as those others were — and they won’t be trying to get us to poison ourselves, either.

Hitting the Curve Balls

In our company, I’m the field supervisor.  I’m the one who has to go deal with things when the site supervisors either can’t handle them or aren’t available.  That happened to me this morning.  A call at 8:00 AM changed my day, and practically all the chores (and fun) I had planned for the day are trashed: the price you pay for being a boss.

As I was rushing through the things I had to get done, I was thinking about how easy it was, compared to the way I would have dealt with the same sort of thing when I was active in my addictions.  First of all, I might have ignored the phone call entirely, and claimed I just didn’t hear it ring.  Then, before the next call, I would have put together an excuse that would not only get me off the hook but that (in my dazed opinion) would have made me look good some way: feeble neighbor to the doctor’s, volunteer at the hospice; or attract sympathy: grandmother died (if I could remember how many grandmother deaths I had left), food poisoning — any addict will know where I’m going here, because we’ve all done it.

Then, of course, I would have had to try to remember the details of the excuse for later, if needed, and also remember that I’d already used that one in anticipation of the next need for a story to tell.  Finally, it would have been one more indication to my bosses that I maybe wasn’t cut out for the job — although I wouldn’t have figured out that part, because I was too smart to get caught.

Now, as a boss, I deal with those sorts of things myself.  I see the patterns, the clues, the behaviors that set off all sorts of alarm bells.  I realize, too, how obvious the trend must have been to the people I thought I was fooling, back in the day.  In fact, I know they were obvious, because they ultimately resulted in my superiors forcing me into treatment with the threat of unemployment (thus saving my life — but I didn’t figure that out until later).

It was so hard being a drunk and addict.  All the excuses, all the fumbling for answers, all the (useless) attempts to keep others from knowing about my problems were an incredible amount of work for a mind that was constantly impaired in some way.  It’s so much easier now.  I just tell the truth: I can, or I can’t and here’s why.  It’s just part of the job — one of the things I get paid for, and that helps to keep our company in business so that I keep getting paid.  Nowadays I mostly do what I’m supposed to — the “next right thing” — and it always seems to work out smoothly in the end.  Life’s curve balls are much easier to hit now, and there doesn’t seem to be as many of them as there used to be.

Go figure.