narcotics anonymous

What are your thoughts about addicts in AA instead of NA?

There is absolutely no reason why addicts shouldn’t attend AA meetings.  However, AA has traditions that are important to the fellowship and to many of the members.  One of those is that they generally confine their discussions to alcoholism and recovery from alcoholism.

Disregarding the fact that alcoholism is an addiction like any other, and disregarding the “a drug is a drug is a drug” of NA, keeping drugs out of the conversation is the custom at the majority of AA meetings.  Everyone attending — cross-addicted people like me, and people not addicted to alcohol at all — should follow that custom in most cases.  It’s simply good manners.

There are, however, situations where a person is in crisis, and simply needs a meeting of whatever kind.  In that case it is perfectly proper — hell, it’s a life-threatening emergency — to say whatever we need to say in order to get whatever kind of support we need.  What I would do in that situation is simple.  I’d raise my hand and say “I’m not an alcoholic, but I really, really need help because I’m about to use.  Will someone come outside and talk to me about it?”  I would probably be invited to stay and say what I need to say, and if not I’d have a horde of people headed for the door with me.

Really, the substance has nothing to do with it.  What matters are the emotions, the behaviors and the solutions.  Those are the same for all addictions, and anyone should be able to talk about them in any meeting without ever mentioning alcohol or any other drug.

On Anonymity in Recovery

Submitted by Bill: I was at a 12 step meeting a few days ago where one of the participants’ remarks showed that he had no real idea of what anonymity meant, or the reasons for it.  So I thought I’d weigh in with a few ideas on the subject.

I tell people that I have no anonymity; that I drank and drugged publicly and I consider it a privilege to recover publicly.  Despite that, however, I do not advertise my membership in a particular 12-step program.  I often mention attending meetings, in my writing and elsewhere, but not which meetings.  I speak knowledgeably about AA, NA, and other fellowships, but I don't talk about membership.  I have what I believe are good reasons for that, and I'd like to share my thoughts with you.

As I see it, there are two basic reasons for anonymity in a program of recovery: protection of the recovering alcoholic/addict, and protection of the program itself.

First of all, if we wanted to tell people we were members of AA, that would be our business, and ours only, provided that we did it on a personal level.  We might do so when speaking to people one-on-one, or in small groups under conditions where privacy can be presumed, because friendships are enhanced by such honesty under most conditions.  Then, too, that revelation might raise opportunities to bring the 12th Step into play.

Another area where we need to be careful is in speaking to outside groups.  We need to be sure that we're not thought to be speaking for a particular fellowship.  If we set ourselves up as some sort of recovering guru, how is the program going to look if, six months from now, one of those folks sees us passed out behind a dumpster, or in the ER being treated for an overdose?

Could happen.  If you don't think it could, speak to your sponsor.

There are excellent reasons, however, for us not breaking  your anonymity.  You might be hindered in your employment if word got out.  You might be an airline pilot with 20 years clean and sober who had neglected to tell the FAA about her problem — required by law — and lose your livelihood due to our big mouth.  It could simply be an issue that you find embarrassing.  It's no one else's business.  Our business is to keep what we have learned about others in the rooms to ourselves, period.  (Whether or not the airline pilot is behaving ethically in that situation is not the issue; it's our behavior we're discussing — and that is not a hypothetical example.)

The last, and perhaps best, reason that I can think of for sticking with the tradition of anonymity is humility.  It makes me just “another bozo on the bus.”  If I'm going try to be a guru, it's going to have to be on my own merits, not those of the program.  That's good for me and for the program, because my opinions often vary somewhat from more traditional positions.   When they do, I need to take the credit — and the criticism.

Anyway, those are a few of my thoughts about the issue, and I'm only speaking for myself.  Your mileage may vary.

What Are The 12 Steps?

This is the first in a series of posts in which we hope to acquaint our readers with some of the details surrounding the programs that we recommend.  There are a variety of other programs, but because we and most other facilities shape our treatment plans around the 12 Step fellowships, those are the ones on which we will concentrate.

Twelve step groups have been much in the news over the past few years.  Most people have heard about one or another celebrity who was in AA (Alcoholics Anonymous), NA (Narcotics Anonymous) SAA (Sex Addicts Anonymous), or another of the roughly 200 fellowships more or less based on AA’s original 12 Steps.

The steps as we know them today were first published in the book “Alcoholics Anonymous” (1939). They were a synthesis of the combined experiences of the first roughly 100 members of the fellowship that took its name from the book, combined with principles from other sources.  There are far too many good histories of AA for me to presume to go further.

Essentially, the 12 steps are designed to change the way we look at addiction, our lifestyles, and the problems they have caused. They help us to accept the reality of our problems, identify issues, and guide us in clearing up “the wreckage of the past.” Finally, they provide us with means to continue to nurture our new way of life, and encourage us to help others achieve the same goals.

The steps work — for people who put in the effort.  However, they require quite a bit of work in order to gain the benefits. Many people who give recovery a try find that they are not able to do the work that is needed, for whatever reasons.  That isn’t surprising, because change is frightening, and because we alcoholics and addicts are accustomed to getting what we want quickly.  How long until I can connect to my next fix, pill, or exciting experience?  Is the sun “over the yardarm” yet, so that I can give myself permission to have that first drink?

After all that time thinking in the short term, it becomes difficult to think in any other way. Thus, when faced with several months or years of working on making changes in our lives and thinking, many of us find it difficult to knuckle down and get started.  Combine this with the ability of all addicts to find reasons, excuses and so forth for avoiding unpleasant things, and the ever-present temptations of old people, places and things, and we can see that there are some real obstacles to successfully completing the necessary work. This is true of all recovery programs, not just those based on the steps. As they say in the rooms, “It works if you work it, but it won't if you don't.”

In our Friday post, and those following, we will cover the steps and the rest of the program in more detail.

Newly Sober? PAWS Still Has You In Its Claws!

We all know that most relapses occur in the first few months after we get clean and sober.  Many of them are related to Post-acute Withdrawal Syndrome.  We talked about PAWS in a previous post, but I wanted to go into it more specifically here.

Although there are differences in the way they act, all addictive drugs function by either stimulating or imitating the chemicals of the brain's reward system — giving us too much of a good thing.

In an attempt to return our brain chemistry to normal (homeostasis), the brain builds more receptor sites for those particular neurotransmitters.  This allows it to deal with the higher-than-normal levels, leading to tolerance: the need for more drugs to fill up the additional receptors so that we can continue to get high.

When we get clean and sober, those extra receptors clamoring to be filled up are what causes withdrawal: acute withdrawal while the drug is clearing out of our system, and post-acute withdrawal during the period when the brain is deactivating the extra receptor sites and returning to normal.  Some authorities believe that it never normalizes entirely, which may be why any use usually leads back to full-blown addiction.

There is a double-whammy effect, too. When the drug is removed, there is a “rebound.” We begin to experience many feelings and physical symptoms that are the opposite of the way the drugs made us feel.  Removal of the drugs' stimulation causes the production of the reward chemicals to drop to below normal, and they return to their pre-addiction levels slowly. During this period we may be antsy, anxious, depressed, manic, or combinations of those feelings. We may feel as though our recovery is hopeless, and that we might as well use.

That's PAWS.  The duration  varies depending on the drug(s) used and individual physical differences.  It can — but usually does not — last for up to two years.  Ordinarily it will peak and then slowly subside within the first few months.  During that period (and in most cases for the rest of our lives), use of addictive drugs can put us back on the merry-go-round quickly.  It will also prolong the period of PAWS.  It can even set us back completely, because it interferes with the brain's repairs.

So, in early recovery we need to be prepared for a prolonged period of slowly feeling better, with setbacks when our bodies need that additional bit of natural feel-good and don't get enough, usually when we are under stress.  Stress aggravates PAWS symptoms because the natural “drugs” that help us to cope aren't back to full strength yet.

The good news: it always gets better, slowly but surely.

The best medicine for Post-acute Withdrawal Syndrome is time, aided by mild exercise, good nutrition, rest, stress avoidance, and distractions.  We need to have some fun.  We need the support of people who know where we're coming from, and who know how to deal with people in early recovery.

That's why we recommend meetings, fellowship, halfway houses, long-term treatment, and some time away from the old grind and the old stresses.  They help us deal with PAWS, while we're getting into the habits that lead to long-term recovery.

As George Carlin used to say, “Just because the monkey is off your back, it doesn't mean the circus has left town.”

If you've had your own experiences with PAWS, how about sharing in the comments?  Questions?  Feel free!

When do you know that you don’t want to do any more drugs?

I’ve been skipping over this question for a while, because there is no way that the answer can be anything but subjective. I can’t possibly answer it for someone else. I finally decided that it’s too important just to blow off with an excuse. Someone asked that question because they were still hurting, and someone else out there is too. Subjective it will have to be.

In my own case, I knew it some time before I got clean and sober, but I just didn’t think it was possible. I knew what happened if I went even for short periods without alcohol or a substitute, and there was no way (that I could see) to quit. But did I want to be free? Oh yes, desperately!

That’s the first part of the answer — the bottom that we talk about. The solution was forced upon me by my boss, who had a better grasp of the possibilities than I. After three weeks of detox and treatment, aftercare, a few hundred 12-step meetings and with the help of my newfound recovering friends, I was in fairly decent shape.

But the question still isn’t answered. When did the craving, the need go away? I honestly can’t say. The intensive program I was working kept me so busy that I hardly had time to think about using. At a couple of points down the line I got the impulse to have a drink or use. Looking back, I can attribute that directly to relationship and work difficulties that I still hadn’t learned to deal with in a less self-destructive way. At least one of those was a case of “drinking at” someone (except, thank goodness, I didn’t).

The desire to turn my brain off with drugs just disappeared when I wasn’t looking. At some point, I realized that I hadn’t thought about using for some time, and wasn’t especially interested in thinking about it then — and it’s been that way ever since. I don’t know if I was especially fortunate in that regard or not. Just as one person can never know (nor judge) another’s pain, so can I not relate my cravings, or lack of them, to someone else’s.

What I can do is tell you why they went away. I found better ways to cope with life. My program, the people in the 12-step rooms, the wonderful friends I made, the relationships that I developed with my wife, kids and other family, and the feeling of self-worth I got from helping others were all so much better that I couldn't imagine throwing that all away — again.

I believe there are three stages to recovery. The first occurs while we’re still using, when we decide we want out. The second is early on, when we are taking the first steps toward learning to live without drugs, and the third is the “maintenance phase,” where we keep on doing the things that helped us to begin with, and things keep getting better as a result. That’s exactly the way the 12 steps work, and I reached that point through their help. It’s not the only way, but it has worked for me and a lot of other folks I know.

And I haven’t wanted to do any more drugs for a long time now.

What about you? What was your experience? Please comment!

Are there groups like NA and AA for younger people?

We don’t know of any fellowships specifically for young people, although some may exist.  However, both AA and NA have groups that consist primarily of younger members. Generally their ages range from the mid-teens to mid-20’s, but it’s not unusual to find a few older members as well, and that’s a good thing.  People with substantial time in recovery provide the continuity that a group needs.

A check with the Intergroup office in your area will get you the information you need on when and where to find young people’s groups.  There are young people’s meetings, conventions, and a variety of other activities aimed at both newcomers and younger folks with some time under their belts, and they are a wonderful way to become engaged in activities within the fellowship.

We’ve always recommended that people go to a variety of meetings: open, closed, discussion, beginner’s, book meetings, young people’s, and so forth.  There’s no question that it is easier to relate to those who are closer to our age and at about the same point in recovery.  However, we need to remember that while we may feel more like they are our kind of people, that doesn’t necessarily mean that they are in a position to provide everything we need to work a program.

If we are uncomfortable with old-timers because we believe they’re judging our recovery, perhaps we need to get to know a few of them and get their actual opinions, instead of assuming that we can read their minds.  We may be surprised.  And they may have a lot to offer us, once we decide to talk to them.  After all, they’re the ones with the track record and experience.

It’s a good idea to mix up our program friends, concentrating not on their ages but instead on the quality of their recovery — but don’t skip the young people’s activities.  They’re the fastest track to healthy fun in recovery, and if you’re not having fun, you’re doing something wrong.

It’s also worth mentioning that both AA and NA have “sister” organizations for young people with recovering parents, other family members, or friends.  Check out Nar-Anon Family Groups or Al-Anon Family Groups for more information.

Anonymity — or not?

Those of us who work in or write about recovery (or both) tread a fairly narrow path when it comes to the issue of anonymity.

On the one hand, most of us want to adhere to the traditions of any fellowships to which we may belong, and anonymity is a basic tenet of most of those.  On the other hand, it is sometimes difficult to remain anonymous “at the level of press, radio and film” while doing a conscientious job of telling people what recovery is all about.  How, for example, is one to discuss questions, provide insight and so forth into the 12-Step programs without admitting — at least tacitly — that they are or have been members?  How is one to discuss the benefits of the steps, or sponsorship, or how those programs help the recovery process if they have to pretend that all they know about them is simply hearsay?

The same is true, in a somewhat broader sense, of recovering addicts in general.  When the fire of recovery is burning in your gut, how do you carry the message without admitting — even eulogizing — membership in the very program that is helping you to recover your life?

Then there is the issue of anonymity itself: am I violating the tradition by simply saying I attend a recovery program, or only if I name the specific program?  (Answer “b” is the correct one.)  Do I violate your anonymity by saying I saw you at a meeting, or must I specify what kind of meeting?  There are myriad variations on those themes.

Eventually all recovering people reach their own accommodation with these issues.  My own is to not mention specific programs.  I simply don't believe I can do my job or support other alcoholics and addicts properly without skating that close to the edge.  I've tried, and I was unsuccessful.

Currently, many people in recovery are questioning the wisdom of anonymity in general.  Their positions vary, but many knowledgeable, thoughtful people believe it is no longer really necessary, since addiction (and I include alcoholism whenever I use the word “addiction”) no longer holds the stigma that it did 75 years ago when the first 12-step fellowship was founded.  Others believe that, realistically, very few of us actually have anonymity anyway.  Still others think that AA, NA and the 150-plus other “anonymous” fellowships are shirking their duty to people who have not yet found recovery by not allowing their affiliation and their success to serve as good examples and inspiration.

I have my own opinions on these matters, but I prefer to keep them to myself on this blog.  It is not my intention to attempt to foist my ideas on others — at least not here.  I do, however, recommend this excellent article in the New York Times, which discusses the issues and presents the opinions of prominent recovering people.

If you would like to chime in with comments, please feel free.  And however you feel about this issue…

Keep on keepin' on.