Helping Teens with Substance Use Problems: Why I Changed My Approach

rehabs-shutter264689282-man-extended-to-young-woman-for-help
Rehab Helps Thousands of Addicts Quit. It Can Help You, Too. 1-888-341-7785

I got a new lease on my professional life in 2011 when publicity about the 40th anniversary of the “War on Drugs” and the oppressive drug policy failures associated with the war led to an “Aha!” moment for me. It motivated me to lift my head out of the sand and gain a wider public health perspective on my work with my young substance-using clients and their families, and it urged me to take a closer look at the effectiveness of the treatment I was providing.

It’s an exciting time to be working in the field because debates about the nature of addiction and its treatment abound. Such discussions prompted me to re-evaluate my approach, based on my training and experience working with teens and their families. I’m now convinced we can more effectively treat substance use disorders through knowledge of the public health issues determining the landscape that addiction treatment providers must navigate.

Skewed Research View

With my vision now clearer, I can see that my training in addiction as a chronic disorder was based on skewed research that included populations of drug users who were least likely to stop using. Many studies did not include drug users who quit on their own, couldn’t afford treatment, or got rejected from treatment.

I was also astounded to learn that most of those who meet the American Psychiatric Association’s criteria for addiction stop using illegal drugs by about age 30 through a process called “maturing out.” (In other words, they outgrow their drug problems.) Another surprise was that the vast majority of people quit using drugs without professional help and make the choice to quit on their own.

Skewed Clinical View

A disease model focus had placed me in an authoritarian position, with an expectation that failure to comply with my “expert” treatment recommendations would likely result in client failure.-Barry Lessin

Between my not realizing that most people mature out of their substance use disorders and my thinking that most who requested treatment with me had severe substance use disorders, I developed what’s known as “clinician error.” This phenomenon led me to believe that everyone who walked through my office doors probably was addicted or on a path to addiction. And all harmful consequences of substance use signified a “red flag” warning that their use was likely on a slippery slope to full-blown addiction. A disease model focus had placed me in an authoritarian position, with an expectation that failure to comply with my “expert” treatment recommendations would likely result in client failure.

Teenage Addiction TreatmentOnce I reviewed the literature about substance use patterns from the public health perspective – combined with what we know about adolescent development and my experience with effectively engaging young clients in treatment – I was forced to relinquish the addiction-as-a-disease concept. I began to recognize that my perspective on addiction and its treatment had become myopic, since it went along with the adage, “If your only tool is a hammer, then every problem looks like a nail.” Indeed, if your view is that everyone with a substance problem is on the path to full-blown addiction, then the possible treatment goals (usually abstinence-only) are narrowed and, by default, the recovery and treatment options are limited. I came to realize that the disease model had lulled me into thinking that I was offering individualized treatment.

I was forced to relinquish the addiction-as-a-disease concept… ‘If your only tool is a hammer, then every problem looks like a nail.’-Barry Lessin

With my mind open to the idea that not everyone who walks into my office is addicted and that some have less severe problems and/or are just looking to change their pattern of use, I began to utilize an expanded treatment tool box which granted my work with young adults an opportunity to be more effective.

Limitations of the Disease Model with Teens

Teenagers often come to treatment very reluctantly. Telling them they have “a disease,” as is common in traditional treatment programs, can undermine their existing emotional vulnerabilities, hampering whatever motivation they may have to get well. Instead, my treatment approach is informed by my training in counseling psychology and based on the human development theory that people have “problems in living” and that the challenges we face are normal ones as we move through our lives in predictable developmental stages.

Another problem with applying the disease model for teens is that it uses substance use disorder diagnoses as a foundation of treatment. While this can guide treatment recommendations and serve as helpful shorthand among providers to share information about clients, such diagnoses emphasize substance use as the treatment focus. This de-emphasizes the need to address co-occurring mental health issues such as anxiety, depression, and ADHD.

Diagnoses also tend to pathologize normal behaviors of adolescence, thereby reinforcing stigma and existing low self-esteem. Risk-taking, challenging authority, and novelty-seeking are normal teen behaviors that often occur as teens establish autonomy and identity. It’s not uncommon for them to exhibit irrational behaviors, poor judgment, emotional dysregulation, and problems with impulse control. Labels obscure this process. Most importantly, labels don’t reflect the uniqueness of each child and the specific family dynamics.

Most importantly, labels don’t reflect the uniqueness of each child and the specific family dynamics.-Barry Lessin

I embrace a psychobiosocial approach that views substance use as a complex interaction of psychological, physiological and environmental variables. It includes respecting the right to make choices and implementing changes through small, positive steps. Rather than focus on restricting or prohibiting risky behaviors, the goal is to reduce the harms associated with them.

For instance, parental ‘zero tolerance’ policies for kids who are going to smoke pot anyway forces kids to lie and be more secretive about their use, escalating conflict even more. It will put the teens in potentially more harmful situations and greatly limits parental response if their teen refuses to comply. On the other hand, opening up a discussion about the pros and cons of marijuana use will help parents better understand why their kid smokes and create opportunity for dialogue about what steps parents can take to effectively help their child.

Addiction as Maladaptive Learning

We’ve thrived as a species by having brains hard-wired to move us towards things and activities that are productive and pleasurable, and away from pain. Substances help us relax, sleep, have fun, improve creativity, and cope with the pain close to the core of more serious mental health issues.

Within this framework, addictions can be viewed as compulsive behaviors driven by cravings that require people to make choices…-Barry Lessin

Within this framework, addictions can be viewed as compulsive behaviors driven by cravings that require people to make choices about whether to use drugs. The compulsions are related to an underlying psychological process involving an interaction of emotional factors unique to each person.

A common denominator in working with all teens is for them to learn to make choices that will more readily shift from maladaptive choices to choices that are adaptive to psychological wellbeing. Teens are at a developmental disadvantage when evaluating the risks and rewards involved in making choices, because their impulse control and ability to weigh short and long-term risks and rewards are a work in progress.

Teens are at a developmental disadvantage when evaluating the risks and rewards involved in making choices…-Barry Lessin

When substance use is involved in the equation, young peoples’ difficulty in seeing future costs often offers the immediacy of getting high as the best choice. It can be more challenging because addictive drugs are most likely to provide immediate benefits but delayed costs.

Adaptive Learning in Treatment

The dynamic adaptive learning approach more accurately reflects a young person’s unfolding developmental trajectory and offers me more flexibility and treatment options than the static disease approach. I view the kids I work with as children, siblings, students, athletes, and community members – who also happen to use substances.

…focusing on their drug use as a choice that they have control over encourages kids to engage in discussions about options for coping with urges to use.-Barry Lessin

In this treatment environment, focusing on their drug use as a choice that they have control over encourages kids to engage in discussions about options for coping with urges to use. Treatment focuses on helping them understand their urges to get high, anticipate and better manage the impulse to use, and work through the underlying issues that are being temporarily solved by getting high.

This perspective allows me to engage more teenagers in treatment and also keep those with more problematic use in treatment longer. Teens are more willing to collaborate in their care when their shortcomings and failures aren’t reinforced, and they feel invested in the process of change.

My expanded and more flexible treatment repertoire, including evidence-based treatments like cognitive behavior therapy and motivational interviewing, allow me to be more proactive in expecting shifts in symptoms and behaviors, and offer me more opportunities to intervene for change. This includes helping clients to understand that the substances they use are not the problem per se, but their relationship with them can be, as can be their relationship with people. For instance, the outcomes of substance use will vary for the person depending on the specific substance and dose, the mindset of the user at the time, and the environment in which use occurs.

Viewed in this way, young people are better able to understanding where the harms lie in their use and are more willing to take steps to change.

Parent Empowerment

Part of my job as a family therapist is to offer parents tangible ways to understand what “makes their kid tick” and the steps to take to effectively intervene. Once parents learn that kids are not just little adults and that their brains aren’t yet developed in important ways, they can better understand why their teens repeatedly and impulsively make reckless or risky choices.

Armed with this knowledge and learning about the stages of change that reflect how people naturally move through a predictable process of change, I can help parents develop a realistic roadmap of the future. The road can be difficult and sometimes treacherous, but having that map offers hope, gets parents back in the driver’s seat and helps them feel more empowered.

 

Photo Sources: istock, pixabay

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Rehabs.com. We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • Kathy Brock Frasier

    I sure wish you had been my son’s counselor when he was a teenager. I participated in all of the standards offered 10 years ago. He’ll be 25 in January, a month after he is released from his last sentence. Great article, Barry.

    • http://www.barrylessin.com Barry Lessin

      Thanks, Kathy- Unfortunately, your comment about wishing you had this approach when your son was younger has been told to me countless times since I’ve been working with parents and parent groups in my advocacy efforts. But please know that your voice and your own advocacy efforts are helping to shift the conversation to make needed changes in our treatment system so more people will get more effective substance use disorder treatment

  • Counselorchick

    This is one brave and illuminating article Barry. There is a lot of skewed research on addiction disorders from which clinical errors are inevitable.

    It’s the clinician, when faced with the facts, who cannot or will not revamp their theories that cause the most harm. The ‘disease theory’ is absolutely the most harmful belief causing the inability of clinicians to meet their clients where they are, which is our mandate. It is highly impressive that you are meeting our code of ethics with the utmost integrity.

    Human beings have been using drugs from the beginning of time and this will never change — most of our greatest artists gained enlightenment with the help of intoxicants and their work has changed our lives for the better. As you said, the vast majority of people mature out of destructive substance use and moderate successfully later in life. Some plants. like marijuana, are highly medicinal and neither the substance, nor the user should be vilified due to a flawed ‘one-size-fits-all’ theory. An alcoholic beverage or any other drug is not ‘cunning, baffling and powerful’ — it is a beverage that holds no power over a person. As you have now realized, their are pros and cons of drug use and an open dialogue among family members is important, whether members of the family are using drugs or not. We, as humans, are faced with these decisions every day.

    Human beings are all-powerful and certainly not ‘powerless’ as some models of therapy would have us all believe. No, teens should certainly not be labelled ‘diseased’ and adults should not as well. That is the opposite of help.

    Labeling someone with a ‘disease’ when they may be in the throes of a behavioral disorder is providing them with nothing but a negative label for the rest of their lives. This ‘disease’ theory has probably destroyed more lives than the use of drugs could or will ever accomplish.

    Thank you for your bravery and your integrity. You are now free to truly help your clients, their families and generations to come. You inspire all of us to do better and continue our educations for the betterment of life.

    • http://www.barrylessin.com Barry Lessin

      Thanks for your kind
      words. To be clear, for about 10% of people who are at the severe end of the
      substance use disorder continuum, their use can take on the characteristics of
      a chronic, progressive disease. And I think there is value in shifting a
      treatment focus for those people with that in mind…but we shouldn’t START
      treatment assuming that everyone’s path will follow a disease-like path,
      especially young people. Medical diseases that are similar to addiction in
      that they also have important lifestyle components–heart disease, diabetes,
      cancer—have choices available to be made by the person that can influence to
      some extent the potential course of the disease.This should be the focus of treatment and can empower people

      • Counselorchick

        Absolutely Barry. As colleagues, we know this to be true. Unfortunately due to the pervasive hijacking of the 12 step industry when it comes to care for a substance disorder, clinicians do and have and continue to START with the dangerous ‘disease’ theory. This is unethical to the extreme and as more of us are awakened to the truth of maturing out, the hope is that clients receive the individual help they need rather than a mandate to either abstain or moderate. The drug itself is not the problem while the beliefs behind the behavior are the answer.

        Thank you again for the excellent article. Incidentally, can you provide a citation for that 10% figure. I have read that it is more like 5%. Whatever percentage it may be, there is an empowerment path (non-‘disease’) and a dis-empowerment path (‘disease”) The semantics of ‘disease-like’ are a rocky road. We need not label anyone with a negative affirmation like ‘disease’ or ‘powerless.’ The distinction is very important.

        Human beings behavior takes on the ‘characteristics of a chronic, progressive disease’ around far more than substance use or misuse. Just the food we choose to ingest is a choice and not a compulsion. Again, the distinction is very important.

      • France

        Hey, really well said. I personally think there’s far too much “alcoholism is this” or “alcoholism is that” going on around here. So far as the DSM-V is concerned with diagnosis, it’s so broad you’d expect people at opposite ends to require very different treatment. I agree chronic alcoholics exhibit different symptoms – and are probably much harder to treat. Spoken as a former chronic alcoholic, naturally.

        • http://www.barrylessin.com Barry Lessin

          Yes, France, each person has a unique path to and through their substance use history…and for sure, having the ‘right’ socioeconomic status can be helpful but money’s no help when you’re paying for ineffective treatment.

      • Peace

        Do you believe alcoholism and and drug addiction are the same thing?

        • http://www.barrylessin.com Barry Lessin

          Yes, I believe that it’s the same thing in the sense that substance use problems are determined, not by the substance itself, but our relationship with the substance. Our mind set and the setting within which we use the substance (specific environment, culture, etc) are important factors that will determine that relationship. Similarly to relationships with people, they are varied and change from time to time and over time.

          • Peace

            I was told, about ten years ago, that anyone can become a drug addict, but not everyone will become an alcoholic. That there is an enzyme in alcoholics that is not in the rest of the population. What are your thoughts about that?

    • Clarabelle12

      Which is why AA doen’t mind being the last house on the block. Try any number of things before you conclude that you may really be beyond the step down approaches. Interesting that drug and intoxicants are credited with creativity (something comedians often say about their drug use – they thought they were funnier, etc…) when that is often what people say about drinking. It made them feel brighter, smarter, funner and wittier. And those would all be great if there isn’t a down side.

      What creates a conflict for me…is when it is lauded if it helps someone write a better joke but anything brought about by a spiritual awakening is viewed as a joke in an of itself. It hasn’t been for the millions helped by AA over decades.

      The story of Brett Finbloom is one of undersaged drinking and tragedy. And even as an AA, I would have put him through many other methods as I think some of the problem was simply not knowing how alcohol works in a body. It would be some time to determine if permanent sobriety would have been thepath for him.

      • http://www.barrylessin.com Barry Lessin

        Clarabelle12, your points reflect the ideas in the article about respecting each person’s uniqueness and put energy into not judging them, but into engaging with them to walk alongside them in their path to take some positive steps forward. Giving honest information about the pros and cons of how substances affect us, trying to keep them safe as possible as they figure out their next steps. I’m not sure if there’s really that much more we can do.

        • Clarabelle12

          I agree, Barry.

          Thank you.

          Sent from my iPad

      • John McCready

        AA is the “last house on the block” because it BELONGS THERE-with its 1939 mindset, and REFUSAL to advance into the 21st century!

        • Clarabelle12

          Which is fine with me, John. Nice to see you.

          Sent from my iPad

        • Jack Shuman

          I’m with you, John. Leave “God’s chosen” in AA away from the general population.

      • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

        Actually, neither you or I speak for AA— but their literature speaks of not having to hit rock bottom. This means, AA doesn’t want the lowest of the lowest drunks and most desperate cases. So much for being the last house on the block— AA members began starting rehabs in order to make AA the first on the block. And today, AA still is welcoming those with short drinking histories into their program. AA began welcoming in “high” bottom drunks decades ago. The 1952 12×12 makes that clear:

        “In A.A.’s pioneering time, none but the most desperate cases could swallow and digest this unpalatable truth. Even these “last-gaspers” often had difficulty in realizing how hopeless they actually were. But a few did, and when these laid hold of A.A. principles with all the fervor with which the drowning seize life preservers, they almost invariably got well. That is why the first edition of the book “Alcoholics Anonymous,” published when our membership was small, dealt with low-bottom cases only. Many less desperate alcoholics tried A.A., but did not succeed because they could not make the admission of hopelessness.

        It is a tremendous satisfaction to record that in the following years this changed. Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism. As this trend grew, they were joined by young people who were scarcely more than potential alcoholics. They were spared that last
        ten or fifteen years of literal hell the rest of us had gone through. Since Step One requires an admission that our lives have become unmanageable, how could people such as these take this Step?

        It was obviously necessary to raise the bottom the rest of us had hit to the point where it would hit them.” Pg. 22-23 12×12

        Turns out the tragedy is AA created this illusion of a chronic progressive disease and young people are being harmed by this belief system.

        • Clarabelle12

          Sooo, is your entire thought based on the word “unmanageable”? Do you think simply because having material means a person cannot feel that parts of life are unmanageable, where alcohol is concerned? “Rock bottom” is going to be different for everyone, Juliet. Remember that the 12/12 demonstrates what AA learned during its first 20 years.
          I don’t speak for AA and never claimed to.

          Sent from my iPad

          • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

            Does this sound unmanageable: “Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism.” Page 23 AA’s 12×12

            • Clarabelle12

              You are projecting your values onto others, Juliet. Of course even people with luxuries can alcoholics.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                How are they alcoholics if they still have their health? I’m just quoting from the 12×12, that’s AA literature.

              • Clarabelle12

                Because you are making judgments.

                Juliet, is your definition of an alcoholic only someone who has to steal library books for hooch?
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                As the author above wrote, “Another problem with applying the disease model for teens is that it uses substance use disorder diagnoses as a foundation of treatment. While this can guide treatment recommendations and serve as helpful shorthand among providers to share information about clients, such diagnoses emphasize substance use as the treatment focus. This de-emphasizes the need to address co-occurring mental health issues such as anxiety, depression, and ADHD.”

                And you had an excellent comment following that up, which read: “The story of Brett Finbloom is one of undersaged drinking and tragedy. And even as an AA, I would have put him through many other methods as I think some of the problem was simply not knowing how alcohol works in a body. It would be some time to determine if permanent sobriety would have been thepath for him.”

                Seems both you agreed with Lessin when he replied to you 8 hours ago: “Clarabelle12, your points reflect the ideas in the article about respecting each person’s uniqueness and put energy into not judging them, but into engaging with them to walk alongside them in their path to take some positive steps forward. Giving honest information about the pros and cons of how substances affect us, trying to keep them safe as possible as they figure out their next steps.”

                I am merely agreeing with both you and Lessin. It is AA and the 12×12 I quoted from that disagree and claim there are high bottoms and AA is the answer for them. I’m confused by the sudden contradictions now. Are you now saying the teenager was an alcoholic? Because hours ago you wrote “And even as an AA, I would have put him through many other methods as I think some of the problem was simply not knowing how alcohol works in a body.”

              • Clarabelle12

                Juliet, why can you just not read what I post instead of looking for contradictions that are not there?
                You seem to have the notion that you have to be a under the bridge to be an alcoholic, to have lost everything. It knows no class, no age, no education level. You are the one assigning what rock bottom is, not AA. I don’t disagree with checking into things and AA isn’t opposed to it, either.
                Brett Finbloom of some personal acquaintance. I knew his father many years ago. You can google the story. At his young age (high school), probably didn’t have full knowledge of the pharmacological effect of alcohol. He wasn’t old enough to have the more traditional experiences alcoholics have before even thinking he had an alcohol problem although some friends have some questions about that. He didn’t have time to get DUIs, job losses, broken relationships…or even to mature out. But even so, I do know of people who were teen alcoholics that came to AA and were successful in stopping drinking. They choose to.
                Lessin is a counselor. It is his job to go through the paces with his client.

                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I read what you wrote and saw a contradiction between what you replied to Lessin and what you replied to me. Didn’t have to look for anything. Lol. I never said that was my notion at all; in fact, that under a bridge idea is very judgmental, don’t you think? AA’s 12×12 defined the membership it wanted didn’t have to be rock bottom. That’s called raising the bottom; I am sure you’ve been in meetings long enough to know what a low or high bottom is. I get my information from the AA literature when it comes to me learning whatever AA thinks about something or another.

                I like what you said about having other methods to check out; I agree with you. But however, AA would say Finbloom was welcome in AA because they think there’s a high bottom alcoholic. One without those “more traditional experiences” you state. How do you square that with the AA literature? Which again stated: ” “Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism.” Page 23 AA’s 12×12

                So what you’re saying is you don’t agree with AA in what they have written in the 12×12. I think Lessin is taking the right approach. One shouldn’t be labeled with a disease early on whereas those negative consequences and belief systems are damaging. I don’t know how I could connect you to the Finbloom story since I don’t know who you are.

              • Clarabelle12

                There were no contradictions, Juliet.

                A person would have been welcomed into AA if they had a desire to stop drinking. Nothing I have said isn’t squared up in the literature. I think you are just misconstruing in an attempt at conversation.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I was complimenting you on how you phrased it: “And even as an AA, I would have put him through many other methods as I think some of the problem was simply not knowing how alcohol works in a body.” In your previous comment. I meant nothing more than that. I simply stated AA does not think so, AA wants high bottoms, binge drinkers, young people, and does not mention “other methods” in its literature anywhere. I squared that up myself with the AA literature and copied and pasted it several times.

              • Clarabelle12

                Juliet, you are wrong and cutting and pasting at your convenience. You decided what does and doesn’t sound like a bottom to you. AA is for those who have lost choice in the matter of drink, and that isn’t limited to any social dynamic. With young people, as is the subject, I do think some things need to be covered before making certain conclusions.
                AA doesn’t believe it is the only game in town and never has. It doesn’t have to be a one stop recovery center. It has its focus. If a person wants something different, they can show some gumption and do some research.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I’m wrong about what the 12×12 states? “Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism.” Page 23 AA’s 12×12

                Edit-addition: I wish AA actually did make it known to whoever stumbles into their rooms, young-old, healthy-not healthy, they aren’t the only game in town. In 2003, you could have fooled me. I had to discover alternatives on my own. That’s a shame. I wasted a lot of time when I didn’t have to. I really didn’t know there was research to be done. I was convinced by a rehab center AA was the answer and trusted them— they were professionals. Of course, I’m not 21 anymore. I am less naive now.

              • Clarabelle12

                Of course it says that. You qualified it earlier as if sounding implausible that anyone with all of that could still be an alcoholic. Of course there can be.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I can believe they have the “things” such as cars or their job— but their health? I doubt one is an alcoholic if they have their health. Yes. I absolutely doubt that. If drinking booze that excessively hasn’t affected their health then why would they be seeking help for alcoholism? Can you imagine someone saying, “I’m healthy, have my family, they’re not mad at me. I have my job, I’m great at it. I take care of my cars, haven’t missed a payment on one, own the other. I think I must have a drinking problem!” Lol… No, I’m not buying it. ESPECIALLY the health part.

                I mean, can you even tell me what on the list would motivate someone to get help for a drinking problem? I can’t see it.

              • Clarabelle12

                What about your mental health?

                I have no physical repercussions from my drinking days. Didn’t when I stopped, either. How someone feels drinking negatively impacts their life is up to them.. George Bush is an alcoholic. At the time he put down the last drink, he had a family, lots of money, owned a sports team and alot of Texas loved him. But he was a falling down drunk, too.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Clara it said “health” I imagine that encompasses all forms of health. But then again, it did not break down health into subcategories. Shame on AA for not being clear and specific for us. George Bush didn’t go to AA to be sober. Even though, by AA’s calculations, if he got sober without AA he wasn’t a real alcoholic. AA’s for those who want it not those who need it. What does your sponsor think of George W’s sobriety without AA?

              • Clarabelle12

                I imagine if we were to discuss W., it wouldn’t have a thing to do with his sobriety.
                AA doesn’t say real alcoholics can’t get sober elsewhere. It encourages anyone to try. Many may need AA but it prefers those that want it.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Then why on Earth is AA accepting court orders and actively pursuing the courts through its literature? I fail to understand AA being an all volunteer group when AAWS prints this material. I hope you understand my confusion here.

              • Clarabelle12

                I suppose it has to do with the huge numbers of people in our prisons who are there for drug/alcohol related offenses. The recidivism rate might be lower with some help. We could ask your same question of WFS, SMART andSOS as all have presence in prisons. Jim’s SOS would collapse without it. Texas State Prisons is his largest taker. The organization as a whole boasts of 20k members worldwide.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                But AA hasn’t lowered the recidivism rate– not even for DUIs. There’s evidence AA actually increases binge drinking and since AA began, there have been more DUIs not less. In jail or prison, there shouldn’t be any alcohol so not sure how “one day at a time” applies there. (Of course prisoners make their hooch or whatever… just in general, there shouldn’t be alcohol.) So what SOS has Texas… AA has all the other states. Seems you’ll pick on SMART for having a safety rules thing and you’ll pick on SOS for being in prisons but never would you pick on AA. Come on, there has to be something about AA you can criticize with the same oomph and gusto! I’m sure you can criticize AA’s flaws better than anyone else could :)

              • Clarabelle12

                I think Tom would be tickled to be in ever state in the same way. That isn’t as AA’s door.
                I don’t know if there is any one thing that can lower recidivism rates, but I do know that most of the alternatives out there are in for their piece of the pie. We cannot address one without addressing the others,and the founder of SMART is going to talk to his board about their role in it. Like me, he doesn’t share the opinion that punishment and recovery make good bed mates. There should be drugs or alcohol in jails or prisons,but we know they are there. I also believe that relationships with booze are mental and physical. That is one reason why relapses often are not spur of the moment happenings. when people look back on them, they can see the mental set up.
                I am not picking on SMART for it safety statement. But I view it as a disclaimer of legal responsibility much like a writer of a diet book would tell you to have a physical work up before trying it.
                If I would criticize anything, Juliet, it would be not properly talking about the medication position. Of course, I also think that people need to read the materials themselves. Fellowship and sponsors are not simply cribsheets for the materials.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Yeah but unlike SMART AA’s medication brochure is for those who order it— it’s not a part of their “curriculum” so to speak. It’s frustrating because not all AA meetings have the same information, that’s a huge problem. If you go to a SMART meeting it’s basic. It’s simple enough you know SMART’s stance on medication right off the bat. With AA there is too much damn literature at this point. Have you seen the enormous volume of AA literature on its website? It’s gotten too complicated to simply state which AA writing is better than some other AA writing…

              • Clarabelle12

                I don’t know where it is in SMART. I cannot go to a meeting so I don’t know if those positions are for personal perusal or if they read them at the beginning. You have to buy their workbooks so I am not sure what the difference is. Living Sober has both the medications thoughts and relationship thoughts more defined. In my dealings, it is the first book we use. I hve noticed where I live now, most of the meetings are discussion meetings. That isn’t a “study”meeting. I would be surprised if many people read much of it if those are the only kinds of meetings they attend. My group at the beach had a discussion meeting, a 12/12, a BB meeting and a ladies/mens meeting.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                The main difference is SMART facilitators are trained; AA members (leaders- secretaries, chairpersons) are not. Living Sober is not the “Main” AA book. I’ve said it before, it’s better than the Big Book. Of course, the AA program tears down self-esteem for those who it may not help at all. Their methods are not helpful to too many who try it. So it’s important AA stays interested in helping alcoholics not just promoting itself to them.

              • Clarabelle12

                That is somewhat debatable, Juliet. When I checked into it, training was available and an option. Detractors thought the SMART meetings were just bridges to more expensive counseling (as most facilitators were not just members of the community but counselors) or Tom’s pretty hefty priced rehabs. As for AA, if you ned other things (which came up in my 4th step) you certainly are encouraged to go get it. The literature says that, especially the primary piece, the Big Book.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Actually the Big Book written in 1939 contains The Doctor’s Opinion, and other bits, that make it seem as though AA is the only game in town. Here’s Dr. Silkworth’s words: “We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics, but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge” Makes it seem as though doctors cannot solve this alcoholism problem… doesn’t it? Silkworth goes on to say: ” We feel, after many years of experience, that we have found nothing which has contributed more to the rehabilitation of these men than the altruistic movement now growing up among them” So no doctors, just this movement called AA. And in 1939 there were no alternatives to AA. Your sponsor may have had better advice than someone else’s… considering AA members are untrained their messages can be different person to person. At least a SMART facilitator has something called “consistency” in their messages.

              • Clarabelle12

                “we have found nothing which has contributed more… isn’t the same thing as there is nothing out there.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Ok, you’re right. I’m wrong. It would mean there is something else out there. Just nothing that “has contributed more.” Which would mean, anything else has contributed less. AA would be the most important player in the game. Don’t try doctors; don’t try alternatives. None other than AA “has contributed more.”

                I believe it’s due time AA clarified the present day world AA exists in. Right now AA lives in the past.

              • Clarabelle12

                It is just my opinion but I think AA wants to focus on its method and leave others to do theirs.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I believe what AA has printed in their literature. So I believe AA wants to focus on its method (as you said) and the AA literature keeps membership uniformed about alternatives. (Because none of their literature informs this.) At least the alternatives are not hiding the fact AA exists. SMART and SOS are honest, open minded, willing, loving, and unselfish.

                AA is self-centered, selfish, and has a huge ego. I wish the organization would take an inventory as their 12 Steps Illustrated claimed it should. AA literature says everything for itself.

              • Clarabelle12

                I disagree, which I am sure is no surprise.

                If I went to an SOS or SMART meeting, I wouldn’t want to be hearing about AA. I remember massive saying she would go to the SOS meeting in LA, vent about AA and leave. There is one SOS meeting in LA. That was an abuse.
                I also think it is hypocritical to expect an organization to be willing to do the bidding of people that roundly criticize it.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                That just sounds weird to me. Isn’t the point of a support group to not censor what one talks about? And if AA was part of someone’s problem of course they are allowed to bring that up at an SOS meeting. And if someone benefits from AA they are allowed to say they attend both AA and SOS. The same thought of sharing (without censorship) should happen in AA. It has nothing to do with going to AA and saying “Let’s talk about how SMART works today!” I’m sure you might agree that one is allowed at the least to mention SMART exists in an AA meeting. Isn’t that rigorous honesty thing about being rigorously honest? Don’t secrets keep AA members sick? Are they not supposed to work an honest program? Or are they busy trying to run the show— if only AA members would not mention SOS or SMART— if only AA members would do this or say that. Sorry, but I disagree with you.

              • Clarabelle12

                I think it does a disservice to others in the group who are trying to learn what SOS has to offer to help with alcoholism.
                I have mentioned alternatives in meetings but that differs from what took place at the meeting as described by the person who did it. Mentioning an alternative in a meeting isn’t the same as letting it dominate the conversation for those who came to hear the SOS (or AA!) message. There Is also one SOS meeting in LA. If I waited all week to go and that is what it was,I think I would have been upset or at least confused.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                So one should only care what other people think not what may help them? Doesn’t sound helpful to the individual. Let alone, that is censorship— I think it does a disservice to the group not to be aware there are other alternatives. Mentioning them in passing does not mean the other group’s methods are being taught at the meeting.

                I think also it is time there was an official support group for those who have been harmed by the 12 Steps because they need to heal, vent, and share their experiences in order to move on. This isn’t really being taken seriously by any agency I can think of.

              • Clarabelle12

                There are, Juliet. The OPF is one. They have their own steps, slogans, chants, etc.
                I have mentioned them in passing. That isn’t the same was what I have seen presented here, which is often that AA should teach those same things or permit them to be. I don’t agree with that.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Awareness and recognition other groups exist is not teaching those other groups’ methods. AA denies others groups exist, and yes, that is not helpful at all to those seeking help from any group for the first time. Members either choose not to educate others of their mere existence or the members don’t know about them either. That’s been my experience. Either the subject is helping alcoholics get well or the subject is being selfishly spreading one group’s methods. On that test, AA is selfish.

              • Clarabelle12

                AA does not deny other groups or methods exist.

                Good night, Juliet.

                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                AA does not inform anyone in its rooms; it does deny the information on a very basic level. Good night Clara.

              • Clarabelle12

                It doesn’t have to, Juliet. Why isn’t it someone’s job to check into a few things? It doesn’t deny it at all and never has. It just chooses to focus on its path and to let others do the same.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                First off I already said good night… Next, yes, AA doesn’t have to be helpful or informative for those who go to AA seeking help. Next, it is AA’s job to supply information but as I just mentioned it does not. Thus, it becomes someone else’s job. But that really shows AA’s true colors. “I went to AA to get help for a drinking problem, and AA didn’t have information that other programs existed. I had to find that out by other means.” That just sounds ridiculous. AA’s path is closed minded and self-centered. AA cares not for helping people with drinking problems they only want people who are helped by AA. Thus, what kind of narrow definition of help is that?

              • Clarabelle12

                I said good night too, Juliet?

                Why is it ridiculous that AA doesn’t do that? It doesn’t endorse or do anything that could suggest or imply endorsement. Do you expect that in every area of your life or just when you want to ride the brand equity of an 80 year old organization? When you bought you car, did you o to the dealership and expect brochures of all the other makes and models? When you went to the doctor the last time, did you see cards for everyone else specializing in the same thing? When you went to college, did you see brochures for other colleges in their admissions offices?
                What a whiner. “I went to AA and didn’t want to do any of my own research and they told me nothing, fools!” Juliet, Ihave called the rehabs advertised on this site, especially the alternative ones. Do you know what they say to me when I ask them the same question? They tell me to do just what I say here. Do your own research. They don’t give me names and numbers of other places.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                It is absurd people go to AA for help and AA’s help is tragically limited. Recognizing court slips, or that other meetings exist, or sending AA members to hold meetings inside rehabs, does not equal endorsement. If I go to the gas station, I expect help with them turning on the pump. That doesn’t mean I expect them to pump the gas for me. I expect doctors to be aware of other doctors in the area. That’s just how things work. My friend works for one car dealership and is fully aware of other dealerships, and will recommend other places once its certain the buyer isn’t in the market for that price range. Lol.

                Why do you think others have said also they never heard of alternatives in AA they wasted time there and felt stupid thinking AA could help them. It does piss people off that they were told AA could help but AA prohibits sharing vital information that could help many more people out. “Do your own research” is a very condescending, pompous, patronizing answer. They went to AA for answers and their answer is, “Just go look it up, we don’t give you answers here.” How rude can a person be? OH well, though, if that’s the image AA wants to have, then they will have to be used to angry ex-members for the rest of their existence.

              • Clarabelle12

                Because they didn’t do due diligence, Juliet. The internet has been around for 15 years. People to day don’t have a reason to not do at least as much discovery on this as they would other things. I have checked out make up online more than many of these people checked out something as serious as help for alcoholism.
                Before that, who knows what they did? Even before the internet, I knew how to research for things I wanted to buy. I knew how to looks for other things as I had to in college. I can’t be the only one. But SOS is 30 years old, SMART is 20 this year. WFS is almost 40 years old. Why is it up to AA to provide visibility for them?
                I have friends in dealerships, too. While they are going to tell someone where the Lexus dealership is, they are not going to discuss other dealers in their brand. They may price match something, but they aren’t going to help sell someone else’s mech. I have friends in food service, too. They will tell you where you can get something not on the menu, but they aren’t going to tell you everywhere else you can get a steak or keep their menus on hand. When I worked in new home sales, I didn’t have brochures from other communities in the area “since we all want someone to buy a house.”
                You simply fail on every point, Juliet, to ever accept that we have an obligation to do some self study. I would say that is self empowerment. And you are wrong on another point. If an AA wants to tell someone of something else, they can. I have done it. But the clubhouse is under no obligation to do what you used to want and that were brochures in the clubhouse. Clubhouses for AA aren’t going to do that and most Boards of Directors aren’t going to allow it. THEY are the ones who determine what is in the clubhouse. Covenants can limit it, too. AA wants no affiliation or perceived endorsement. They have that right. Again, you just want someone with brand equity to push your brand when they should be doing it themselves.
                Sometimes someone has to want something enough to look into it.

                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                “You simply fail on every point Juliet to ever accept that we have an obligation to do some self study.” In all respect, although I agree the Internet is a fantastic source, many arrive in AA (or through rehab) and are told it is the only way. The source (a rehab counselor, doctor) seems credible and professional; or those in AA with their 79 years of existence, seem credible. Simply, people are not aware what to look up— if there is something to look up. Unlike, say, with cars. Why is it everyone should think and know everything when they get to AA, or be as smart as you may be? Isn’t that an unrealistic expectation on your part of others that they’re essentially stupid not to know or not to do exactly as you do and think? That attitude is exactly why AA is closed minded and seems unconcerned with supplying information to people in need. I don’t accept that because AA’s role in society is too large and important for them to act so irresponsibly.

              • Clarabelle12

                I think that counselors certainly should educate on all modalities, Juliet. I don’t think it is AA’s job to nor do I think it is irresponsible of them to take that position.
                Sent from my iPad

              • Clarabelle12

                Juliet, it sounds ridiculous to you because you want something from them.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Are you saying people who go to AA don’t want anything from AA? AA’s not supposed to give them anything? Then why is anyone there?

              • Clarabelle12

                You do, Juliet. of course people going to AA want something form the program. But you don’t want AA or its program, just its 80 years of brand equity to move your preferred programs forward. I have explained to you why this isn’t going to happen. But I do find it a bit humorous that you would want them to benefit your programs while you down on it all of the time.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                You mean a brand equity that doesn’t inform, educate, or be honest with its membership? No, I don’t like AA’s current brand equity. That’s an interesting way to deflect and distort the problem unto myself and the other groups and not point any fingers at AA, here. But it seems the previous 30 some years AA has built up its “brand equity” by pretending it is the only program around and the very best one at that. May this purposeful ignoring of reality and current times be part of the reason AA maintains its monopoly? I do not find it humorous that AA is more interested in itself than actually helping others get better, even if its not them. Despite the smaller scope of SMART and SOS’s reach, neither of those two organizations ignore AA exists. Why are you not thanking SMART and SOS for helping others to know AA exists? At least SMART and SOS are working an honest program.

              • Clarabelle12

                I would think, given your opinion of AA, you wouldn’t want anything to do with it. But you would if AA suddenly threw open its doors and became some sort of “recovery fair”. But it isn’t. It doesn’t want to affiliate or endorse anything else, so why not just let them conduct its business as it sees fit?
                You have in interesting way of looking at it. It’s very black and white. If you don’t get what you want, suddenly AA is ignoring or denying something. It doesn’t and never has. Just because it chooses to not involve itself in others is fine. It would be fine if SMART chose not to as well. No one asked for that.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Clara, my opinion has nothing to do with the facts of which I am extremely concerned about. With rehabs requiring the 12 Step program and up to 95% using the 12 Step education I cannot avoid having an opinion. There are too many others (not myself) expose to the AA program each day and they are the ones who need the information and honesty disclosed to them through AA. Even those who do not enter AA through rehab. I will not turn a blind eye and just wish they’ll use the Internet first because society has trained the majority of us to think of AA as where to go to for help. My way of thinking is linear and logical, not black and white at all, but more matter-of-fact. Of course AA is ignoring remedies which may help alcoholics and it is denying to offer information which help. To reply that is something AA just won’t do and to accept that is unconscionable. That’s not even black and white thinking that’s just shutting the door on a conversation. You don’t speak for AA, so although I appreciate your opinion that “it chooses to not involve itself in others” it is not fine with many. In fact, it is more important to look beyond black and white/ what AA does or doesn’t do/ yes or no thinking… AA is involved in rehabs, schools, courts, and medical facilities and otherwise. AA chooses to involve itself in so many things it is absurd that AA would avoid mentioning groups that are not AA. Hell, AA guidelines mention NIAAA and ASAM so I call b.s. that AA doesn’t involve itself in other things. It is a good thing SMART meetings acknowledge other methods exist because it is HONEST. Doesn’t AA teach “honesty”? Why doesn’t AA practice what it preaches?

              • Clarabelle12

                I simply disagree, Juliet. I agree that rehabs have the obligation. I believe that schools and courts should do the same thing. You should be talking to Tom Horvath and Jim Christopher about moving their programs, not expecting AA to do it. You are looking to the wrong people for help, the very organization you despise.
                I think it is a new era. Even if people didn’t google options before, there is no excuse not to now.
                If a person comes to AA and it isn’t for her/him, then go on to something else.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                So the responsibility is thrown onto the rehabs, schools and courts even though AA prints its literature instructing AA members how to approach and work with rehabs, schools and courts? And SMART and SOS should do this, or should do that, but AA does not have to do anything? If I’m following you, rehabs, schools, courts, SMART, and SOS must do things and change what they’re doing, but AA does not have to do anything or change anything? That is weird how AA is not responsible for its own actions ever, according to you, but I’m sure others would disagree with you even those on the AA board may disagree with you. It’s too bad even I heard in AA that AA was the only way, the best way, and there was no other way but “jails, institutions, or death.” In fact, those were alternatives to AA I was told about— no other program was referenced. Not even doctors were referenced. How on earth are we supposed to control the bad advice members’ give? Because certainly you would not give advice that left out other programs if you were talking one-on-one to a newcomer. So, for newcomer,s is it hit or miss or the luck of the draw who they meet in AA and what that person tells them? Guess so.

              • Clarabelle12

                Yes, if they want the same success, perhaps the alternatives should work as hard as AA did for 80 years.
                I would still tell a newcomer to do their own research, to be involved in their recovery, Juliet.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                AA did not have to challenge a monopoly. As it is AA had a clean slate to build up the rehabs (Minnesota Model) favoring their 12 Steps. They made their empire and do not want to inform others about any other way. Now I admire that you do your best to inform newcomers to research what they can. AA should do what you do. AA’s literature makes research seem like “fantasy” and makes “fantasy” seem like research… have you read AA’s literature. It makes promises that newcomers may find a Utopia and a new freedom and happiness. It claims the only alternatives to AA are “jails, institutions, and death.” I can’t imagine, hearing what you believe in and stand for, that you can agree with much of any of AA’s literature aside from it’s spiritual teachings. The program is very self-centered and does not teach others to do their own research.

              • Clarabelle12

                I found those things, Juliet.

                That you don’t believe AA is not the issue. Your issue is that you want the alternatives more represented. They have to do that.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Clara, wanting the groups to be more represented has nothing to do with AA being dishonest and not informing participants of factual information. Whether or not AA informs of SMART or SOS or names them at all would not even begin to solve AA’s dishonesty issues. SMART and SOS will continue to have a presence as more and more people leave or don’t recommend AA because of its problems being exposed. Would I prefer AA to be informational and educational, sure, but AA has the reputation of not being that and that truth is getting out there. Wherever someone doesn’t know about it, I’ll let them know. Word of mouth is good for now.

              • Clarabelle12

                Juliet, I don’t think they are being dishonest. I don’t think it works for everyone but I agree with Tom int haat people go to these things because they do get some help there. Those who do not move on to other things.
                But whatever it is you feel about the program, you still want AA to help the programs you do believe in to move forward. That isn’t right.

                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Clara, I don’t think the sky is blue in that case but the sky is as blue as AA is dishonest. I believe AA offers very limited help and if AA doesn’t help someone AA puts the responsibility on the participant instead of seeing where AA fails to help or what else it could do to be more helpful. It has nothing to do with my opinion of AA it deals with the facts, but AA doesn’t deal with facts so you’re right— I want a faith based organization that ignores facts to suddenly change and care about the facts. I am likely fighting a losing battle. However, if others are informed by my posts and writings and learn that AA isn’t educational they will likely not choose AA as they’ll know better. I don’t ask AA to help out SMART or SOS, that is a twisting of the situation whereas I suggested AA honestly acknowledges they aren’t the only program and there are others. That is what is right; that is “more will be revealed.” AA’s own literature demands that AA becomes “friendly with its friends” as Bill W. put it. But I don’t know if I can believe that if AA is being dishonest anyhow. So what I want— if you’re asking— is for AA to be an honest program like it says it is.

              • Unwelcome Guest

                Asking AA to be honest is like asking a liar to admit they are lying.

              • Clarabelle12

                Well, Juliet, I guess we are just going to have to end another night with agreeing ti disagree.
                I don’t think any of the other programs doesn’t require effort on the part of those seeking to benefit from it. All anyone can ever do is offer tools for another to use. AA has always said it was a spiritual program and invited people to take another path if this was wasn’t for them.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                At least the other programs encourage research unlike AA and they are open about what those other paths are. AA likes to be all secretive and dishonest, that’s AA’s problem really and I’m only one person who can’t fix AA single-handed. Good night Clarabelle12, and have a great week.

              • Clarabelle12

                I think if you were to ask for membership records of any of the alternatives, you’d find them unavailable, too.
                Sent from my iPad

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Membership records? Why would I want SMART, SOS, or AA to have membership records? Very out of the blue comment.

              • Clarabelle12

                Those are the records people talk of when they say AA keeps no records.
                Sent from my iPad

              • LaurenGlenn

                Girl, get help!

              • Amythist

                Yes, when I was in AA the censorship was unbelievable. Everyone was expected to say exactly the right things in exactly the right way and if they didn’t they’d get told after the meeting was over.

                I guess that’s why they tell you to take the cotton out of your ears and put it in your mouth. You’re not allowed to speak freely. You have to follow a certain formula and even the old timers sometimes make mistakes!

              • Guest

                Psychiatrist gets out pad of paper & pen

                Patient tends to lean on the side of desperation and psychotic delirium a great deal of the time. Accuses others of being judgmental, yet judges everyone herself.

                stops writing, draws a stick figure of patient hanging from a gallows

                Patient assumes others are projecting (not sure what) onto her, yet she herself projects her thoughts onto others, and seems confused. I sense paranoia and deep-seated issues stemming from her deceased father figure, resorting to fantasies of men like Clancy and BillW in an attempt to rekindle memories of her daddy.

                End of session, rolling eyes

              • Clarabelle12

                Why isi t that you keep chaning your name back to guest? What I get in my inbox generally has a name attached to it but then it gets changed to “guest”. Monica Richardson does this as des Gunthar and another few oranges. Why not just be straight up about who you are?

                You disagree with me, fine. If so, why continue to give me so much of your time? Perhaps you should lay on your own couch. Perhaps after a latte at Starbucks.

              • Kid Lovin Clara

                As if your name is “Clarabelle,” Susan.

              • Clarabelle12

                When I have done that, the oranges come out in force that I am not maintaining my anonymity. But I am not using one moniker only to then change it later. Monica uses her real name in connection to advertising, but then goes on rants under a pseudonym that are rather entertaining.

              • ClaraHell Texas

                Go ahead and lay down, please. I’ll be with you shortly.

                Psychiatrist gets out pad of paper & pen

                Patient tends to lean on the side of desperation and psychotic delirium a great deal of the time. Accuses others of being judgmental, yet judges everyone herself.

                stops writing, draws a stick figure of patient hanging from a gallows

                Patient assumes others are projecting (not sure what) onto her, yet she herself projects her thoughts onto others, and seems confused. I sense paranoia and deep-seated issues stemming from her deceased father figure, resorting to fantasies of men like Clancy and BillW in an attempt to rekindle memories of her daddy.

                End of session, rolling eyes

              • Clarabelle12

                I am truly humbled. I cannot believe that someone would be up at 2:25 AM to give me so much attention as I snooze in my luxurious kingsize bed with fabulous sheets. Guess I had better things to do last night. ;)
                Sent from my iPad

              • ClaraHell Texas

                You guess wrong, miss thinks-she’s-such-an-expert…at nothing. I work the nightshift, if it’s any business of yours. Which it’s not. So kma and have a nice meeting.

              • Clarabelle12

                Wow, you can seek me out on your job? I am even more than humbled!!

                We did have a nice meeting. We are taking a vote to discontinue the 24 Hour Book.
                Sent from my iPad

              • ClaraHell Texas

                Wow, everybody. She assumes I sought her out. Bwahh haaa haaa. Funny. rolls eyes

              • Clarabelle12

                I amnot assuming anytihng. You see, a number of of posts came into my inbox under differennt names. Whne I then click on the link to to come the blog, the same posts exist under yet different names. So what we ahve is one person posting under several names -all to me.

                Now…you have my attention, dear. What do you want?

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                A very serious important issue… ending the 24 hour book. Much more important than safety issues or the derogatory sexism of the AA literature— small pebbles compared to the nuisance of that 24 hour book. (Official AA business must keep people awake at night with worry, huh? :) )

              • Counselorchick

                Kma means Kiss my ass right? Thank you! Bahahahahaha.

              • Clarabelle12

                Are you really that unsophisticated?

              • Godlessweasel

                She obviously has no time-zones where she is at. I guess she really must be the centre of the universe!

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                When you say luxurious… what’s the thread count of the fabulous sheets?

              • Jack Shuman

                I think she wants you to ask what she paid for them.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I was actually going to ask if they’re from Bed Bath & Beyond, because if they’re from Bed Bath & Beyond it doesn’t count as “luxurious” because BB&B is a chain store. I was hoping they were imported from the same company the British Royals go to for their bed sheet needs.

              • Counselorchick

                Bahahahahaha. Thanks for that. Too funny.

              • terryr97

                When I was going to college to become a Substance Abuse Counselor, I recall one professor stating that alcoholism, drug addiction, etc. was labeled a disease so that rehab could be billable through insurance companies. When it comes down to it, though, when the time comes that your addiction has brought you to the point where you believe that you need to go to rehab or meetings, whether you are labeled or not really is not the point. Staying alive and living a better life is. There are times, when one decides to drop out of society for 28 days, that they may have to tell someone that they have a problem with alcohol or drugs and they need help to get clean. If that person is at that point, I could be wrong but I believe what they are labeled is not their biggest concern. Getting help might be the greater concern. Or, if they tell no one and do not go into rehab, they can just quietly and anonymously just go to 12-Step meetings and, contrary to popular belief, they do not have to introduce themselves and they do not have to say “I am an alcoholic” if they don’t wish to. If they go to a meeting and are mortified because Fred the co-worker is there and might see them, they have to remember that Fred is also there and doesn’t look like he’s afraid that you’ll see him. He might wait until you go up to greet him, so he doesn’t freak you out, though.

              • Jack Shuman

                As we’ve seen in the past, it’s the C-parrot’s job to defend AA. The words of the AA literature are presented as something that mean nearly everything. The facts, the truth, what is actually stated in AA literature actually means nothing. Here, AA is used as a tool a sick person can use to make themselves seem important or try to make another person feel small. Never mind the facts, never mind what it most clearly states. What’s important is how “I” decipher it (at the moment).

                And then of course the old trick, “But if you don’t see it my way, there’s something wrong with YOU!”

                You have your cross to bear trying to debate the C-person, Juliet. Good luck.

              • terryr97

                “AA is used as a tool a sick person can use to make themselves seem important or try to make another person feel small”
                Huh?? Where do you get your facts from?? Either you’ve never been to a meeting or there are some wacky meetings where you’ve been! “It’s a WE program, not a ME program.” That’s why the first sentence of How It Works states: “Rarely have WE seen a person fail who has thoroughly followed OUR path.” There is no leader, no one special person. The first 164 pages of the book Alcoholics Anonymous (which lay out how the program works) have not changed since it was first published back in 1939. Which is why hundreds of other programs have borrowed from the 12-Steps of AA. Because they work. And why would a sick person try to make themselves seem important? To who? A bunch of drunks just like they are? Who do they try to make feel small? The new person who picks up a white chip that the crowd then cheers and congratulates and gives their personal phone number to, asking them to call anytime, day or night? Your perception of the program is so off that I would suggest you either go to different meetings or stay away because you have no desire to have the program work for you.

              • France

                Which is why hundreds of other programs have borrowed from the 12-Steps of AA. Because they work.

                You really don’t even have to trust me on this one: 12 step programs definitely don’t work for everyone; the numbers they do work for are most likely very small.

              • terryr97

                That’s fine. Since they worked for me, my many friends in the program, and enough other people so that there are programs all over the world, as well as other programs based on the 12-Steps, I’d have to say that the program has been very successful. If it didn’t work for you, ah well. Find another way. Good luck to you.

              • France

                This is what you said:

                Which is why hundreds of other programs have borrowed from the 12-Steps of AA. Because they work.

                I’ll respond in a more direct way here, as you obviously did not clearly read my reply:

                For the overwhelming majority of alcoholics, 12 step programs have yet to be shown to be beneficial.

              • Jack Shuman

                Terry, for one thing I am empowered and have no need of the AA program which was founded by a shyster and his proctologist friend. I stand by my statement that AA is a tool used by narcissists and other sick people. Funny you should ask where I get my facts as AA employs very few and discourages logical thinking. I would suggest you have a truly open mind and read some of the other posts written by thinking people rather than the AA parrots you’re accustomed to hearing.

              • margaret

                you got that right, jack. i was just thinking today: why do i feel so comfortable with “normies,” and so uncomfortable with AAers? god knows i tried. i was a pretty low bottom drunk and felt Aa necessary for the first couple of years just to maintain my sobriety, but then i realized: i’m not gonna drink again; i need to cut this program loose. but that is prolly why i didn’t like it so much: you are right: they are either narcissistic, neurotic, or usually–both. and they seem to have an inordinately difficult time with the “real world.” they’re constantly sharing about how they can’t have relationships, they can’t get along with their boss, they “don’t play well with others,” etc. so that is that. people that gravitate towards that program do not seem to “play well in the sandbox.” thanks for sharing, jack. lol.

              • terryr97

                See my other two new replies (if you wish). It really does not matter to me whether the program works for you or not. If you can stay sober without the program, why were you going anyway? If you can manage without the 12-Steps, have at it. I certainly will not lose a day of my sobriety (thanks to AA) whether you go or not. I have written enough papers on this subject since I’ve gone back to college 7 months after I got sober (getting my undergrad and now graduate degree in Social Work from the 11th ranked college for this subject). I have done enough research papers on the effectiveness of 12-Step programs. I would have to say that my 7 years of sobriety is proof enough, for me, that it works. Anyone else’s choice on whether it works for them is their own business, though. Hey, abstinence didn’t work for me but you don’t hear me hating on others for whom it did work, do you? I’m too busy enjoying mine, and my friends in the program, life. I went from an isolating drunk with no friends, life, or hopes for the future. With AA, I have a life beyond my wildest dreams. If AA gets one person sober, then it was a success. :-) Oh, and I don’t care about what Bill W. did outside of the program. That’s between him and his wife or “higher power”. Principles, not personalities, right? I’m there for the program. People in glass houses and all that. I am the last person to judge someone else.

              • Jack Shuman

                “Hey, abstinence didn’t work for me but you don’t hear me hating on others for whom it did work, do you?” I’m sorry that abstinence didn’t work for you. It certainly worked for me. Apparently joining a religious cult worked for you, and AA is cheaper than Scientology I suppose. Is criticizing your weird religious cult hating on you? Since when?

              • terryr97

                Yes, because the over $60k in college expenses which I have incurred in the last 7 years (after I got sober) going to college to become a substance abuse counselor and social worker have not exposed me to any “thinking people”, right? Since all that I seem to do is write papers on the effectiveness of 12-Step programs in lowering recidivism rates of those incarcerated for drug/alcohol related offenses, I believe (as do my professors) that I have a basic working knowledge on the effectiveness, or lack thereof, of 12-Step programs.

                According to the US Dept. of Justice, of all of those requesting access to AA and NA programs while incarcerated, only 15% were able to be accepted (1,143,113 inmates at 64 locations). Of those accepted, there was a 50% long-term effective rate in stopping recidivism 3 years post-initial study. I would say that that’s pretty successful.

                Prisons, T. F. (2012). Annual Report on Substance
                Abuse Treatment Programs Fiscal Year 2012. Washington, DC: Department of
                Justice.

              • margaret

                “rarely have we seen a person fail that has thoroughly followed our path?” seriously? you only have a three percent success rate. looks like most everyone fails. and it is not a “we” program. it’s only a “we” program as far as sharing the same dogma, aka, the twelve steps or twelve traditions. on an individual basis, there are way too many narcissist. that was the first thing i noticed about AA people when i went. and believe you me, i really wanted to get sober. seriously. but the artificial cheeriness, the holier-than-thou attitude, the robotic behavior, the inability to get along with “normies” and only stick with the tribe of AA, struck a very despondent chord in me. i was so disappointed. so i’d go and try another meeting and another. sure there are some really great people in AA. but i’d say there were more jealous, toxic, humorless, hostile, disingenous, narcisstic folks than nice ones. and i get along great with “normies.” so why do you think i had such a hard time in AA? can you really blame it on me not trying? or “contempt prior to investigation?” or i love this one: “an inability to get honest?” god, i met more hypocrites in aa than just about anywhere.

              • terryr97

                No one, anywhere, is going to be perfect. I had the same attitude and belief that you did, the first time I tried AA. Relapsed, had a complete “psychic change” and then it worked. It’s a “we program” in that if I stayed home, read the book and were accountable only to me, it wouldn’t work. But us, together, at meetings, working with others, working with a sponsor, doing service work, gets us out of “me” and into “us”. I learned how sober people live a life without having to drink. It’s called “modeling” others behavior. And, it’s not that we don’t get along with “normies” but that we don’t hang out with them like we used to because then we will start to believe that we can drink like they do. Why tempt yourself like that? After you’re sober for a while, people do drop off and live lives away from the program but, in the first year, you’re not really in any state of mind to be doing that when all you know how to do is use a substance to be social. But hey, if you feel that you can stay sober without the program, have at it. Most people who are in AA (and NA, etc.) find that they can’t and that’s why they go to meetings. It’s not a rule that, in order to get sober you HAVE to go to meetings. It’s just that, if you go to meetings, all you’re going to meet are people who go to meetings. What did you expect? People who had no problem staying sober without the program but go anyway?

              • margaret

                oh please. i lost my desire to drink. i go occasionally to aa for the social aspect of it, but that is it. i would never stop hanging out with my friends alcoholic or not just because i got sober. to me, that is just plain cruel. i was just lucky to have sincerely lost the desire to drink, so being around people that drink doesn’t bother me a bit. i spose some people just can’t be around others that drink and i totally understand. i’m just saying i honestly feel more comfortable with normies. aaers seem to have some kind of contrived persona. it’s hard to nail it down. . i just feel there are a lot of fake people in there. i also do not like the idea that aa won’t allow people to be proud of their acheivements. that is so sick. if you work hard, stay sober, dammit, it was you, you that did it, not AA. i suddenly realized that one day. and i decided from that point on that i was not going to get up on that podium and say: “if it wasn’t for AA,” or “thanks to my HP,” or “without AA i’d never done it.” rubbish! people should be proud of their lives! it’s their lives. it’s not a “we” life. it’s “your” life. i have a lot of suspicion for any group that values the group over the individual. we are all special and unique. to deny that, and act selfless, just turns people into secret narcissist.

              • terryr97

                There is nothing with you being able to wake up one day and decide to quit drinking on your own, and I never said that there was! That’s wonderful! Unfortunately, that is not my story. I tried every which way to do it on my own and, unfortunately, I just couldn’t do it. As is the story of many people in AA. Even prison time for drunk driving and killing someone didn’t help. AA did.

                We can’t celebrate our success at staying sober? I guess they give out chips and medallions for no reason? Or when they say that the person who picks up the white chip (24 hours) is the most important person in the room, because they remind us how it was when we first came in?

                I hate to tell you but, if it weren’t for AA, I’d be dead now. Because, left on my own, I would still be trying to figure out why I can’t stop drinking. I’d still be trying to intellectualize my way to sobriety, which I did for over 30 years.

                Oh, trust me, there are narcissists in the program, I do know that! People who forget what it was like when they first crawled into the rooms asking for help with their dying breath. I avoid those people. People who seem to me like the only time someone listens to them is the 15 minutes they go on about how much better they are than everyone else cos they have 30 years or some such shit. Yeah, that’s my cue to hit the bathroom. Thankfully, they are the exception and not the rule or I’d have quit long ago. I spent far too much time believing I was a worthless piece of crap, I don’t do that anymore. I love me now! :-)

              • margaret

                well, hey, good for you. whatever works. if you found your niche, wonderful. but i didn’t exactly wake up one day and say “no drinking,” no way. i made by sticking myself in an eight month program–lockdown rehab. gradually i lost my cravings and they’ve never come back. believe me, i tried on my own, and i unduly tried AA. i would have died in AA. i was way too far gone for AA to help. but once i got my cravings under control and saw alcohol for what it really was, it was a done deal. but, no, i don’t want to celebrate my clean time. i just don’t want to go back there and want to close that chapter of my life. that’s all. and i do smoke pot occasionally, so i guess i wouldn’t really be welcomed back even if i wanted to go. which kinda pisses me off because the doctors have prescribed me all types of narcotics for pain and anxiety and i know in Aa they are considered “acceptable” as long as a doctor has prescribed them, but i know how menacingly dangerous they are, so i try and take them as little as possible. and the twelve steps? don’t get ’em, sorry. i think to do them on a person level is fine, but i don’t like discussing them with people. it’s just weird and creepy. i don’t want to talk about my inventories, sexual or otherwise, i don’t want to have a sponsor controlling my life. no way. my life is my own, and i’d like to keep it that way. but good for you! i’m glad you’re happy!

              • Jack Shuman

                “No one, anywhere, is going to be perfect. I had the same attitude and belief that you did, the first time I tried AA.” You’re ignoring the fact that Bill W. lied in the big book and that’s the program you follow, that you say works for you. So much for it being a program of honesty.

              • Godlessweasel

                Loads of young people are being conned into AA simply because they are drinking the way a lot of young people do. They are inexperienced, enjoying themselves, trying to keep up with friends etc, of course things are going to get out of hand now and again. Most grow out of it and they certainly shouldn’t be labled terminally diseased by a bunch of unqualified crooks. But it’s Clarawhore’s job carry the mess to the vulnerable teen with the hangover…

              • Dire Wolf

                People walk into AA meetings more often then not wanting someone to say..”what are you doing here, you’re not an alcoholic!!” They have to figure it out for themselves but if you’re in a church basement on a Tuesday night having a cup of coffee with a bunch of sober drunks you probably belong.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                What people are you referring that you know want others in AA to say that? I figured anyone who voluntarily walks into AA is looking for answers– for help. If AA isn’t it, if it has something to do with the AA program, why not offer a list of alternative suggestions that will appeal to a person looking for help. The faith based answer of AA is not always appealing nor does it work— 95% who try AA leave AA. This doesn’t mean they’re out their getting wasted, either; it means they left to find something else that works. 75% of alcoholics recover without any form of treatment or AA program. Guzzling coffee with other alcoholics— not sure if that is part of the AA program or just a traditional routine they do at some meetings. Best wishes to you and have a great holiday season, Dire.

              • terryr97

                I always laugh when someone quotes numbers about what percentage of people who go to AA actually get sober. You do recall the Anonymous part of Alcoholics Anonymous, right? They don’t take membership dues. You don’t sign up for anything when you go to meetings. How are you going to quote a percentage of an anonymous group? If you’re in a room with 100 alcoholics who all got sober going to AA meetings, you can be sure that your percentage of people in that room who got sober in AA is going to be zero. I, personally, have never been asked to fill out a questionnaire from anyone about my getting sober in AA. And I never will be, which is one major attraction of going to AA meetings: Anonymity.

              • France

                By laughing here you’re showing your ignorance about how these studies are conducted. The people tracked in nearly all studies which evaluate 12 step programs are not anonymous. That’s how they keep track of them.

                I, personally, have never been asked to fill out a questionnaire from anyone about my getting sober in AA.

                Yes, that’s because you haven’t been included in a formal study. They don’t do it like that. The fact you’ve never been handed a questionnaire in an AA meeting says nothing about whether it’s been subjected to academic inquiry or not.

              • terryr97

                Other than I, as a graduate student doing research in Social Work as well as taking enough research classes, know enough about all forms of research surveys and such, feel free to read my other replies that I’ve posted today on this. I would only be repeated myself.

              • France

                There’s nothing here that addresses anything I said.

                When you understand that the peer reviewed studies on AA almost always rely on on raw data and not AA’s official statistics, maybe you can retry,

              • terryr97

                “By laughing here you’re showing your ignorance about how these studies are conducted.”

                That’s what I was replying to. I am not ignorant about how the studies are conducted.

              • France

                You continually appeal to the fact AA is anonymous and does not normally disclose their public records. That alone demonstrates that you probably haven’t read the peer reviewed literature, as very few published studies reference AA’s records directly.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Which is why “Rarely have we seen a person fail…” a lie… and not scientific… but mainly a lie. Many testimonials from the early members reveal most failed at AA. (They just didn’t count the failures)… Statistically this remains the same… most people leave AA. Sometimes AA works. Sometimes AA harms. AA conducts random surveys but surely they haven’t reached everyone claiming to be in AA. AA cannot though just claim “it works” without proof it does.

              • terryr97

                When does AA conduct random surveys?? They do not get funding to perform scientific research, nor would there be any reason for them to. Since people come in and out of the program, anonymously, what would be the point? As someone who does do scientific surveys for research, using random sampling (and other forms), it would not only be impossible to form a conclusion based on any surveys, there would be no point to it and, trust me, we would have heard about an anonymous group like AA performing research. I would ask where you got your information but it would be inaccurate so I wont.

                AA doesn’t harm; an individuals inaccurate interpretation of the Steps, Traditions, and Principles harms. AA (or any 12-Step program, or any program for that matter) doesn’t work when a person does not work it. If they are unwilling to commit to it, it won’t work. Simple as that! And then they bash the program because it didn’t work.

              • France

                Other people conduct random surveys, not AA. I’m getting the feeling you’re poorly educated about how basic scientific research is conducted.

                AA has been demonstrated to harm some people. This has already clearly been established – there’s no argument to be entered into over this.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                Terry, I don’t work for AA, so I’d ask them what their last survey I know of (the 2011 Membership Survey) is. Why it was conducted, and who did they contact. link to aa.org

                AA does harm; it is inaccurate to not believe it doesn’t. I testify for myself it does. Others have also expressed the same thing. It “doesn’t work when a person does not work it” means you believe AA works 100% of the time. Nothing works 100% of the time. Simple as that. Expressing a negative opinion of AA is not bashing it, it’s called being rigorously honest. Doesn’t AA teach that members should be honest? Never heard AA teach honesty is only expressing positive thoughts. Maybe the best way to express it is, AA has defects of character. AA has shortcomings. AA has harmed others but the question is, does AA realize it and will AA make amends for their wrongdoings?

              • Dire Wolf

                Many people walk into AA wanting to “manage” there drinking, not be abstinent forever. They want to learn to drink responsibly. With that they want to hear, “you’re not that bad.” Many people walk into AA knowing they have to stop. Yes they do walk into AA for answers and help. But many times the question they want the answer to is, how do I drink and not lose control? It’s only after time that they come to realize the affliction and the reality of the situation.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I’m not sure who those people are, it would seem to me the majority go to AA fully expecting a “quit drinking” program. Perhaps they do go there, sometimes, hoping to not relate to anyone there. However, why did they go there again? Seems most go to AA for help not to find out they don’t need help… I’ve never in my lifetime heard a “misconception” that AA was a controlled drinking, how to control drinking, program… Everyone’s reality is also different. Not everyone who gets drunk occasionally, has suffered from drinking problems, is an “alcoholic” nor are they going to relate to AA’s definitions and examples. Also, group supports come in a variety now (SMART, WFS, SOS to name a few) and sometimes, group supports are not the answer.

              • Godlessweasel

                According to the 20 stupid questions posed by AA, anyone who answers ‘yes’ to one of them is probably an alcoholic. Therefore anyone who has taken a drink in the wee small hours of the morning (most nightclub goers) is doomed. And they twist them any which way they please if it means scaring somebody into their cult. I seen them do it.

              • Dire Wolf

                Alcoholism is a 3 fold disease. Spiritual, Physical and Mental. All three don’t have be at rock bottom before deciding to take your foot off the pedal. That is a problem with youth and addiction. The physical element is not prevalent. They are young and invincible. Mentally and spiritually they are feeling it but because they bounce physically they have a sense of it not being so bad. Keep reading the literature. read the big book and the step book, but if your not an alcoholic the concepts might seem odd. It saved my life. Whatever path people choose I hope it works. This worked for me (so far).

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I think that’s the AA/ Minnesota Model definition of alcoholism… I cannot offhand think of one other “spiritual” disease and for that matter, any disease can be a spiritual one if one believes it is… Next, most diseases I know of cannot be purchased at the convenient store which makes alcoholism a behavioral problem (disease?) not one that is obtained via virus or germ. Lastly, the quote from the AA book clearly states a person has all of their health and still has alcoholism… that simply does not make sense. It doesn’t even match up with your 3 fold disease theory. I base this on AA literature mind you and not other data or research that would contradict AA itself. The quote from the 12×12 claims all health is in tact so it can’t be alcoholism. (P.S. Glad you took control of your behaviors and made all the necessary changes, and I believe you would have done so with or without AA. You did it; not AA. It’s strange to me if someone succeeds in AA it’s AA’s credit— if someone slips it’s not AA’s fault… What do you think? How about we give the individual the credit and not give it all to AA? After all, data shows AA only works for 5% who try it. Keep up what you’re doing, whatever it is it is working for you and that is great.)

              • terryr97

                You can still have your health, your cars, job, family, and your life with alcohol could be unmanageable. If you drink all day, every day, thinking that you want to quit drinking before you lose all of the above yet, every night, you find yourself going to the liquor store, that is unmanageable addiction. And, I don’t know why it works but for some reason, having a group of like minded individuals helping me to get sober worked where doing it alone didn’t. We did, together, what I could not do alone. I wasn’t forced by the legal system to go to AA. I could have tried, yet again, to do it on my own but trying to get sober on my own didn’t work. Going to AA meetings and working the program did. To me, it doesn’t matter why, what matters is that it did. And, in an effort to “keep it simple,” that’s a simple enough explanation. I don’t HAVE to keep going to meetings if I don’t want to, but I do want to because I enjoy hearing other people’s story, helping another sick and suffering individual, and seeing my friends. As with anyone else, I enjoy hanging with people who have the same interests as I do, which happens to be staying sober. I don’t find it fun hanging out with people at a bar while they proceed to get drunk. It’s just not entertaining to me, which is my choice. If anyone doesn’t like AA, don’t go. If you want to work on getting sober, then go. People can talk crap about AA all they want but there’s a reason why, when you mention AA, many people think of Alcoholics Anonymous. It’s not due to their failure rates. One reason is due to the fact that, if you want to get sober and don’t have 25k to slap down for rehab, you can go to AA/NA for free. If you work the program, it works. If you want to “hang on to your old ideas” go just to find fault with it, it probably wont work. It’s that simple.

              • France

                All you’re essentially saying here is what worked for you. This is where your comment should end, but you keep going with baseless assertions.

                I don’t know why it works but for some reason, having a group of like minded individuals helping me to get sober worked where doing it alone didn’t.

                That’s great, but you’re making a mistake assuming everyone else has exactly the same experience you did.

                If anyone doesn’t like AA, don’t go.

                Many people don’t have that option. I’m assuming here you’re not familiar with coercion into 12 step programs.

                If you work the program, it works.

                There’s actually nothing substantiated which supports this. It’s sort of the opposite: only those who actually achieve sobriety are said to have worked the program.

                if you want to get sober… you can go to AA/NA for free.

                Anyone can go to AA for free. And most people who do don’t find sobriety there.

                If you want to “hang on to your old ideas” go just to find fault with it, it probably wont work.

                Again, I’m not sure what data you’re working with here other than your own experience, but many people who attend AA freely admit there are problems with the program and willingly find fault with it. God knows what this has to do with their sobriety.

                Again, your personal experience is your personal experience, however you’re conflating this by assuming several things which AA doesn’t claim, such as that it works for everyone.

              • terryr97

                At any given moment, as soon as you thought my comment was worthless, you could have, and maybe should have, stopped reading. It was your choice to go on.

              • France

                I never said your comment was “worthless”. An ongoing behavioral theme with you is your choice not to read comments you reply to in a thorough manner.

              • terryr97

                Your belief that my comment had “baseless assertions” led me to believe that it was worthless to you. Having just written, and posted, a 985 word response further up in this thread kept me from wanting to write another 500 word reply.

              • France

                I made that comment because you made some assertions that were baseless…. it’s quite straightforward. I’m not sure what you’re achieving in this conversation other than trying to have the last word, as you’re not responding to anything I actually said.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I do admire you made changes in your life, and decided to get well, whether it was in AA or not you would have made the decision to get well. I’m also glad you found something you liked that works for you. All I’ll say is sometimes AA doesn’t work for someone, even if they “work” it, and for them there are other options. Folks in recovery should be aware of non-AA options, at the very least, instead of insisting on “more” AA if it hasn’t worked for someone. You write: “If anyone doesn’t like AA, don’t go. If you want to work on getting sober, then go.”

                The issue I take with this is you claim people quit AA b/c they don’t “like” it… why can’t it be phrased instead, “If AA doesn’t work for someone, don’t go.” If you want to work on getting sober, there are a variety of methods. It has nothing to do with “not liking” AA when AA doesn’t work. “People can talk crap about AA all they want but there’s a reason why, when you mention AA, many people think of Alcoholics Anonymous.” I take issue with this sentence because who is talking crap about AA— more so, why would they? What was their experience? Was it just different than yours? And what does that have to do with mentioning AA… How about, when people mention alcoholism people think of recovery, no matter what form it takes? AA can’t be everything, nor has it succeeded at that. Many AA/NA members work in those 25K rehabs which teach AA/NA… when one can’t make money off AA they make it in rehabs. These rehabs are not offering anything different for that money.

                So if you want to hang onto old ideas (that it’s AA or die is an old idea) then there will continue to be people talking crap about AA… because they are interested in recovery not just in AA’s methods. “It probably won’t work…” Your attitude about other methods is a problem and it won’t help others get better if you tell them that when they leave AA… you plant a seed in a person’s mind that they will fail without AA. That’s my problem with AA, these planted seeds of “AA or die” that are not true. Many, most, have left AA and lived. I wish the truth were told more often in AA meetings.

              • Dire Wolf

                AA doesn’t take all the credit. They applaud the efforts of the new comer. They encourage them to raise there hand and share with other new comers the results of there work. If someone slips it is not AAs fault. Agreed. I am sober, I can share with someone how I did it. If they want what I have I will gladly guide them through how I did it. If not i wish them well on there journey. However, I am powerless over that person. It’s definitely not “my” three fold disease theory. If you don’t by the “disease” label that’s cool. but at the end of the day many self inflicted ailments can be purchased over the counter. Alcoholism, overeating, gambling, anorexia are manifestations of a problem that existed before they acted out in unhealthy behavior. Putting the cork in the bottle is the first step. After that the work begins.

              • http://aarmedwithfacts.wordpress.com/ Juliet.roxspin

                I speak from my experience listening to hundreds of leads and thousands of shares— AA is given credit when one stays sober and a person blames themselves for not working the program when they fail… often times, they work the program and still fail but don’t think they did it right. I disagree, sometimes what AA teaches does make a person slip. I’d know— I didn’t know how to deal with how AA made me feel and the old coping mechanism of getting drunk was a last resort. At first I’d blame myself but with time, I realized I was just doing the same thing expecting a different result— I was taking the AA medicine over and over and failing. People can buy a hammer and hit their heads with it but that won’t make it a disease. We don’t just tell anorexics to “eat” and we can’t tell overweight people to abstain from all food. So the solutions to behavioral problems are varied… even for alcohol problems. The real work begins when we accept there are many solutions and journeys for people and AA has it’s good and it’s bad side effects. That’s true acceptance.

          • William

            I am not so sure that this is true, in reference to what AA learned. If you read the official AA literature, ie Co-founders you will find that it is stated that before the BB, AA or the drunk squad of the Oxford Group was a secret society and run on what would be called oral tradition.

            It is also true, if you look at the BB that there is no mention of Sponsor, that was developed out of the sponsoring of individuals into hospitals and the notion of Sponsor was not noted until the 12 & 12 mentioned Sponsors in more detail. It is also true that Living Sober has a more extensive account of Sponsor, yet we all know that Wilson was Sponsored by Ebby and Dr. Bob was Sponsored by Wilson.

            The secret society functioned absent the BB and what was written only documented what was practiced. I am not so sure that I would agree that these publications are a reference to what was learned as you say.

            • Clarabelle12

              The Big Book certainly does speak to helping and working with others, William.
              I thought the original bit about sponsors were the people who brought you to meetings back in the day when meetings did take place in people’s houses. The 12/12 was written later to show what they had learned during 20 years of fellowship. The paragraph that Juliet referenced was a big game changer. People in Bill’s day did think alcoholics were bums under bridges. My own grandfather owned car dealerships and my grandmother was told that he wasn’t an alcoholic because he hadn’t lost it all. He paid his bills, treated his employees well, was successful which exacerbated his drinking, and home life was hell. My mother married at 16 to move on from it. Yet AA was telling Grandma that her husband wasn’t an alcoholic. According to another poster, because he did have all of those external things, including health, how was life unmanageable? How was he an alcoholic? There is also a page where it talks about those who were able to stop in time. I was one of those. My grandfather progressed and died a broken man.
              Sent from my iPad

              • William

                I would disagree as to what was learned or what was known and not necessarily written. It was later written as discussed by Wilson that all the ideas came from the Oxford Group and this was known, not discussed and sidestepped in the BB. It was not necessarily what was learned, rather what was known and later discussed.

                If you look at other writings, ie Dr. Bob and the Good Old Timers, Pass it On, AA comes of Age and Lois Remembers you learn what was not reported elsewhere, but was known and probably discussed.

                Character defects are sins and that is not clear in the BB, and was clearly known. It isn’t until the 12 & 12 and elsewhere that this is discussed. The only ones learning are the ones that were not there when this was discussed.

                It was known that the grace of God removed the obsession to drink, yet not discussed until the 12 & 12.

                It was known that Wilson accepted Christ as Lord and Savior at Calvary Chapel yet you don’t find that discussed in the BB or in the 12 & 12. It was known, not learned. The only ones that learned this were those that were not part of what happened and what was learned later.

                Tell me something that you believe was not practiced and was later learned as you see it in the writings of the BB and 12 & 12.

              • Clarabelle12

                Untrue. Bill W. freely admits that he borrowed heavily from the OG. He borrowed from a number of places, which is why I have often pointed to him more as a compiler than an author.
                Bill talks about how he thought that Christ was a good man but he wasn’t sure of his feelings in terms of personal Savior. He later came to believe differently. He certainly attributed much to his white light experience. Ironic that this is the same thing another poster discredits even as she says much creativity has been derived during episodes just like that and points to artist contribution.
                Feel free to disagree with me, William. I see differences in the 12/12 that came from their experiences through the years.
                Sent from my iPad

              • Clarabelle12

                William, if you want to discuss this man’s article, I am up for it. I weary of people just contacting me to debate AA and I think it does a disservice to those who write these articles.
                Sent from my iPad

            • Clarabelle12

              AA wasn’t the secret society. While Bill appreciated what he learned there, it wan’t how he wanted AA to be structured.
              Sent from my iPad

              • William

                You need to read official AA literature, ie Co-Founders, Dr. Bob in one of his last talks says…”before the BB all we had were Oxford Group Principles and the Good Book…we were a secret society”…….this is what your literature says.

              • Clarabelle12

                Yes, as far as what there was for anything for alcoholics outside of drunk wards. I think you’d be right. What was there before the Big Book was written, William?
                Sent from my iPad

    • I’ll Be FREE Or Die

      Excellent! I think it is particularly important (as you note) that the vast majority of people do grow out of it. Young people need to be empowered through valid information. Evidence-based treatment and resources must also be made known to them and readily accessible if we are to turn this tide that has flown in the wrong direction for far too long. When we tell them the truth they respect us and value our advice more. They may turn to us rather that become victims of peer pressure…or heaven forbid–cults at some point.

      • Counselorchick

        Absolutely. Without forced cult indoctrination and forced attendance in a cult, our young people have a chance. Otherwise, they are to blame, according to the prevailing dogma and spend the rest of their lives (if they have lives) believing themselves to be ‘diseased’ and ‘powerless.’ Barry is turning the tide with this brave article and his brave work to help rather than harm.

    • Peace

      i have never met a heroine or crack addict that can moderate successfully. Have you?

      • Godlessweasel

        I seem to meet an awful lot of them

      • Dire Wolf

        I have not and I agree with you

    • Peace

      I have never met anyone that destructively used heroine or crack that can successfully moderate. Have you?

      • France

        Yes. many people successfully return to moderation, however the feasibility of returning to moderation over lifelong abstinence varies depending on the drug involved.

        If you’re implying that no one can ever return to moderation, that’s demonstrably incorrect.

      • Tristan Charles Smith

        I used opiates (including heroin) for 5 years, way too much. The last time I used before quitting opiates entirely, I was able to keep it to about once every 5-7 days for months on end. It’s possible with discipline, but then so is having sex and just “sticking the tip in”. It’s kind of excruciating, to me. It never used to be like that, years before I would occasionally use opiates no problem, but some things were different then:

        a) I was younger and more resilient,
        b) there was no serious hookup or large supply of opiates that I knew of, it was always a treat when we got them from time to time
        c) I had no way to afford an opiate habit, and no desire to acquire one,
        d) I had no prior addiction, or even the idea that I would get addicted to them, addiction was not part of my mindset…I felt I was stronger than that. And I was.

        In between “active” (heavy, regular) use, I went for about a year in a new city without having opiates regularly. Didn’t search them out, didn’t have them. Then I met a friend who had fentanyl patches for cheap, and except for a) above, the same three things applied and I didn’t “fall back into old habits”. I used occasionally as a treat, maintaining because I had to, and because I didn’t want to get the habit again. In fact, at one point I started to feel a tinge of withdrawal and cut myself back for awhile to keep it from getting out of hand. Before any of the rehab brainwashing I’ve had to deal with in the past couple of years, I believed I had the power to control it, and I did.

        When life didn’t work out in the new city and I moved back home, I was depressed, and kind of fell back into more regular use by default. That was when the last time described above happened. At a certain point, even using occasionally is no fun because all that ends up happening is you spend the whole time making sure you don’t use “too much”. So it is stupid. But…there is nothing about the drug, or a person, that actually precludes moderate use.

        I think it’s even easier with cocaine then heroin, since cocaine you can just not use. and after two days it’s not a big deal not having any. It doesn’t have as long-lasting of a hold as opiates, though maybe that is just me. Nevertheless, it can be done. It’s not worth the trouble to me, so I don’t use at all, and it’s OK.

  • http://www.addictioncapetown.blogspot.com/ Shaun Shelly

    Great article Barry. Your points are extremely valid, and especially pertinent for adolescent treatment settings. I have said very similar things to you and have had to face extensive criticism. It is important that we keep putting this vital information out there. Keep up the great work.

    • http://www.barrylessin.com Barry Lessin

      Thanks, Shaun–What’s sad and pathetic is that we clinicians face our own form of stigma by our own colleagues’ judgments, mirroring our own clients’ stigma in some ways. For me, an important part of writing pieces like this is to connect with the many clinicians I’m convinced are out there but are not comfortable speaking out.

  • Guy Lamunyon

    Barry, parents do not need to know what makes their kids tick, they need to understand what makes their kids drink/drug . . . and often it is the parents drinking/drugging behavior modeled for them. Make the home an alcohol and drug free zone.

    Guy C. Lamunyon MSN, RN, CAS

    • http://www.barrylessin.com Barry Lessin

      Guy, I totally agree with you about needing to understanding why kids drink/drug; my point is that we can get to that point more readily by not focusing exclusively on the drug use because that will tend to shut down any dialogue. And for sure, parents substance use and attitudes about their use is an important variable in determining the kid’s attitudes and can affect their kids’ use. Unfortunately, teens are more influenced by peer judgments about using drugs than their parents attitudes, so that’s why dialogue remains important . Setting clear expectations about drug/alcohol use in the home is also important but we really can’t prevent kids from using if they really want to, so my point is to reduce the likelihood of harms if they do use

  • John McCready

    I cannot think of a WORSE IDEA then the “disease concept” to give to teens (who already have trouble with accepting responsibility for shit!), who are addicted to some drug! If there is anything that would feed the teen mind of “its not my fault”, then the idiotic “disease concept” is it!

  • I’ll Be FREE Or Die

    This is a phenomenal article. I wish I had more time to leave a more in depth reaction to this. Still, I would like to commend you for adding to the growing wave of information of dealing with Substance Use Disorder which the CDC reports has reached epidemic levels in this country.

    • http://www.barrylessin.com Barry Lessin

      Thanks for your comments. It’s important to look at the data closer and see through media distortions about historical patterns of substance use. The reality is that overall substance use in the US has remained constant over the last 40 years. Over the short term, individual substances have their own peaks and valleys of use and right now there is a sharp increase in opiate use.

  • Vicki Zollo

    Having worked extensively with the teen population I am in complete agreement with the author’s insights. Teens are at at time in their lives which I view as the in between stage. In between childhood and adulthood. In their efforts to move forward they often think they are adults, engaging in rebellious, risk taking behaviors to prove the point. Deep inside whether they are fully conscious of it or not they are vulnerable.

    Healthy adult role models who work with teens in my opinion will be more effective in their work if they start focusing on, “catching kids doing things right”. Focusing on teens strengths while simultaneously providing a safe environment in which teens can share their values and goals may help them to be more willing to explore underlying issues and problems.

    If the focus remains on what is wrong with the teen or the so called “pathology” we are sure to turn them away thus defeating our efforts to be of a help. Providing guidance and teaching coping tools the teens can use in real life Is vital.

    The current educational curriculum does not provide effective life skills training and I strongly believe it is time that it start doing so.

    • http://www.barrylessin.com Barry Lessin

      Vicki, we need more forward-thinking people like you working with teens! When trust is shattered by their kid’s substance use, it’s really hard to “catch them doing things right” as you say; but there’s almost always positive things about the kid and the relationship with his family that can be identified and massaged into some healing steps

  • William

    The Psychobiosocial model of addiction would be that that is most commonly accepted by the American Psychological Association. It is also the most practical, not just for teens, but for all.

    If you look at Natural Self Change, Klingenmann and Sobell, understanding that there is not and should be a triage of modalities for anyone including teens for what works best to resolve change in behavior then it provides the therapist to use modalities in a specific for that person approach.

    Understanding that MI is useful and that BI are now being paid for by the new Medicaid/Insurance programs knowing that this may save millions then it would be prudent to educate the clients as well as motivating them and intervening briefly in encounters. When those that fail to modify their behavior in this paradigm need more intense approaches then an educated approach to the client to know what is out there and guidance for more help can be provided.

    The Disease model should be abandoned for teens and adults. It should be considered an outmoded approach that has served the purpose of bringing awareness of a problem to the public and has allowed for investigation of better and more effective approaches. Good for you Barry…..

    • http://www.barrylessin.com Barry Lessin

      Thanks, William, and thanks for elaborating on the research. Despite the American Psychological Association’s recommending of a psychobiosocial model, they tend to embrace a medicalized view of addiction that NIDA and American Society of Addiction Medicine (ASAM) embrace, and so I don’t look to them for guidance in my work.

      • William

        Help me understand this Barry. In my reading over the past 10 years or so the AMA and the American Psychiatric Association are disease model oriented. ASAM and NIDA are definitely disease model oriented.

        In cruising the American Psychological Association site and their monographs on Smoking, Gambling, Substance abuse, Drug Abuse, Alcohol….I see “syndrome” “Behaviors” and in those monographs the disease model is mentioned in passing and I don’t see it embraced.

        in the publication Addictive Behaviors, a compilation there is a plea for Psychologists to address Behaviors and in the monographs mentioned AA is seen as self help and SMART as Monitored Self Help….I was amused in the Smoking monograph that 12 steps were to be considered only when the Psychologist lacked time to implement a full program with the client obviating the notion of disease.

        I don’t want to be passing misinformation. Tell me where the
        APsychologicalA is embracing the disease model on their web or in their writings. All I see is disorder, behavior, syndrome and for me that flies in the face of disease model…help me understand where the APsychologicalA is embracing what I am not aware of….as I stated I don’t want to spread misinformation.

        • http://www.barrylessin.com Barry Lessin

          William, sorry for the confusion. I was focusing on the MEDICALIZING of addiction, which is a reductionist view that NIDA embraces, that addiction is a “brain disease”. Not to dismiss the biological aspect, but we treat human beings, not brains. APA endorses NIDA’s work and maybe I’m guilty of APA’s “guilt by association” but I’m very very wary of NIDA’s research for a couple of reasons. 1) as a government agency, NIDA is strongly influenced by Office of National Drug Control Policy (ONDCP) which prohibits the government funding research relating to the legalization (for medical or any other use) of substances listed in schedule I (includes marijuana, lsd, heroin, MDMA). Confirmation bias is rampant in their research because they rarely focus on research results other than the
          dangers of these drugs. 2) ONDCP policy remains to this day as established by Nixon to have a prohibitionist, misguided drug-free America agenda that infiltrates NIDA’s research and educational material and prevents the implementation of effective public health policies. I give NIDA huge credit for advancing the scientific study of addiction but their obvious biases contribute to me scrutinizing their work very closely. And as you can see, I feel strongly enough about it that it affects my using APA as a resource. There are other reasons for my avoidance of APA as a resource that aren’t relevant here, that I can share with you if you want to contact me directly.

          • William

            You had me at NIDA. I understand and dismiss NIDA. I am of the William Glasser, M.D., bent, dismissing the DSM as well. I was unaware the the Psychological Association endorsed NIDA. That does not come across in their website or in their publications. I believe I understand your position. Thank you.

      • Counselorchick

        Thank you! ASAM doctors are not reliable. It’s all a scam and a front for 12 step programs which we all know work for those experiencing spontaneous remission and after a few months, most people move on with their lives. Our rehab industry has been hijacked by the 12 steps and have done a disservice to all those searching for evidence-based help rather than faith healing. Please read the article below and listen to the podcast. It’s highly enlightening.

        link to cougarblogger.com

  • http://CommunityThrive.org Matthew Kuehlhorn, CPSII

    Great perspectives and nice to see this field moving in this area. I push on the ‘drug prevention’ field as there is much work to be done in shifting an old mindset along the path towards where there are no drug problems. Let’s focus on life problems and realize people are individuals with their own values and aspirations. How can we help more people get after what they want- without blame and shame.

    This will drastically reduce the prevalence of unhealthy risky behaviors.

    And, love the perspective for parents. Parents, stay in the game :-)

    • http://www.barrylessin.com Barry Lessin

      Yes, Matthew, parent and families have been neglected by treatment programs..traditional psychoeducational “family programs” are not as effective as family therapy using CRAFT (Community Reinforcement and Family Training) approaches. For a ‘user-friendly’ guide to CRAFT, check out http://www.the 20minuteguide.com

      • http://CommunityThrive.org Matthew Kuehlhorn, CPSII

        Great resource. Thanks for sharing!

  • John McCready

    So, has a “final definition” of this medical condition called “disease” been arrived at, and HOW exactly, does a substance abuse BEHAVIORAL issue meet its criteria? Just wondering if that got nailed down (besides the idiocy of the AMA VOTING “alcoholism” into existence as a “disease” in the 1950’s)!

  • http://www.nadaytona.org/ AntiDenial

    What a great article. The logic of always treating the “disease of addiction” before treating co-occurring mental heath issues such as ADD, depression, anxiety disorders never made sense to me. The drugs or alcohol was the first most important thing to focus on. etc.

  • ClaraHell Texas

    It really is rewarding and refreshing to see more and more people coming forward with articles like this (films & documentaries too) with accurate, up-to-date, logical, truthful, more medically sound information and studies that are rapidly chipping away at the antiquated AA ‘disease model’ nonsense. Alternatives like SMART, RR, SOS, and others are so much better and empowering. I find it quite amusing how desperate the steppers are acting since 48 Hours’ documentary. I can hardly wait til THE 13TH STEP: THE FILM finally comes out!

    • Clarabelle12

      I can’t, either, Laura. It seems as if it has just been something floating in the wind for years. I wonder if I had put my money behind it instead of The Anonymous People if it wouldn’t have been released much sooner. Of course, I imagine that could have been a big hold up. You see, her fundraiser only garnered a midge of what she was shooting for whereas Greg William’s efforts brought in a huge amount over what he was asking for! Crowd funding wasn’t an embarrassment for him, that’s for sure!

      I liked the 48 Hours piece. I noticed that Glaser glossed over Karla’s problems as booze and some prescription pills. Then she got refuted by the tox report. It was a mad house over there. Just horrible. I noticed too that the millions that AA has helped was mentioned a couple for times. Good for them. Neither 48 Hours nor Katie Couric on her show permitted any bashing. The piece did just what it was supposed to do. It pointed to all of the people that knew about this yet only one organizations is getting the blame for the lack of action on the part of Karla. When it was all said and done, the one person with all of the power…did nothing.

      • Empowered Not Powerless

        Thank you. We’re all refreshed and challenged by your unique point of view.

  • Dan Carr

    It’s true that we label everyone who uses drugs as an addict and they very well may not be, but there are still some people with the disease of addiction so it’s not an all or none thing.. we in 12 step differentiate “hard drinkers” and “real alcoholics” and hard drinkers (or users) do have the power to quit and it is a disservice telling them they are powerless… but abandoning the disease model altogether is equally big of a mistake

  • Lisa Jackson

    Such an awesome article and reinforces the same beliefs that I’ve had not only in my personal recovery but working in the field as a Substance abuse counselor and Mental Health professional. I believe more in the strength based, solution focused model and that the substances as well as other compulsions are just a symptom to as bigger issue. I also use Motivational interviewing and the Recovery model as a tool to help individuals find their own solutions.

  • Lupe Garcia

    I wish that I had this type of perspective when my son started smoking marijuana. Instead I became so angry with him and would yell at him every time I smelled pot on him. I think this led to him using drugs I couldn’t smell. Eventually he became very addicted to crack which then led to other destructive behaviors that inevitably landed him in prison, where he is now.
    My son also exhibited ADHD symptoms at an early age which may also have contributed to his drug use. I think you are on the right path in dealing with teenage drug use.

  • margaret

    thank you for this great article. wish there were more like you out there, mr. Lessin.

  • Josephine Cannella-Krehl

    Yes, yes and yes! A common sense approach to addressing substance use disorders. Client centered approaches, meeting the client “where they are” and getting to the root of the reasons behind substance use are essential. Understanding that many behaviors associated with teen drug/alcohol use are normal to the “teenage” experience is crucial to connecting with and encouraging teens to modify their “problematic” behaviors. Thank you Barry, for such an insightful perspective.

  • Kazuma Yagami

    i like that if your only tool is a hammer every problem will feel like a nail

  • Shira Goldberg

    This is a glimpse of the compassion and integrity Barry Lessin has, and I truly admire admire him for that. This is the mentality that shapes legislation, public policy, and is crucial for change. Lessin and others collectively have helped change the addiction recovery landscape, and became the voice for the voiceless. Harm reduction, introduced to me by Kenneth Anderson founder of HAMS, Dr. Josh King of The Center for Motivation and Change, taught me that there is no “One size fits all, ” and that there is room for compassion using scientific research. The majority of the addiction treatment industry cannot continue to overlook such things, or treat everyone like they are the same anymore.

    When there are more questions than answers, one can’t help but pay attention. Now, I have begun to extend this wealth of knowledge that I am surrounded by and impart a much more individualized experience with my own clients. In the end, harm reduction has given everyone an opportunity to recover, defined by the individual not the cultural expectations, governing bodies or fellowships that have disputed evidence-based protocols, blaming the individual if it doesn’t work, but taking full credit if it does.

    When our biases no longer shape the lens of how we see, it is inevitable that what we see changes as well.

    What a role model!

    It is quite a challenge to be more advanced than societal norms, to speak against is misconstrued as blasphemous propaganda. It is about discovering answers through one’s own biases, to defend a position so many are against. If one is dedicated enough, perhaps crazy enough, to forage ahead, it is a long and windy road filled with the unfamiliar. It is a mission that feels lonely, oftentimes scary feeling like you are the minority. Just one individual foraging ahead, clearing the path to get to the truth and for others to follow. The efforts of so many before me have instilled by example the power each of has. It is through such efforts create a paradigm shift that is being embraced in certain circles, that we feel now. The more we hear about harm reduction the more we understand it and it isn’t as scary to change.

    Thank you Barry Lessin for being a shining example of what it takes to be a pioneer navigating through uncharted territory because it is the right thing to do. Because of such efforts I don’t have to unlearn, and relearn. I started out understanding person first, not pathology, seeing the person separate from the problem. I don’t call someone a name and label them. I don’t even like to know much about someone before I see them to prevent someone else’s bias from becoming my own. I assess based on the individual, their experience and where they are. Treatment should fit the individual, not the other way around.

    I understand that because of the efforts of the men and women that continue to advocate, the warriors of harm reduction.

    Shira Goldberg, MFTt/ PCCt
    Harm Reduction Advocate & Coach