Progressive Disease: Anonymity in Medication-Assisted Recovery

Progressive Disease: Anonymity in Medication-Assisted Recovery

I just spent a fantastic weekend at the West Coast Symposium on Addiction Disorders where we, at Catalyst Recovery, spent our time socializing with some wonderful colleagues and catching up on the latest in the industry. I will admit that I mainly go to these events to socialize, market and connect with other professionals in the hopes of expanding the Catalyst name and establishing new relationships, but I happened to take a look at the the agenda of speakers and presentations put on by various clinicians and professionals. Of all the great topics and sessions available I saw one that really stuck out to me, not because it was entirely new but it was a topic that I realized I don’t know much about: Medication-Assisted Treatment (M.A.T.) such as Methadone, Suboxone, Subutex, Naltrexone, Vivitrol.

I have worked in the field of substance abuse treatment for a relatively medium length of time – 7 years – and have had my share of experience working with recovering individuals in various stages of their treatment episode who were either currently on, have been on, or plan on using medication to aide in their long-term recovery goals. On a personal note, I am also in recovery and obtained my recovery through the traditional 12-Step model of abstinence from alcohol/narcotic substances and cultivating a lifestyle rooted in service and spirituality. By all accounts, I was very fortunate and am grateful that the 12-Step model was sufficient enough for me to find my own sobriety. However, as I entered the field of addiction treatment and actually started to work on a professional level with others, I found that my own experience and story influenced my judgement of others who sought different methods of achieving recovery. I don’t believe that I am the only professional who has let their judgement run rampant, but when I took notice I wanted to change and look for ways to broaden my own mind, heart and ability to help those struggling with substance abuse disorders.

I have not experienced many success stories when it comes to medication-assisted treatment. I, often, interacted with individuals seeking treatment again because the continued use of medication actually turned them back to the illicit drugs they were taking in the first place. Through the many stories of either lying to medical professionals to be on higher doses, abusing other substances while on the medication or those who had learned how to vacillate between their medication and illicit drugs I continued to foster this close minded sense of, what I can now recognize, superiority as someone who did not need the “easy way out” of my addiction. The ego of an alcoholic or addict will never cease to amaze!

The cliché comparison of the disease model of addiction to cancer comes to mind. I have used this comparison, as well as many others I’m sure, to describe to a non addict/alcoholic the process of becoming sober; “We are not bad people becoming good, but sick people getting well.” Now using the same comparison: let’s say an individual has stage 3 or 4 “cancer” and maybe I found recovery while still in stage 1. Maybe I was lucky enough to only have “cancer” in a single limb instead of in my bone marrow. If addiction and alcoholism is comparable to a disease and labeled a disease by the American Medical Association then to treat it as such is to acknowledge that a disease can spread, destroy and consume in various ways. While my own disease only needed abstinence based treatment, it is within reason to understand and empathize that others may need certain medications to treat their own. I came across this well written article by Jillian Bauer-Reese at Slate on this newly formed 12-Step group that openly accepts those on the aforementioned medications. As I read the article and accounts by some of the contributors about the treatment they had received while on their medication(s) and attempting to participant in traditional 12-Step programs like Alcoholics Anonymous or Narcotics Anonymous it struck me the harm that can be caused, in a setting that is supposed to be safe for people seeking help, guidance and love through their struggle. For myself, this is really the first time I have read about an experience such as this due, in part, to my lack of asking questions and understanding around M.A.T and what individuals may experience while seeking additional support from groups and methodologies widely available.

As I listened to the panel at the Symposium, a panel that included a Medical Doctor and master level trained Clinicians, I realized just how little I knew about the entire process. About the amount of time discussing the pros and cons of medication, the benefit of anti-craving drugs while engaging with psychotherapy, the statistics around the decrease in overdose related deaths and crime. For myself, it was a truly “eye opening” experience to simply take the time, albeit brief, to listen to some well-trained/versed professionals speak on the matter. Interestingly enough this panel even mentioned the concerns and stigma still widely held regarding Medication-Assisted Treatment and how it was ok! It is ok to come with judgement and confusion but as a substance abuse treatment professional, and even as a sober member of society, to also come with an open mind. Ask questions and ask the right people. Discuss the fears, concerns and hesitations, but work together as a team for the good of those seeking help. Jillian’s article (which I have shared the link to below) is a step in the right direction. To see a new group created out of the same principles from which I obtained my sobriety, and one that allows an open forum for those who may need added methods of treatment opens the possibility to save and better even more lives. It is apparent that M.A.T is not going anywhere, though I do believe that some of the pitfalls will need to be addressed and may never be completely without risk, I am confident that with enough support, care and guidance for those on these medications – a better life is possible and our duty, as professionals, to make available to those seeking.

There’s a New 12-Step Group: Medication-Assisted Recovery Anonymous by Jillian Bauer-Reese

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