I was recently invited to be interviewed about the rise of pharmaceuticals in the addiction treatment industry, and the trend to create and use more and more medications to combat drug and alcohol addiction. There are also vaccines that could potentially prevent addiction to certain substances that are already undergoing testing in some cases.
Do you personally believe that a 12 step program is a better idea for lasting sobriety than the quick-fix that these vaccines and medicines could offer to addicts?
First of all let me clarify that there is not necessarily a huge demand that we are seeing from the client side of things. The real trend that I have noticed is in research and pharmaceutical companies that are trying to “cash in” on this type of problem. That is of course what drug companies do and I don’t think we should necessarily fault them for it.
In other words, addicts are not necessarily the ones who are clamoring for the easy fix in all cases. If anything, I notice some doctors who are encouraged by new drugs that can potentially combat cravings, much more so than the treatment facilities and drug rehabs.
Certainly there is quality sobriety to be had with a 12 step fellowship. Many advocates of the 12 step program argue that those who are working a 12 step program will have higher quality of sobriety and have deeper meaning in their life than those who find recovery through other means. They would argue that if someone just simply takes a pill that fixes their addiction, that they are missing out on a vast opportunity for spiritual growth and a whole wealth of social connections that they could be getting from the fellowships of AA or NA.
My personal belief is that this quality sobriety is very hard to come by without radical change in the life of the addict. Total and complete immersion in a 12 step program is one way to move towards this transformation, but it is by no means fool proof and certainly the success rates could be a lot better. Many who attempt the 12 step program will fail and even AA’s own internal census data says that something like 80 percent will never return to AA after their first meeting.
So this is nothing against the 12 step model in general, but clearly this approach does not, and can not work for everyone.
My personal belief is not that 12 step programs should be advocated over the use of medications, but that an integrated approach is probably necessary in order to find the combination of therapies that works for the individual. Addiction is a complicated condition and it affects many parts of the individual, including the emotional, physical, mental, and spiritual aspect. Why would we expect the solution to be single faceted? Any solution to such a complex problem like addiction is going to be holistic and comprehensive if it is to be effective for different types of addicts who all have unique situations and backgrounds.
What is the general consensus among members of NA and AA about this subject? Do they believe that people are truly clean if they were to involve themselves in these kinds of methods of recovery?
I cannot speak for all of the 12 step fellowships, but certainly you are going to find many people in both AA and NA who consider these types of medications to be “cheating.” Some of this will be unspoken, some of it will be accusations hurled at each other in broad daylight. For the most part, there is no consensus, as I have seen both extremes on this argument and everything in between.
Some try to take a sensible approach and recommend that we seek the advice of a doctor when it comes to medications of any sort, including those that might help with cravings and such. But addicts can manipulate doctors, sometimes without even realizing it. This is part of the disease itself in some cases. So we have to be extremely careful and get knowledge from many different sources and try to find doctors who are experienced in dealing with addiction.
For the most part, I think there will always be some resistance to addiction medications among both the 12 step fellowships as well as among the treatment industry.
Would you ever consider choosing this method of recovery instead of a 12-step program? Why or why not?
I started my 8 plus years of sobriety in a 12 step program with no medication. To this day I do not take any medication at all save for an asthma inhaler. Before I got clean and sober, I did experiment with one medication that was supposed to help with alcoholism but it did not work for me. At the time I was simply not ready to stop drinking, so I am not really faulting the medicine.
Interestingly, I later tried to use medications in order to quit smoking cigarettes. My efforts at this failed until I finally tried to do it cold turkey and was finally successful that way. So in my direct experience, I have not had much success in using medications to fight my own addictions. But I have seen them work for others in some cases too.
Quitting smoking was a learning experience that lasted me for several years. I tried so many methods and ultimately I just toughed it out and made it through cold turkey. I think that says a lot in itself so if I was facing a similar challenge in the future I think I would draw from that experience and not rely so much on a medical solution.
This is not the ultimate answer though. Eight years ago I got clean and sober, but ten years ago I was drinking heavily. If someone had offered me a magic pill at that time, it might have made a difference. I might have gotten sober much sooner. I do not discount that possibility and I think that keeps the door open for more research for future medications (at least in my mind).
Do you think people who take this as a quick fix are ever able to fully experience and embrace the recovery process?
People who do anything as a quick fix are not going to get deep, rich benefits from doing so. The “quick fix” part negates a deep and rich experience. That being said, I still think people might benefit from medications that offer them a “boost” in early recovery, and can still find the path to lasting, quality sobriety.
Quality recovery cannot be found in a pill. But it might start with one.
Think of it like this: can an intervention save a person and get them sober? Not directly it can’t. But it can the catalyst that drives the change. It might not even happen immediately, and it usually doesn’t.
These medications can act in a similar way. They might give someone a temporary edge, or just enough insight or clean time to have a revelation. They are not a cure; they cannot work magic. But medications might open a door for someone or give them an opportunity to seek further change.
Even with a maintenance type medication, I do not believe it is sustainable without real effort in other areas of an addict’s life. There has to be more to recovery. Does it have to be 12 step based? Does it have to be spiritual? Does it have to be a social solution? No in all cases. But it does have to be significant and it has to give their life purpose and meaning, at least as much as the passion they felt for their drug of choice. A new life must be created in place of the old one and using medication alone is not going to cut it. More must be utilized.
Do you think that these pharmaceutical companies are just trying to make money off of desperate people and their families?
Sure. And this is an efficient way to innovate.
But I do not think the drug companies are that greedy or evil necessarily. This is actually not a huge segment to target; in fact it is pretty small compared to other diseases and disorders out there. Sure there are a lot of addicts and alcoholics, and it is a growing problem, but it is really, really tiny when compared to some other diseases and disorders. It really is not a huge market for the drug companies to chase after, so I admire all the research and innovation that they are doing.
Do you think it would be ethical or a good idea to give kids a vaccine that would make them immune to the effects of alcohol and hard drugs if we had that resource?
I don’t think a vaccine that made them immune to the effects of drugs would ever gain traction. The reason is that so many drugs, even illegal ones, are usually based on something that has a medical equivalent. If we started immunizing for all sorts of different chemicals, then we might end up with a generation of people who cannot really be properly treated for pain, or possibly have some other complications. I think it is dangerous territory, but people will approach it as such and I really don’t see it going anywhere.
Now a vaccine that just prevented addiction, but still allowed the drugs to take effect and medicate a person? That would the magic wand right there but I doubt we are anywhere close.
If drugs and vaccines were to be successfully developed, do you think a few year’s from now programs like NA and AA will die out?
There is an old joke that says if you ever made a pill that cured addiction, you would still need 12 step meetings because addicts would get addicted to the new pill!
But the joke raises a good point: addicts and alcoholics have a problem that goes beyond chemical dependence. For example, NA (Narcotics Anonymous) argues that using drugs was but a symptom of our disease of addiction, not the problem. We can still take away the drugs and the alcohol and manage to act out in some really bizarre ways and do some insane things without abusing chemicals.
Keep in mind that AA is a self organized, leaderless organization. It is a very difficult thing for it to die off because of this inherent disorganization. New groups can pop up at will. Even with a magic pill developed, there will be many who refuse it, others who seem to be immune to it, and others who find new addictions that go beyond chemical dependency. I think there would be strong reasons for the 12 step community to stay alive, even if other, more efficient solutions came along.
Can you share with me a little about the beginning of your journey to recovery? When did you realize that you needed help and what made you reach out to a 12-step program?
The beginning of my journey was in asking for help from a trusted family member. I had been to traditional rehab before but never stayed sober for any length of time, not even a little. This last time I had simply had enough, I was beaten down totally and completely and I had found that necessary level of surrender. I have tried to explore this moment of surrender and figure out how to bottle it and sell it, but I cannot discover the magic in it. The addict is ready when they are ready. No amount of convincing, pushing, shoving, or prodding can get them to give sobriety a chance if they are not willing to surrender.
I believe the element of surrender is necessary to make a start at recovery. At the time I got sober, the 12 step program was available to me and it was presented to me in such a way that I felt I had no choice; no options. For now I think this is fine and if someone wants to explore their new life in recovery they can certainly grow beyond the boundaries of traditional 12 step programs. It is a solid starting point and there is a ton of support to be had in the meetings. Plus, it is free.
I was introduced to 12 step programs because that was what was available to me when I went to treatment. In most places it is the only option. In my opinion this is not a huge deal because other options do not fair much better or worse in terms of success rates.
Based on my experience and what I have observed both in and out of AA, the real winners in recovery take whatever program they were given and they shape it and sculpt it and they make it their own. They are creating a new life for themselves and any program is just a structure to base this new life on. But the program is not their salvation, it is not what saved them, it is not even the instructional manual for how they were saved. Instead it is a loose framework on which they based some of their recovery experiences.
The real magic happens in the way that the addict approaches their new life and builds upon their successes. They are building and creating something, not eliminating. They are establishing positive habits, not eliminating old ones. Recovery is deliberate, purposeful living that goes beyond medications and group therapy.
Recovery is creation.