Calling bullshit on addiction treatment bullies

About three years ago, I was attending a national conference on public health (American Public Health Association) and presenting my posters on the relationship between drug use and violence, and sexually transmitted infections and injecting drugs. As I walked the aisles I ran into a woman who runs a Florida addiction “treatment” facility. We talked for a bit about my work, her facility, and then we shared some of our personal stories. Mine included meth addiction, jail, recovery, and now graduate school studying addictions. Everything was great until I mentioned that I now drink alcohol socially… “We’ll save a seat for you” she told me as she handed me her business card. Idiot.

Recovery bullies and addiction treatment

Dr. Adi Jaffe Lecturing in Los AngelesAs soon as my version of recovery from addiction didn’t match her expectations, it was an immediate failure. Forget the 6 years I’d spent free from crystal meth use, the excellent graduate school career that was producing real results I was there to present. Forget the fact that my family, my bosses, and my girlfriend at the time thought I was doing amazingly well – As far as this woman was concerned it was her way, or her way. Well I call bullshit on that thinking once and for all.

Unfortunately for her, the research evidence, as well as the actual human evidence that I’ve seen, shows that recovery from addiction comes in many colors and flavors, like pretty much everything else in life. We’ve covered research on all about addiction before showing that the best evidence to date actually calls into question the idea that relapse is the necessary disaster so many paint it as. The fact that the majority of those who meet criteria for drug dependence at some point in their life actually recover on their won is also there, and although this does nothing to reduce the impact of addiction on all those who have an incredibly difficult time quitting, it’s there and can’t be ignored. Drug dependence is almost certainly not a one size problem and the solution is probably far from a one-size-fits-all, no matter how much you like your own solution.

So there’s cognitive behavioral therapy, peer support solutions (like SMART Recovery, Rational Recovery, Life Ring, 12 Step groups like Alcoholics Anonymous, and more), medication-supported recovery (like Suboxone, Methadone, Vivitrol and more), Motivational interviewing and other Motivational Enhancement techniques, as well as a whole host of psychotheraputic approaches that are more eclectic. No research we have to date indicates that any of these approaches is necessarily more effective than others, which means that they are all essentially equally effective. We’ve already talked about some combinations that work very well together, like PHP programs for physicians, but there is absolutely nothing to indicate that the 12-steps (for examples) are somehow superior to CBT, or Rational Recovery, when it comes to treating addiction.

If you get better, you’re a success in my book

When it comes down to it, whether this Florida 12-stepper likes it or not, I am still a social drinker and I still don’t believe that this nullifies any of my other achievements or my successful recovery. More importantly, it doesn’t nullify the success of millions of others, no matter how poorly it fits with some people’s notions. When a life gets overrun by drug use or another addiction, a successful outcome to me means recapturing a functional life that is no longer dictated by the pursuit of that addictive behavior. Anything more or less is a personal preference sort of thing. The problem with these idiots who will absolutely ignore success because it doesn’t conform to their expectations is that they drive people out of treatment and away from success and that is not okay. I’ll continue to call them out for their narrow mindedness and hopefully eventually, their voice will be far from the dominant one.

11 responses to “Calling bullshit on addiction treatment bullies”

  1. You call them “bullies” – they are known to everyone else as “recovery professionals” and they effectively write the book and MAKE THE RULES about who is “Clean and Sober” and who is not. Obviously, the 12-step/treatment paradigm requires complete abstinence from all substances regardless if you ever had a problem with them or not, as well as lifetime participation in 12-step groups. Any less and you’re at best a “dry drunk.”

    As Penn and Teller describe in their Showtime show, it’s the 12-step recovery program itself that is Bullshit:

    If you had been a part of a “diversion program” for licensed professionals and this “drinking socially” were discovered, this would be considered a relapse and you would be put back to square one as far as being on probation and the time it would take to get your license back. Ask any doctor, nurse or attorney who has become part of their licensing board’s diversion program about it. And that’s just part of the problem of 12-step programs and the “recovery industry.”

    Judging from this blog post (and a quick glance at a few others), it appears you don’t realize the scope of the grip that 12-step based treatment and these “bullies” have. Here’s some sites you may find interesting, or offensive, depending on your sensitivity to the statements made:

    • Well Ben, I agree to an extent. I’ve met plenty of “recovery professionals” who are very open minded whether they support 12-step principles or not. I’ve also met some people who will write-off anyone who is in 12-step programs whether they’re doing well or not. I think it’s the functioning that should be determining how successful someone is at controlling their addictive behavior, not the method they used to get there and their particular take on it.
      I do agree about the diversion program although many who get there (at least within the medical profession) I would consider chronic-relapsing addicts and for many of those, though of course not all, I think abstinence is a good option.
      I have a very good idea of how much control this dogma has on the conversation and the field, but I think being dogmatic the other way is the wrong way to go which leaves me also at odds sometime with many of the sources you cited. I think we can learn something from (almost) anyone and writing off one method because it’s based on principles we don’t believe in would leave me in a very boring world.

  2. I’ve been through alot when it comes to drugs, and for me, rehab didn’t work well.
    I’m to the point now where I feel like I’ve learned. It’s been a rough ass road, and I would rather not live that way.
    I was active in NA, but my nerve problems threw me into having a mild nervous breakdown. When I get really super upset, I have blackouts.
    The last blackout I had was really bad. I woke up in the hospital from an overdose on heroin. I had not done it for so long that I had no tolerance to it.
    I have severe memory loss to where I can’t remember 5 minutes from now. I do have most of my long term memory thank god.
    Had I been able to take my anxiety medication, I would not likely be in the boat I’m in. Infact, I’m pretty sure of it. Unfortunantly Na doesn’t think that’s ok. For some maybe it wouldn’t work, or maybe people just think it doesnt work because that’s what they are told to believe?
    I don’t know? I don’t mean to put anyone down, I just had really bad experiences in rehab. I really was not doing much more than drinking and mild experimentation. Not enough to be in a rehab that took 2 years to get through. Back then my mothers motives for putting me in KHK better known as pathways, was to regain control of me and punish me because my brothers followed me out of her house, and she lost her child support. Sound crazy…She is certifiable.

    If I had not known so many people who were bad on drugs stop by thierself, then I might not be questioning everything so much.
    I don’t think a glass of wine is gonna hurt me. Maybe that would be a good solution. I really don’t like the headaches I get from it, but it’s still an option.
    I may be wrong in what I think. It’s possible. I guess only time will tell. I would appreciate someone else’s insight. thanks…

  3. it is a logical decision that people like to romanticize and try to be the best lil’ victim they can be be because the media says basically says “your drug addiction is your parents fault and not yours”
    fuck all of you that think that you can relate to that victimization and grow a brain and make your own decisions about your life. here is a hint
    *think about someone besides yourself about 5 times a day for starters you selfish prick/cunt
    *Quit the shit that makes you feel bad
    *If the shit that makes you feel bad pays your bills… there are entitlment programs that help you get on your feet and don’t tell me they don’t work because I have had to work them because my husband is has put me through the ringer and I have had to provide for my kids through entitlements and shaking my ass
    *no he is not clean but guess what….
    so quit whining that so and so didn’t do this or that and quit being a fucking VICTIM.

    • Well nightmare,
      It sounds as if you’ve been seriously hurt by your husband’s actions and that makes sense and I understand your hurt. I’m sorry. good luck with everything and I hope your luck changes since I’ve known more people in your situation than i’d like to admit through my own experiences.

  4. sorry if I missed something here, but if you were addicted to meth, how does that correlate to knocking back a beer?

    I can rock a few lines and never feel the need for more, yet throw some liquor in my way and I’m a bloody animal.

    On the flip side, a good friend can’t even have a sip o’ grog without getting ill, yet she has no qualms about rockin out.

    Such is how it is.

    Sadly, that woman’s views are the attitudes that whitewash the good that people who actually HAVE experience can provide.

    I only googled here, going to read more now.

    Best of luck Adi,

    – Ross

    • Hi Doug,
      I in fact could not agree with you more about the notion that a meth addict may be able to drink responsibly. However, I think you’ll agree that this is by no means the prevailing opinion in the field. That issue is made more complicated by the fact that I have no doubt that many people who meet criteria for addiction at one point their life may still be able to use that substance responsibly at a later point. Given the numerous influences on addiction, I think it is likely false that “once an addict always an addict” is true for everyone.

      Thanks a lot for reading and I hope you’ll share your viewpoint on more articles!


  5. Las Vegas Recovery Center, what an oxymoron. I spent six weeks in this Alcatraz and it wasnt worth it. Dr. “Greased” Pohl, the so-called Medical Director, was a real piece of work. He’s abusive and accusatory with a big Ronald McDonald smile, and wont listen to reason. Everyone is a teenage crystal meth addict bank robber to him, and he treats people like Nevada dust. God help you if you dont do everything they make you do, like the stupid 12 steps and the horrible AA and NA meetings, which is all just superstitious bunk. My husband was told he needed to work the 12 steps because he was in denial about being an addict, but he only has a few beers a week and never a problem. The staff is nuts. They make detoxing and withdrawing off alcohol and drugs so much harder with all their religious B.S. Im surprised a straightjacket wasnt issued to us patients as standard equipment. My husband and I aren’t surprised there are other complaints about the facility. The rich drug addict owner is said to be bi-polar or something equally scary. “Duh…winning!” Just like Charlie Sheen. Rehab helps some but hurts others…and thats just crazy. Want an effective rehab? Doesnt exist. The next best thing? A non-12 step rehab; there are more and more every day. I, myself go to Smart Recovery meetings….so much better. Go to Smart Recovery website for a list of decent clinics.

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