Sunday, March 16, 2008

Medications and Recovery: from Dual Recovery Anonymous

http://draonline.org/medications.html


D.R.A. members often go to Alcoholics Anonymous and Narcotics Anonymous meetings for additional support and fellowship. Often men and women who have been diagnosed with a dual disorder say that they have received misguided advice about their diagnosis and the use of medication at other Twelve Step meetings. Some have been told that they do not have an emotional or psychiatric illness, and that they are experiencing merely self-pity or some other character defect "You don't need those pills; they'll cause you more problems" and "If you're taking pills, then you're in relapse and not really sober". Individuals who have followed such advice have experienced relapse: some have been hospitalized; some have returned to alcohol or drug use; some have attempted or even completed suicide. To say the least, it can be very confusing. Though we can not speak for other organizations, their literature makes clear that these types of statements are not the official position of A.A., N.A., or any other Twelve Step recovery groups that we are aware of.

On page 133 of the Big Book of A.A. it says in part:
"Now about health: A body badly burned by alcohol does not often recover overnight nor do twisted thinking and depression vanish in a twinkling. We are convinced that a spiritual mode of living is a most powerful health restorative. We, who have recovered from serious drinking, are miracles of mental health. But we have seen remarkable transformations in our bodies. Hardly one of our crowd now shows any dissipation.

But this does not mean that we disregard human health measures. God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons. Most of them give freely of themselves, that their fellows may enjoy sound minds and bodies. Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward."
Reprinted from Alcoholics Anonymous, with permission of A.A. World Services, Inc.

There is also an important piece of A.A. conference approved literature called "The A.A. Member - Medications & Other Drugs" that addresses these issues specifically plus issues of cross addiction. Some D.R.A. members carry copies of this pamphlet with them to help educate others when this issue is brought up. Here are a few excerpts:

"...A.A. members and many of their physicians have described situations in which depressed patients have been told by A.A.s to throw away the pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from schizophrenics, manic depressives, epileptics, and others requiring medication that well-meaning A.A. friends often discourage them from taking prescribed medication, Unfortunately, by following a layman's advice, the sufferers find that their conditions can return with all their previous intensity..."

"It becomes clear that just as it is wrong to enable or support any alcoholic to become readdicted to any drug, it's equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems."
Reprinted from The A.A. Member - Medications & Other Drugs, with permission of A.A. World Services, Inc.

Narcotics Anonymous says they have no opinion on the issue of medications that are properly prescribed to control the symptoms of a psychiatric illness. When asked about this issue, N.A. Fellowship Services, states that "The question of prescription medication should be decided between the member, their doctor, and the member's Higher Power. Our pamphlet "In Times Of Illness" and our 10th Tradition, make this abundantly clear. We strongly recommend telling our doctor's about our history so that when prescription medication is absolutely necessary they can prescribe it knowing that we are recovering addicts."

We also must keep in mind that few recovering alcoholics and addicts in these groups are mental health and treatment professionals. Almost all are certainly well-meaning. Many don't fully understand the difference between the usual depressions and anxieties most recovering folks go through in early sobriety and our psychiatric illnesses--nor should they be expected to. Some people may falsely think that antidepressants are "mood elevators" much like the street drugs they may be familiar with. These are understandable misconceptions, but can lead to poor advice even from some of the "old-timers".

It is clear that no one should play the role of doctor but a licensed physician or psychiatrist. Sponsors and other well-meaning Twelfth Steppers should not give medical advice. DRA members who seek sponsors in other 12 Step groups must weigh carefully the potential sponsor's attitude and understanding concerning medications and psychiatric illnesses. We can not expect them to fully understand, but an attitude of acceptance toward the the nature of our dual disorder and the place properly prescribed medications play in our dual recovery is key. Experience has shown us that honesty is the basis for successful sponsorships.

DRA members do need to keep in mind when attending the various Twelve Step groups that the Traditions and Primary Purpose of each particular organization need to be respected. Those guidelines were developed through much hard won experience, that their meetings, purpose, and message, not be diluted with outside issues or controversy. Those programs were not developed to address the problems of dual disorders. They offer neither direction nor guidance for dual recovery. Most of these organizations are single-purpose organizations--one disease, one recovery. Dual recovery does not fall within their primary goals. It is our responsibility to manage our psychiatric illness in a healthy and constructive way and do what is best for our dual recoveries.

People who have a dual illness recognize that it cannot be divided into simple and separate parts. They acknowledge that while they do find support for aspects of their illness from many various 12 Step groups, they also need a group in which they can look at their total illness and recovery needs. Dual Recovery Anonymous was formed specifically to address the needs of individuals who had two no-fault illnesses: an emotional or psychiatric illness and chemical dependency. The DRA program is based on three simple ideas, that are suggested as a foundation for dual recovery.

* Today, I will be free of alcohol and other intoxicating drugs.
* Today, I will follow a healthy plan to manage my emotional or psychiatric
illness.
* Today, I will practice the Twelve Steps to the best of my ability.

DRA recognizes that psychiatric medications are used for the purpose of managing psychiatric symptoms and are not taken for the purpose of achieving a "high". Therefore, the use of psychiatric medications is not considered to be the same as relapse.

Note: Some individuals in dual recovery must take certain medications that can have a potential for abuse or physical dependence. These medications, when properly prescribed and taken precisely as directed, can be an important tool in controlling psychiatric symptoms and may be crucial to an individual's dual recovery and well-being. We use every caution with our medications and understand that at times, there just isn't another option available to us. Our doctors know best. We are rigorously honest with our doctors and treatment professionals in regards to our dual illnesses and our history of chemical dependency. When we take these medications in accordance with our doctors advice and our recovery plans they do not interfere with our sobriety or "clean time." Dual Recovery Anonymous recognizes that psychiatric medications can be an integral part of a recovering persons plan to manage their emotional or psychiatric illness in a healthy and constructive way.

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Dual Recovery Anonymous is interested in how you have faced issues concerning prescribed medications and support group peer pressure. We invite your stories, comments, and feedback about this topic and related issues. Please send them to the World Services Central Office. We always appreciate hearing from our members and learning how they have dealt with recovery issues. Submissions may be used in various future publications by Dual Recovery Anonymous World Services Inc., and become the property of DRA. As always, the tradition of anonymity will be preserved; first name with last initial only, or a pseudonym may be substituted. Thank you.

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