Addiction and recovery are often seen as a black and white paradigm. That is, a person is either on drugs, alcohol, or both, or they’re 100% sober from everything. And if they’re 100% sober from all substances they’re able to get the social status of being in recovery. At least, this is the common framework at mainstream rehabs and 12-step meetings across the country.
Another approach to viewing addiction and recovery (that is often criticized by the total abstinence-only believers) is called harm reduction.
What is harm reduction?
Any positive change.
Not every person that struggles with alcohol or one or more other drugs has the goal of quitting every substance until they take their last breath in this lifetime.
Harm reduction is a much-needed approach for individuals in this population…
That is why Matt Finch chose harm reduction to cover in episode 236 of the Elevation Recovery Podcast.
In episode 236, Matt Finch introduces, then reads word-for-word, and then analyzes the recent article published in TIME titled Rethinking What it Means to Recover from Addiction.
Here is a snippet from the article which Matt covers in this episode:
“CRA’s approach is called harm reduction, and it defines recovery as making “any positive change.” This means that anything from starting to use clean needles to becoming completely abstinent counts. From this perspective, if someone quits smoking crack, gets a job and reconciles with her family, she counts as being in recovery—even if she stills smokes marijuana daily.
Or, if someone goes from drinking a bottle of Scotch a day to having a daily glass of wine—or from drinking daily to binging only on weekends—these too are positive changes, not just “active addiction.” Here, recovery is a process, not an event. It’s difficult to learn any new skill without trial and error, and this includes developing coping skills to manage or end drug use. For most people, even with behaviors short of addiction, big changes take time.
This broad definition obviously includes people who take addiction medications. Doing so is a positive change because it dramatically reduces the risk of death, even for those who continue to take other substances.”
There are Many Paths to Recovery
One of the key philosophies of harm reduction is that there are many paths to recovery. And recovery can be whatever you choose it to be.
Rigid rules around recovery come from followers of a book written almost 100 years ago. The Big Book of Alcoholics Anonymous (AA) has helped countless people over the decades.
However, devotees of the fellowship have created a dogma around the teachings of the Big Book and apply the dogma to people other than themselves.
Meaning they judge and either approve of or condemn other peoples’ recoveries based on their interpretation of one book on addiction recovery out of thousands (that was written almost a century ago).
Rethinking What it Means to Recover from Addiction
The logic regarding current mainstream addiction recovery concepts and even rules is unfounded. It’s unfounded because there is no logical basis, only emotional investment, ego investment, and groupthink.
We need to rethink what it means to recover from addiction.
And in episode 236 Matt takes you on a journey down an empowering path to redefining what recovery can mean for each unique and sovereign being.
By watching, listening, or reading the episode you’ll be much more equipped to transform the areas of your life that you’re working on.
You’ll receive inspiration, education, entertainment, empowerment, and resources, tools, strategies, and tactics to help you take positive action forward in the face of adversity.
Here are some ways to learn from this episode:
- Listen to the audio
- Read the transcript
- Right-click here and save as to download this episode on your computer.
Matt Finch: The one-size-fits-all recovery approach doesn't work. One-size-fits-all medical approach for everyone, regardless of their differences, doesn't work. The one-size-fits-all diet for all 8 billion humans, regardless of our biochemical differences and genetics and DNA, doesn't work. The one-size-fits-all philosophy for people to live life by doesn't work. One-size-fits-all religion doesn't work. One-size-fits-all types of intimate relationships doesn't work for all 8 billion people on the planet, recovering from addiction, whatever, however you want to define that. One size fits all is a thing of the past-
Announcer: Thanks for tuning in to the Elevation Recovery Podcast, your hub for addiction recovery strategies. Hosted by Chris Scott and Matt Finch.
Matt Finch: Welcome to episode 236. This is Matt Finch. And in today's episode, I'm going to read you an article that is very recent from Time magazine on time.com. The title, Rethinking What it Means to Recover from Addiction. I absolutely love this article. I'm looking forward to reading the book by the author, which is titled Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction. This article is from September 29th, 2021. So it was just a few days ago. Really glad I found it and I can't wait to share it with you. So here we go.
Matt Finch: "When I kicked cocaine and heroin in 1988, I was told that there was only one way to get better: abstain forever from psychoactive substances including alcohol, and practice the 12 steps made famous by Alcoholics Anonymous. The only alternative, counselors and group members said, was jails, institutions or death.
Matt Finch: "My addiction was so extreme that by the end, I was injecting dozens of times a day. So I grabbed the lifeline I was thrown and attended the traditional 12-step rehab program recommended by the hospital where I underwent withdrawal.
Matt Finch: "But once I began to study the scientific data on addiction, I learned that these claims were not accurate. In fact, research shows that most people who meet full diagnostic criteria for having an addiction to alcohol or other drugs recover without any treatment or self-help groups, and many do so not by quitting entirely, but by moderating their use so that it no longer interferes with their productivity or relationships.
Matt Finch: "There is no one true way to end addiction, and the idea that one size fits all can be harmful and even deadly in some cases. Until we recognize this and celebrate the variety of recovery experiences, September's National Recovery Month and similar efforts to promote healing will fail to reach millions of people who could benefit. During an overdose crisis that killed more than 90,000 people in 2020 alone, a better understanding of how people really do overcome addiction is essential.
Matt Finch: "Unfortunately, rehab hasn't improved much since I attended in the late 20th century. At least two-thirds of American addiction treatment programs still focus on teaching the 12 steps and promoting lifelong abstinence and meeting attendance as the only way to recover. The steps themselves include admitting powerlessness over the problem, finding a higher power, making amends for wrongs done, trying to improve character defects and prayer, a moral program unlike anything else in medicine.
Matt Finch: "Moreover, despite the fact that the only treatment that is proven to cut the death rate from opioid addiction by 50% or more is long-term use of either methadone or buprenorphine, only about one-third of residential programs even permit these effective medicines, and around half of outpatient facilities use them, typically short-term.
Matt Finch: "Worse, when they do allow medication, most treatment centers also push people with opioid use disorder to attend the 12-step program, Narcotics Anonymous. That creates what can be deadly pressure to stop the meds. The group's official literature says that people on methadone or buprenorphine are not clean and have only substituted one addiction for another.
Matt Finch: "I have been contacted by more than one family who lost a loved one to overdose because their relative had rejected or prematurely ended medication based on this view. If we don't start to view recovery more inclusively, we are denying hope and healing to those who benefit from approaches other than the steps.
Matt Finch: "So, what does a more accurate and expansive view of recovery look like? To me, one of the most helpful definitions was devised by a group known as the Chicago Recovery Alliance, CRA, which founded the Windy City's first needle exchange. CRA was also the first organization in the world to widely distribute the overdose reversal drug naloxone, and train drug users to save each other's lives by using it. Naloxone, also known as Narcan, is a pure antidote to opioids: it restores the drive to breathe in overdose victims but must be given rapidly to be effective. If used in error, it is safe: it won't hurt people with other medical problems and typically works even if opioids have been combined with other drugs.
Matt Finch: "CRA's approach is called harm reduction, and it defines recovery as making 'any positive change'. This means that anything from starting to use clean needles to becoming completely abstinent counts. From this perspective, if someone quits smoking crack, gets a job and reconciles with her family, she counts as being in recovery, even if she stills smokes marijuana daily.
Matt Finch: "Or, if someone goes from drinking a bottle of Scotch a day to having a daily glass of wine, or from drinking daily to binging only on weekends, these too are positive changes, not just active addiction. Here, recovery is a process, not an event. It's difficult to learn any new skill without trial and error, and this includes developing coping skills to manage or end drug use. For most people, even with behaviors short of addiction, big changes take time.
Matt Finch: "This broad definition obviously includes people who take addiction medications. Doing so is a positive change because it dramatically reduces the risk of death, even for those who continue to take other substances.
Matt Finch: "Moreover, those who do quit nonmedical use and stabilize on an appropriate dose of these meds can drive, connect with others and work as well as anyone else. They are not intoxicated or numb, just like people taking other psychiatric drugs as prescribed.
Matt Finch: "While patients on methadone or buprenorphine remain physically dependent on medication to avoid withdrawal, they no longer meet criteria for addiction. According to psychiatry's diagnostic manual and the National Institute on Drug Abuse, addiction must include compulsive behavior despite negative outcomes, it's not simply needing something to function.
Matt Finch: "Of course, for people steeped in traditional abstinence-oriented recovery, CRA's 'any positive change' definition can be challenging. In the 12-step world, members who have maintained continuous abstinence for many years are revered. The longer their time away from alcohol and other drugs, the higher their status tends to be. The lure of such social acclaim helps some avoid relapse. Granting the status of recovering to those who have not quit entirely seems unfair from this perspective.
Matt Finch: "However, it could save lives. In 12-step programs, people who break continuous abstinence, even for just one day after 20 years, are seen as returning to square one, and their sober time and its associated status is completely erased. Research shows that having such a binary view of recovery can actually make relapses more dangerous. That's because people figure that, since they've blown it already, their small slip might as well be a massive spree.
Matt Finch: "Since most people do relapse at least once, moving away from the idea that only continuous abstinence matters, not quality of life, not the ability to maintain relationships and contribute to society, would likely be healthier for everyone.
Matt Finch: "But there's another way to reconcile conflicting views of recovery, which preserves traditional ideas for those who prefer them. That is, simply define it for yourself and let others do likewise. If you've heard someone identify themselves by saying, 'I'm a person in long-term recovery and for me, that means abstinence,' you've seen this idea in practice.
Matt Finch: "My own perspective has changed over time. From 1988 through 2001, I was continuously abstinent from drugs other than caffeine, including alcohol. Since then, I have used alcohol and cannabis responsibly, without difficulty. However, I have no illusions that I could moderate either cocaine or heroin use, so I continue to avoid these drugs and count myself among the recovering.
Matt Finch: "Now, though, I suspect that my recovery probably started before my abstinence, when I was taught to use bleach to clean my needles in 1986 and began to fight to get HIV prevention information and equipment to other injectors. That positive change likely helped prepare me for further transformation, including seeking rehab. It almost certainly helped me avoid AIDS.
Matt Finch: "What really matters is not whether someone recovers via medication or moderation or 12-step programs or anything else. It's that, like me, most people do get better. And even more of us can if we recognize and support many roads to recovery."
Matt Finch: I don't know about you, but I love that article. And it goes along with a lot of what I teach people about as well on the podcast, my YouTube channel, and also with coaching clients and articles. I mean, despite what many believe, the truth is that life after addiction doesn't have to follow a specific script, a specific narrative, someone else's narrative that was created almost a hundred years ago. There's been so many myth-busters that have busted the myth of the one-path recovery doctrine that says that there's only one way to recover from addiction.
Matt Finch: I used to feel the need to defend this even as recent as a few years ago, but now I'm just glad to see it even in the mainstream all over the place, where it's like people have caught on to this... Five years ago, and especially 10 years ago, you were like a quack if you were talking about this stuff. If you were saying that people can get sober or reduce drug use and moderate and live productive lives, even using substances after they've been addicted to one substance, you'd get ostracized from a bunch of circles and people would make fun of you and say you're being dangerous.
Matt Finch: So, I mean, it's cool to see that this stuff is now in the mainstream and it's been there for a while. It's catching on more and more. People are waking up to this, waking up to the fact that you don't need to define your life post addiction as being in recovery. You don't need to attend meetings. You don't need to get a sponsor. You don't need to do step work. You don't need to memorize your sobriety date and celebrate it every time it comes around and count the days and years and months and weeks that it's been since you're last been addicted. You don't need to believe that you're powerless over your addiction. You don't need to call yourself a recovering addict or a recovering alcoholic or an addict or an alcoholic, or a former addict or a former alcoholic.
Matt Finch: And finally, you might even be able to use potentially addictive substances, medicinally and or responsibly therapeutically, spiritually, many different reasons to use, instead of swearing off the use of all mind-altering drugs and substances forever, along with alcohol. That's exactly what this person's article was talking about, which is what their book that just came out is about too, redefining what addiction recovery means.
Matt Finch: I don't even like that word. We have the word recovery in Elevation Recovery and also in Fit Recovery. I mean, that's just where things are at these days. There was nothing probably more suitable to call it, because otherwise, how are people going to know what we even do? But I really don't even like the word recovery. I don't like the word addict. I don't like the word alcoholic. I don't like the word clean. I don't like the word sober. Not because of the words themselves, but because of at least here with American mainstream culture, and especially mainstream recovery culture, but to a even broader aspect less niched down the culture of America, those words just have these weird meanings.
Matt Finch: It's like recovery is seen as abstaining from all alcohol and all drugs for the rest of your life. And if you're always recovering, if you've had an addiction for six months of your life, say you had alcohol addiction for six months, and then you get clean and sober and AA, and you start doing the Big Book and doing all those things. Well, even though your addiction was only six months and maybe you're 21 years old, when you turn 21 that's when it started because you were partying a bunch, you have to be going to those meetings and doing that program for the rest of your life. It doesn't make sense. There are so many different people, so many different situations and experiences and severities of substance misuse or overuse or uncontrolled use, whatever somebody really wants to call it.
Matt Finch: The one-size-fits-all recovery approach doesn't work. One-size-fits-all medical approach for everyone, regardless of their differences, doesn't work. The one-size-fits-all diet for all 8 billion humans, regardless of our biochemical differences and genetics and DNA, doesn't work. The one-size-fits-all philosophy for people to live life by doesn't work. One-size-fits-all religion doesn't work. One-size-fits-all types of intimate relationships doesn't work for all 8 billion people on the planet, recovering from addiction, whatever, however you want to define that. One size fits all is a thing of the past. The only reason it's still being practiced today is because of the corporate big profit rehab centers that are making a killing with all the people suffering from addiction and alcohol use disorder and opioid use disorder.
Matt Finch: These rehab centers are making a killing. They have run lots of marketing campaigns and SEO campaigns and paid advertising campaigns to everyone that's searching on Google, lots of people on YouTube. They're finding these big rehab centers because it's so easy to find them, and all they're doing is the same exact thing. They're hooking people, "Oh yeah, yeah, it's..." Building up that pain, stirring up the hurt in them to try to enroll them in their treatment program, lying about their success rates, lying about a lot of different things, omitting lots of truths. To get those signups, they can bill the living shit out of people's insurance companies. Then when they slip or relapse later, if that happens, oftentimes they'll go to the same place thinking it was their fault 100% and they just need to do it better this time.
Matt Finch: The treatment center, of course, "Yes, we'll take you back, and no, we're not going to give you a discount. You can come here five, six, seven times, and if you don't make it in the real world, it's just because you don't want it bad enough, or you didn't do the program hard enough and serious enough." It's sickening. It's actually sickening.
Matt Finch: Just recently in the news articles as well, I saw the story where there was these two gentlemen, I believe down in Florida, that are getting some serious charges right now in court due to them doing fraudulent things where they were somewhere in the Northeast, maybe Massachusetts, somewhere up there, getting people that were hooked, I think on opioids and then doing some insurance fraud stuff, getting them down to promising them like the super plush premium Florida treatment. And then when they get there, it's totally different. A bunch of stuff that was not right at all. And so this is really... They got busted. The amount of criminal charges they're getting is horrendous. It's sickening to see this. This is not an isolated case. This is happening all over the country. Just crazy, crazy, crazy how much money there is to get these referrals, to get people into these inpatient long-term treatment centers and building insurance. And so it's illegal and people are doing it like crazy, trying to milk this addiction in recovery market.
Matt Finch: I remember a long time ago, maybe two years ago, somewhere around there. I was a member of this really large addiction recovery Facebook group back when I was a big time into posting on Facebook and sharing every aspect of my life on there. I'm so glad I don't do that anymore. I'm so much happier and more calm. But back then I was really into it. And one of the guys in this group I'm talking about was saying that, "Do people really need this? This 12 step, is it really that important? It just doesn't make sense to me that everyone has to have it. Maybe some people have to have it, but I really feel like, do I need to remember my sobriety date and count my days clean, call myself sober and all this?"
Matt Finch: And so I get this question a lot and really AA and other offshoots of this, they're not the only way to overcome drug or alcohol addiction. Despite what they may have told you at the meetings and more typically from the AA police and the dogma pushers and the Big Book thumpers, not necessarily the Big Book itself or the program's 12 steps or 12 principles, or anything of that matter. Simply the AA police and the Big Book thumpers who are really the indoctrinators, the dogma pushers, who then train other people to become dogma pushers, Big Book thumpers, and other AA police members. You might've heard us say this word dogma on this podcast before. A dogma is a principle or a set of principles laid down by an authority as incontrovertibly true. The teachings in the Big Book have helped countless individuals over the years, and that's quite extraordinary and notable. It's phenomenal. It's really a miracle.
Matt Finch: But my point is, suggestible members of 12-step programs often develop ego investment in the teachings. And then they become what I call programmed, meaning they no longer have the ability to think for themselves in the domain of addiction and recovery. That's been hijacked. And now everything that they say, even though they think most of it's coming from themselves, it's not. It's actually the dogma that's doing the talking. They have something called ideological possession. They're literally possessed by a particular ideology. Even though they may think for themselves quite well in other areas such as politics, relationships or religion, although if they're programmed in addiction recovery, they're probably programmed in many of these other areas as well, if not all of them, it's quite common. I was programmed in all of these different areas for the vast majority of my life. I'm going to be completely honest.
Matt Finch: Anybody that grows up on mainstream media and now social media and all that, you are being programmed, whether you like it or not. But the problem happens when many of the programmed members, then they'll make the mistake of shaming others who want to end their addiction without using the dogma that the programmed person has not just been programmed in, but have actually developed ego investment in. Ego investment. So now their ego is attached to that belief. So if you attack that belief, which is just a belief, it feels like an attack on themselves and the ego wants to make us be okay and be safe and survive and get status and be right and have other people be wrong. The ego is never ending, never shuts up. There's never enough and it's very separate.
Matt Finch: Groupthink is basically the practice of thinking or making decisions as a group in a way that discourages creativity or individual responsibility. One thing that I'll say here as well is feels like, at least to me, and I know I'm not the only one, that groupthink permeates our society. And it's very prevalent in AA and NA meetings as well.
Matt Finch: All right, to make a summary of that wonderful article from Time magazine and I'll link to this in the show notes page for this episode, and I highly recommend checking out the book, if you're interested in these types of topics; harm reduction for addiction recovery. If that sounds like something that could interest you, check out the book as well.
Matt Finch: Now that we've talked about... We've basically busted the myth of the one-path recovery doctrine, meaning that there are many different paths to recovery and you get to define it, the language of it, everything about it all to yourself, and don't let anybody ever tell you anything. Otherwise, it's your life, and do not be bullied or shamed by other dogma pushers and groupthinkers that want you to fit in to make them feel comfortable. But here's some wisdom that I've learned over the years that my co-host and friend Chris Scott has learned over the years. We talk about this stuff a lot. That although there's many paths to recovery, there are some things that are usually general tenants that occurred with all of us. Even that being said, not all of us, because each of us is so unique and our situations are so unique, but here are some kind of guidelines where these are very common and most people can expect these.
Matt Finch: It won't be easy. There will be many challenges along the way. It will be uncomfortable. It will probably take a long time. You might fail many times along the way. Some people might judge you, envy you, or even resent you. The haters. You might give up. You'll need to develop empowering habits and break disempowering habits. You'll almost certainly crash and burn without developing a daily and weekly routine. If you don't exercise regularly and eat at least a somewhat healthy diet, it'll probably be a much harder journey. Developing your character mindset, philosophy, stress resilience, and skills will pay off well in the long run. Your progress will sometimes come to a halt or even backtrack, but constant awareness of this can get you moving in the right direction again. And most importantly, it is worth the struggle.
Matt Finch: Quick disclaimer. If you love AA or NA and have ended your addiction and transformed your life because of the program, then obviously this podcast episode was not done for you. You've already found the path that works for you, and this podcast was not intended to get you to quit doing what's working. This podcast was done for individuals that have been told they can't have an extraordinary life without going to meetings and working a strong program, but who intuitively and perhaps even logically, aren't really convinced this is a truthful statement. This podcast was created for people that have tried AA or NA over and over again, keep failing, and don't feel like it's necessarily their inability to work the program right, but rather the simple notion that it's probably not the most effective path of quitting an addiction for them personally.
Matt Finch: Finally, this podcast was done with the intention of educating people on the ideas of dogmatic beliefs, emotional reasoning, ideological possession, ego investment, and groupthink being the main reasons why so many people believe in the one-path recovery myth and the various ironclad rules that go along with it. Which perpetuate due to the vast number of AA police, dogma pushers, and groupthinkers indoctrinating the one-path recovery dogma into their sponsees, other members of the program and more, who then do the same. Thus, continually perpetuating the conscious and subconscious reprogramming of the teachings of the Big Book.
Matt Finch: In short, nearly eight centuries of Big Book indoctrination, an ideological possession has led to this dogma being completely embedded in the domain of recovery. And this makes it a difficult task to unplug people from the one-path recovery matrix. It's a scary process for some, but it's completely liberating for others. Life after addiction can be whatever you make of it. If you feel strongly that AA or NA isn't right for you, well, now you've seen evidence that many people are living extraordinary lives post addiction, without going to meetings.
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