A Lesson from Sobriety: You Are Allowed to Feel Hopeful

Imagine waking up one day and everything has changed. Overnight you’ve lost the ability to go to work. All the places you eat, drink, and socialize are closed. You walk down the street and people cross over to avoid your path. You are living the definition of empty. Void. Vast nothingness. You have no idea what tomorrow will bring, but if it’s more of the same, you might not want to have another tomorrow.Welcome to the reality of COVID-19. Many of us are currently living under stay at home orders where the situation feels similar to what I’ve described. Overnight, jobs lost or sent to work from home, daycares and schools closed, the few restaurants remaining open offer take out only, and, for some reason, toilet paper has become the national currency. I’ve noticed life during a pandemic has some clear parallels to life when contemplating going from substance abuser to sober.Fortunately, most of us can survive this pandemic if we practice some safety guidelines and weather a storm that has an uncertain end date. Again, the same can be said for sobriety. When I first contemplated sobriety, the uncertainty of what the future would look like kept me from moving forward. Eventually, I had to embrace this. I looked at what my life had become versus what I wanted it to be and I knew even uncertainty was better than the present.I made the decision to become sober six years ago. For me, sobriety meant losing a routine I’d become comfortably habituated to. A destructive routine that involved daily consumption of alcohol, often until I couldn’t drink any more on any given night. Right now, we are being told our normal routine could lead to a worsening of the pandemic, the potential to spread the disease and expose those most vulnerable to its fatal effects. We’ve been asked to willingly adjust our routines with the absence of an end date.In sobriety, I had to define a new normal. This happened both purposely and organically. Part of what I did was attend counseling and AA sessions. That was on purpose. I also started writing more and performing better at work. That was more organic. I didn’t order alcoholic beverages while out with clients and colleagues. That was on purpose. I fell in love with ice cold seltzer water. That was organic.We don’t know what our new normal will look like after this first round of COVID-19. There are some behaviors many of us have adopted that will probably persist: wearing masks, avoiding handshakes, increased hand washing. We will adopt other behaviors or adapt in ways we can’t foresee in the coming months. Many of these will bring us joy, or at least decrease potential future situations like our present condition.The Present and the Presence of HopeEveryone--sober, drunk, or indifferent--is facing some unexpected hardships right now. We’ve been told by experts we are experiencing loss and should feel permission to grieve. This is true. But we have permission to feel hopeful as well. Hope is what led me to embrace and eventually thrive in sobriety. Hope will get us through this pandemic.I could have never imagined the wonderful things waiting for me on the other side of sobriety. A marriage (later a divorce, but hey), a child, Saturday mornings, physical health, mental clarity, reduced anxiety, and vomit-free carpets are only some of the things I wouldn’t have accomplished if I were still drinking.Having hope during a terrible situation isn’t the same as false hope. Hope is a fundamental ingredient of human resilience, a mechanism that sets our brains apart from other species. Hope has kept individuals and societies moving forward to better ourselves since the time our external gills disappeared, and our tails fell off. Or we were fashioned from dust. Whatever you choose.Hope is what countered the fear and uncertainty I felt initially entering sobriety. Excitement for a future without the shackles of alcohol. We are in the same situation now; there’s no other motivation to go through this if we have no hope the future will bring something better than the present.We have some time before this will pass. Spend some of it dwelling on hope. Make a list of things that might be better post-pandemic. Plan your dream vacation (we will travel again). Do something you’ve always wanted to do for yourself. Along with anxiety, fear, or grief, you are allowed to feel hope and excitement in our current situation. Something different is waiting for you. Potentially something better than you can imagine.

Recovery and Religion: Conflict and Solutions

Many people with addiction struggle with the idea of organized religion. And, many organized religions struggle with outdated ideas of addiction.What can the recovery community and church communities do to knock down some of these walls? Is it even necessary?What better place to begin to explore such a volatile topic than a faith-based college campus like Baylor University? Baylor is a conservative, Baptist institution founded in 1845 in Waco, Texas. While the university is founded on Baptist traditions, the student body is diverse. Baylor’s Beauchamp Addiction Recovery Center (BARC) faces these challenges daily.Imagine you are a student at a university like Baylor. Consider these three addiction recovery dilemmas:Let’s say you’ve been raised in a religious atmosphere where addiction is still viewed as a moral failing. You think you have a drinking problem, but you attend a conservative university with a religious foundation similar to your faith. You assume the addiction recovery center on campus also sees addiction as a moral failing. Will you walk through the doors and ask for help?You’ve experienced religious abuse. You want nothing to do with organized religion, despite your parents’ heavy pressure. Yet, you need help for an addiction to opioids. Do you walk through the doors of the collegiate recovery center at a faith-based university and ask for help?You’ve had no religious upbringing. In your eyes, talking to someone like a minister about your drinking is foreign and uncomfortable. Do you walk through the doors? Like all collegiate recovery professionals, Baylor faces Herculean tasks: Educate a campus full of young people about addiction (These same young people, mind you, were raised with long-held American stereotypes about acceptable drinking in college); ask this campus of adolescents to take an honest look in the mirror when it comes to their own drug and alcohol use; create a safe and encouraging atmosphere for those needing help.Now, let’s make the whole subject even trickier by adding religion to the conversation.Instead of buckling under the pressure, Baylor is establishing a model for other faith-based organizations attempting to bridge the gap between addiction recovery and religion. Lilly Ettinger, BARC’s assistant director of wellness recovery and Stanton Corley, BARC’s recovery support coordinator, offered their professional insights around collegiate recovery and the topic of religion. Pathways to RecoveryThe BARC treads religious waters cautiously by offering students multiple pathways to recovery, including faith-based and secular approaches. Each individual meeting with a student at the BARC ends with a few questions regarding the student’s religious beliefs. If a student discloses a difficult relationship with faith, secular paths to recovery are explored. The questions have a general tone like, “Are you spiritual or religious?”If students have a history of spiritual abuse, empathy is key. “We don’t defend anything that may have happened to them,” says Ettinger, “instead, we’re there to empathize and agree with their past experiences.”This isn’t to say Baylor isn’t first and foremost a faith-based institution but, according to Ettinger, the BARC allows each individual seeking help to set the religious tone.“It is complex and complicated tackling religion and addiction recovery, in many ways,” says Corley. “It may be more complicated at a Christian university navigating multiple pathways to recovery,” he continues. “Many times, we have to be more vocal about our non-religious approaches, rather than our religious approaches,” he adds.Both Corley and Ettinger are seminary trained with theological educations, and both are in recovery. They see their seminary training as an asset, drawing on an ability to build a level of trust with anyone from any background. “We’re trained to empathetically and actively listen,” says Corley. He credits this training, in part, to building trust quickly when a student walks through the BARC’s doors. “We focus on empathetically entering whatever space they are in, with them,” he explains. “This kind of trust allows us to ask hard questions and, sometimes, self-disclosing our own recovery stories. That’s the nature of having a story,” he continues, “we can share our experience, strength, and hope, then say, ‘Hey, this works for me. It may not work for you, but that’s okay, because we have a bunch of alternatives.’”Corley acknowledges some students on campus may have preconceived ideas about addiction. Some students may associate an issue with drugs and alcohol as a moral weakness. “In the right context, I will self-disclose and tell someone my story; how it wasn’t because I was a moral failure,” says Corley. “It was because I had a substance use disorder that led me to go to treatment.”Baylor draws on programs like SMART, Recovery Ally, 12-step programs, and more for training and wellness.Stay on the Same PageBaylor enrolls more than 3,000 students with each freshman class. At each of the roughly 10 freshman orientations each fall, a representative from BARC speaks to parents and new students. No new freshman walks away without an understanding of all the counseling and recovery programs available on campus.In addition, Baylor recovery professionals pay close attention to the language used on campus, drawing mainly on the DSM-V for structure around language and information. The careful language selection is meant to convey a uniformly objective, medical approach to recovery.“Substance use disorders are a common ailment among young adults,” Ettinger explains, “and students who have them shouldn’t be treated any differently than students with any other potential struggle.” Words like “abuse” are discouraged. “No one wants to help an abuser,” she continues. If a student expresses doubts or uncertainty about recovery, students are shown the DSM for clarity around a diagnosis.Because Baylor leads many addiction recovery research programs, the BARC benefits from cross-promotion and cross-information. BARC programs are privy to relevant research and research faculty are offered relevant recovery training.“We’re invited often to speak at faculty trainings,” says Ettinger. “The fair amount of research done across campus is helpful to us,” she continues, “and some research brings a lot of money to the university.” Because Baylor makes research promotion such a priority, the BARC frequently gets acclaim without even knowing it.“My background is church work,” Ettinger explains. “I’m happy to be a part of such a great campus, with great faculty, great research and a great staff. I like to think we have one voice,” she continues. “Addiction research informs our BARC practices and beliefs about recovery, meaning we stay connected with how to best help students.”Changing Outdated Ideas on Both Sides How can collegiate recovery programs at faith-based schools like Baylor lead the way in terms of erasing old stigmas and misinformation around addiction recovery and religion? “We talk about intention vs. impact a lot,” says Ettinger. “There are a lot of really well-intentioned people who want to help people find recovery and wellness.” These same folks, according to Ettinger, may believe recovery is as simple as saying a prayer and showing up at church. “Showing people how recovery looks different for different people is part of what we do,” she adds. Both Ettinger and Corley agree training programs followed by informed discussions for faculty and staff go a long way when it comes to dismantling old stigmas.More than training, however, Corley sees courage on both sides as critical when it comes to knocking down the barriers between the church community and the recovery community.“I find myself telling people how I didn’t use near as many drugs as some of my college classmates,” Corley says. “However, they were able to put it all down, graduate in four years, and have families and careers, but I ended up in treatment twice.” Corley says the response he gets from most folks still surprises him. “More times than not, they’re shocked,” he says. “It doesn’t make sense to them, because whoever uses more drugs is going to have a bigger issue, right?” Corley believes the courage to share experience, strength, and hope will pave the way for change.“It’s going to take humility and courage on both ends,” he says. “Religious organizations need humility to admit wrong-doing and ignorance, plus great courage to commit to do something about it.” Corley doesn’t stop there, he sees a part for the recovery community as well. “People like Lilly and I are churchgoers, and we need to have the courage to stand up and have these same conversations with our church leaders,” he continues. “Because my faith is so important to me, I want to see humility and courage on both sides. I want the recovery community to have the courage to see the importance of religious organizations and institutions and try to understand the hope and good they provide for some people.”As for BARC, Ettinger is proud of their place on the Baylor campus. “I’ve been around since the beginning of the program,” she explains. “I was a Baylor graduate student who helped start one of the first women in recovery meetings on campus in 2015,” she adds.After graduation, Ettinger was hired with the opening of the BARC program in 2017.For more information on the BARC program, visit: https://www.baylor.edu/BARC/

5 Addiction Medications You Should Know About

Decades ago, addiction was treated in meeting rooms with little more than guidance between friends. While 12-step programs and group supports are still important, addiction treatment has come a long way in the past few decades. Today, there is an understanding that people with substance use disorder need professional medical help to address their disease. Oftentimes, that involves using medication to help treat substance use disorder.Recognizing the value of medication for addictionAs the opioid crisis ravaged the country over the past 20 years, American doctors recognized that people with opioid addiction needed another tool on their side. The intense physical cravings that accompany opioid use disorder make it difficult for people to stay in recovery, no matter how motivated or dedicated they are.Because of this, the addiction and recovery communities became more accepting of medication-assisted treatment (MAT). People on MAT still do therapy and often attend group meetings — the cornerstone of recovery. However, they also use medications to help them manage their cravings.Today, MAT is the standard of treatment for opioid use disorder. Many addiction recovery experts hope that there will soon be medications to help treat people addicted to other types of drugs, like methamphetamine.5 Common Addiction Treatment MedicationsMany of the medications used to treat addiction center on opioid use disorder. However, there are some other applications for using medication to treat addiction, especially for treating alcohol use disorder. Here are some of the most common medications used for MAT:Methadone: Methadone is one of the most common medications for treating opioid addiction. It is an opioid given in low doses to stop cravings and withdrawals. However, most people on methadone treatment will need to visit their clinic daily to receive their their dose. It’s very effective: 80% of people with opioid addiction who try methadone treatment will still be in the treatment program in six months.Buprenorphine (or Suboxone): Buprenorphine is also an opioid medication, but it is considered safer than methadone. Because of that, people using buprenorphine to treat their addiction can get a regular prescription, and they only need to visit their doctor every two to four weeks, sometimes even less frequently. Many people prefer that to daily visits to the methadone clinic. Naltrexone: Naltrexone blocks the opioid receptors in the brain. Some people prefer it because unlike methadone and buprenorphine, it is not an opioid and cannot be abused. Naltrexone is available as a daily pill, or as an injection that is given once a month (Vivitrol). Naltrexone can also be used to treat people with alcohol use disorder.Disulfiram (Antabuse): Disulfiram is used to deter people from using alcohol. It is prescribed after someone has detoxed from alcohol use disorder. The medication is a daily pill that blocks the breakdown of alcohol in the body. If someone drinks while taking disulfiram they become sick and could experience vomiting, sweating or headaches.Acamprosate: Acamprosate is a drug that that can help control cravings for alcohol. To start this medication, you need to be sober for about five days. Then, acamprosate is taken as a pill three times a day.Controlling underlying conditionsUsing medications to treat addiction can increase your chances for maintaining sobriety. So can getting on medication to treat any underlying mental health conditions that you may have. If you have a well-controlled mental illness, you will be less tempted to self-medicate with drugs or alcohol.It’s important to work with a treatment provider who is experienced in treating co-occurring mental illness and substance use disorder. These professionals can help you get on the medications that will be most effective at treating your substance use disorder.While medications are very effective at treating opioid or alcohol use disorder, they’re not the only treatment you should explore. MAT is most effective when people use medications alongside therapy and behavioral interventions. Learn more about Oceanside Malibu at oceansidemalibu.com. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

6 Ways to Stay Sane and Not Despair During a Pandemic

These days, it seems like the bad news is coming from all angles. Hospitals are overwhelmed, small businesses are closed, and the economy is tanking. And yet, somehow, we have to find a way to keep from falling into despair.The good news for people in recovery is that you’re experienced at overcoming challenges. You’ve been desperate and overwhelmed, and made the choice to do the hard work needed to survive and thrive. All of that is applicable to how you respond to the current upheaval in the world.“As a person in long-term recovery and a practicing recovery coach, the one phrase that comes to mind throughout all of the craziness is, ‘this is what I prepared for,’” says Michael Ahearn, a recovery coach at Mountainside Treatment Center. “This is what the work we do is all about. All the therapy sessions, meetings, self-care — this is the biggest stage for all of that in a way.”Even with all that preparation, dealing with this crisis can be difficult. Not only is the news scary, but the unprecedented nature of the response has everyone on edge. Plus, no one knows what the coming weeks or months will bring.And yet, we have to try. Here are six tips to keep your head up during the coronavirus outbreak and subsequent response.1. Draw on your recovery principalsIt might sound cheesy, but before you roll your eyes, consider this: most people in recovery have done tons of personal work. All of that can strengthen the way you respond during this crisis.Richard A. Singer has been in recovery for 15 years. He had a relapse last year, but even then was able to focus on the lessons he had learned in recovery to come “back stronger than ever.”“The slogan one day at a time, combined with mindfulness practices, help me get through any and all challenges in life,” Singer says. “Staying in the moment and being present allows me to deal with things that confront me one step at a time which simplifies my life in this crisis and in the struggles of regular everyday life.”If you need a bit of extra help, it’s available from mindfulness apps. Ten Percent Happier has a free Coronavirus Sanity Guide and other mindfulness companies are waiving fees. 2. Stay busyLetting your mind spin too much can feed into anxiety and maybe even thoughts of relapse. That’s why it’s important to stay busy, even when you’re at home. Mike J., who has been sober for nearly two and a half years, has been self-isolating for nearly a week. Even while he’s at home, he’s making sure to stay as busy as possible.“Keeping your mind busy is key,” he says. “If you don't let yourself think about drinking you stand a lot better chance to succeed.”In addition to focusing on new tasks like a shift to working from home and trying a home exercise regimen, now is the perfect time to tackle projects around the house. Mike, for example, has been painting his guest room.3. Look for new inspirationAhearn, the recovery coach, challenges himself to find new inspiration during challenging times. That means spending time with books, movies, and art that he finds awe-inspiring.Although many cultural institutions are free right now, it’s easier than ever to find inspiration from home. Broadway shows are available for streaming; thousands of museums, aquariums, and zoos are offering free virtual tours; and musicians from The Indigo Girls to The Dropkick Murpys are streaming “COVID concerts.” Many libraries have also increased access to audiobooks and other media.4. Be of service​​​​​​​​​​​​​​If you follow the 12 steps, being of service is a central tenet of your recovery. Even for those who aren’t friends of Bill W., the feel-good endorphins that come from helping others can be just the boost you need during these trying times.So, pick up the phone. Check in on a friend or sponsee. Ask your neighbors if they need anything before you brave the stores. Smile and wave (from a distance) when you’re walking around. These little interactions are more important than ever at a time when most socializing has come to a screeching halt.“It can be something as simple as calling a friend or fellow in recovery to ask how they are doing. Don’t talk about yourself, talk about them. This shifts your thoughts, focus and entire attitude,” says Ryn Gargulinski, a recovery coach.5. Use technology mindfullyTechnology and social media are allowing people to socialize even when we’re stuck at home. That’s great —digital meetings, hangouts, and even telemedicine sessions will help people stay healthy during this time.However, it’s important to be mindful about your social media use. Being on social media too much can increase anxiety during the best of times, and there’s no doubt that the effects are amplified during the outbreak. Don’t be afraid to unplug entirely or consciously limit your use. If you’re looking for a mindless activity online, try a museum tour instead of scrolling through panicked posts.6. Check in with yourself daily​​​​​​​​​​​​​​Jay Shifman, a recovery coach, recommends that people take a few minutes each day to monitor their feelings and emotions. Even if you’re not experiencing cravings, you might notice changes to your sleeping and eating patterns, or to your temperament.“Changes in these are often red flags or warning signs for these weeds growing and pushing up through the dirt,” Shifman says.Shifman recommends opening a note on your phone and typing the words “I feel…” Then, complete the sentence again and again until you have no further thoughts.“Think of this as clearing away some of the dirt and seeing what’s growing. Sometimes you discover a few weeds you need to deal with,” he says. Then, if necessary, reach out to someone who can help you deal with whatever issues you’ve uncovered.

How Recovery Prepared Us for Coronavirus

Fear, confusion, anger, grief. What a crazy month this has been! Moods are rightfully heavy right now, due to the unprecedented COVID19 crisis. With the whole world seemingly in panic mode, and everyone struggling to cope with the forever life-altering implications of this virus and the current shutdowns, I cling to one silver lining: Recovery has definitely prepared me for this shit.The crisis is both global and personal. And although it’s definitely the first global crisis of its kind in my lifetime, it’s far from my first huge personal crisis. This ain’t my first rodeo: That one was getting sober. The gravity of the life change I had to make felt heavy and undoable. But so did continuing to live in addiction. Day by day, I got through it. And day by day, I began to accept the permanence of the change, and eventually find all the benefits in it. Basically, I was far from thrilled about my switch to sobriety in the beginning. But gradually, as I continued to work a program of sobriety and take the next right steps, my mindset changed. I learned to love and appreciate my new sober life. Right now, I am far from an attitude of acceptance towards the current medical crisis. However, I know that I can get there, because I have learned to accept and then appreciate hard changes in the past.I also learned the value of service and community in recovery. Right now we need our support communities more than ever, and I am so grateful for the abundance of online meetings and gatherings popping up every day. I’m lucky that because I am sober I have real friends I can turn to when times are tough. We are staying connected however possible! I also know, thanks to recovery, that my ability to be of service is vital to my mental health. Regularly reaching out to others and asking them how I can help them keeps me out of my own demoralizing pity party.I asked a few of my friends in recovery how they felt their journeys of sobriety have helped them cope this week. Here’s what they said:“I used to deal with every semi-stressful situation the same way. I would buy a bunch of whatever booze I was into at the time, and numb myself until I had made the situation drastically worse. I did this for years, never feeling my feelings, never dealing with the bad stuff, just drowning it away.Transitioning from alcoholic life to a clean life was a drastic change. I changed my job, my friends, moved, started exercising regularly… this list goes on. Whatever happens how, I know that I will be ok. I know that changing my life into a life of recovery was the biggest change that will ever happen in my life. I know that 'this too shall pass' and it always does.The community I have in recovery is a group of people that has my back. When I was drinking I thought I had friends, but they weren’t there when the times got tough, only when there was a party. These sober people around me are the ones holding shit together. They are the ones that are holding me up through this crisis.Self-isolation is something I had to do in the early days of getting sober. Everything outside of my safe zone was triggering and far too many paths existed that would take me to destroying myself. Quarantining for COVID-19 reminds me of those days. Recovery taught me to deal with the bad shit without tearing myself apart. I now have dozens of ways to entertain myself from home that also cultivate positivity instead of self-destruction or fear.Experts have recommended drastically cutting down alcohol intake as one of the best things you can do for your immune system. So basically, without recovery I would be in terrible health and have no positive coping mechanisms or people to support me through this.” - Zachary Minnich“Recovery has given me the gift of acceptance. Acceptance has taught me to not freak out about what I cannot control—empty shelves, shuttered businesses, and canceled plans. I may not like it but I can accept it—and even find the gift in it.” - Roses"My recovery journey has everything to do with how I have been able to stay semi-calm through this current crisis. The principles I have learned in 12-step programs such as 'One day at a time, this too shall pass' and keeping an 'attitude of gratitude,' have been monumental for me when fear starts to creep in. My yoga practice has taught me to slow down, be patient, and trust that everything is going to be okay. Also, that things don't always go as planned and I do my best to stay open and optimistic and hope for the best possible outcomes. These practices help me find peace and serenity amidst the chaos and I am grateful that I have been on this spiritual path to prepare me for the uncertainty that we are all experiencing.” -Emily Killeen“Self-care means more than a trip to the nail salon. It means listening to your body’s needs, both emotionally and physically. Eat, sleep, exercise. Whatever it takes to get through the day. Some days this might mean taking the dog for three walks, on others it may be binge watching Schitt’s Creek until noon. Listen to your emotions, they are telling you something. We must allow ourselves to grieve losses and disappointments.Asking for help is not a sign of weakness but rather strength. Learning to lean in to fear is a superpower.The phrases 'one day at a time,' 'keep it simple,' and 'this too shall pass' are words we live by. Fostering connections, especially in times of change and uncertainty, is the single most important thing we can do for ourselves and our communities.” -Margaret Ward“My life was hell in addiction! Getting through that and getting sober has given me hope that things will always be okay as long as I put faith in my higher power.” -Alessandra Hurt“My sobriety (a collection of tools including yoga, breath work, meditation and AA) has taught me to slow down, to think things through before I act on them and to be considerate of others around me. In this time that a lot of people are in crisis, I can be of service by putting others first and not drop into my selfish ways that could lead to relapse. I choose to be of service.” - Ryan Griffis

New Study Supports AA’s Effectiveness, but Professionals Caution

In the past few weeks, the pace of news has been unrelenting, so it would be understandable if you missed a flutter of headlines last month claiming that Alcoholics Anonymous and other 12-step programs are more effective and cheaper than other treatments for addiction.While the work is important — and validating for the millions of people who have used AA to get and stay sober — there are caveats to the research. Here’s what you should know about the latest study about the effectiveness of AA.What the study foundOn March 11, a team of researchers with the Cochrane Collaboration published a scientific review looking at the effectiveness of AA and other 12-step programs. The review looked at the conclusions of 27 different scientific studies, which overall included 10,565 participants.After examining the results from these studies, the authors concluded, “There is high quality evidence that [AA and 12-step programs] are more effective than other established treatments, such as [cognitive behavioral therapy], for increasing abstinence.”It’s important to note that the studies in the review specifically looked at alcohol use disorder, not any other types of addiction. Still, the results were striking. People in 12-step programs were more likely than those getting other therapies to be continuously sober at 12 months, and two studies found this benefit continued up to 36 months. People in 12-step programs had a higher percentage of days abstinent at 24 and 36 months. And, unsurprisingly, the cost associated with 12-step treatment was lower than the cost associated with other therapies.The study was a followup to a 2006 review by the Cochrane Collaboration that found inconclusive evidence to support that AA was more effective than other treatments. Since then, additional studies have provided evidence for the superior effectiveness of 12-step programs."High-certainty clinical research evidence now clarifies that AA is a viable recovery option," study author John Kelly told Medscape Medical News. Kelly is the director of the Recovery Research Institute, Massachusetts General Hospital and a professor of psychiatry in addiction medicine at Harvard Medical School.The study’s limitationsIt may be tempting to look at the headlines surrounding this study and conclude that anyone struggling with addiction just needs to get themselves to a meeting. However, that’s not the case. The study only looked at alcohol use disorder. Plus, it only compared AA to other behavioral interventions, not medication-assisted treatment (MAT).“Our concern is that people will misinterpret the study, to assume that nothing else is needed other than 12 steps,” says William C. Moyers, vice-president of public affairs and community relations at the Hazelden Betty Ford Foundation.This could be particularly harmful for people with opioid use disorder, for which MAT is the standard of care. It could also be dangerous for more than 9 million Americans who have substance use disorder and a co-occurring mental illness.“The 12 steps themselves are not going to help with depression, bipolar disorder or trauma,” Moyers says. “Whether it’s medication, CBT or talk therapy, there are many tools that are vital to how people struggling with substance abuse are treated.”The 12 steps as an adjunct to treatmentMoyers says that while the 12 steps are “a proven pathway to recovery” for millions of people — himself included — they should not be classified as a treatment. This became especially clear to the providers at Hazelden Betty Ford when the opioid epidemic began.“When it came to treatment of opioid patients, the 12 steps by themselves are not enough to keep patients on the course of recovery, particularly after they left treatment,” he says. “The physical cravings are too powerful for the 12 steps to keep at bay.”That’s why Hazelden Betty Ford began using MAT in addition to 12-step programs to treat people with opioid use disorder.“Now, we’re truly treating the mind, body and spirits of our patients,” Moyers says. “It’s working.”Laurence M. Westreich, MD, a professor of psychiatry at New York University School of Medicine, shared a similar message with Medscape when he commented on the recent study."AA can be a powerful adjunct for those trying to stop addictive behaviors,” he said.He added that those "who are most successful in addressing an addiction choose the most productive idea from professional therapies and peer-led support groups like AA in bolstering their recovery.”The study supports this. Researchers found that 12-step programs were particularly effective when used alongside and after professional treatment. In short: when you’re trying to get and stay sober, use all the tools that are available.The 12 steps can increase access to treatmentOne of the biggest issues in the treatment of substance use disorder nationally is the “treatment gap.” The National Institutes of Health has estimated that as few as 10% of people who need addiction treatment get it. Cost and time to dedicate to residential treatment are huge factors that keep people from accessing care.AA and other 12-step modalities are free and readily available, both in person and online. Because of that, they can be a powerful tool for people who might not have other means to get treatment."It's universally available any time of day, any day of the week, and it's free,” Carol J. Weiss, MD, a professor of psychiatry at Weill Cornell Medical College, told Medscape.While ideally everyone who needs treatment would have access to MAT, high-quality therapy, and 12-step programs, that’s simply not the case. For people facing a frustrating and expensive healthcare system, free 12-step programs can provide benefits at a very low cost, Kelly told The New York Times.“It’s the closest thing in public health we have to a free lunch,” he said.

Practicing Our Principles in Perilous Times

Fear. I’ve been paralyzed by my real and imagined fears about the COVID-19 pandemic and all that will be asked of me and all of us to keep ourselves and our communities safe… for weeks? For months? And when I wake up in the middle of the night panicked? It feels like forever. Fear of the known, but also of the unknown, and so much is unknown about this pandemic. Oh sure, I am stocking up on the recommended four weeks’ worth of groceries (though honestly, more chocolate than canned corn), shifting to online work (while simultaneously downshifting), practicing restraint in my toilet paper use (just enough but not too much!), video chatting with family and friends (sending virtual hugs and kisses), and fending off out-of-the COVID-blue text messages (past boyfriends who ghosted me and are now looking to relieve their stay-at-home boredom). I’m also watching the news, scrolling through Twitter, and keeping diligent count of rising infection numbers and my simultaneously plummeting optimism.But my pandemic fears are controlled by a more fundamental primal fear: I am controlled by my fear of losing control. A “no win-no win” oxymoron. This fear of losing control is inextricably linked to my hubris: while I am fully aware that I am human (so fallible and shortsighted), I sometimes believe I am a god (goddess) in disguise, so in control of my addiction, my karma, my 24 hours at all times. Also, this hubris is linked to my ridiculous belief that I can control how others feel and act, the speed of the world’s rotation, the alignment of stars in the sky, and the sun rising and setting according to my whims and needs. Consequently, in this pandemic, I believe that if I stock up on exactly the right number of canned vegetables, frozen pizzas, bags of rice, hand sanitizer products, and rolls of toilet paper, if I stay bunkered at home and keep others at least 6 feet (better 12) away (my dog excepted), if I remain productive, sticking to a strict work-and-play-and-clean-and-exercise at-home regimen? Then I will be safe.My frenzied attempt at control during this national crisis and under real duress mirrors my other long-ago attempt to control my drinking and eating, all the while I was still guzzling wine, cutting my arms, parsing out my daily allotment of 500 calories, and running precisely five miles every day to burn off those calories. That manic micromanagement? An absolute failure that landed me in the psychiatric unit and in residential recovery programs more than 20 times.So, in this pandemic, I’m trying to regroup, to practice my principles and regain balance. As anxiety’s vise tightens, I can get caught up in the doing, doing, doing instead of breathing and being. Time to revisit Step 1 of the 12 Steps: “We admitted we were powerless over alcohol and that our lives had become unmanageable.” Nine years ago, I took my first 1st Step when I walked into my first meeting. I was bereft, emptied out, and close to my end (but certain that I was in control even if only in control of my end). This group helped me to stay alive, to get sober, and to reclaim my life. "Just do the next right thing," they said."Honesty, Open-mindedness, and Willingness," they said."Trust us to help you see how you can transform your life and find purpose and joy again," they said.Also, nine years ago, my therapist asked me to push back my long sleeves. “What do you see?” he asked.“Scars upon scars,” I said. Dozens of scars criss-crossed my forearms from my years of self-injury.“What’s missing?” he asked.I looked away in shame.“What’s missing?” he asked again.“Oh,” I said. “Words.”Words. He insisted I write words up and down my forearms with a Sharpie: Hope, Loved, Forgiven, Resilient, Beautiful, Compassionate, Worthy. Visible perseverance.“Wear your words,” he said.I started with Hope. Courage might seem the obvious counterweight to Fear, but before I could summon courage, I needed hope. This morning, watching the news and counting my cans of garbanzo beans, I picked up a Sharpie and on one arm wrote Hope, and on the other Courage. I am not in control of this pandemic and I am powerful nonetheless. Both/And. So are you.Two choices are within our sphere of control:(1) Give in to fear or hold fast to hope(2) Proceed with extreme caution or with radical courage. Hope and courage offer directional integrity. Isn’t the world always uncertain? Aren’t our lives always provisional? One day at a time, across time. Many years ago, I took riding lessons at a stable that fostered rescue horses, many of whom had suffered neglect and abuse. For a few months, I rode Chandi, a horse that spooked at everything. One morning, rain pounded the arena ceiling, wind howled outside, and barn sparrows flitted and darted every which way. Chandi was paralyzed and disorganized by fear: he snorted and hopped away from the jumps and shifted haphazardly from trot to canter to a halting stop. My own first fear-filled instinct: If I could control the environment, I could control Chandi’s fears (and mine!). So I kept us to a guarded tentative walk and studiously avoided the jumps. Why court trouble? Just bypass them!My instructor put a quick end to that. “Of course it’s easier,” she said. “But you haven’t tried to go over the jumps yet, so you don’t know how he’ll react. Remember: calm line and pace.”Calm line and pace: prepare to proceed with hope and courage. I gathered myself, steadied my breathing, relaxed deep in my seat, and applied firm but light pressure with my legs and reins. Onward in a trot. We approached the jump and as expected, Chandi snorted and tried to sidestep it. I flapped my calves to keep him moving and centered, and then, as if he could see where I wanted us to go, he flew over the jump and through his fear--over and through, again and again. “Smart riding,” my instructor said. “You kept your cool. Really good there.”Balanced seat. Balanced riding. We jumped the obstacles together.Similarly, in recovery haven’t we been practicing this principle in all our affairs? Might we be uniquely equipped to help others proceed with hope and courage in these perilous times? We’ve been learning how to gather ourselves through fellowship and right action, proceeding forward one day at a time, one step at a time.