Twelve step program question

So, main issue alcohol but used other stuff
The person would be assessed on entry and probably enter some kind of detox unit to make sure they were clean (this varies facility to facility). Their bags would be checked - amazing what people will bring in! But people in detox are typically detoxing, from whatever. They are not segregated alcohol vs drug (some faciities may vary but I have never seen this)

Facilities that are Twelve-step oriented will not segregate alcohol vs drug; treatment is treatment. There isn't really a "drug" tx vs "acohol" treatment. They may take their clients to community AA or NA meetings, and which one someone attended would depend on how they identified. Overall, although there can be strong recoveryin NA, AA is still usually the strongest,so many people, even if they were more "drug"oriented, like to at least attend those meetings (although they may have an NA sponsor).

I wouldn't use 12-step programmes or AA, this article has some info you should read before you decide whether to use that or not.

Also, as someone who stopped using drugs without help from anyone, (something several friends of mine have also done,) I'd not actually use rehab if that was not central to the story. Depending on what you need to happen for your story/character there is a lot that can happen outside of an institutionalized setting that cannot happen in one.

Well, kudos to anyone who has managed to stop using, regardless of what method got there.

However, i would most respectfully disgree with the author of the Atlantic article.

First, AA is not treatment. Treatment can be 12 step oriented but AA itself is not treatment. And should not be confused with treatment. It is one way of living without drugs and alcohol.

It is appealing to many because it does NOT require treatment. It is compatible with many faiths. It is free. And there is plenty of evidence(in peer reviewed journals) that it works. And you need to read the articles to see how "work" is defined, length of sobriety, etc.

It does not work for everyone, by any means. And people should definitely decide for themselves what they need. People will try 12 step stuff, or CBT, or Church, or rational recovery, or some Native tradition, or changing friends, or social groups or jobs, or whatever.

In a treatment facility, one might get 12 step and/or cognitive behavioral therapy which also works (for many, not all, although most people use some kind of CBT even if they are unaware of it).

And, particuarly now, one might get some form of psychopharm...

And of course, one will, one hopes, get any co occuring mental health issues addressed (and actually AA is quite well suited to handle this, in general but certainly is not hte only path). AA can be funny (and not ha ha funny) about meds. MOST groups are supportive of medication but every once in a while you'l find some crabby old timer with wildly uninformed views on the subject. They are not the norm.

As a psychologist, I do agree with the idea that "addiction specialists" who (now) have a two year degree are the ONLY ones in some placs that can refer people, and wind up making pretty big decisions for people well beyond their scope of practice are undertrained. I think it's ridiculous. We do not have "bipolar specialists" or "anxiety specialists". I would totally support giving addiction back to people who actually have at the very least a masters.

And no good provider is goign to take the "AA/CBT/etc is the ONLY road and if ou don't do it you're screwed" approach. If they do, run for the hills!

But..for a storyline - treatment centers offer plenty! you can have the agony of detox, the other clients, recognizing how "broken" a brain can get, some of the shit that gets done while using, remorse/regret/atonement/forgiveness, families and the impact on them, therapists who get to see clients come and go, some who seem to make some changes and others who do not. And the clients who surprise,and against all expectations do get and stay clean and sober.

Yes, the treatment could focus on the alcohol issues, but the past abuse of other substances would certainly be addressed. Many times people go to both AA & NA meetings--AA seems to be more readily available in a lot of places, so seems to be the default for a lot of people.

Another thing to consider is that many people, addicts & alcoholics included, consider alcohol to be a drug, so they do very little in their personal treatment to distinguish between the abuse of alcohol and the abuse of other substances.

Either way, pass the detoxing stage, much of the recovery will be similar--like someone else mentioned, in a rehab or treatment facility there will be therapy, and planning a course of action for when they get out, etc.

bombergirl69 said:

It is appealing to many because it does NOT require treatment. It is compatible with many faiths. It is free. And there is plenty of evidence(in peer reviewed journals) that it works. And you need to read the articles to see how "work" is defined, length of sobriety, etc.

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Thanks for saying this. It always surprises me how many people overlook the cost component of addiction treatment, and what AA does in that regard.

As I don't feel the need to turn this into a platform for my feelings on AA, I will address the OP's question.

Drug addicts go to AA meetings all the time. And narcotics anonymous meetings (naranon).

Not to be confused with narcanon which is Scientology based.

I've also known alcoholics to visit naranon meetings as well.

But these are support groups.

Treatment programs might suggest AA or NA meetings on top of clinical work. And programs run the gambit of being alcohol related, drug related or both.

AA can't prescribe drugs. Or give medical advice. They can hold a "philosophy," about things. Nothing that any participants need to follow.

It's up to a doctor to council on detox. I don't know anyone in their right mind who would pretend to take on the detox process for another person. Just a doctor. Detox can be life-threatening in some cases.

CrastersBabies said:

AA can't prescribe drugs. Or give medical advice. They can hold a "philosophy," about things. Nothing that any participants need to follow.

It's up to a doctor to council on detox. I don't know anyone in their right mind who would pretend to take on the detox process for another person. Just a doctor. Detox can be life-threatening in some cases.

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Yes. A lot of people don't know that a hardcore alcoholic can die from the withdrawals. It is nothing to play with.

CrastersBabies said:

As I don't feel the need to turn this into a platform for my feelings on AA, I will address the OP's question.

Drug addicts go to AA meetings all the time.

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Technically, AA is only for alcoholics (who might or might not also have drug problems). In the 1980s there were so many self-proclaimed "drug addicts" attending AA meetings that these statements were distributed to groups and it was suggested the appropriate one (for open or closed meeting) be read at every meeting:
http://www.aa.org/assets/en_US/f-17_primarypurposestatementcard.pdf

There are also "liberal" AA meetings where it is accepted for attendees or members to call themselves addicts.

A little "secret" is that some Narcotics Anonymous members "graduate" from NA, and start going to AA because AA is seen as having "better sobriety." Such people (depending on what AA meetings they go to) often start calling themselves alcoholics when they introduce themselves in AA meetings.

And narcotics anonymous meetings (naranon).

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Narcotics Anonymous is abbreviate NA:
http://www.na.org/

Nar-Anon is a separate group, for families and friends of drug/narcotics addicts, just as Al-Anon is for families and friends of alcoholics:
http://www.nar-anon.org/

There's no formal relationship or connection between any of these groups, other than they all use (slight variations of) AA's 12 steps.

I'd go with what your story needs!

Yes, depending on the severity of the withdrawal symptoms, someone may be given drugs to help. In some cases they are sent home with drugs. Does your story need this?

If you want to get technical, the American society of addiction medicine (ASAM) has criteria which indicate what level of care a client might need. There are six dimensions and is found here. http://www.asam.org/publications/the-asam-criteria/about/So when someone gets assessed, not only are they potentially getting a diagnosis but also a placement (sort of like, this person is fine to go home with some antibiotics, as opposed to get this person up to ICU stat!) The six dimensions look at withdrawal, environment, other mental health issues and so on.

But you may not need any of this! If your MC does NOT need drugs to detox, that's totally believable. If they do, that's a good story too.

Rehab certainly offers the potential for some very interesting characters!

benbradley said:

Technically, AA is only for alcoholics (who might or might not also have drug problems). In the 1980s there were so many self-proclaimed "drug addicts" attending AA meetings that these statements were distributed to groups and it was suggested the appropriate one (for open or closed meeting) be read at every meeting:
http://www.aa.org/assets/en_US/f-17_primarypurposestatementcard.pdf

There are also "liberal" AA meetings where it is accepted for attendees or members to call themselves addicts.

A little "secret" is that some Narcotics Anonymous members "graduate" from NA, and start going to AA because AA is seen as having "better sobriety." Such people (depending on what AA meetings they go to) often start calling themselves alcoholics when they introduce themselves in AA meetings.
Narcotics Anonymous is abbreviate NA:
http://www.na.org/

Nar-Anon is a separate group, for families and friends of drug/narcotics addicts, just as Al-Anon is for families and friends of alcoholics:
http://www.nar-anon.org/

There's no formal relationship or connection between any of these groups, other than they all use (slight variations of) AA's 12 steps.

Click to expand...

Drug addicts go to AA meetings and are encouraged to go if there is not an NA meeting nearby or at a convenient time. Sometimes, drug addicts might need more than one meeting a day and opt to attend an AA meeting so they have extra support.

This goes the same for alcoholics who might need a meeting and only have access to the next NA meeting. I'm not an alcoholic and I have attended AA meetings when no alanon meetings were available. I rarely talk during those sessions, but being there helps. Ive also gone with people who invited me. For example, when they get a coin, or have something important to share. I have two family members who run AA meetings in a rural area, and they always invite me to go when I'm visiting.

There may not be formal connections, but they do cross over sometimes. Some of the addicts I've worked with have attended 2, 3, 4 meetings in a day just to make it through and will go to whatever is available. I have never heard of someone being turned away because they aren't an alcoholic in the AA meeting or aren't a drug addict in the NA meeting.

To the OP, I'd say whatever works for your story. If your character is located in a city, there will be a plethora of meetings. But, if they are in a more rural area (like I have lived), then addicts will often take what they can get in terms of support. Even if it's not a formal exact perfect fit. (Not that there needs to be.) Or, if they are desperate and in need of support and encouragement immediately they might take the first one/nearest one/most convenient one they can find.

It is NOT a situation where you are scanned with technical equipment to make sure you're an alcoholic, or, forced to provide an AA ID card, or asked, "hey, are you an alcoholic, because only alcoholics are allowed."

If you are struggling and want to go, you go.