I’m not just against 12-step ‘recovery centers’ because we have philosophical disagreements about the definition of the word ‘addiction’. I am against them because they do real, terrible, lasting harm to many people; my patients, my patients’ families, and all the people out there who are in similar situations, but can’t find their way to help because of 12-step propaganda or ignorance.
I have recently had more than one stable, functioning patient leave my care against their will to attend a 12-step program. These are people who, for the first time in many years, were finally able to lead productive, happy lives. The medication I prescribe had done for them what medication is supposed to do — give them relief from the symptoms of their illness, and allow them to continue their lives. One patient in particular has been doing very well on Suboxone for more than a year.
These patients didn’t want to leave. They knew that Suboxone was helping them to feel normal. But others around them — their families, friends, employers, counselors — told them constantly that they were weak, sick and dirty. Despite feeling better and seeing more clearly than they had in years, my patients were being pounded at from all sides with messages of defeat, invalidation, and surrender. This week, I’ve had more than one come to me in tears, desperate to stay but being forced to go to some 12-step facility by family members who refused to consider their newfound well-being as an improvement. They were still taking something, so they weren’t clean.
So how do the loved ones of these patients want them to ‘get clean’? By being nauseous, achey, overtired, consumed by cravings, and locked in a group counseling session, all day every day for thirty days, and at enormous financial and emotional cost. Compared to the free, normal lives these patients could be living with basic medical assistance, the environment of an in-patient 12-step program is cruel.
The thought of this happening to my patients, the people I am caring for, infuriates me. It’s partly the fault of the 12-step programs themselves, but more than that it’s the fault of narrow-minded friends and family members, many of whom won’t come into my office to talk to me or hear about the medication from me. This is another terrible consequence of our society’s failure to treat addiction as a biochemical disease. No one would refuse to talk to a cardiologist who was treating a loved one for heart disease. The refusal to talk to qualified medical professionals, and the decision to cling to emotional, outdated prejudices instead, is frankly appalling.
That is why this blog exists. I am here to tell everyone, addicts and loved ones alike, that the barbaric 12-step facilities are not the only option. I, as a physician, follow the oldest rule of physicians: ‘First, do no harm’. I’m not convinced that 12-step programs can say the same.