AA-NOT THE ONLY WAY
2nd Edition
YOUR ONE STOP RESOURCE GUIDE
TO 12-STEP ALTERNATIVES
INCLUDING A COMPREHENSIVE DIRECTORY
OF LICENSED PROFESSIONALS AND
TREATMENT PROGRAMS
“Some books get better and
better with each passing edition. This is the case of "AA Not
The Only Way", written by Melanie Solomon…Overall, this is a
book whose existence needs to be shouted from the rooftop,
evangelized on street corners, and should be REQUIRED READING in
EVERY Alcohol and Drug Counselor certification program in the United
States! A copy should be sent to every drug and alcohol treatment
center in the U.S., and most importantly, this book should ON THE
DESK OF EVERY "coercing authority" that has the power to
"force" people with addictive disorders, into treatment
facilities… If you are in recovery, or know someone who is, or
wants to be, this book is a MUST READ! Don't start or continue a
recovery path without it!”
John McCready, NCAC-I, M-RAS
Oceanside, CA
“As a dedicated member of a 12
Step recovery program one may think that my review on Melanie's book
"AA Not the Only Way" might be one of disapproval. However
you would be mistaken.
AA Not the Only Way pulls no punches when
describing Melanie's personal experience with conventional treatment
and 12 Step fellowships. Determined to tell her story truthfully it
may appear to be a bashing of these programs, but in reality nothing
could be further from the truth.
Having said that may I say that
this book is an absolute must read for anyone seeking an alternative
to conventional treatment, 12 Step fellowships and typical court
ordered solutions of the day… this book is as important to the
recovery community as any other method available today. The simple
truth is Melanie Solomon's book has successfully convinced KHLT
Recovery Radio and myself that her book is a must read for all in
recovery. !2 Step or otherwise. Thank You Melanie for a Job Very
Well Done.”
Monty Meyer
Executive Producer
KHLT Recovery
Radio
MELANIE SOLOMON
FOREWORD BY MARC F. KERN, PH.D.
PREFACE BY FREDERICK ROTGERS, PSY.D.
Published by Capalo Press
3705 Arctic PMB 2571
Anchorage, Alaska 99503
Copyright © 2010 Melanie Solomon
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, including photocopying, reproducing, republishing, posting, transmitting or distributing, or by information storage and retrieval systems without prior written permission of the author. Brief quotes may be used for the purpose of reviews. For more information:
http://www.aanottheonlyway.com
AA-Not the Only Way; Your One Stop Resource Guide to 12-Step Alternatives: Including a Comprehensive Directory of Licensed Professionals and Treatment Programs/ Melanie Solomon; foreword by Dr. Marc F. Kern; preface by Dr. Frederick Rotgers; edited by Ana Hayes and Lynn “Kayla” Baugh.
Includes bibliographical references.
ISBN# 0-9762479-8-4
TABLE OF CONTENTS
Foreword……………………………………………………………………… 3
By Marc F. Kern, Ph.D.
Preface......................................................................………………………4
By Frederick Rotgers, PsyD, ABPP
My Story………………………………………………………………...……....6
Introduction……………………………………………………………………13
Section I: Self-Help Groups…………………………………………………20
Part One: Total Abstinence………………………………………………20
SOS………………………………………………………………………....20
SMART…………………………………………………………………......22
LifeRing………………………………………………………………..…...23
Rational Recovery………………………………………………..………24
Pennsylvania Model………………………………………………..…….25
Part Two: Programs Designed By Women for Women
(Now Adapted for Men)……………………………………….28
Women for Sobriety…………………………………………….………..28
16-Step for Discovery & Empowerment Model……………………...30
Part Three: Moderation…………………………………………………….33
Moderation Management……………………………………………......33
The Sinclair Method……………………………………………………...36
Part Four: Harm Reduction……………………………………………......37
Section II: Alternative Treatments………….…………………………….....39
Acupuncture……………………………………………………………….39
Chinese Herbs……………………………………………………………..41
Hypnotherapy…………………………………………………………….. 43
Nutrition……………………………………………………………………..44
Personal Fitness…………………………………………………………..46
Yoga…………………………………………………………………………47
NTR-Neurotransmitter Restoration…………………………………….49
Affirmations………………………………………………………………....51
Section III: For Family Members and Other Loved Ones………………..53
Section IV: What Works? What Doesn’t? ..........................………………54
Section V: How to Choose a Treatment Program…………………………56
Section VI: To Rehabs, Sober Livings & Other Institutions
Mandating 12-Step Participation
Legal Basis for Expanding Knowledge of Alternatives-Trend for Recovery in 21st Century……………………………………………………………………60
Conclusion…………………………………………………………………….. ...62
Section VII: Licensed Professionals………………………………..………..64
Part One: Providers Registered with SMART…………………………...64
Part Two: Moderation Management-Friendly Professionals………….67
Part Three: Cognitive Behavioral Therapists ………………………….. 80
Section VIII: Treatment Programs……………………………………….…....109
Part One: Treatment Centers in U.S. who Offer Choices
Beyond 12-Step Approach……………………………………..109
Part Two: Treatment Centers Outside U.S. who Offer Choices
Beyond 12-Step Approach………………………………….....129
Appendix: Additional Resources……………………………………………...133
Website Resources…………………………………………………..………133
Recommended Reading……………………………………………………..136
Notes:………………………………………………………………………….……140
About the Author……………………………………………………………….....143
Ordering/Website
Coaching Info ……………………………………………………………………..144
FOREWORD
Dear friends,
I have long awaited this directory of addiction treatment alternatives. It represents what I believe to be the future of the field. It is a pioneering effort to organize this unique body of knowledge. A directory of this type was never available before -- in part due to technology, but also because there were so few providers of non-12-step based services.
As you can see, the field is growing and maturing. In no way is this directory bashing AA or saying that the 12-step method is wrong. Rather, it is the first project to document that there is a real need for alternatives, because as we all know one size of anything is not right for everyone.
Scientific research has been showing that the traditional AA approach only retains about 5% of those who walk through their doors. Apparently, not a very attractive mythology for 21st century consumers to achieve sobriety. While other more contemporary methods, including motivational therapy, cognitive therapy and brief interventions are proving to be much more effective.
As a pioneer in this field myself, this document represents a significant endorsement of what I have always believed in since I sought help for my addictions: that people want new ways to talk, think and resolve their addictions, or just manage their life better. A new way that is not clouded by traditional verbiage and notions about the phenomenon we call addiction.
The programs and resources listed here are out of the 12-step box. Their effectiveness has yet to be fully tested, but they represent a new hope, a new type of solution for those suffering from addiction. I believe the future of healthcare depends on opening up one’s eyes to the realities of a world where chemical substances can be helpful as well as harmful. A new world where there is much more personal choice for one’s lifestyle; where people’s needs and wants direct the treatment of harmful behavior -- not the other way around.
This directory is a result of months of research in the field of addiction, and for anyone with a problem with drugs or alcohol, provides valuable information about the growing number of options available to achieve a happy and healthy life.
Bravo Melanie.
Marc F. Kern Ph.D.
http://www.addictionalternatives.com
PREFACE
In 1991 the National Clearinghouse on Alcohol and Drug Information published a poster with the title “Typical American Alcoholic”. The intent of the poster was to inform the general public about the incredible diversity among people with alcohol (and by implication) drug-related problems. Sixteen portraits are presented in the poster, showing both men and women, as well as people with different skin coloring, and clearly different dress. The point being that there is no such thing as a “typical” person with alcohol or drug problems. If this message is in fact true, and I believe it is, then why is it that for more than four decades we have insisted that the same basic approaches be used for every single person who comes in contact with a treatment program or provider for help with an alcohol or drug-related problem?
Since the 1940s, when Marty Mann, the first women to become sober in Alcoholics Anonymous, formed that National Council on Alcoholism (NCA, later the National Council on Alcoholism and Drug Dependence, NCADD) with the express purpose of de-stigmatizing alcoholism (and later other drug dependence) by promoting the notion that alcoholism was a medical “disease”, NCADD and numerous other public and private organizations (including the National Institute on Drug Abuse, whose former head, Dr. Alan Leshner declared with absolute certainty “addiction is a brain disease.”) have joined in that effort. It is safe to say that, at least in the United States, the “disease” notion of addiction has become the most widely accepted view of addiction, both by the general public and by many treatment providers.
In medicine, diseases are often complex phenomena, varying in severity from individual to individual, sometimes varying in course, and often requiring different treatments depending on the particular patient and his/her biological circumstances. In medicine when treating chronic relapsing diseases (such as diabetes, hypertension, or asthma) physicians utilize a wide variety of medications and behavioral approaches that are frequently tailored to fit the particular patient. For example, a recent Google search retrieved information showing that there are at least seven classes of medication used to treat hypertension, and within each class there are six to eight specific medications available. This search did not include formulations that combine one or more medications. Simple arithmetic suggests, therefore, that there are at least 50 different medication approaches to treating hypertension. This does not include a variety of behavioral strategies (dietary changes, increasing exercise, etc.) that are typically part of treatment for this chronic disease.
All of this is to point out a basic conundrum in how we address helping people with alcohol or drug-related problems. Why is it that despite the widespread insistence that such problems are nearly as diverse as the people who suffer from them, and the widely held belief that these problems are the result of a “disease”, much like the chronic diseases I have just mentioned, we have for decades maintained that there is virtually only one appropriate treatment for people with alcohol or drug problems—confrontational (if necessary) referral to 12-step based support groups coupled with counseling aimed at convincing the patient that he/she suffers from a “disease” that requires lifelong abstinence from all psychoactive substances in order for the “disease” to be arrested (but never “cured”).
This notion, that “one size fits all” in the treatment of alcohol and drug problems has been thoroughly debunked by scientific research. In fact, as long ago as 1990, the Institute of Medicine asserted that there is no one universally effective treatment for alcohol or drug problems. Yet, we have persisted in sending our children, our spouses, our partners, our employees, and even our criminals to the same, single mode of treatment. And we then wonder why only a small percentage of the people we attempt to fit into the 12-step cubby hole, get better. And, we have done this despite the fact that there are a variety of other psychological and pharmacological treatments that have been shown by solid scientific research to be highly successful in helping people with alcohol or drug problems, even when our cherished traditional approaches have been either resistant to scientific study or have not shown up well when rigorous research has compared them to the alternative treatments, many of which have been around for 3 decades or more!
As consumers, I suspect you wonder why it is that treatment providers have not “jumped on the band wagon” to learn and employ these new evidence-based approaches to treatment. There are many reasons for this failure to grow on the part of treatment providers, but I will not rehearse them here. Suffice it to say that there are alternatives to the traditional 12-step oriented, often confrontational approaches that have been virtually the only treatment available in the United States. The problem is finding treatment providers who provide these alternative, evidence-based approaches. Melanie Solomon has taken a wonderful step toward making that process, of identifying alternatives to traditional treatments, easier. By both providing her own story as a justification for this book, and by listing an ever growing list of providers who use up-to-date, evidence-based approaches in their work helping people with alcohol and drug problems, Ms. Solomon has done a great public service.
Her work is not finished, however, with the publication of this directory of alternative resources. Daily more and more treatment programs and providers begin to receive training in these new, effective approaches to working with people who have alcohol and drug problems. For now, though, this is an excellent starting point for patients, their families and those who are close to them who wish to find help that does not emphasize “powerlessness”, but rather empowers consumers to find the most effective help for alcohol and drug problems.
Frederick Rotgers, PsyD, ABPP
Associate Professor of Psychology
Philadelphia College of Osteopathic Medicine
MY STORY
When I woke up, I found myself on my living room floor. I couldn’t remember anything, but I knew that something was terribly wrong. When I made it to the bathroom and pulled myself up to look in the mirror, I was shocked at what I saw. I did not recognize the reflection staring back at me. I was covered in blood, one eye was black and swollen to almost twice its normal size, I had several bumps on my head, and my body was covered in bruises. I didn’t know what had happened. I wondered if I had a seizure and had blacked out. I began to shake. I was scared, uncertain, disoriented…
10 Years Earlier…
Having been accepted by UCLA Law School, it looked like all those years of endless studying had finally paid off. I was 22 and my life was full of promise. I was going to become a lawyer, just like my dad. My life was going to be perfect, or so I thought. Sure I partied and experimented with drugs in high school and college, but it never interfered with my schooling or anything else. The only close call had been when my boyfriend turned me on to cocaine during a semester off one year in college. But after a few months of doing it, I realized that I would have to snort cocaine all the time, 24/7, or not at all because I loved the high but couldn’t stand coming down. So, I quit.
The summer I was accepted into law school, I went to see a doctor about my migraines and he prescribed for me a nasal spray that I had never heard of. It seemed like a good solution; one I had no apparent reason to question but should have because before the end of the week, I was hooked. (Later when I researched the medication I found out it was not just a nose spray, but actually a form of liquid morphine). Using this prescription set off a chain of events during my first year of law school that would eventually lead to my demise. After my prescription ended and my headache specialist in Los Angeles would not prescribe anything stronger than Imitrex, I began taking Vicodin. I had never abused Vicodin before, but when I ran out of that nasal spray, I began to feel violently ill. In order to make it through the day or even function, I had to have something in my system. Unfamiliar with addiction at that time, I had no idea what I was suffering from was withdrawal symptoms. All I had done was take some medication my doctor had prescribed to me. He had never once warned me about the possibility of becoming addicted to it.
During this time, I began experiencing extreme anxiety and panic attacks, so I went to see a psychiatrist who immediately put me on benzodiazapams, which are more commonly known as benzos. I was prescribed Xanax and valium for my anxiety, induced by the withdrawal from the nasal spray, as well as Ativan for sleep. By the end of the year, I had built up a tolerance not only to pain pills but Benzos as well.
Upon trying to quit taking the pills, I was horrified to find out that I could not stop. By the beginning of my second year of law school, I was a mess, both physically and emotionally. After sharing my predicament with my mother, a therapist, and my father, a lawyer who is also a strong advocate of AA, I was admitted to an alcoholic rehabilitation center. This is where I was introduced first hand to Alcoholics Anonymous, commonly referred to as AA, and its sister programs, Narcotics Anonymous, NA, and Cocaine Anonymous, CA. I was also introduced to the whole “incurable and progressive disease” concept, which was grilled into me as the one and only undeniable cure. I was never told that there were any other solutions or treatments in existence.
And so began my Nine-year nightmare, where my life ceased to be my own, where I was told to stop thinking for myself, because “it was my best thinking that had gotten me here in the first place,” and that my intelligence was actually blamed as my roadblock to staying sober.
But staying sober wasn’t my problem. The pills were my problem and I was very clear with the rehab people regarding the help I needed. I needed help getting off the pills so I could get back to my life. Knowing this to be true, I brought my law books and laptop with me so I wouldn’t fall behind in my studies. However, the staff refused to listen and continually insisted I was an alcoholic and took my laptop and studies away. My boyfriend came to advocate for me and they refused to listen to him as well. I pleaded with them that I had never been addicted to alcohol or any other drug in my life until now. I showed them the warning labels on the prescription pills, which stated they might be habit forming and addictive. They laughed, patted me on the head and said, “Don’t worry, honey. You just don’t know it yet, but by the end of your stay here, you’ll realize that you’re one of us, that you are an alcoholic. Right now you’re in denial.”
So I attended the required AA meetings, 90 meetings in 90 days, and found what they were saying to be true: “Go to enough meetings and you’ll end up just catching alcoholism!” This might sound ridiculous, but this is exactly what happened. I caught alcoholism! Stating, “I’m Melanie and I’m an alcoholic” over and over, sometimes twenty times a day, was not only a negative affirmation, but I began to internalize it as well. Before I knew it, I had created this entire story surrounding the fact that I was a victim of this incurable, progressive, fatal disease called alcoholism, and that there was no way out.
As most people, I was vulnerable entering rehab. I was lost, confused and I started believing what the “professionals” were telling me. (I now know that most “professionals” at traditional rehabs are merely drug and alcohol counselors who have had some “clean time” in a 12-step program). At the end of my 30 days, my counselors told me I needed to go into their sober living program and I complied since I still needed their help and my dad’s financial assistance. So I listened to him and did whatever they told me to do. My life just got worse with frightening speed. I was told that anyone who was not an alcoholic or an addict would not be able to understand me. My boyfriend, the love of my life, was not an addict. He was what they called a “normie”, so I broke up with him because I believed that he couldn’t possibly understand me anymore or what I was going through. Soon, law school became too stressful and began to interfere with my “recovery” and all of the AA meetings I had to attend, so I quit. I couldn’t hold down a job anymore, so I decided I had to go on disability, because I was not well and had this incurable disease called alcoholism that was “trying to kill me on a daily basis”. I was now officially on the recovery merry-go-round. Staying sober in the program for 6 months to a year, I would eventually relapse, ending up in a rehab or hospital emergency room, or sometimes even a psych ward. This had become my life!
This insanity continued for nine long years. I spent all of my time trying to get and stay sober with the use of a 12-step program, which I had been told by countless rehabs, doctors and other 12-step members was “the only way” out. With each relapse, I ended up feeling more and more hopeless, thinking towards the end that I must be one of those people that the Big Book of Alcoholics Anonymous talks about as being “constitutionally incapable of being honest with themselves”. My life was becoming more and more meaningless. Even while sober, my life revolved around working the steps and going to meetings and relapsing again and again. And again.
With each relapse, I became less and less confident in myself, to the point that even with six months sober, I decided to put myself into a sober living facility and stay there for over a year because I had lost all faith and trust in myself that I could stay sober living on my own. That became my sole focus in life. Nothing else mattered except that I stay clean and sober. I no longer knew who I was, except that I was an “alcoholic” and an “addict.” I had completely lost myself. I no longer knew who I was. I had lost touch with my friends and family. I had left my life, my home and my animals behind. My family lost respect for me, thinking that once again I had failed the program and that there must be something terribly wrong with me. I was caught in my own personal hell that I thought would never end. I did not think I would ever see the light again. I was caught in a vicious cycle of institutions, rehabs, sober livings, AA meetings, relapsing, and ending up back in rehab, again. This cycle fits perfectly under AA‘s own definition of insanity: “To do the same thing over and over again, expecting different results.” In fact, I’ll just quote James DeSenna’s definition of insanity:
Insanity: 12-step addiction treatment and lifelong “recovery,” that is, doing the same thing over and over while expecting different results, despite its lack of efficacy and obvious negative, and sometimes deadly, consequences.” (DeSena, Overcoming Your Alcohol, Drug and Recovery Habits, 2003).
After 10 years of hell… I woke up on the living room floor, covered in blood; I was horrified by what I saw…
I had just returned home from my Saturday meeting. I had recently put my cat, Felix, to sleep, the week before, and I was completely devastated. I really felt like having a few glasses of wine, but I knew if I drank, this would mean yet another relapse. That would mean starting all over again; letting everyone down, especially my family, and I’d have to raise my hand as a newcomer, and “lose” all my time again. I couldn’t handle that kind of shame, not even one more time. So instead, I decided to try to get a harmless buzz from an old prescription I still had. I took a few more pills than I normally would have, but what I took reacted horribly with the antidepressants that I was taking. I apparently had a major overdose, as well as multiple seizures, ultimately giving myself a concussion.
When I came to on the living room floor, I was horrified by what I saw. I had lost all control of my bodily functions. Later I found out that this often occurs right before a person dies. But for some reason I did not die. When I looked over at the couch, one of the cushions was entirely covered in diarrhea which was also stuck in my hair and smeared all over my living room. I had almost died because I didn’t want to have the “stigma” of an alcoholic relapse. Unlike many others on this recovery merry-go-round who when thrown off their horse have landed in death, I was one of the lucky ones.
After a few days of recuperation, crying and praying, it suddenly came to me that there had to be another way, even though during my nine years in AA no one had ever told me that there was. Awakened and filled with hope, curiosity and purpose, for the first time in my life, it became crystal clear that AA was not only not working for me, but had become detrimental to my life. I got on the internet and began furiously searching for alternatives to AA. I was driven and began researching and working around the clock as though not only my life depended on it, but the lives of countless others who shared similar experiences. To my amazement I found that there were many wonderful options to AA, and I wasn’t the only one out there for whom AA had failed. I soon realized that I had not failed the program. It just wasn’t for me. In fact, it doesn’t work for most people! The more research I did, the more driven and astonished I became. Why was I never told about any of the other options that were readily available? None of the rehabs, institutions, counselors, sponsors, therapists, doctors, nobody had told me that there were viable alternatives, ones that were proving to be more effective than AA! I knew that I had to get this information not only for myself but for others experiencing the hopelessness and despair that I had felt. This book provides a multitude of other solutions that are available in addition to or instead of AA. What you are about to read will astonish you at first, but it will open you up to new possibilities leaving you with hope, a word that too many of us have forgotten the meaning of. My prayers are that this book will help you find it once again.
I am now 33 years old, and have never felt so free in my life. While we are all on this life’s journey together, we are all unique. It is my great desire that we can all find solutions that work for us as individuals. There are many different paths. The most important thing I’ve learned is that there are more than one, and what works for one person, might not work for another. All that matters now is that a door has been opened for us to see that there are alternatives, and we have choices! With the information I have found, you can now make an informed decision for a treatment program that feels right for you or a loved one. My nine heartbreaking years of trying the same program over and over again expecting different results was an experience I went through out of ignorance; both my own and the recovery industry’s as well. This is an experience I pray none of you have to go through, or if you’ve already been through it, you can use this information to stop the cycle right now. Knowledge is power. And AA is not the only way. Thank God.
With the updated version of this book, three years have passed since I wrote the above story…one year was fabulous, the next one my greatest downfall, and the latest my long struggle back. After writing this book, I felt great! I was finally getting an important message out by doing press releases, doing lectures and going on radio shows. I was working day and night and going to my kundalini yoga classes which, for me, worked better for my sobriety than any meeting I had ever gone to. Unfortunately, after about five months, I stopped going to yoga, and was not doing anything else that I wrote about in my book that could have also helped me. (You can have all the information in the world, but unless you apply it to your life, it won’t help you!) Instead, I focused exclusively on my work, having absolutely no balance in my life. I was beginning to be stressed out all of the time. Plus, and most importantly, I had been misdiagnosed for years, as just having some anxiety and depression, when in reality, I was bipolar 2. Therefore, I was improperly medicated for my sensitive chemical imbalance.
At about the nine month mark, I had an actual physical breakdown, where my thyroid, adrenals and other crucial systems simply shut down. I had no energy, to the point where walking to the bathroom seemed to be too hard. While I was in this weakened state, my ex-boyfriend and best friend came to stay with me to help me out. He ended up bringing crack cocaine back to my house (which I had never done before) and I actually let him convince me that it would give me some of my energy back and let me get back to work. Well, it DID give me energy, but after a week of using cocaine, he went out and got heroin, his drug of choice, and overdosed on my couch. I thought he was just passed out for the night, but when he was in the same position the next day, I knew something was wrong. It turned out he was in a vegetative state and stayed that way for months until he was declared brain dead and the plug was pulled.
I LOST it after that. One minute we were getting back together, and the next he was DEAD! I mean, I’ve overdosed so many times, but I just come out of it…how could he not?? It just did not compute. I tried to focus again on my work but something inside me had snapped. A friend, who later became my boyfriend, came over to my house. He happened to be on a crack run at the time (which I didn’t know about). He pulled some out and asked me if I wanted to smoke some. Since I didn’t really care about my life anymore, I joined him, not thinking about any of the consequences because at this time I was welcoming death. We smoked crack day and night for about a month. I no longer cared about anything, not even my love of doing my life’s work of helping people with their addictions and their suffering. I just couldn’t care. Nothing was left in me. Between my physical health and then my mental, emotional and spiritual health, I was going down, and going down fast. I honestly think my cat was the only thing keeping me from completely doing myself in because she had no one else to care for her.
Before doing crack, I hadn’t done cocaine in almost 15 years, and I stopped on my own because I realized it had the potential of becoming a problem. Crack was 100 times worse. I needed it all the time. I spent all of my money on it to the point of being broke and homeless. I had a crypt gang member crash in my front glass door because I owed him money, but I still didn’t care. I did not care if I lived or died. Period. So even this event didn’t scare me in the least.
Finally, we stopped using for a few months and tried to get some help, but eventually relapsed on New Years Eve. My life got even worse than I could ever imagine. My apartment, my safe haven, got completely trashed and I had to give it up. Everything I owned got destroyed and I was living in utter filth. My boyfriend got arrested for possession right outside my door. My website got taken down and all that I worked so hard for was going down the toilet. My lungs and ribs hurt so badly I could barely breathe. I later found out I had almost fatal pneumonia. Still, all I mainly cared about was getting and staying high. This went on for another month, until the morning I was having major oral surgery. I almost didn’t wake up out of the general anesthesia and when I did, my life became pretty much a living hell. I wished I had just stayed asleep.
Since I had no more home to go back to, I stayed at my boyfriend’s parents while he was at a sober living facility (my worst nightmare). The pain did not go away in my chest, so I went to the ER where I stayed for a whole month getting Demerol shots every four hours. After that, I had to go to into a hospital program to detox of all the meds I got in the hospital, then back to the parents’ house to look for a good dual diagnosis program (since as I stated, I am bipolar 2 which is a whole other issue that needs to be addressed).
After doing much research, I found there are very few places that specialize in dual diagnosis and when I was confronted with a couple of very poor choices, I thought my only option was to die…to get out. I couldn’t take the pain, stress and suffering anymore and it seemed like no one could really help me. My depression and anxiety were at an all time high. I took all the pills that I had on hand, which were a LOT since I’ve been on just about all of them trying to get the right mixture. I downed them with some alcohol, I wrote a note, smoked what I thought was going to be my last cigarette, and laid down. Well, my boyfriend’s mom found me, didn’t think anything was wrong until she found the note, and then called 911. I went to the hospital and they made me drink charcoal. My life was as bad as ever.
I have been diagnosed with Bipolar 2, which means I get simultaneous major depression along with high anxiety, PTSD, in addition to ADHD . Most treatment programs don’t have the qualified staff or programs to address these conditions which are at least as important as the addiction itself. Research has shown that 70% of all people with substance abuse problems also have some co-occurring disorder, so why are programs not adapting to meet these needs? This is one reason so many people are falling through the cracks, relapsing, overdosing and killing themselves. People are almost guaranteed to fail if neither their addictions nor their co-occurring disorders are addressed.
Luckily, I did end up finding a good rehab program that could deal simultaneously with my addictions and co-occurring disorders. I was able to finally heal and recover from my boyfriend’s death, get stable on my medications and learn how to get and maintain balance in my life. Things I have found helpful with regards to balance include using exercising, meditating, positive thinking and therapy. I have begun to realize happiness is a choice, so why not choose it? I have spent too many years living in misery. I have made the choice now to live differently. I am telling you that you too have that choice.
If people, including me, are going to have a chance at leading happy, successful and sober lives, it is all of the co-occurring issues that have to be dealt with and resolved. There are some who think that these co-occurring issues need to be addressed first, while others say it can happen simultaneously with addictions treatment. It can also depend on what the primary problem is. For example, if a person mainly has psych problems and it is only when their medications are out of balance or something else occurs that sets off their primary condition, then this needs to be handled before any real sobriety can take place. Otherwise, relapse is almost inevitable.
It took me a long time to accept that I was dually diagnosed. Now I finally have. I have no other choice. If I don’t, I will continue on this horrible cycle and never get the help I need. When I “relapse”, it’s not to party or for any other reason. It’s because I’m out of balance and am trying to self medicate with prescriptions, or other cocktails, the best that I know how. This cannot happen anymore because my last, best answer, was to simply take my own life. If I did this, there would be no way I could go on doing what I love, which is helping others get through life, just as I have, whatever their diagnosis or problem.
So many people need help and I would be honored to be one of those who understood from first hand knowledge, thereby being able to offer my experience, strength and hope and some real helpful direction for others who so desperately need it.
Even if AA works great in keeping someone sober, it doesn’t address co-occurring issues, which is why the “Big Book of AA” encourages people to seek outside help. This is nothing to be ashamed of, since most of us have deep, underlying issues and drinking and using is a symptom of that. It is the root which needs to be discovered and dealt with and eventually discarded. Once that happens, the need to use mind altering substances will start to dissipate on its own.
No matter what path you decide to take to stop or moderate your drinking, it is dealing with your co-occurring (primary or secondary condition) which is going to allow you to sustain your health for good. We are all individuals, and there are just as many ways of coping with our struggles as there are our problems with alcohol or drugs. Please see future chapters that can address these issues, then pick and choose the ones that you feel will work for you. This will ultimately determine your success, and more! As for me, I am still finding my path. What has worked best in my life has been getting and staying on the right medications, doing yoga, meditating and daily affirmations. I know I am fortunate in my knowledge of all the options and resources out there to be with me on my journey. Now you will have that as well.
INTRODUCTION
“Keep coming back. It works if you work it!” This is what is chanted at the end of every meeting, but what if you have “worked it” and you still keep going back and getting drunk or loaded? Now, most people in the program will say things like, “Well, you must not have really done the steps right,” or “You didn’t go to enough meetings,” or “You didn’t pray to your Higher Power,” or “You know you did something wrong or else you would still be sober!”
Since what you are taught to believe the minute you step into a 12-step Program is, “You either get AA, or you die,” you tend to stop thinking for yourself, (since it was your “best thinking that got you here“), stop questioning, and just follow what other’s tell you to do. This would be fine if this is what worked… but unfortunately, evidence is proving otherwise.
The 12-step success rate is showing to be approximately 3 percent. Yes, that’s right… only 3 percent! (Brown, Treatment Doesn’t Work, 1991). Here are some more startling statistics:
45% of the people who attend Alcoholics Anonymous meetings never return after their first meeting.
95% never return after the first year.
5% retention rate (Based on Alcoholics Anonymous World Services' own statistics).
93-97% of conventional drug rehabs and alcohol treatment centers are 12-step or AA based, so those who leave AA to look elsewhere, such as conventional alcohol and drug treatment for solutions, are essentially rejoining AA!
Let’s look at these numbers in even more detail: For many years in the 1970s and 1980s, the AA GSO (Alcoholics Anonymous General Service Organization) conducted triennial surveys where they counted their members and asked questions like how long members had been sober. Around 1990, they published a commentary on the surveys: Comments on A.A.'s Triennial Surveys [no author listed, published by Alcoholics Anonymous World Services, Inc., New York, no date (probably 1990)]. The document has an AA identification number of "5M/12-90/TC". The document was produced for AA internal use only. Averaging the results from the five surveys from 1977 to 1989 yielded the following numbers:
81% attendees are gone (19% remain) after 1 month;
90% attendees are gone (10% remain) after 3 months,
93% attendees are gone (7% remain) after 6 months,
And 95% are gone (5% remain) at the end of one year.
That gives AA a maximum possible success rate of only 5% (even if you define "success" as staying sober for only one year). That is not what a competent doctor would call good medical treatment. The FDA would never approve a medicine that is only successful on 5% of the patients. (Kolenda, Golden Text Publishing Company, 2003).
AA hardly sounds like a “proven method,” let alone one that works for most people. So, if only about 5% of the people are getting the help that they need, what about the 95% of the people who are not being helped? That is the purpose of this booklet… to provide much needed information to individuals, rehabilitation centers, hospitals, sober living units, and even 12-step programs themselves so that people with substance abuse problems can be helped. The bottom line is this… is the goal to get alcoholics and addicts into AA or NA or CA, or is it to actually get them help?
Let me mention from the start that I think 12-step programs are wonderful for those individuals who it does work for. I have seen it change many lives for the better, including my dad’s, who has now had 17 years of continuous sobriety, maintaining his sobriety from his very first meeting. It is also a great fellowship to share experiences, strength and hope. So, in no way am I anti-AA, however, it is becoming clearer to me that substance abuse is not a “one size fits all” problem., Let’s look at how AA can help before pointing out some drawbacks.
AA has been helping alcoholics quit drinking since 1935. Current membership is in the millions so you can find meetings all day long, 7 days a week. AA offers social support based on a spiritual model. People help each other stay sober and gain guidance from each other. Each member also works through the “12 steps”, giving the person a set of ethical and moral goals to achieve. It also offers total involvement in a sober community, which makes it easier for you to break away from your drinking and using. When you join AA, you join a ready-made social scene to replace the drug and alcohol scene. As an AA member, you can gain a sense of belonging, which can make you feel more valued yourself.
In a way, AA destigmatizes alcoholism. You’re seen as a person with a disease so it’s no your fault. However, you are responsible for your sobriety and staying sober. AA may help you accept that you even have a problem. Slogans are short, often clichéd statements, which tend to help people stay sober, and they actually are very similar to what you would learn in cognitive-behavioral therapy. (So you don’t even have to like AA to utilize them.) The most well known is most likely, “One day at a time.” By using this slogan, you are not shaming yourself for your past, nor are you worrying about your future. You can stay in the moment and tell yourself, “If it’s this bad tomorrow, I’ll drink,” and most of the time, people with years of sobriety say this never has to happen. This is a good, healthy exercise to practice, not only in regard to alcohol or drugs, but to everything in life. It keeps you from getting too overwhelmed and just giving up on whatever you are trying to accomplish. It also relieves much anxiety and fear, by enabling you to fully live in the present.
“Think it through” is another helpful slogan. When you find yourself thinking about how great it was when you were getting drunk or high, (this is called selective memory), think of all the consequences that follow that action, whether it’s a huge hangover, drunk driving, getting arrested, whatever the negative consequences that usually happen to you. This can help you to stop “romanticizing” your drinking and using, getting you back to reality, which in turn will help you to avoid returning to it.
“HALT” (Don’t get too Hungry, Angry, Lonely or Tired) is one you’ll hear all the time and is also known in cognitive-behavioral therapy as “internal cues.” It’s interesting to note that most relapses occur due to emotional discomfort and wanting to self-medicate.
“Take what you like and leave the rest” basically says it all. Everything in the 12-step program are merely suggestions; they are not orders. So, if there are parts of the program or fellowship that you do not like or do not resonate with you, ignore them and just focus on the aspects that you might find helpful. And the program is free! So, if you’ve never been to AA, or another 12-step meeting, I would suggest trying a few and seeing if they are for you. If they are, then you might not have to look any further. If not, do not despair. There are many other alternatives that could work for you and for the 80% to 95% who are not “making it” in AA. So what are some of the 12-step programs’ drawbacks?
There has been much scientific research done since the 1930’s, and AA takes into account none of the relevant data; they never change, so many professionals have criticisms of AA, mainly:
AA ignores the physical. There is no medical advice given and no information on healing. You get no encouragement to change your diet, exercise, or learn stress reduction techniques (all very important to staying sober.) In fact, at most meetings you’ll find doughnuts, coffee and cigarettes as the mainstay “diet”. This can be the worst on your central nervous system and create more anxiety which is just a setup for an impending relapse.
AA requires social involvement. This is great unless you get nervous in groups and usually drink to get by in these types of social situations. AA requires some belief in God, or a “Higher Power”. Six out of the 12 steps refer to God or some greater power so you’ll be lost if you don’t start to believe in something. Many people are put off by the religious thinking that dominates 12-step programs. These groups claim to be spiritual, and not religious. However, there is a clear Christian origin to many or their beliefs. The idea of being powerless, and the only answer being to ‘turn your will and lives over to the care of God as you understand him” does not sit well with a lot of people. They want to have some power in reclaiming their lives. This is especially true for those who are not religious and for people who have traditionally been put into roles of being powerless their whole lives, such as women and minorities.
Many people have problems with the public confessional approach. At meetings, members constantly recount their problems with alcohol and drugs and this can often take up most of the meeting. These “drunkalogues” or stories about alcohol, make many people think of the good old days and crave alcohol even more than if they didn’t go to the meeting!
Some have said that people become dependent on AA, so it’s just like trading addictions. Going to meetings, the new habit, replaces the old habit of drinking, and this can be very unhealthy in and of itself. People have said that they seemed to have lost their own identity, being consumed by the AA group. This problem will be greatest among independent minded persons.
Alcohol and drugs remain the central focus in their lives. Instead of being preoccupied with drinking, now they are completely preoccupied with NOT drinking. Now instead of remembering the good old days, they simply remember how bad things were. So they still can’t break their all consuming relationship with alcohol; it’s just been switched from love to hate, but they can’t break away.
AA members believe they are powerless over alcohol. But according to the research, this is not true! It may be true before you quit, but you definitely show some power once you quit and even greater power the longer you stay away from it.
Members say, “Once an alcoholic, always an alcoholic.” This is not exactly true. Once you’ve decided to quit, why wouldn’t you just drop the idea that you’re an alcoholic. For example, ex-smokers don’t call themselves smokers once they’ve quit, even though the likelihood is high they’d become addicted again if they started smoking again. The same holds true for people with drinking or other drug problems. Some people believe, and research has shown that many people can return to normal, moderate levels of drinking if they start again and not be an alcoholic. So, in, reality, that original statement is false.
After reviewing both the positive and negative attributes of AA, and checking out a few different meetings, you can make an informed decision about what is right for you. Regardless of which treatment path you take, I want you to have as much information as possible
The National Institute of Drug Abuse, NIDA, has even gone on record to emphasize that no single addiction treatment method is right for everyone. They claim that matching treatment services to each individual’s specific needs is critical to success. In addition, research studies indicate that even the most severely addicted individuals can participate actively in their own treatment, and that active participation is essential for good outcomes. According to the NIDA, counseling, either individual or group, and other behavioral therapies are critical components of effective treatment for addiction. It’s interesting to note that participation in a 12-step program was never mentioned anywhere in this research based guide which discussed the principles of effective treatment.
Reliance on outdated and ineffective treatment methods has created an environment that fully expects individuals to fail, and fail again until such time that rock bottom has been reached. It is often said that once an individual has reached rock bottom there is only one way to go, UP. The problem with that philosophy is that for many people, the ultimate rock bottom is death. (Vacovsky, Executive Director, American Council on Alcoholism, May 12, 2005).
Vacovsky goes on to write:
“Many, (if not indeed most) alcohol dependent individuals have lost faith in themselves, and more importantly hope for the future. It is common for such individuals to have numerous attempts at sobriety, most often using 12-step methods. They have been programmed to accept themselves as hopeless and powerless, with their chance for recovery being slim to none… It is up to the individual to determine what the most appropriate treatment is. It is up to the treatment community to provide options that set up individuals to succeed, rather than be expected to fail (italics added).”
Sadly, Americans are largely unaware that such options even exist. At least, the general public is. While the public is being told that “turning your will and life over to the care of God as you understand Him,” as AA suggests, is the only treatment for their illness, scientifically based research has been going on for decades. Results of this research are threefold:
We now have options for treatment that are based on science rather than fundamentalist religion;
We can give back choice and a sense of control to the individual, which is proving to be extremely important and
We now have evidence that is in direct contradiction to the traditional view of problem drinking.
What, exactly, is the research finding? Here is what some of the experts in the addiction field have found:
Well-designed research conducted over more than three decades has conclusively demonstrated that problem drinking will not inevitably get progressively worse, and that this is one attribute of being a “disease” of alcoholism that is simply wrong. Some problem drinkers “progress,” but the vast majority don’t.
What most Americans believe about drinking problems and their treatment is substantially inaccurate.
Drinking problems do not occur as a result of a disease. It is a learned behavior, and additional learning can therefore modify behavior.
For no other “disease” do so many physicians, psychologists and counselors themselves believe in the non-research-based myths of problem drinking, ignoring the research of their own peers in developing their treatment plans.
“Problem drinkers in the United States are faced with a daunting dilemma when they seek help. They can either accept the prevailing myth that abstinence is the only effective means to resolve a drinking problem, or they can be accused of being “in denial…”
Insistence by treatment programs to only offer abstinence has been shown to deter many problem drinkers from seeking treatment.
Individualizing treatment is crucial.
Chronic “relapsers” can actually be harmed by the 12-step model view that once a slip has started, you are powerless to stop. The stronger one’s belief in this is, the longer and more damaging the relapses are.
The confronting and treating of alcoholics and addicts as children, commonly thought necessary to help them, actually often hinders any change.
Many providers deliberately resist change because they have too much of an attachment to their own ideas of what should work, claiming, “I know what worked for me, and I’m sure that it can work for everyone else as long as they just do what I say.”
The only way to resolve a problem with alcohol is to abstain for life is wrong for the majority of people. A substantial proportion becomes moderate drinkers even when achieving abstinence is the primary focus of treatment.
Dr. Patricia Owen, Director of Research of the Hazelden Foundation, who was a long-time supporter of abstinence-only treatment, referred to these individuals as “in recovery without abstinence” and acknowledged their presence in large numbers among a sample of Hazelden graduates.
Of course, not even all scientists agree on the nature of and best treatments for alcohol abuse. But this is the twenty-first century. No one would disagree that all patients suffering with an alcohol or drug problem have a right, just like any other patient suffering with any other problem, to be fully informed of the available options, the risks or areas of uncertainty, and, after reviewing the relevant information, in consultation with one or more providers, choose a course of action. This is simply good medicine. Should problem drinkers accept anything less?
It is finally time to stop living in the dark ages of recovery, educate people about all the choices and alternatives that are out there and maybe start making a dent in the alcohol and drug use problem that millions are facing each day instead of continuing to perpetuate it. If you are one of those people who still believes that the 12-steps are the “only way” to recover, I implore you to please keep an open mind. In fact, Bill W., one of the co-founders of AA said, "It would be a product of false pride to claim that A.A. is a cure-all, even for alcoholism." Bill W. repeatedly said that "our hats are off to you if you can find a better way" and "If [those seeking a different cure] can do better by other means, we are glad."
It is important to note that recovery programs are not necessary to discover how to quit and stay quit. The following is from the Harvard Medical School’s Mental Health Letter, the August/September 1996 issue:
Most recovery from alcoholism is not the result of treatment. Only 20% of alcohol abusers are ever treated… Alcohol addicts, like heroin addicts, have a tendency to mature out of their addiction…
In a group of self-treated alcoholics, more than half said that they had simply thought it over and decided that alcohol was bad for them. Another group said health problems and frightening experiences such as accidents and blackouts persuaded them to quit… Others have recovered by changing their circumstances with the help of a new job or a new love or under the threat of a legal crisis or the breakup of a family.
Study results from addiction researchers, Doctors Linda and Mark Sobell, confirm Harvard’s 20% treatment statistic:
Surveys found that over 77 percent of those who had overcome an alcohol problem had done so without treatment. In an earlier study… a sizable majority of alcohol abusers, 82 percent, recovered on their own.
However, even though it is possible to recover on your own, you may want a recovery program, or at least a licensed professional for support. That is why I have provided you with options, options that don’t threaten you with “jails, institutions or death” if you don’t completely follow their path. I have divided this book into seven sections. First I have described the major self-help alternatives to AA. Next, I go on to describe alternative treatment modalities. Section III is for the family members and loved ones. In Section IV, I list the top and bottom 10 treatments for alcohol abuse, taken from the most exhaustive review of alcohol treatment literature available. Then you will discover how to choose a treatment program. The last two parts are a directory. I have listed professionals who are registered with SMART, cognitive behavioral therapists, those who provide training in moderate drinking and finally, what makes this publication the first of its kind, I have listed, described and given contact information for over 100 treatment centers, both in the US and abroad, that go beyond using just the traditional 12-step approach.
SECTION I
Self-Help Groups
PART ONE: TOTAL ABSTINENCE
SAVE OUR SELVES (SOS)
SOS was the first large-scale alternative to AA. SOS was founded by James Christopher in 1985, an alcoholic himself who quit drinking in 1978, who early on in his recovery recognized that AA was not for him. SOS respects recovery in any form, regardless of the path by which it is achieved. It is not opposed to or in competition with any other recovery programs. SOS supports healthy skepticism and encourages the use of the scientific method to understand alcoholism; it does not limit its outlook to one area of knowledge or theory of addiction. All those who sincerely seek sobriety are welcome as members in any SOS Group. Although SOS believes sobriety is an individual responsibility, life does not have to be faced alone. In fact, SOS believes that the support of other alcoholics and addicts is a vital adjunct to recovery. In SOS, members share experiences, insights, information, strength and encouragement in friendly, honest, anonymous and supportive group meetings.
SOS believes that sobriety must be a priority for its members and that they must accepts that drinking or using, no matter what the circumstances, is no longer an option for them. Each member is responsible for achieving and maintaining his or her own sobriety, without reliance on any “Higher Power.” In addition, members learn about the cycle of addiction and replace it with the cycle of sobriety. Here are the SOS Guidelines for Sobriety: