What Turns Me Off of 12 Step Meetings and Why 12 Step Advice can Affect Harm Reduction in Opiate Rehabilitation
I was walking back home from school one afternoon. I was fifteen years old at the time and I remember it was a sunny autumn day. For some reason I can’t recall what happened, however I woke up in the ambulance without being able to move and felt excruciating pain all over my body. Several days later I was told I had been drifting in and out of consciousness and that I had gone through two spinal surgeries, I had been runover by a drunk driver. This is when I got started on oxycodone, the pain was simply unbearable and the drug helped, a lot. Before I knew it, three years had gone bye, I couldn’t get of the opioid that had helped me through the pain caused by the accident. This story is not about my accident, it’s about how I treated my opioid dependency and how the strict twelve steps method simply did not work for me, even though it has helped millions of others in the past.
My personal view is that an opioid addiction is a chronic disease and should be treated in the same way as any other such diseases.
It needs to be continuously treated and monitored because, I believe, you don’t simply get over it like if it where the flu. You should feel free to seek the treatment with your doctor, who is properly trained to help you.
Opiates and other drugs of abuse can modify brain plasticity of areas that regulate neuronal morphology of dendrites and spines, which are the primary site of excitatory synapses in brain regions that regulate incentive functions motivation, reward, and learning.
Repeated exposure to opiates in the treatment of pain produces long-term changes in the postsynaptic density of sites (dendrites and spines) in sensitive areas of the brain, such as the prefrontal cortex and the limbic system (hippocampus, amygdala), as well as in the caudate and accumbens nuclei. This is believed to happen due to the cellular mechanisms involved, mainly dopaminergic and glutamatergic receptors, as well as the synaptic plasticity achieved by changes in dendrites and spines in this area. You can read more about this here.
Substance Abuse Disorder is a disease that affects the brain and behavior of a person and leads to the inability to control the use of a legal or illegal drug or medication, this includes alcohol, tranquilizers such as benzodiazepines, stimulants, and opioids. Unfortunately, changes in the brain and the development of tolerance and withdrawal are not under the control of the person. It is much more correct to consider drug addiction, including opioids, as a chronic (long-term) disease, such as diabetes or high blood pressure. This does not include mental health disorders, which are another topic on its own and many times substance induced or developed. The good news is that addiction is a curable condition, and a person can get professional help.
My first step towards rehabilitation was to admit that I had a problem with the way I depended on the opioid.
So, with the help of family and friends, I realized I had a problem and sought help.
I then committed that I would get rid of this addiction by taking control of my behavior and my actions.
In my attempt to treat my addiction I joined a twelve-step group and believed that they could help me deal with this disease, as my situation worsened, I decided to blindly follow the advice they provided, which also included going cold turkey on the use of oxycodone without the help of any other harm reduction drug therapy.
Signs and symptoms of withdrawal began 6 to12 hours after the last dose, nausea, vomiting, abdominal pain, and anxiety, for starters. After 24 to 48 hours the withdrawal symptoms worsened. The symptoms persisted for the following days and lasted over two weeks, this is when I started feeling dysphoria, despair, nausea, vomiting, and diarrhea. In group therapy, I addressed shared issues with others, gained support, and learned new skills. Nonetheless, physical symptoms were too much to bear even with this kind of group support. I was continually yawning, my bowel movements increased and were not healthy, my blood pressure rose, and my respiratory frequency was high. In other words, suffering was becoming constant.
It was then that I learned that it’s important that treatment be tailored to a person’s specific needs and focused on treating the whole and not just the substance dependency. Harm-reduction treatment for opioid addiction has the potential to be very effective and may help prevent relapse and is different for each person. The main goal of treatment is to help you stop taking the drug and to lower the chances of “falling off the wagon”.
Your doctor may prescribe certain medications to help ease your withdrawal symptoms and later tapper down accordingly.
They will also help you control your compulsion. These medication assisted treatments include methadone (often used to treat heroin addiction), buprenorphine, and naltrexone. Now please, don’t self-medicate and go talk to your doctor. I’m not a doctor nor am I in anyway giving medical advice.
In general, interrupting the use of opiates abruptly (cold-turkey) is not recommended due to the extreme illness and anxiety that patients experience.
I decided that detox should be the next step in my recovery process. It involved a set of interventions designed to help me safely and comfortably withdraw from the substance and become medically stable before entering other forms of treatment. I engaged in a supervised, medical detox commonly utilized for people undergoing opioid withdrawal.
I used medications during detox to minimize and prevent withdrawal symptoms. They also helped me prevent relapse and increased my chances of success during treatment.
Long-term treatment can limit the effects of the disease and help the patient to go back to daily activities and social life. Pharmaceutical interventions are highly effective to treat opioid addictions, however, given the biological, psychological, and social complexity of the disease, treatment should be supported with psycho-social therapy.
A physician’s knowledge of the neurological and biological basis of opioid dependency can facilitate the understanding of a patient’s behavior and basic problems, in this way the patient and physician can establish together goals and optimal treatment.
I have friends, some of them close, who have successfully achieved a sober life through the twelve-step system. I am in no way discrediting this highly effective and compassionate path to sobriety. Hang tough, life is worth enjoying and never give up. With that out of the way, my personal experience with opioids and the twelve-step program was a turn-off. Why? Because my problem was not only about behavior, but it was also biological-neurological and I truly believe that if I had only listened to what my 12-step sponsors said about the cold-turkey/no drugs, I would still be using if it weren’t for the help of the drugs my doctor prescribed. Today after medical supervision I tapered down safely from the prescribed drugs and I’m two years sober. Check out this link and see for yourself if the Twelve-Step Method can also do something for you or a loved one.
Now, I’m not just blowing out steam here, this is my personal experience and if you feel like reading a little more about this view this is an article I found from the National Institute of Health (NIH) which supports what I’m saying.