Today we are highlighting treatment resources for substance abuse and addictions. While the general public may be aware of Twelve Step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), there are other alternatives. SMART Recovery® is one such organization that is gaining popularity.
This is taken directly from their website:
SMART Recovery® is the leading self-empowering addiction recovery support group. Our participants learn tools for addiction recovery based on the latest scientific research and participate in a world-wide community which includes free, self-empowering, science-based mutual help groups.
The SMART Recovery® 4-Point Program® helps people recover from all types of addiction and addictive behaviors, including: drug abuse, drug addiction, substance abuse, alcohol abuse, gambling addiction, cocaine addiction, prescription drug abuse, sexual addiction, and problem addiction to other substances and activities. SMART Recovery® sponsors face-to-face meetings around the world, and daily online meetings. In addition, our online message board and 24/7 chat room are excellent forums to learn about SMART Recovery® and obtain addiction recovery support. If you’re new to SMART Recovery®, get started with our introduction here.”
As someone who has been to literally hundreds of NA meetings over the past ten years but who is also a trained mental health counselor, SMART Recovery® appeals to me in ways that NA does not. For the record, if NA or AA work for you, then by all means keep doing it. But for me, some of the ideals that NA holds sacred are the ones that I find most difficult to accept as a practicing clinician. Here are 4 ways that SMART Recovery® is different:
1. It’s okay to have a mental illness.
When I was new to recovery, I just assumed that everybody who was in recovery also had a mental illness. This is called dual-diagnosis – basically, you are an addict AND you suffer from something like depression, anxiety, or bipolar. I was surprised to learn that this wasn’t the case. It’s probably a matter for debate, but I knew any number of recovering addicts who claimed that they had never experienced any mental health issues – aside from the addiction, of course, which invariably had ruined their lives. Moreover, I soon found that those addicts who did suffer from a mental illness were reluctant to admit it in the rooms. You would certainly talk about it with your sponsor, but these kinds of topics were considered controversial in a general meeting.
I never could understand why that seemed to be the case. I suspect it has something to do with NA’s belief in a Higher Power and the power of The Program. The idea is, if you’re working the program the way you should, your sanity should be restored and you get to be a productive member of society. Extremists in the groups would inevitably claim that you were not working the program to the best of your ability if you were still depressed or manic any of the other things that come with a mental illness. I suppose this is true for some, but it was certainly not the case for me.
SMART Recovery®, on the other hand, completely recognizes mental illness as a real thing, sometimes separate from the addiction but often times linked. They acknowledge “possible psychological factors” and members are treated accordingly. This just makes sense to me.
2. They support evidence based use of psychological treatments and the legal use of prescribed psychiatric medication.
This might be the single biggest difference between SMART Recovery® and NA. Both NA and AA make a point of separating themselves from “professional services.” It’s even against their guidelines to have trained clinicians involved in meetings. NA, for example, believes that “the therapeutic benefit of one addict helping another is without parallel.” That sounds great, and for many it’s true. Except when you think about it, you’re talking about one sick person, with no training, helping another sick person. Admittedly, this does work for many, but why is it a bad idea to use evidence based therapy or even prescribed medications in the fight against addiction and co-occurring mental illness? Many members of NA despise the very idea of medication, for any reason. Some would go as far as to say you are not working an honest program if you are using any drug, prescribed or otherwise. total abstinence from everything.
While it is perhaps not a good idea for a recovering heroin user to take narcotic pain killers when Advil would do, this belief gets a bit more murky when you start looking at mental illnesses such as schizophrenia and bi-polar disorder. These are conditions which can absolutely be managed with medication and therapy, bu the bottom line is that some schizophrenics are completely unable to function without their medication. In an example like this, abstinence from all substances seems like a horrible idea. I attended NA meetings for years, and was under a doctor’s care the entire time for both severe anxiety and depression. I was prescribed medication for both. I told exactly zero people in NA about that part of my life. Not because I was ashamed, but because I didn’t want to be accused of “relapsing” when all I was doing was taking legally prescribed medications. This ended up being a major reason I eventually stopped attending meetings. Even as a licensed counselor, I’m hesitant to talk with people about psychotropic medications, as I’m not a medical doctor. I simply don’t think it’s a good idea to have completely untrained people give medical advice about anything. But that’s unfortunately what sometimes happens in the rooms of NA.
3. NA sees addiction an simple; SMART Recovery recognizes its complexity.
NA touts it’s program as a simple program for complicated people. That sounds like a great idea. Except that addiction is a complicated disease that gets further complicated when you try to oversimplify it.
Consider the following: Not all addicts are built the same way. I know many addicts in recovery who claim they can get addicted to anything – heroin, crack, sex, soap operas, you name it. I know others who had their one drug of choice and who never really had problems with anything else. I was one of those types of addicts. I had what can best be described as a psychological addiction to marijuana. In my past, I’ve tried many other drugs. None of them really interested me. To this day, I have a beer occasionally, but I can’t remember the last time I ever got drunk. I’ve also never been arrested or in trouble with the law, which for many addicts is the norm. All I’m saying is that we are not all alike. SMART Recovery® recognizes this. SMART Recovery® accepts that this is a complicated, multi-faceted disease. Some addicts require medication; some don’t. Some addicts require hospitalization; some don’t. Some addicts need therapy; others need accountability, direction, structure, or all of these things, or none.
4. SMART Recovery is based on science, not spirituality.
The following is taken from the SMART Recovery® FAQ section: SMART Recovery® has a scientific foundation, not a spiritual one. SMART Recovery® teaches increasing self-reliance, rather than powerlessness. SMART Recovery® meetings are discussion meetings in which individuals talk with one another, rather than to one another. SMART Recovery® encourages attendance for months to years, but probably not a lifetime. There are no sponsors in SMART Recovery®. SMART Recovery® discourages use of labels such as “alcoholic” or “addict.”
If you’ve never been to a 12 Step meeting, the differences might not be obvious to you. But the differences are profound. At an NA meeting, if I speak, I’m supposed to say “Hi my name is Randy, and I’m an addict.” It’s weird if you don’t. NA’s position is that we have to accept who we are, and I do agree with that. But is it possible that we can change? I think it is. But if I went to an NA meeting and said “Hi my name is Randy and I used to be an addict,” rest assured there would be drama.
Furthermore, the basic assumption with NA (and AA, for that matter) is that you attend those meetings FOR THE REST OF YOUR LIFE. Even if that is the right thing to do, how realistic do you suppose that is? Certainly some people do end up doing this, as addicts have a bad habit of dying young. SMART Recovery® on the other hand recognizes that at some point treatment has to stop. It’s just the way things are. Professional counseling these days is centered around brief therapies that are really not supposed to last for more than six months. If you’re seeing the same therapist five years later, you really have to ask yourself if any work is actually being done. Wouldn’t the same thing be true with NA?
Finally, powerlessness was an issue that I always had with NA. It’s also a HUGE part of their philosophy. We have to admit that we are powerless. Only then can we admit we need help. That’s true, but the problem is that people tend to use powerlessness as an excuse for all sorts of things. SMART Recovery® advocates self-reliance, which is the cornerstone of any modern treatment modality. If we are to get better, we will need to lean on others at first, but eventually, we are going to have to lead our own lives. In addition to this being a more realistic way of looking at things, it also has the benefit of being tue.
If you have found success in the rooms of NA or AA, then by all means, I want to encourage you to keep doing what you are doing. It’s obviously working for you, so why change it? But if you are like me, and parts of NA or AA just don’t sit well with you, or you prefer a more scientifically-based approach to substance abuse treatment, check out SMART Recovery®. It’s free, they offer meetings both online and in person, and they even have an online chat feature if you have any questions or concerns. If you or someone you know is struggling with an addiction, use whatever tools you have to fight this cunning and elusive disease. Check out SMART Recovery®.