Addiction Is Not a Disease and Rehab Is Bullshit
- Thread starter Jabberwocky
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Phil.McKeer
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I'll have to think about that for a bit. At face value I'd think if "it works when [you] work it," then even if it's you doing most of the work, it's working. And again that's good that you get something out of it, even if you have to put a lot in to get a little back.
Ya I don't mean to oversimplify. I'm sure under the 12-step or "X Anonymous" tent there are a wide variety of doctrines, tendencies, different people who each have different ideas, etc. There are some common traits though, but I'd never presume that it is completely monolithic. It doesn't seem to be organized in a way for a top-down control to be possible.
I hope you didn't take offense, I wasn't trying to say you're crusty or washed up, or anyone else for that matter. I dont know you or know anything about ypur life. Plus I know some people go to AA because of court orders, some of their own volition, etc. I've never been to one myself but it just doesn't seem like a happy place or a place where I'd want to be if I'm trying to resist temptation. Surrounding yourself with fellow paychonauts or alcoholics or whatever and talking about drugs (talking about NOT doing them, but still) seems like a quick ticket to "Fuckitville".
The 5-10% figure came from a 2006 Cochrane Collaboration inquiry looking at numerous trials, all randomized and double-blind (IIRC), starting from the 1960's to 2006, all of which were studying 12-step program's efficacy and relapse rate.
In case you haven't heard of them or know about them, Cochrane is a fairly reputable medical science review group that analyze scientific trials to provide findings of said trials to the public; and their mission, taken from the About Us section directly from their website, is: "...to provide accessible, credible information to support informed decision making for...global health." They basically go around, gather all the information on a subject that medical research has discovered in the last x years or months or w/e, and then they disseminate that to the public with the hopes of helping people make more informed decisions...like whether to attend AA, or Smart Recovery, or just find a counselor and do CBT.
Nah man I'm in my early 30's. I can't party all the time and drill blow up my schnoz every chance I get. I have to do my own damn taxes. I just think that there are some empirically obvious issues with the way addiction/dependence is spoken about, thought about, and that language can have a profound effect on perception. "Disease" is disempowering. Surrendering to a higher power and admitting you are powerless and require their interjection is also disempowering.
Intense
Bluelighter
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The person has to want to stop. Period. Otherwise treatment will never work.
Personally treatment never worked for me, I'd always go back. I decided I needed to stop certain things so I did. Cut everyone off I was associating with and moved to a different part of the city. Given, I was having medical issues due to my addictions so it was a nice nudge for me. Now I am happier than ever and have a gf who doesn't do any drugs except some weed, which I will probably always do here and there. That was the hardest part, dumping my other gf, but she was simply not willing to get sober nor wanted to. And who was I to force that? So I left her and moved.
I don't believe in rehab or treatment for MYSELF. But it DOES work for some. You still have to want it though, and it makes me sick the ones who are attention seeking, "feel sorry for me", types who take advantage of the programs that are out there and ruin it for the ones who truly want and need it.
Personally treatment never worked for me, I'd always go back. I decided I needed to stop certain things so I did. Cut everyone off I was associating with and moved to a different part of the city. Given, I was having medical issues due to my addictions so it was a nice nudge for me. Now I am happier than ever and have a gf who doesn't do any drugs except some weed, which I will probably always do here and there. That was the hardest part, dumping my other gf, but she was simply not willing to get sober nor wanted to. And who was I to force that? So I left her and moved.
I don't believe in rehab or treatment for MYSELF. But it DOES work for some. You still have to want it though, and it makes me sick the ones who are attention seeking, "feel sorry for me", types who take advantage of the programs that are out there and ruin it for the ones who truly want and need it.
Jabberwocky
Frumious Bandersnatch
- Joined
- Nov 3, 1999
- Messages
- 84,998
I get the feeling some of you (Sharapovafistpump) haven't actually read the article... all I really hear getting batted around in here is whether or not addiction is a disease. The article is about far more than such an overplayed recovery meme.
Also, please keep things civil in here. As cj posted, if things don't stay on topic and comments remain constructive the thread will get closed (and I'll have to find another article to start another thread on the topic, so we might as well stay with this one
).
I think my particular beef is not whether or not we call it a disease, but what we actually mean when it is called that.
I see the articles seems to have sucked you in. I'm fairly certain this was a major consideration in choosing the words for the title. I tend to agree that in some ways the title is misleading, but it's like calling some new product something outrageous like "Fuck." Once people hear about it everyone is interested in it.
Addiction as a disease is fairly unique. Nowhere else in medicine would a treatment that fails over nine out of ten patients be considered successful on any kind of level (perhaps it was "successful" for an individual here and there, but what I'd take issue is the way people understand success). Just because those who end up relapsing are blamed for the failure of the treatment that was supposed to help them doesn't mean those who didn't relapse were any more successful. THE ONLY thing is means is that the treatment was appropriate paired with those who found some kind of lasting remission with it.
A huge issue with addiction treatment is that people legitimize it (abstinence based treatment) as just another form of the pinnacle of modern medicine, which it demonstratively isn't for most people who encounter it. I can certainly envision a world where rehabs only offered evidence based therapies, treated their clients with respect and dignity and weren't primarily interested in making a profit. However, that is far from the world we live in. At least as many inpatient treatment providers as not still rely on "tough love" forms of treatment that are, at best, experimental (with no research to support their efficacy). It's commonplace to find staff who belittle, manipulate and in some cases outright exploit their clients, and the vast, vast majority of rehabs are still profit maximizing machines.
If treatment providers were provided a financial incentive to successfully treat addiction, and didn't have the kind of financial incentives they currently do for ignoring patient concerns (because someone who's concerns are ignored in their treatment is likely to relapse, and relapse means another financial opportunity for further "treatment").
It's also worth pointing out that with somewhat more straightforward conditions like cancer or, say, gout, a treatment wouldn't be considered effective if it only possessed a 5-10% success rate (and this is generous, as a lot of other studies point the success rate of abstinence only treatment to be more like 4%). At best it would be considered as a limited success, if there weren't other more effective forms of treatment available I mean.
And that is the thing, there are far more effective forms of treatment available than the 12 step abstinence only model when it comes to treating all forms of substance use disorder. The majority (trauma therapy, motivational interviewing, MAT protocols, MBSR/MBRP, career and education placement (yes this has a significant impact on one's recovery) and harm reduction based housing programs (yes, harm reduction is an effective tool at promoting recovery)) are rarely found in treatment. Most places rely almost exclusively on group based therapy, and while this can be helpful, it is little more than a tool for producing conformity (which may or may not be helpful given the individual issues you're dealing with).
What's inappropriate beyond words is that a self help group (12 step stuff, SMART recovery, etc) that is designed to be provided for free (or with strictly voluntary donations) are being packaged as part of something that is incredibly expensive. Those 12 step meetings you go to in rehab? You're paying for them. If I'm going to pay for something like that, I'd want to use my limited resources most expeditiously, and that would ideally mean paying for only that which really needs to be paid for in order to access it (in order words, clinical interventions, not self help groups or gurus).
There is certainly a lot more help for and awareness of folks with substance abuse disorder today than ten or twenty years ago, but it is still in far more demand than is available. Access to treatment, particularly the appropriate form of treatment for a given individual's particular variation of substance abuse disorder.
I personally don't have a problem calling addiction a disease. The point is that addiction - otherwise known as the spectrum of substance use disorders - is a far more complicated condition than most other primarily biological disease. True, it could be argued that most if not all diseases are to some degree biopsychosocial conditions in some way (as in cancers can be prevented and their treatment can be positively affected by social and psychological lifestyle type changes). The difference with addiction is that for the vast majority - basically everyone except (perhaps) those with the most extreme variations of the disorder - the sociological and psychological aspects to the condition are far more significant than its biological origins.
The knowledge that I have a gene for addiction, if we were to actually find some constellation of gene's that correlate to increased incidence of addiction (which I believe it is highly unlikely will ever be discovered as anything like an "addiction gene" - anyone who understands how genetics works understand the fallacy involved in this), is far less important or helpful than learning about the social components I can actually tailor my environment to account for or the psychological aspects to it I can likewise learn to overcome. After all, anyone ever see Gattica?.
That's precisely the issue with the way rehabs tend to be run. Most of them focus on the substance use disorder without any comparable efforts given to treat co-occuring conditions, mental health concerns, trauma, etc. etc. The primary reason for that is the inpatient model for treating substance use disorder and the fact that rehabs would have to actually employ qualified professionals to treat things like mental illness that, if they didn't and tried to treat it (however futile an unqualified attempt would likely be) they would lose standing with the agencies that grant accreditation and get the treatment covered under insurance.
I have no problem with inpatient treatment per se. Just the way it currently tends to exist.
Most drug users never enter treatment because most drug users never have need for treatment. Another huge issue with rehab is that they are filled with folks who don't truly belong there. After all, the vast majority of those with drug use issues that could technically be labeled as some form of addiction never receive help yet "age out" of their issues with substance use over their 20's and 30's.
It's actually fairly preposterous why we think rehab will even help some of the people who end up there: They got caught with heroin or some other less stigmatized drug and their family members freaked out, or some other plethora of triage failures. Again, a huge problem is the financial motivation for placing people in any form of treatment whenever there is any hypothetical reason for it.
If there was a financial motivation for not only placing people in treatment but in the appropriate treatment for them, there would be far fewer issues in the industry. Also, again, a big part of the triage issue isn't even money (I mean, that is the overarching issue), but a lack of actual clinical training outside of abstinence only sorts of staff indoctrination. In many cases the people who are doing triage are those least qualified to (drug counselors still working on their associates degree are hardly qualified to handle something as complex as triage).
Where to start... Regarding LSD and Bill W, you know how he essentially became totally ostracized as a result of his drug use? That says a lot, well a little given the time when it happened, about the ignorance of the organization and it's narrow minded focus on their abstinence groupthink.
Actually, I'm not even going to touch your straw man augments. I will comment how not having what most people would think of as a traditional addiction is no way disqualifies one from appreciating or understanding the urges and impulsive that characterize even the most severe forms of substance use disorder. Those who struggle to make such connections between their own issues and compulsions and those more dramatic ones of the junkie don't demonstrate much other than the fact that not everyone possesses the same ability to empathize with others.
I don't mean to be a dick, but you understand the irony and contradiction of the philosophy you seem to be expounding and your own inability to live by it?
Amen, although no sense in putting up with douchbags either
Also, please keep things civil in here. As cj posted, if things don't stay on topic and comments remain constructive the thread will get closed (and I'll have to find another article to start another thread on the topic, so we might as well stay with this one
). I think my particular beef is not whether or not we call it a disease, but what we actually mean when it is called that.
I see the articles seems to have sucked you in. I'm fairly certain this was a major consideration in choosing the words for the title. I tend to agree that in some ways the title is misleading, but it's like calling some new product something outrageous like "Fuck." Once people hear about it everyone is interested in it.
Addiction as a disease is fairly unique. Nowhere else in medicine would a treatment that fails over nine out of ten patients be considered successful on any kind of level (perhaps it was "successful" for an individual here and there, but what I'd take issue is the way people understand success). Just because those who end up relapsing are blamed for the failure of the treatment that was supposed to help them doesn't mean those who didn't relapse were any more successful. THE ONLY thing is means is that the treatment was appropriate paired with those who found some kind of lasting remission with it.
A huge issue with addiction treatment is that people legitimize it (abstinence based treatment) as just another form of the pinnacle of modern medicine, which it demonstratively isn't for most people who encounter it. I can certainly envision a world where rehabs only offered evidence based therapies, treated their clients with respect and dignity and weren't primarily interested in making a profit. However, that is far from the world we live in. At least as many inpatient treatment providers as not still rely on "tough love" forms of treatment that are, at best, experimental (with no research to support their efficacy). It's commonplace to find staff who belittle, manipulate and in some cases outright exploit their clients, and the vast, vast majority of rehabs are still profit maximizing machines.
If treatment providers were provided a financial incentive to successfully treat addiction, and didn't have the kind of financial incentives they currently do for ignoring patient concerns (because someone who's concerns are ignored in their treatment is likely to relapse, and relapse means another financial opportunity for further "treatment").
It's also worth pointing out that with somewhat more straightforward conditions like cancer or, say, gout, a treatment wouldn't be considered effective if it only possessed a 5-10% success rate (and this is generous, as a lot of other studies point the success rate of abstinence only treatment to be more like 4%). At best it would be considered as a limited success, if there weren't other more effective forms of treatment available I mean.
And that is the thing, there are far more effective forms of treatment available than the 12 step abstinence only model when it comes to treating all forms of substance use disorder. The majority (trauma therapy, motivational interviewing, MAT protocols, MBSR/MBRP, career and education placement (yes this has a significant impact on one's recovery) and harm reduction based housing programs (yes, harm reduction is an effective tool at promoting recovery)) are rarely found in treatment. Most places rely almost exclusively on group based therapy, and while this can be helpful, it is little more than a tool for producing conformity (which may or may not be helpful given the individual issues you're dealing with).
What's inappropriate beyond words is that a self help group (12 step stuff, SMART recovery, etc) that is designed to be provided for free (or with strictly voluntary donations) are being packaged as part of something that is incredibly expensive. Those 12 step meetings you go to in rehab? You're paying for them. If I'm going to pay for something like that, I'd want to use my limited resources most expeditiously, and that would ideally mean paying for only that which really needs to be paid for in order to access it (in order words, clinical interventions, not self help groups or gurus).
There is certainly a lot more help for and awareness of folks with substance abuse disorder today than ten or twenty years ago, but it is still in far more demand than is available. Access to treatment, particularly the appropriate form of treatment for a given individual's particular variation of substance abuse disorder.
I personally don't have a problem calling addiction a disease. The point is that addiction - otherwise known as the spectrum of substance use disorders - is a far more complicated condition than most other primarily biological disease. True, it could be argued that most if not all diseases are to some degree biopsychosocial conditions in some way (as in cancers can be prevented and their treatment can be positively affected by social and psychological lifestyle type changes). The difference with addiction is that for the vast majority - basically everyone except (perhaps) those with the most extreme variations of the disorder - the sociological and psychological aspects to the condition are far more significant than its biological origins.
The knowledge that I have a gene for addiction, if we were to actually find some constellation of gene's that correlate to increased incidence of addiction (which I believe it is highly unlikely will ever be discovered as anything like an "addiction gene" - anyone who understands how genetics works understand the fallacy involved in this), is far less important or helpful than learning about the social components I can actually tailor my environment to account for or the psychological aspects to it I can likewise learn to overcome. After all, anyone ever see Gattica?.
That's precisely the issue with the way rehabs tend to be run. Most of them focus on the substance use disorder without any comparable efforts given to treat co-occuring conditions, mental health concerns, trauma, etc. etc. The primary reason for that is the inpatient model for treating substance use disorder and the fact that rehabs would have to actually employ qualified professionals to treat things like mental illness that, if they didn't and tried to treat it (however futile an unqualified attempt would likely be) they would lose standing with the agencies that grant accreditation and get the treatment covered under insurance.
I have no problem with inpatient treatment per se. Just the way it currently tends to exist.
Most drug users never enter treatment because most drug users never have need for treatment. Another huge issue with rehab is that they are filled with folks who don't truly belong there. After all, the vast majority of those with drug use issues that could technically be labeled as some form of addiction never receive help yet "age out" of their issues with substance use over their 20's and 30's.
It's actually fairly preposterous why we think rehab will even help some of the people who end up there: They got caught with heroin or some other less stigmatized drug and their family members freaked out, or some other plethora of triage failures. Again, a huge problem is the financial motivation for placing people in any form of treatment whenever there is any hypothetical reason for it.
If there was a financial motivation for not only placing people in treatment but in the appropriate treatment for them, there would be far fewer issues in the industry. Also, again, a big part of the triage issue isn't even money (I mean, that is the overarching issue), but a lack of actual clinical training outside of abstinence only sorts of staff indoctrination. In many cases the people who are doing triage are those least qualified to (drug counselors still working on their associates degree are hardly qualified to handle something as complex as triage).
Where to start... Regarding LSD and Bill W, you know how he essentially became totally ostracized as a result of his drug use? That says a lot, well a little given the time when it happened, about the ignorance of the organization and it's narrow minded focus on their abstinence groupthink.
Actually, I'm not even going to touch your straw man augments. I will comment how not having what most people would think of as a traditional addiction is no way disqualifies one from appreciating or understanding the urges and impulsive that characterize even the most severe forms of substance use disorder. Those who struggle to make such connections between their own issues and compulsions and those more dramatic ones of the junkie don't demonstrate much other than the fact that not everyone possesses the same ability to empathize with others.
I don't mean to be a dick, but you understand the irony and contradiction of the philosophy you seem to be expounding and your own inability to live by it?
Amen, although no sense in putting up with douchbags either
Last edited by a moderator:
Jabberwocky
Frumious Bandersnatch
- Joined
- Nov 3, 1999
- Messages
- 84,998
So I want to remind everyone that the article (and this thread) isn't actually about whether or not addiction is a disease. It is about the failing of the treatment industry to treat it like other diseases. In particular, the failure of the addiction treatment industry in doing so.
This is obviously highly problematic, I mean the way the treatment industry continues to deal with addressing substance use disorder. If you want to discuss something about the treatment industry - whether inpatient (rehab) or outpatient - please contribute to this thread.
This isn't the place to discuss 12 step groups or methodology outside that context. If you want to discuss it within the contact of formal treatment programs or methology, feel free. This thread is not a place to criticize the 12 step community outside that context though. We are NOT talking about the larger 12 step self help group community, its benefits or detriments here.
12 step work is unfortunetly often treated by people in the recovery community as akin to treatment, but anyone who knows anything about twelve step programs - ironic how few people who work in the industry actually seem to understand this - understands that 12 step work is NOT treatment, clinical care or evidence based. 12 step groups are non-professional self help groups that some may find helpful in augmenting their recovery, whether or not they receive actual treatment, but nothing more.
My last point gets me back to the article that started off this thread. Really the title is annoying because, as I said, the article isn't really about whether or not addiction is a disease. It is about how culture and medicine treat it in ways that we don't treat any other disease (prayer and powerlessness are not part of how modern medicine treats any other form of disease, etc. etc.).
I really would prefer this thread not to be any more of a discussion of the issues or benefits of 12 step communities however. So, if you want to avoid any warnings or infractions, please remain civil (and chill on the name calling and personal attacks please) and try not to discuss 12 step stuff, certainly not outside the context of how the role it plays in how the most established addiction treatment model (rehab/inpatient) is a pretty dismal failure regarding treatment efficacy or reducing treatment recidivism.
tl;dr
Watch it on the personal attacks and immature behavior. Expect warnings and infractions (and temp bans) as appropriate. Please review the BLUA and in particular the Sober Living Guidelines for what we expect of you in terms of your behavior as members of the BL community.
Let's try and forget the first part of the title of the article in this thread and focus on the second part: How is rehab bullshit?
Please avoid a critique of the 12 step community or methodology, particularly outside of its context within the formal/clinical treatment industry.
If you want to continue to participate in this thread, please discuss the following questions. If we can keep things civil, then we'll keep the thread open. I do hope we can keep this open as this is very important discussion for anyone interested in recovery or the treatment industry.
Q1: Have you benefited or been held back in your experience with inpatient treatment?
Q2: What was the treatment like, and what do you identify as reasons it benefited or held you back (or some combination of the two)?
THANK YOU for your cooperation!
This is obviously highly problematic, I mean the way the treatment industry continues to deal with addressing substance use disorder. If you want to discuss something about the treatment industry - whether inpatient (rehab) or outpatient - please contribute to this thread.
This isn't the place to discuss 12 step groups or methodology outside that context. If you want to discuss it within the contact of formal treatment programs or methology, feel free. This thread is not a place to criticize the 12 step community outside that context though. We are NOT talking about the larger 12 step self help group community, its benefits or detriments here.
12 step work is unfortunetly often treated by people in the recovery community as akin to treatment, but anyone who knows anything about twelve step programs - ironic how few people who work in the industry actually seem to understand this - understands that 12 step work is NOT treatment, clinical care or evidence based. 12 step groups are non-professional self help groups that some may find helpful in augmenting their recovery, whether or not they receive actual treatment, but nothing more.
My last point gets me back to the article that started off this thread. Really the title is annoying because, as I said, the article isn't really about whether or not addiction is a disease. It is about how culture and medicine treat it in ways that we don't treat any other disease (prayer and powerlessness are not part of how modern medicine treats any other form of disease, etc. etc.).
I really would prefer this thread not to be any more of a discussion of the issues or benefits of 12 step communities however. So, if you want to avoid any warnings or infractions, please remain civil (and chill on the name calling and personal attacks please) and try not to discuss 12 step stuff, certainly not outside the context of how the role it plays in how the most established addiction treatment model (rehab/inpatient) is a pretty dismal failure regarding treatment efficacy or reducing treatment recidivism.
tl;dr
Watch it on the personal attacks and immature behavior. Expect warnings and infractions (and temp bans) as appropriate. Please review the BLUA and in particular the Sober Living Guidelines for what we expect of you in terms of your behavior as members of the BL community.
Let's try and forget the first part of the title of the article in this thread and focus on the second part: How is rehab bullshit?
Please avoid a critique of the 12 step community or methodology, particularly outside of its context within the formal/clinical treatment industry.
If you want to continue to participate in this thread, please discuss the following questions. If we can keep things civil, then we'll keep the thread open. I do hope we can keep this open as this is very important discussion for anyone interested in recovery or the treatment industry.
Q1: Have you benefited or been held back in your experience with inpatient treatment?
Q2: What was the treatment like, and what do you identify as reasons it benefited or held you back (or some combination of the two)?
THANK YOU for your cooperation!
Last edited by a moderator:
I get really angry sometimes when I think about the treatment models for addiction, particularly in the US- because those honestly do seemed to be based on stigma and shame more than anything else. I do believe very firmly that bio-chemistry and dependency are a part of things: but treatment models confuse me because, they blend acknowledgment of that with almost an outright denial of the behavioral and toss in a big dose of shame while, pushing shame based behavioral changes? I am not sure I am wording this right- I just know like most things, particularly here in the US: the statistics aren't lying. This is not, nor has it ever been particularly effective on the whole. There's no denying people have been helped but it's not that dissimilar to the recitivism rates in prisons. Odd how they're both for profit models...riiiight? Anyway-
My first experience with inpatient treatment, I was 15- and yes, actually, I did benefit: but I think this is one of those deals where the exception proves the rule as at that time my life was a chaotic mess and I had no stability or structure whatsoever- and I managed to land in a really decent comprehensive rehab for kids, which provided the nutrition I'd been lacking, the structure, and encouragement. I think this is maybe a good thing to point out because: this one was based on us having been the victims of neglect and abuse- which lead to our using. Unfortunately, it was only a six week program and from what I understand: they ran out of funding. My second trip to rehab was...less than healthy. VERY shame based and dogmatic- and I am in no way criticizing 12 Steps- it's just this particular one was quite geared towards one particular higher power, and I was a bisexual pagan surrounded by not only a very guilt driven model: but my higher powers were wrong, I was wrong, you get the idea. It was just *that* one, but I think that it's kind of an offshoot stigma we see a lot of. (I later would be in meetings a lot and find a lot of wonderful support, I'm just using this one example because it was a HUGE part of their inpatient protocol- but it was also the only one I could afford, as it was sliding scale.) I think maybe the whole "addiction as a disease" thing meant well- but, it's become it's own stigma in addition to the ones everyone's used to. I left the first rehab feeling much stronger, much more stable and able to confront a lot of things- I left the second feeling like some kind of sinful piece of crap doomed to hell ontop of having a "disease" I couldn't control and all sorts of questions about that. Much later on, ended up in another inpatient program which was...pretty much a dumping ground. They'd pull you in, pat you down, the whole 9- and there wasn't any help with w/d whatsoever, because you had to suffer so you could see how far you'd fallen, basically. Kind of cold, uncompassionate, and then you'd go see a therapist once a week, go to group each night. I honestly felt so weird in there I couldn't wait to get out and get back to it.
I should also mention that I have been in and out of various behavioral health facilities most of my life- and honestly, those not geared towards addiction aren't particularly helpful for many of the same reasons. I do often think about the exceptions- and I tend to think that maybe there are some people who are more motivated by that sort of thing, but my experience runs the gauntlet from that first one: which was about empowering kids who'd had it rough- to the last, which was just typical of what the author of the article is critiquing: and the differences are pretty staggering. I wound up bouncing around in the juvenile justice and foster care system after the first- and I think that had a big hand in why I relapsed. I can't imagine how differently things would have been had I had a stable place to land on top of that more stable foundation- but I also tend to think about how it might have been so much worse had I not experienced it. (And I try to avoid really thinking along those lines for the most part- because it doesn't help. Lol But I used to quite a bit.) As far as it goes, I know you'd asked to steer clear of the critiques of the 12 step programs- but, my experience with that particular inpatient program was colored a great deal by it and later, balanced with more positive experiences. Still- being taught and encouraged in the first rehab, vs. being told I had no control: yeah, it makes a BIG difference.
My first experience with inpatient treatment, I was 15- and yes, actually, I did benefit: but I think this is one of those deals where the exception proves the rule as at that time my life was a chaotic mess and I had no stability or structure whatsoever- and I managed to land in a really decent comprehensive rehab for kids, which provided the nutrition I'd been lacking, the structure, and encouragement. I think this is maybe a good thing to point out because: this one was based on us having been the victims of neglect and abuse- which lead to our using. Unfortunately, it was only a six week program and from what I understand: they ran out of funding. My second trip to rehab was...less than healthy. VERY shame based and dogmatic- and I am in no way criticizing 12 Steps- it's just this particular one was quite geared towards one particular higher power, and I was a bisexual pagan surrounded by not only a very guilt driven model: but my higher powers were wrong, I was wrong, you get the idea. It was just *that* one, but I think that it's kind of an offshoot stigma we see a lot of. (I later would be in meetings a lot and find a lot of wonderful support, I'm just using this one example because it was a HUGE part of their inpatient protocol- but it was also the only one I could afford, as it was sliding scale.) I think maybe the whole "addiction as a disease" thing meant well- but, it's become it's own stigma in addition to the ones everyone's used to. I left the first rehab feeling much stronger, much more stable and able to confront a lot of things- I left the second feeling like some kind of sinful piece of crap doomed to hell ontop of having a "disease" I couldn't control and all sorts of questions about that. Much later on, ended up in another inpatient program which was...pretty much a dumping ground. They'd pull you in, pat you down, the whole 9- and there wasn't any help with w/d whatsoever, because you had to suffer so you could see how far you'd fallen, basically. Kind of cold, uncompassionate, and then you'd go see a therapist once a week, go to group each night. I honestly felt so weird in there I couldn't wait to get out and get back to it.
I should also mention that I have been in and out of various behavioral health facilities most of my life- and honestly, those not geared towards addiction aren't particularly helpful for many of the same reasons. I do often think about the exceptions- and I tend to think that maybe there are some people who are more motivated by that sort of thing, but my experience runs the gauntlet from that first one: which was about empowering kids who'd had it rough- to the last, which was just typical of what the author of the article is critiquing: and the differences are pretty staggering. I wound up bouncing around in the juvenile justice and foster care system after the first- and I think that had a big hand in why I relapsed. I can't imagine how differently things would have been had I had a stable place to land on top of that more stable foundation- but I also tend to think about how it might have been so much worse had I not experienced it. (And I try to avoid really thinking along those lines for the most part- because it doesn't help. Lol But I used to quite a bit.) As far as it goes, I know you'd asked to steer clear of the critiques of the 12 step programs- but, my experience with that particular inpatient program was colored a great deal by it and later, balanced with more positive experiences. Still- being taught and encouraged in the first rehab, vs. being told I had no control: yeah, it makes a BIG difference.
Jabberwocky
Frumious Bandersnatch
- Joined
- Nov 3, 1999
- Messages
- 84,998
Thank you for your post Nike
Using shame based (otherwise known as confrontation) behavioral conditioning (it is most apparent in the group dynamics and therapy of a lot of these places that employ it) is very common among abstinence only treatment providers. What is sad is that this approach ties the identity and sense an individual's self worth with conformity to group normals. But if they do anything (like relapsing) that goes against the grain of the behavior their group identifies as good - or thinks too outside the box in any way really - they become ostracized from the group and their sense of self worth takes a blow.
That critique is one of my biggest problems with confrontational techniques and the kind of in-group/out-group dynamic and the way it tied a positive sense of self to conformity with group normals. It's actually quite manipulative.
Using shame based (otherwise known as confrontation) behavioral conditioning (it is most apparent in the group dynamics and therapy of a lot of these places that employ it) is very common among abstinence only treatment providers. What is sad is that this approach ties the identity and sense an individual's self worth with conformity to group normals. But if they do anything (like relapsing) that goes against the grain of the behavior their group identifies as good - or thinks too outside the box in any way really - they become ostracized from the group and their sense of self worth takes a blow.
That critique is one of my biggest problems with confrontational techniques and the kind of in-group/out-group dynamic and the way it tied a positive sense of self to conformity with group normals. It's actually quite manipulative.
Experience: 6 years in and out of AA/NA rooms
7 trips to both short term(30 days or less) and long term(1 year) rehabs
Been through the 12 steps
Sober homes
Suboxone and Methadone therapy(legal drug dealing IMO)
DOC: Mainly IV Heroin but would take anything to give me a different state of mind as well as euphoria
About me: 25 years old
Born in Cleveland, Ohio
Raised in Columbus, Ohio and lived their until 24
Recently moved to Florida to get away from the Midwest opiate epidemic
So here is my two cents on this article/controversial topic. Everyone is different and there are programs that work for certain people. Keep in mind that many addicts and alcoholics are either forced into rehab by court systems or pressured to go because of family. Not everyone gives it their 100% effort. Personally I think that whatever works for you is what you should do. Don't feel pressured to follow the social stigma of doing what society thinks you should do. Everybody in this world is different and that is what makes each individual unique in their own way. I would suggest trying some programs to get a feel if it's something that would help you. I think we need new programs that stray away from the strict 12 step programs and typical rehab centers. I will say what worked best for me was social interaction and playing sports with others in these rehabs(volleyball, basketball etc.) Learn how to love yourself. Treat yourself the way you want to be treated. FOLLOW THROUGH WITH ALL THOSE DAYDREAMS OF BEING THE PERSON YOU WANT TO BE AND APPLY YOURSELF 100% JUST LIKE YOU WOULD IF IT WAS A DRUG. Think about today and today only. Last thing I am going to say is this...
There is nothing in this world that you can't accomplish and the biggest obstacle that is in your way is YOURSELF.
Love everyone Trust no one
7 trips to both short term(30 days or less) and long term(1 year) rehabs
Been through the 12 steps
Sober homes
Suboxone and Methadone therapy(legal drug dealing IMO)
DOC: Mainly IV Heroin but would take anything to give me a different state of mind as well as euphoria
About me: 25 years old
Born in Cleveland, Ohio
Raised in Columbus, Ohio and lived their until 24
Recently moved to Florida to get away from the Midwest opiate epidemic
So here is my two cents on this article/controversial topic. Everyone is different and there are programs that work for certain people. Keep in mind that many addicts and alcoholics are either forced into rehab by court systems or pressured to go because of family. Not everyone gives it their 100% effort. Personally I think that whatever works for you is what you should do. Don't feel pressured to follow the social stigma of doing what society thinks you should do. Everybody in this world is different and that is what makes each individual unique in their own way. I would suggest trying some programs to get a feel if it's something that would help you. I think we need new programs that stray away from the strict 12 step programs and typical rehab centers. I will say what worked best for me was social interaction and playing sports with others in these rehabs(volleyball, basketball etc.) Learn how to love yourself. Treat yourself the way you want to be treated. FOLLOW THROUGH WITH ALL THOSE DAYDREAMS OF BEING THE PERSON YOU WANT TO BE AND APPLY YOURSELF 100% JUST LIKE YOU WOULD IF IT WAS A DRUG. Think about today and today only. Last thing I am going to say is this...
There is nothing in this world that you can't accomplish and the biggest obstacle that is in your way is YOURSELF.
Love everyone Trust no one
I see alot of good points being made on all sides of this here....
I don't think anyone said rehab is completely pointless, I would guess because we can all at least agree that it can and does help some... the step work stuff too falls into the same category too, bottom line it works for some... I'm sure if there was a sure fire way to guarantee sucess for the rest of one's life then it would be being done (and alot of us would be there). So to pick on things about different recovery programs that at least actually try to help people is counter-productive in my opinion. Now I can agree and can see how discussing what could be added to a program, or what the best parts of a specific program are can help others to know what to look for and help evolve newer programs... Nothing will ever be 100% and the more options out there for the sick and suffering addicts of the world the better... I'm sure we can all agree on this.... that's the beauty of options (which we definitely cant have enough of) to pick what would work best for you.
I see alot of success rates being tossed around... but i wonder what, for this case when coming up with stats, actually makes a sucess story... is it never ever again picking up any drug for the rest of one's life? Because it's obvious why that would create low numbers... What about if a person was to start a program and then relapse for a day or a while, are they counted as a failure in the stats, if/when they start the next program do they now account for a totally new data point for the end statistical result, in that case one person could possibly be counted many many times... if this is the case then the low numbers for sucess rates are unavoidable ...no matter what program for recovery a person is following...
The bottom line that a person must actually want recovery and actively choose to take the path of recovery. There is only one person that can make that choice for you and that's you. If someone does not really want it then failure is inevitable and unavoidable.
I don't think anyone said rehab is completely pointless, I would guess because we can all at least agree that it can and does help some... the step work stuff too falls into the same category too, bottom line it works for some... I'm sure if there was a sure fire way to guarantee sucess for the rest of one's life then it would be being done (and alot of us would be there). So to pick on things about different recovery programs that at least actually try to help people is counter-productive in my opinion. Now I can agree and can see how discussing what could be added to a program, or what the best parts of a specific program are can help others to know what to look for and help evolve newer programs... Nothing will ever be 100% and the more options out there for the sick and suffering addicts of the world the better... I'm sure we can all agree on this.... that's the beauty of options (which we definitely cant have enough of) to pick what would work best for you.
I see alot of success rates being tossed around... but i wonder what, for this case when coming up with stats, actually makes a sucess story... is it never ever again picking up any drug for the rest of one's life? Because it's obvious why that would create low numbers... What about if a person was to start a program and then relapse for a day or a while, are they counted as a failure in the stats, if/when they start the next program do they now account for a totally new data point for the end statistical result, in that case one person could possibly be counted many many times... if this is the case then the low numbers for sucess rates are unavoidable ...no matter what program for recovery a person is following...
The bottom line that a person must actually want recovery and actively choose to take the path of recovery. There is only one person that can make that choice for you and that's you. If someone does not really want it then failure is inevitable and unavoidable.
simco
Bluelight Crew
- Joined
- Aug 20, 2014
- Messages
- 2,246
^^
Nice post, Wrongguy. I agree completely that the notions of success and failure are ill-defined in the recovery community.
I also agree that having many options on the table is a net win for people looking to leave addictions behind. To play devil's advocate, though, it's unfortunately the case that for many people, various recovery options are forced on them (by courts, jobs, even well-meaning family). To me, that's the real shame in our (i.e. The US's) current setup...too many addicted people are disempowered when they enter treatment.
Nice post, Wrongguy. I agree completely that the notions of success and failure are ill-defined in the recovery community.
I also agree that having many options on the table is a net win for people looking to leave addictions behind. To play devil's advocate, though, it's unfortunately the case that for many people, various recovery options are forced on them (by courts, jobs, even well-meaning family). To me, that's the real shame in our (i.e. The US's) current setup...too many addicted people are disempowered when they enter treatment.
herbavore
Bluelight Crew
- Joined
- Jul 26, 2011
- Messages
- 14,942
^Yes, the disempowerment, not to mention the abuse associated with the more hardcore ("bootcamp", synanon etc) approaches tend to make people that were forced into it very passionately opposed to say the least. My brother was ordered by the court to choose either a bootcamp style rehab or prison. He made the obvious choice and when I heard about the methods they used I was not only irate (that is not a choice) but terrified for him. But for a long time he credited the bootcamp approach to being the only thing that could penetrate years of self-denial and lying to himself (and everyone else) so thoroughly for so long that he didn't even have access to his own authentic voice. Still, I could not believe that taking a person with no self-esteem and tearing them down on purpose could be anything other than psychological torture. It has been many years now since that experience and he has come to a 180% opinion of those methods but he still maintains that his defenses were so impenetrable that it took something way out of the norms to catapult him off his trajectory. I guess what I am trying to say here is that sometimes life comes through the back door. Experiences that are less than desirable to downright horrendous can give us something in the end that no other experience could. I am not trying to advocate for a simplistic "what doesn't kill you makes you stronger" but just to add one more nuance into the discussion.