I want to make this clear and get it out of the way immediately: I am 100% abstinent. I have been 100% abstinent since 1992. I, as an individual in long-term recovery, am more than convinced that I cannot, under any circumstances, consume any psychoactive substance. Doesn’t matter if it is marijuana, alcohol, psychedelics, tranquilizers, stimulants, etc. I can safely take nothing. Nada.
I am also rather hard core regarding this. I mean, certain over-the-counter medications make me feel as if my mind/mood is been altered. I do not take them, ever. In extreme cases, I have taken a steroid as prescribed by a physician for a specific infection, but other than that, if it messes with my perception of reality it is out of limits. The one and only exception to that is caffeine. But I am not fooling myself, I am well aware that I have tolerance towards it and I’m susceptible to withdrawal. And the fact that the DSM_5 does not yet categorize caffeine abuse disorder, doesn’t give me a free pass. It’s the closest thing to a substance of abuse that I use.
So for me, it’s been a total devotion to 100% abstinence.
In my professional life, I am 180° the opposite. I don’t know, maybe it’s seeing dozens if not hundreds of people emotionally abused and shamed going to 12-step meetings. Maybe it’s being at 12 step meetings, and witnessing firsthand the public shaming that can occur if one speaks outside of “twelve-step cannon.” Maybe it’s the cult-like adherence to vague, nebulous principles. It could be the reliance on completely unstudied, unverified, and untested steps (for the record, I have yet to see a meaningful clinical study regarding the efficacy of the actual steps. Everything I have seen is about the social support and twelve-step attendance. If you know one, leave me a link below.)
But I’m being catty:
It’s actually because of the hundreds, if not thousands, of patients I have worked with, directly or indirectly, who have found stability and improved their quality of life by engaging in harm reduction. And yes, I have seen numerous people achieve 100% abstinence, after allowing the Stages of Change to work in their lives and make an internal decision to leave psychoactive substances behind. It happens. A lot. But it’s not a requirement for respect.
So it was with great interest that I’ve seen YouTube videos and social media posts regarding “California sober”, as presented by popstar Demi Lovato. And I gotta tell you, I am completely in awe of her courage to speak out about her struggles with opioid addiction, and her conscious decision to use less harmful substances while she figures out who she is and what she wants out of this life. I have also enjoyed, somewhat gleefully, the predictable reaction of the “recovery cult” and paraprofessionals posing as experts and interventionists.
The thing is, and I’ve seen this mentioned a few times, California sober is not a new concept. Back in my early, fanatical phase of recovery, I remember one person in particular. Let’s call her A. She was a person with nearly 20 years in sobriety. She attended multiple Alcoholics Anonymous meetings in the area, and even belonged to a “private” group that held meetings in a person’s house and was basically run by an AA Guru. I remember being shocked and dismayed when she explained to me that she still smoked weed, and considered it an “outside issue”, separate from the intent of the Big Book and Fellowship of Alcoholics Anonymous. I am shamed to admit, I don’t think I ever spoke with her again. I did everything I could to avoid her, and I’m sure that on more than one occasion I gossiped about her and her shocking habit of substituting marijuana for alcohol, considering herself sober.
Come to find out, she was far from the only one. Back then, in Northern California, ironically, it was referred to as “marijuana maintenance.” And as soon as I found out someone was on marijuana maintenance, I excised them from my life. No longer part of my support group, no longer on my phone list, no longer safe to interact with. Now, I get it. Back then, that was the choice I had to make considering where I was at the time. I could not afford to slip into marijuana use, which I still believe caused far more psychological and emotional harm than any other substance that I used.
Unfortunately, I was not alone in my fanaticism, and over the years I’ve encountered similar intolerance. And I’m not talking just one isolated area. My meeting experience includes California, Washington state, North Carolina, Virginia, Ohio, Idaho, Montana, and back to California. Anything that looks remotely like harm reduction is essentially banned. In fact, according to Narcotics Anonymous, anyone on agonist therapy like methadone or buprenorphine isn’t supposed to even speak at meetings, should not be getting keychains, cannot hold service positions, and certainly can’t sponsor people. They are welcome to attend, as long as they are seen and not heard.
From my perspective, that is one of the most toxic elements recovery culture: an absolute intolerance towards anything other than complete abstinence and adherence to the steps and traditions (even though they are only a suggested program of recovery, wink wink.)
So, I don’t know. This might be a one-off rant. Or, I might actually focus myself and start presenting information in this blog, from sources such as the ASAM Principles of Addiction medicine, and even the DSM-5, that call into question the very concept of complete abstinence, and actually identified a concept called “non-abstinent remission.”
In the meantime, anyone practicing a program of California sobriety has my support. Whatever it takes to keep you alive, and keeps your future more hopeful. Anytime a human being can move from certain death behavior to something that is at least moderately less harmful, I wholeheartedly support that person. If for no other reason that it gets them one more day without an overdose, critical health issue, or the dreaded jails, institutions, and death. Because that one more day may give him/her/they time to make even more positive change. But on their own terms, which are the only terms that matter.
For anyone actively engaged in 12-Step recovery, please feel free to ignore what I’m writing. YOUR decision and dedication is the only thing that’s important, and my perspective might screw with you. Don’t let me (or anyone) discourage your program. I only ask that you try not to shame those who take a different path…
For those on the fence, wanting recovery but not wanting the mind-washing that can occur, reach out for help from doctors, psychiatrists, psychologists, social workers, counselors, ministers or opioid treatment facilities. Don’t give up! Recovery is a big tent, and it’s getting bigger.
For my fellow professionals who are speaking out against California sobriety: shame on you. Stop practicing voodoo, do some actual professional research, and learn to be an advocate for your patients who honors the ethical principles of autonomy, beneficence, non-maleficence, justice, fidelity and integrity.
And finally, for Demi Lovato: thank-you for your honesty and courage. Yeah, some dolt went on TV and said you’re “almost criminal.” Ignore him. You might save many, many lives and inform people that they have choices. Thank-you for that!
