This page provides links to the home pages of a number of key peer support groups, e.g. AA, SMART Recovery. Learn why peer support is important.
‘Why the empty seats at the free public health lunch?’ by Dr. David McCartney
January 9, 2023
When I worked in the addiction field in the UK in the first decade of this millennium, I was surprised how few treatment practitioners encouraged their ‘clients’ to access Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and other mutual aid groups. This fact was all the more puzzling in that the treatment services that were having the most success in helping people overcome substance use problems always strongly encouraged the people who were seeking help to access mutual aid groups.
Here’s an excellent blog post on Recovery Review from one of my favourite bloggers, Dr David McCartney of Lothians and Edinburgh Abstinence Programme LEAP), about this issue:
‘A few years back in my first few months of working full time in addictions, I attended a seminar on mutual aid. Facilitated by an addiction psychiatrist, the meeting was packed with a variety of addiction treatment professionals.
The facilitator laid out the evidence base for mutual aid as it was at the time and discussed how assertively referring to mutual aid organisations could result in high take-up rates with benefits to patients. This was in the days when most groups were 12-step – SMART and other groups were still to be launched locally.
‘Peer recovery support: a bridge to hope and healing’ by Dr. David McCartney
November 29, 2022
I’ve just been reading another excellent post from Dr. David McCartney on the Recovery Review blog.
Good human relationships and social connections are potent protections against both physical and mental ill health. In an analysis [1] involving hundreds of thousands of people researchers looked to see to what extent social relationships influenced the risk of death. They found that those who had stronger relationships were 50% less likely to die early. Loneliness and social isolation have significant negative impacts. You want to live a long and healthy life? Get loads of friends.
In the same way, being connected to pro-recovery social networks improve outcomes in addiction treatment. For a variety of reasons, not least because of stigma, those suffering from substance use disorders are often relatively socially isolated. Guidelines consistently recommend connections to peer groups like mutual aid and LEROs [Lived Experience Recovery Organisations], though this has historically not been a priority for some services. For recovery from alcohol use disorders, being part of mutual aid has an impact at least as great as evidenced psychological therapies like cognitive behavioural therapy. [2]
‘It doesn’t work for everyone’—a take on 12-step approaches, by DJMac
April 18, 2022
Yesterday, I was going through old Recovery Stories blogs (from the period 2013/4) when I came across this gem. It’s a guest blog by a GP who gives a personal view on professional perspectives of mutual aid. No doubt, it is just as relevant today as it was then.
“‘Astonished’
I was astonished the first time I was taken to an NA meeting. I mean, really gobsmacked—you could have knocked me off my seat. The room was full of recovering heroin addicts; something I’d never seen in my 20 years (at that time) in practice.
I was both excited—at the possibilities—and ashamed at the fact that I didn’t know such places existed. It curls my toes to think of it now, but I had not referred my patients to them. That was a while back.
‘The Astonishing Power of Example’ by Peapod
November 2, 2021
Here is a post from one of my favourite bloggers on our online recovery community Wired In To Recovery, which dates back to April 2009.
‘Astonishment. That’s what I felt the first time I was taken to a mutual aid group meeting.
I was in treatment at the time in a residential centre. I was also neck deep in trouble. I had lost my job through my using. As part of the fallout from my own million megaton addiction detonation, I’d caused someone else to lose their job. The police were on my tail and I was massively in debt.
I didn’t particularly want to be in treatment, but I’d run out of alternatives. As the detox began to bite (and my god, the teeth were sharp), the permanent fog in my head began to clear. This was not a good thing.
Learning From Wired In To Recovery
July 12, 2021
As part of our Wired In strategy, my colleagues and I launched the Wired In To Recovery online community in November 2008. Our initial aims with Wired In To Recovery were to:
- Highlight role models who show that recovery from addiction is possible, and illustrate the multitude of paths to recovery.
- Provide information and tools that help people better understand and use the options they have to overcome the problems caused by their own, or a loved one’s, substance use.
- Create an environment in which people can inspire and learn from each other and provide mutually beneficial support.
- Establish a ‘people’s journalism’, or Voice of Recovery, which acts as a strong source of advocacy both for recovery and the Recovery Movement.
- Identify key individuals who would join, or collaborate with, Wired In to help us realise our ambitions.
The Recovery Scholarship of Ernie Kurtz
January 16, 2015
Here’s some great reading for you, from one great scholar and storyteller about another. Bill White starts the New Year with this excellent posting on his blog. Enjoy!
‘One of the distinctive voices within the modern history of addiction recovery is that of Harvard-trained historian Ernie Kurtz.
Spanning the 1979 publication of his classic Not-God: A History of Alcoholics Anonymous to the just-released Experiencing Spirituality (with Katherine Ketcham), Kurtz has forged a deep imprint in studies of the history of A.A. and other recovery mutual aid groups, the varieties of recovery experience, the role of spirituality in addiction recovery, and the personal and clinical management of shame and guilt.
‘“It doesn’t work for everyone” – a take on 12-step approaches’ by DJMac
November 26, 2014
Excellent blog from the DJMac website. Good discussion as well.
‘What follows is a guest blog by a GP who gives a personal view on professional perspectives of mutual aid:
“Astonished”
I was astonished the first time I was taken to an NA meeting. I mean, really gobsmacked – you could have knocked me off my seat. The room was full of recovering heroin addicts; something I’d never seen in my 20 years (at that time) in practice.
I was both excited – at the possibilities – and ashamed – at the fact that I didn’t know such places existed. It curls my toes to think of it now, but I had not referred my patients to them. That was a while back.
‘Experiencing Recovery – Part 8′ by William L. White: History of Recovery Support
July 14, 2014
Bill introduces about the various types of recovery support that have existed historically: natural support, limited generalist support within the community, peer recovery (mutual aid) and treatment. He then goes on to describe how things have been changing in recent years.
‘Experiencing Recovery – Part 4′ by William L. White: Frameworks of Recovery
July 8, 2014
In this part of his talk, Bill White discusses the degrees/depths of recovery. He describes how some better people feel ‘better than well’ after recovery.
He goes on to describe different types of recovery initiation/maintenance framework and different styles of recovery.
‘Experiencing Recovery – Part 2′ by William L. White: The Rise of Modern Addiction Treatment
July 6, 2014
I continue Bill White’s talk that he gave at the Harvard Addiction Conference in 2012, the Norman E. Zinberg Memorial Lecture. An amazing history of recovery and treatment for alcohol and drug addiction.
‘Experiencing Recovery – Part 1’ by William L. White: Early History of Recovery in the US
July 5, 2014
Last week, I highlighted the fact that a new edition of Bill White’s classic book Slaying the Dragon: The History of Addiction Treatment and Recovery in America has just rolled off the presses. I can tell you that this is one of the best (and most fascinating) books that you will ever read.
To celebrate the ‘rolling of the presses’ and Bill’s remarkable career in the recovery field, I am going to show a talk Bill gave at the Harvard Addiction Conference in 2012, the Norman E. Zinberg Memorial Lecture. I will show one part a day for the next 10 days, taken from Bill’s excellent website.
In the first part, Bill describes shows just how far back recovery goes historically in the US – to Native American Indians in the 1730s!
The Road from Crime – Extended Preview
March 10, 2014
Excellent preview, I’m heading to watch the full film.
‘What can we learn from those former prisoners who have successfully “desisted” from criminal behaviour or “gone straight?”
The exit at the prison gate often appears to be a revolving door with nearly 60 per cent of released prisoners re-offending within two years of their release. Prisons and probation departments have, almost literally, tried everything in efforts to rehabilitate offenders over the past century, but the results have been uniformly bleak leading many to conclude that “nothing works.”
What Works in Treatment?: Tim’s Story
October 30, 2013
Here are Tim’s experiences of treatment. Well, actually two different forms of treatment, one which did not help and the other that helped Tim overcome his addiction to alcohol and opiates. Tim is a doctor and his Story is packed full of insights. Here, I’ll start with his moment of clarity.
‘The epiphany which did eventually provoke some help-seeking was relatively simple. I came down to the kitchen one morning feeling wretched and defeated. I opened the cupboard and reached up. With one hand I brought down the cornflakes and with the other the whisky bottle.
I flexed my elbows to bring the two closer to me and weighing them up in my hands I thought, “There’s something not right about this… there’s something very wrong with this picture.” The bit of me that wanted to drink finally began to yield to the bit that didn’t. Shortly after, I went so see my GP.
‘Narcotics Anonymous Comes of Age’ by Bill White
October 8, 2013
Bill White has recently written a blog and co-authored an article on the 60th Anniversary of NA.
‘Narcotics Anonymous (NA) is too often relegated to the status of stepchild of Alcoholics Anonymous (AA). NA’s unique history, culture, and distinctiveness are routinely obscured within references to “AA and other Twelve Step programs.”
For the past several years, Chris Budnick, Boyd Pickard and I have been conducting research on the history of NA, and we recently authored an article commemorating the 60th anniversary of NA’s founding. In this article we identified and discussed 12 things we believed every addiction professional should know about NA.
Serenity Recovery Fringe Festival
August 18, 2013
In an earlier blog, I highlighted an article by Bill White on Recovery Carriers.
Recovery Carriers are people, usually in recovery, who make recovery infectious to those around them by their openness about their recovery experiences, their quality of life and character, and the compassion for and service to people still suffering from alcohol and other drug problems.
I know two special Recovery Carriers in Edinburgh – and there are many more – David McCartney and John Arthur. Here’s John’s latest blog:
‘Keeping the monkey off your back: top five tools to sustain recovery’ by Peapod
July 24, 2013
“Just because you got the monkey off your back, doesn’t mean the circus has left town” George Carlin, comedian and author.
Getting sober and drug-free is hard enough for most of us, but staying that way is a challenge. The evidence is that many people coming out of abstinence-oriented treatment will relapse in the first year and most of them in the first few weeks. Recovery initiation, the start of the journey, is just that: a beginning. In the past, we’ve treated it like the main event and had little thought for what happens next.
The circus may not have left town, but there are ways to avoid ending up in a ringside seat and having that pesky monkey trouble you again. These things are the tools of recovery. There are plenty of them and we need to find the ones that work for us. Some however are more reliable than others according to the evidence we have. Here are my own top five tools:
‘Recovery: what matters?’ by David McCartney
June 27, 2013
Here’s an interesting Wired In To Recovery blog from David McCartney from September 2013 about the importance of social relationships.
‘If you wanted to live a long and healthy life, what measures could you take to achieve your goals? Stop smoking? Lose weight? Exercise? Drop your blood pressure? We have evidence that all of these make a difference, but a recent analysis of 148 studies on the subject found two things that made more of a difference to mortality than anything else. What were they?
Well, having strong social relationships and being integrated socially seem to protect against death. This analysis was not specifically about addiction, but suffering from addiction is strongly associated with increased death rates and it seems very likely that if we could promote strong social links in those seeking help it will reduce the risk of relapse and ultimately of early death.
‘Detoxification: the ‘nuts and the bolts’ by Peapod
June 17, 2013
“Expect the first few weeks to be rocky emotionally. Life can feel a bit ‘greyed out’ for a while and youʼll need to adopt a longer-term view. Getting to as many recovery meetings as you can manage during this period will help.”
Okay, youʼve got to the point where you are looking to detox but youʼre not sure what the nuts and bolts of it are. How do you go about it and how do you know you are ready? What can you do to boost success?
Here are my suggestions, which are based on guidance and my own experience of working with hundreds of people going through detox.
First things first: “detox plus”
The first thing to say is that any detox which is not connected to other things will almost certainly fail. You might get through the detox (or “stopped”) but remaining drug free (“staying stopped”) is very, very unlikely without other things added in. Not to mention that itʼs potentially dangerous too. Donʼt set yourself up to fail.
Itʼs best to see detox as a tiny part of the recovery process. Important, no doubt about it, but in the grand scheme of things not a giant cog in the machinery. Recovery is a longer-term process.
What is the “plus” part of “detox plus”: what needs to be added in?
1. Ask: am I ready? You will probably have a feel for this because youʼve been working towards this goal for a while and others have been supporting you. If youʼre using regularly on top of your script or have major stressful life events going on, you may want to wait a bit, or get referred for consideration of residential options where the support is highest.
2. Weigh up the pros and the cons. Everything involves some sort of risk. Talk to others whoʼve done it successfully. Make an informed choice.
3. My next suggestion is to get referred to an intensive community or residential rehabilitation programme. Some will offer detox as part of treatment. Your prescriber or support worker will be able to advise. Try to get onto a programme that is at least three months long and that prioritises connecting up their clients to peer-led recovery communities.
4. Get involved with local recovery community activities in any case. The most important of these is mutual aid. Groups like Narcotics Anonymous, Cocaine Anonymous (you donʼt need to have a problem with coke) and SMART recovery offer peer-based support.
The evidence suggests that engaging with these groups reduces relapse rates and adds much to quality of life too. You donʼt need to be drug-free to attend.
5. If youʼre not going to sign up to intensive treatment, then get started with meaningful activities daily. Find an educational course or volunteering opportunity and get stuck in. Structure your days and donʼt spend time in bed or stuck to the TV or computer screen.
6. Stay away from using friends and places you associate with scoring and using. These are powerful triggers to use when you are feeling vulnerable.
Detox basics
1. Donʼt do your own detox. Shutting yourself in a room with DFs and Valium might seem like a sensible idea, but it is not known for its success rates. Achieving your goals is much more likely if you have an expert in detoxification supporting you as you do it. Cold turkey is being unkind to yourself and has low success rates.
At the same time, this is your detox, so youʼll want to know you have some say in how it looks. It shouldnʼt be something that is done to you, but something you do with the support of the prescriber. Alcohol, GHB/GBL and Benzodiazepine detoxes are particularly dangerous if not medically supervised.
2. If you are coming off opiates, discuss whether you want to use methadone or Suboxone to detox. In some areas you might also have the option of lofexidine (Britlofex) too. Occasionally some doctors offer a dihydrocodeine (DF118) detox. Iʼm going to write a separate article on choosing between a methadone detox and a Suboxone detox.
3. Get as much support around you as you can. If you are in a structured day programme, residential treatment or a therapeutic community, the support ought to be built in.
If youʼve chosen to try this without that sort of intensive input, then tell your mutual aid group members what youʼre planning, get your prescriberʼs support and that of family members (non-drug using). Do some relapse prevention work and donʼt rely only on yourself. I canʼt stress this enough; most of us need help to do this.
4. If you are struggling, admit it. There are various medications that can be added in to help with any unpleasant symptoms like pain, insomnia, nausea, diarrhoea, cramps etc. Emotional support from positive people will boost your chances of success. If you know people whoʼve been through detox successfully, find out how they did it and get their help.
5. Expect the first few weeks to be rocky emotionally. Life can feel a bit “greyed out” for a while and youʼll need to adopt a longer-term view. Getting to as many recovery meetings as you can manage during this period will help.
6. Guard against relapse and if you do go back to using, remember loss of tolerance and the increased risk of overdose. Donʼt use as much, donʼt use alone, donʼt inject and donʼt mix heroin with other drugs (particularly alcohol or valium).
7. Remember a lapse is not the end of recovery. Itʼs common and not a cause for shame or giving up. Most of us need more than one go. Going back onto maintenance for a while is a viable option, as is getting referred to a more intensive treatment setting.
