After yesterday’s post, we need a little hope and a reminder that people with opioid addiction can achieve full recovery.
Some local people in recovery from opioid addiction were growing frustrated with media representations of opioid addiction that suggest full abstinence-based recovery is not a realistic goal.
They decided to start The Unicorn Project and I’ve helped them with a website.
Media reports and comments from “experts” give the impression that opioid addiction (heroin, vicodin, etc.) is a near hopeless condition and that the only hope is maintenance on other opioids (buprenorphine and methadone).
Some of these reports acknowledge that there are people who achieve drug-free recovery, but imply that they are extremely rare. It almost sounds like everyone’s heard of them, but no one’s seen one–like unicorns.
We know this isn’t true.
We want people to know that opioid addicts can achieve full recovery without opioid maintenance drugs. And, it’s not rare or unusual when people get the right kind of help.
We’re not here to argue that medications like buprenorphine and methadone are bad, or that our path to recovery or one form of treatment is better than another.
We just want people to know that drug-free recovery is a legitimate path to recovery, that many people already succeed with this path, and that more people could also succeed on this path—if they are offered the right kind of help.
Our evidence is us. We’re all in long-term recovery from opioid addiction.
All of us have been in full recovery for more than 5 years.
This is just a start. The current postings represent just a small fraction of the recovering opioid addicts in a single community. They have several more unicorns working on their stories.
Addiction & Recovery News 
A few of my friends are in long term recovery from heroin addiction using NA or AA and of course they went though treatment –
1 person with 31 years.
5 people with over 25 years
2 – people with over 20 years
5 – people with over 15 years.
I appreciate your anecdotal information and hope that they are, in fact, in recovery. One of the problems that we encountered when trying to study outcomes, was that people are often ashamed and will not tell the truth. I have many good friends who are in recovery from opiate dependence, however, their employers (or employees) don’t know that that recovery, also, includes their daily dose of buprenorphine. Your numbers may be, completely, accurate however, there was a reason why the Hazelden/Betty Ford took the extremely unpopular stance of embracing buprenorphine maintenance. According to my discussions with them, they could no longer ignore the EVIDENCE that medication assisted treatment helped a greater number of people into recovery and abstinence.
I have directed treatment programs since 1983, and throughout those years, monitored outcomes, only to find that our opiate dependent patients, treated with abstinence only methodology, had a recovery rate of around 5%. Do some people get clean, absolutely. However, how many die, are incarcerated or live a life of addiction as they disappear from our memories. I can remember so many of my friends who overdosed and only their families think of them each day.
This debate is not good against evil, it is a matter of numbers and study after study has indicated that buprenorphine maintenance (often followed by a gradual titration, enhances outcomes and saves lives.
Synanon, used to advertise 100% recovery for the people who completed their treatment. What they didn’t mention, was that their, year long program, only had a very tiny percentage of patients that graduated from the physical and psychological abuse, that they endured, while enrolled. What happened to that vast majority that left, and thus, were never counted in their absurd figures.
Why do we need to be so “either/or”. Is it possible, that patient centered treatment accounts for the strengths and weaknesses of the differences in each of us and we are all trying so hard, just to be content and complete. I hope that your colleagues have found the magic of recovery, but if a few were on buprenorphine, but still continued to attend meetings, treat their fellow man with love, dignity and humility, would they be “dirty” as those in NA tend to refer to anyone using a legitimate medication to save their lives?
I know you’ve spent enough time on this blog to know that I read the studies you refer to. I don’t find them persuasive and explain why with quotes and links to the actual studies.
There were several posts on the subject in November and here’s another post that covers the issue.
It doesn’t have to be either/or. I’ve repeatedly told you that I just want good informed consent and access to the treatment of their choice.
However, one important piece of evidence (or lack thereof) is about MAT + counseling. Despite it being frequently repeated that MAT should be accompanied by behavioral supports, the evidence isn’t there. Researchers who conducted a meta-analysis (not cherry-picking) reported that the evidence to support MAT + counseling was “sparse.”
Jason, I respect your blog and appreciate your position. I agree, medication without quality treatment yields little and abstinence only treatment (without the options of MAT), diminishes individualized care and, thus, does not enhance successful outcomes. Recovery is, and will be until the day I die, the foundation that allows me to live a life more complete than i ever imagined.
The numbers of people dying, upon discharge from inpatient abstinence only treatment is, relatively, easily quantifiable and the rate of overdose and death anything but sparse. Thanks for keeping the dialogue in front of the public. Perhaps, a column that addresses the real danger of treatment like call center salespeople, patient brokering, fraud via drug testing or out of network billing and that infamous oxymoron non-medical detox, may be sources for conversation. Our field has become flooded with sober living housemanagers and van drivers, who have, suddenly, become the CEO’s of their very own treatment program. Often fed by internet marketers, who pick desperate patients off the web and place them in the program that bids the most. Insurance and law enforcement are beginning to respond but there are so many scam programs, that they are unable to respond adequately.
There are many ways to Recovery and every individual’s brain is wired differently – maybe due to their genetics and/or maybe due to the drugs they have abused. However, we must provide hope to “All” addicts and offer many avenues that just may provide that road to recovery for them. Specifically. I do believe that in the long term: Abstinence, The 12 Steps, a strong spiritual life, helping others to stay clean and sober, and physical exercise with a commitment to health will also assist in maintaining recovery. I would never “judge” anyone’s attempts to get clean and sober if they have the desire to do so. Every road begins with the first step…
I am a mother with a son in recovery and I am also in a Family Recovery Group and have learned that “one-size” does not fit all!
Well said J.
So…abstinence with 12 steps equals “full” recovery and everything else is substandard? And those FEW who achieve it are special unicorns? How wonderful for you! Buy a black suit because all the ordinary people are dying.
Did you actually read the website before firing this off?
There’s this:
And this:
And this:
It’s said all of that since day one.
And, you’re making their point. Their point is that they are not “few” and they not out of the “ordinary.”
Further, the site says nothing about defining being “unicorns” as being in 12 step recovery.