There is one sentence in the Standards that deserves particular acknowledgement: “Recovery check-ups by addiction specialist physicians, just as those by primary care physicians or other providers, may promote sustained recovery and prevent relapse” (p. 13).
. . . The “recovery check-up” language marks an important milestone in the history of addiction medicine and the history of ASAM. Projects are underway in Philadelphia, Pennsylvania and Ann Arbor, Michigan [That’s us at Dawn Farm!] to develop recovery checkup protocol for primary care physicians. Those projects mark the next step in integrating addiction treatment and primary medicine and the next step in extending acute care models of addiction treatment to models of sustained recovery management.
Imagine a day when everyone entering recovery will have an addiction-trained primary care physician and an addiction medicine specialist as sustained resources through the long-term recovery process.
What we’re imagining is a complete cure. This is not a method for, let’s say, alcoholics not to drink, but an actual cure that would take away the illness and allow people with addiction to use just like normal people. This is because the imagined cure takes away the symptoms and the special response. They feel like normal people, and they’d have a normal person’s reaction to, say, a couple of drinks. It wouldn’t do for them what it does for the person with addiction. I’m not saying such a thing exists or that stem cells would or even could provide such a cure, but it’s my thought experiment so I get to make up anything I want.
So what would the mainstream Addiction Medicine doctor think of this? Well, to be honest, their first response would probably be fear for their job or resentment that neurosurgeons would get all their business, but after they got over that they’d realize that their greatest wish had come true; addiction would be gone. I think they’d be deliriously happy… as soon as they found another job.
But what about some of the members of the group I joined? Would they be happy? I doubt it. When discussing addiction treatment with them I heard such things as the necessity of suffering, the primacy of the spiritual experience, the necessity for gratitude for the illness as a way to a better relationship with God. I heard some of these doctors say that medication for addiction was counter to the point of recovery, because the patient would then be robbed of the opportunity to turn their pain into spiritual growth.
There’s a lot of truth in what he says. And, I respect his position that the meds we have are ineffective and very oversold. His thought experiment also does a good job of exposing the models of addiction (moral, medical, etc.) these people operate from.
A recent study reported that men and women benefit from AA in different ways:
For both men and women, participation in AA increased confidence in the ability to cope with high-risk drinking situations and increased the number of social contacts who supported recovery efforts. But the effect of both of those changes on the ability to abstain from drinking was about twice as strong for men as for women. In contrast, women benefitted much more than men from improved confidence in their ability to abstain during times when they were sad or depressed. “It is striking that this effect was virtually absent in men while it was a major contributor to women’s ability to remain abstinent and to limit the number of drinks they consumed when they did drink,” says Hoeppner. Several factors that helped to reduce the intensity of drinking in men – such as less depression and fewer friends who encouraged drinking – did not appear to be as important for helping women.
Kelly says,”AA helps both men and women stay sober following treatment by enhancing sober social networks and boosting confidence in coping with high-risk social situations. In terms ofalcoholism recovery more generally, we found the ability to handle negative moods and emotions was important for women but not for men. Conversely, coping with high-risk social situations – which could be attending sports or other events where people are likely to drink – was important for men but not women. These differences suggests that, for women, finding alternative ways to cope with negative emotions may yield recovery benefits, while among men, a greater focus on coping with social occasions that feature drinking may enhance recovery.