Do You Have To Be in Recovery to Help Someone with Addiction? (and other myths)

Do you have to be in recovery to help someone with a drug problem?

No.

That is the unequivocal answer, but I am happy to make my case with another 958 words. There are a few other foolish assertions that should be addressed as well. Over the years, I have heard the following statements out of numerous AA members, paraprofessionals, and licensed therapists:

  • Only you can decide if you are an alcoholic
  • No one shows up to an AA meeting by accident
  • Only an addict can help another addict
  • If you haven’t lived it, you don’t know it
  • People in recovery are better at working with substance abusers and others in recovery

Let’s address these one at a time.

  • Only you can decide if you are an alcoholic

This is a ridiculous assertion. We do not allow individuals to diagnose their own depression, anxiety, diabetes, cancer, HIV, or heart disease. One of the most common defense mechanisms that people with alcohol and/or other substance misuse disorders use is denial. A common form of denial is blaming others (I had a rough childhood, my girlfriend is mean, marijuana should be legalized, the cops were out to get me, school/work cause me a lot of stress). Another major form of denial is minimizing: they will say I’ve never been arrested. If they’ve been arrested, they’ll say I’ve never been to jail. And so on with prison. We can play this game with alcohol, then pills, then heroin, then needles and then sticking needles in the neck. Waiting for a person to admit they have a substance abuse problem is a poor plan, whether you are a family member, friend, member of AA, or professional counselor. Licensed medical professionals are trained in assessing and diagnosing. Some are clearly better at it than others, but they can do an excellent job at getting past denial.

  • No one shows up to an AA meeting by accident

I showed up to a Gambler’s Anonymous meeting by accident once. The GA members welcomed me, asked me 20 questions in the middle of the meeting and then eventually said, a bit disappointedly, “you don’t have a gambling problem.” Over the last 10 years, I have sent hundreds of nursing, pharmacy, communication, social work, and law students to open 12-step meetings to learn more about addiction, recovery and the power of communities. Courts have forced people to attend meetings who made a mistake or committed a crime, but don’t meet diagnostic criteria. There are dozens of young people I’ve met whose parents forced them to attend meetings because they caught their son or daughter smoking pot or were outraged that they came home drunk. People show up to meetings by accident, and they are sometimes sent to one when they don’t have a problem.

  • Only an addict can help another addict

I got clean and sober at 19 (I’m 40 now). When I went to treatment, every counselor and paraprofessional there was in recovery themselves. They talked about their own experiences a lot. Because of their openness, I felt both less alone and less like an outcast. I thought everyone that worked in the field should be in recovery. I had a psychologist who was not in recovery. He helped me with improving relations with family members, discuss college life, navigate job conflicts, point out my faults in romantic relationships and generally become a better version of myself (and better person). After graduating from Rutgers, I took a job in a long term treatment program. Every counselor and paraprofessional was in recovery. Many didn’t attend 12-step meetings outside of work, most had a lot of countertransference issues and there were several with real boundary problems. I remember thinking, “man…people in recovery really shouldn’t be in this field.” I left that job for an outpatient program where less than half of the clinicians were in recovery – I found there were some really good therapists in recovery, really good ones not in recovery, not so good ones in recovery, and not so good ones not in recovery. I am going to belabor my point. We don’t ask suicidal people (or formerly suicidal people) to work with those with current suicidal ideations. Most cardiologists are not in remission from heart disease.

  • If you haven’t lived it, you don’t know it

I figure I’ve used over 2,000 toilets around America and in 21 other countries on four different continents. I can’t fix toilets for @#$%. This is the kind of folk wisdom that you might hear in a 12-step meeting sometime, but I turn it on its head by claiming ignorance in the face of experience rather than expertise from experience. Experience with a problem can be helpful in dealing with an issue or treating someone else, but it isn’t a requirement. I have never had depression, been bullied because I was gay, gotten cancer, overdosed on opiates or lost a child, but I’ve helped people with those problems over the years. And I’ve been very effective at it. I find that people that claim an expertise because of their own recovery most likely don’t have other knowledge, education, training, or skills that they can utilize to help people.

  • People in recovery are better at working with substance abusers and others in recovery

I used to believe in this. Then I worked at that aforementioned program where everyone was in recovery and many of them were terrible at their job. If someone is in recovery, they might be able to use their personal narrative to connect with someone. But there are people who are not in recovery who have stories that can also connect with others and help get them to open up and consider making behavioral changes. I’ve known a number of great clinicians who are not in recovery, and the statement that people in recovery are better than them is not only offensive, it is false.

 

*I wrote this for Hazelden back in October of 2016. It was recently taken down from their website, so I have republished it here.

A Veterans Day Story

My close friend and colleague Eric Arauz died in March. I wrote about him everyday for one month. Others followed suit. I took a bunch of the stories and made them into a book, which was published last month. Eric served in the Navy during Gulf War I, back in the 1990’s. He described himself as “a poor sailor but a great veteran.” He loved talking to other veterans and he was an excellent advocate for them, especially those with mental health and/or addiction issues.

Near the end of October, I traveled to the Psych Congress annual conference in Orlando. I was invited by the organizers to come down and talk about Eric. They honored him by naming the kickoff keynote after him and also creating an award in his name. Very cool. I read a few sections from the book. Before I closed with my chapter on Eric at Elizabeth High School, I mentioned how I really would have liked to tell him the story about an Army veteran that I met a week earlier in Philadelphia.

Independence Blue Cross of Pennsylvania put on an all day event about the Opioid Epidemic at the Kimmel Center in Philadelphia. There were four panel discussions and a keynote speaker. I was impressed with the event, and every panel had at least one truly impressive person. The keynote took place just after lunch. The speaker was retired U.S. Army Master Sergeant (MSG) Justin Minyard.

MSG Minyard is a big guy (over 6’5″). He wore a suit, no tie (I approved). His hair was short but he had grown a beard. MSG Minyard began his talk with an apology. “I had a traumatic brain injury,” he said, “and there are times that I can’t get my mouth to say what I am thinking. As frustrating it is for you to watch me pause and stumble, it is even more frustrating for me. Please bear with me.” It was a powerful introduction, and my heart went out to him. I think that most of the audience had a similar reaction.

MSG Minyard was stationed near Washington, DC in the late 90’s and early 00’s. He was on details for both President Clinton and President Bush II, and he also had the honorable task of guarding the Tomb of the Unknown Soldier. Within a couple of hours of the attack on the Pentagon on 9/11, MSG Minyard and his unit were at the site trying to rescue people trapped under the rubble. “I was trying to reach a woman who was trapped under three floors of debris and while trying to reach her a load bearing wall collapsed on me and I had spinal damage and had to have several discs removed.” He was 21 years old.

MSG Minyard was a good soldier but a terrible patient. He cut his physical therapy time by more than half and demanded to be returned to the field. He served multiple tours in Iraq and Afghanistan (at least five) and was injured on several occasions. He told a story about how he and a half dozen other special forces operatives were tasked with attacking a bunker in a city. The helicopter was 60 feet above the target. Just as MSG Minyard jumped out of the chopper and went to grab the rope to repel down, they took incoming fire and the helicopter swerved. MSG Minyard was not able to grab the rope and he fell the entire 60 feet. To compound matters, the soldiers that came after him (down the rope) landed on him, exacerbating his back injury.

To deal with the pain and trauma, he was prescribed Oxycodone and Valium. During his speech, MSG Minyard filled a glass with his daily drug cocktail. Then he filled up a glass vase with his monthly dosage. It was a powerful effect and the audience gasped. He lived this way for almost three years. It devastated his wife and his daughter.

“It got to the point that when my four year old daughter asked me to read her a bed time story, I would respond to her with the worst words possible at the highest volume, just inches from her face. Because if I read to her, that was 15 minutes that I could not spare because the CVS would close and I would not be able to get my medication and I’d go into a horrible withdrawal.”

Silence. And then, “I did that. I’m responsible for that. I can never undo what I put my ex-wife and daughter through.”

He talked to therapists and doctors. More than two and half years into his prescribed addiction, someone talked to him about alternative ways to deal with pain. “Why am I just hearing about this now?” he asked.

More silence. And then, “Think about this. I’m just a big dumb Army guy, but I did guard two Presidents and the Tomb of the Unknown Soldier. I was deployed multiple times and worked on highly important missions. I had access to care and support. If this can happen to me, it can happen to anyone around America.”

MSG Minyard was given spinal cord stimulation and got off his pills. The recovery process was difficult. He has been clean and sober for about eight years and now works for Boston Scientific (the company that developed the spinal cord stimulation technology). He said that he still has pain, but it is mostly manageable. He finished by talking about his 11 year old daughter and how she still wants to hang out with him (“at least for another year and a half”). He takes her to “an expensive park in Orlando” and they walk around all day and evening. The all day walking causes him pain, but he does it for his daughter.

He earned a standing ovation, even from me (I rarely do that). I left my seat and forced my way backstage, past staffers and security. MSG Minyard was drinking water and was guarded by two off-duty Philadelphia police officers. I went up to him and introduced myself. We shook hands. I told him what I do and I thanked him for his talk.

And then I asked him if he wore cufflinks. He said yes.

“Do you have a pair of Army cufflinks?” I asked him.

“No.”

I started to take mine off. He saw what I was doing and said, “Sir, I can’t possibly take those.”

“Sergeant, you’ve earned them. Wear them with gratitude and pride.”

One of the cops turned towards MSG Minyard and said, “You have to take them. He outranks you.” Then the cop turned to me and saluted.

With tears in our eyes, we all shook hands. I gave him my card and told him that I’d like to connect and possible bring him to Rutgers for a talk. As I started to walk away, my first thought was that Arauz would have loved that guy’s speech and my gesture. It was a resurrection story.

A Veterans Day story.