Tuesday, December 18, 2007


A recent article discusses "addiction recovery: its definition and conceptual boundaries" (J Subst Ab Treatm 2007; 33:229-241). Among the various perspectives cited is that of ASAM, which defines recovery as a "process of overcoming both physical and psychological dependence on a psychoactive drug with a commitment to abstinence-based sobriety". Also cited is Narcotics Anonymous World Services, whose Board of Trustees "affirms the right of NA meetings to refuse to allow those using medically prescribed methadone as 'drug replacement therapy' to speak at meetings and refers to such individuals as 'under the influence of a drug,' 'still using,' and 'not clean.'" The reference for the ASAM position is 1998, and that of NA's Board is 1996. However, we're unaware of any publicized change of position of either.

Clearly, we have a long way to way to go - still! - before narcotic addiction is recognized as a chronic medical problem for which medication can be not only appropriate but life-saving. The challenge of gaining acceptance for this view, put forth originally 42 years ago by Dole and Nyswander, is greatest among our colleagues in the field of addiction treatment.


At 11:49 AM, Anonymous Anonymous said...

I was a member of N.A. for eight years in New york and it was stressed at our meetings that if you used in the last 24 hours you could not share. That meant methadone also.They stressed that they wanted to hear from you and not the drug.It was by hearing this message that I did get clean from methadone after being on it for 15 years.I did service work, stayed involved with the program, Hung with other recovering addicts, worked the steps to the best of my ability, But guess what? Here I am back on methadone Maintanance.This may sound strange but I feel better on the program then when I was off. I still go to meetings but I go where there is not an issue with methadone. I wish N.A. would change there stance with their policy about methadone. I know in my heart of hearts that N.A. saves lives, But when it comes to medication, They are a bit to harsh.Billy K. Still a member because I said I am.

At 11:46 AM, Blogger RGNewman, MD said...

Thanks for your candor. You might be interested to know that the rejection of methadone maintenance by AA was not reciprocated by the co-developer of methadone maintenance, Dr. Vincent Dole. He was for many decades a lay member of AA and always very supportive. And as for your personal situation - I have very often said and written that if I had a son or daughter who was a former heroin addict and today was no longer using anything illicit - I could not give the least damn if that kid was receiving methadone, or acupuncture, or had found Jesus or whatever... and I truly mean that. The success is identical in my mind whether medication is being taken or not. Be happy - and be proud.

At 2:56 PM, Blogger franz said...

Nice blog, I was not into that drug thing, i'm afraid to go to rehab centers, i'm afraid that they might call me drug addict, its kinda shameful in my part because i belong to a family of religious leaders.


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