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Other Forms of Assistance
Rational Recovery
Rational Recovery is, according to its website, “the exclusive, worldwide source of counseling, guidance, and direct instruction on self-recovery from addiction to alcohol and other drugs through planned, permanent abstinence.” It was begun in 1986 by Jack Trimpey. Rational Recovery used to offer group meetings, but the program is now offered only via the Internet, books, videos, and lectures.
RR believes that recovery is an event rather than a process. It rejects the disease model of addiction and suggests that those who drink or use too much need to focus on their abilities and reject addictive thinking and thoughts. RR encourages people to follow their “own native beliefs and intuitions” and quit once and for all.
There is much that is interesting on the website, and the program looks as though it could be quite useful, if one can set aside the hostility aimed at other recovery programs, treatment centres, addiction counsellors, and the special loathing reserved for AA.
As noted in the previous chapter, people who sober up without ongoing support are often prone to paranoia and anger issues. At risk of sounding glib, I’d venture a guess that the founder of Rational Recovery could use a meeting. The website rails against “cultural recoveryism” as evidenced by a time when Google “banned” Rational Recovery for a month in 2008.
To join Rational Recovery, people are asked to subscribe to the website or to become a “patron subscriber.”
A splinter group called SMART Recovery formed from Rational Recovery when RR stopped holding group meetings. SMART Recovery is an international non-profit that provides help to addicts and alcoholics. It uses a secular, science-based approach, including techniques such as Motivational Enhancement Therapy and Cognitive Behaviour Therapy. SMART offers a four-point approach to recovery: building motivation, coping with urges, problem-solving, and lifestyle balance. It is often listed as an alternative to twelve-step programs, but many people use it in conjunction with the twelve steps.
Counsellors, Doctors, Addiction Specialists
Many addicts and alcoholics use the services of counsellors, therapists, doctors, and addiction specialists. Among counsellors, therapists, and doctors, the degree of knowledge about addiction may vary, as may the preferred approach to dealing with substance abuse issues. In order to access subsidized rehab services, you will in many cases need to be referred by a drug and alcohol counsellor or a doctor.
Professional help can be particularly valuable once a person has achieved a period of sobriety. When people are still using, they tend to create the same problems over and over. People in recovery, on the other hand, have a shot at actually working through their issues, and professionals offer a wide range of supports that cannot be accessed through self-help programs alone.
Harm reduction is public health policy aimed at reducing the damage that results from high-risk behaviours, such as substance abuse, casual (unprotected) sex, and the sex trade. According to the International Harm Reduction Association, harm reduction includes “policies and programs that attempt primarily to reduce the adverse health, social and economic consequences of mood altering substances to individual drug users, their families and communities, without requiring a decrease in drug use.” The British Columbia Community Guide to Harm Reduction calls harm reduction “a set of non-judgmental policies and programs” and notes that “for some people, abstinence is the most feasible way to reduce harm. Interventions that aim for abstinence and for safer drug use both have a place within harm reduction.” On the spectrum of harm-reduction activities, you’ll find needle exchange programs, sex education, condoms in schools, methadone programs, and certain types of drug and alcohol counselling.
Harm reduction is controversial in certain quarters because it is seen as condoning unhealthy or immoral activities. Other people point to the evidence that shows that some harm-reduction strategies minimize the damage done to individuals who engage in potentially dangerous activities.
Perhaps the only thing even more insidious than the idea that one day addicts/alcoholics will finally be able to just say no is the idea that they will find that miracle technique that will allow them to start using or drinking “socially.” This is also the idea that underlies some harm-reduction programs, particularly those designed for adolescents and low-bottom (severely hard-up) addicts and alcoholics. The thinking seems to be that in the case of teens, they’ll grow out of it, and in the case of street people, they can’t get better.
One nineteen-year-old woman I spoke with who’d gotten sober at seventeen told me about sitting down with her high school counsellor. They worked out a program whereby she would smoke pot only three days a week rather than seven. She would confine her drinking to Fridays and Saturdays, and she would stop getting drunk on school nights. It was a good plan, but not a successful one. Her addiction proceeded unimpeded, and by grade eleven she was in a twelve-step program.
One counsellor I spoke with, who felt that abstinence is the only real solution for addiction, referred to harm reduction as “harm induction.” Another treatment expert I interviewed called it “palliative care,” and another suggested that harm reduction was promoted by “well-meaning people who do not understand the addicted mind.” Those who are skeptical of harm reduction point out that addicts and alcoholics are often obsessed with finding methods that will allow them to continue to use. Other people worry that harm-reduction policies shield the addict or alcoholic from the consequences of their using, which can prolong the disease or even make it impossible for the addict to clean up.
Harm reduction is practised and promoted by numerous in- and outpatient programs and promoted by all manner of counsellors. In Canada, many programs that receive government funding follow the harm-reduction model. When I asked addiction specialists why harm reduction is so popular, they pointed to measurable statistics. You can create statistics, for instance, to show how much crime is being prevented or how many fewer trips to jail a person experiences. Harm reduction certainly has its place.
If you are not ready to quit drinking or using, by all means try a harm-reduction program. If it doesn’t work, abstinence is a good thing to consider. Using clean needles may prevent the spread of AIDS, but it’s very unlikely to aid in a user’s rehabilitation.