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First and formost, before I say anything else that might sound disparaging, it seems like the twelve steps worked for you and that’s great, that you found something that worked…for you.

AA and it’s spin0ff are strict abstinence recovery programs and they have dominated the recovery landscape for quite some time. Unfortunately, they don’t seem to work so well. Last time I checked like 4–5% success rate. If I am mistaken here, please correct.

Unfortunately, trauma plays a major role in substance misuse. I no longer use the word “addiction” because it has acquired a great deal of stigma and baggage and assumptions, not the least of which is the messaging “you must go to AA, or NA, or Whatever A.)

I have several issues with twelve steps and I won’t go into them here. Let’s stick to trauma. Very often trauma, particularly childhood and teen trauma, play a role in young addiction. It is very possible that many traumatized individuals are never going to maintain a sobriety in the long term and frankly, that seems fair to me. But should they be left out in the cold with all the health ills of substance misuse as well as the stigma and harm that gets piled on top of that by a disingenuous, tongue-in-cheek Just Say No culture? I think not.

I am a big proponent of seeing all our recovery models move towards Harm Reduction, which does not require sobriety but tries to work with clients where they are so they can manage their use and still get as much out of life as possible, as well as get clean and sober when they are ready and able. Sometimes people are ready to cut back but are not ready to quit.

Now I generally make this argument for drug users and I include myself in that group. I know their are some additional, or at least different, issues with alcohol, but then each substance offers a unique set of issues. But it is a lie that people can’t use a substance without misusing it, and it is a lie that people who misuse can’t learn management and to heal into more moderate use. It is also the greatest lie of all to tell people that if they are alcholics or drug users that they are failures and have nothing of value to offer. History would beg to disagree.

Remember substance trouble is always a symptom of some other trouble. Manufacturing additional consequences that add to the trouble is it questionable way to address the initial trouble.

Furthermore, Harm Reduction, which does exactly what it says, seeks to reduce harm, works. There is a growing body of proof. It is humane, it honors free will and it…works. This coupled with the immediate dismantling of the disasterous and draconion human rights catastrophe we call The War on Drugs is the world’s best way forward for all substance issues. And the rest of the world agrees. So why is our own country, along with allies like Iran and Russia, holding us up.

Everyone can live a healthier, calmer, more productive life. But they may need help getting there. And some people are going to go further than others and that has nothing to do with their value or their character. It’s just the way life is. Trauma consideration must be a part of all recovery conversations and programs that want to be current and taken seriously.

Is shocking to me that they are still legit recovery programs that don’t offer a higher reduction framework or that they’re still talking alcohol counselors and programs that ignore that underneath most substance misuse is some form of either or serious mental health crisis playing out. To say mentally L, that’s just to say in response to stress that may not be entirely appropriate or optimal. This sounds like something that a person should do it with the family and the doctor not with the legal system and policeman, and frankly in my opinion and this is my opinion,not with a room full of strangers who seem to be rather dogmatically committed to that chapter of their life defining their whole life. But then I’ve never been an alcoholic. People are vastly different and you listings for vastly different reasons and it is silly to think that there will be a one-size-fits-all answer; where else is that ever true?

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