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Recovery (MAT)

Allies member shelleybobelly shares her experience and mixed feelings about MAT:

"I will tell you MAT was working very well with my daughter. She was functioning at a level I had never seen. An added benefit is that it helps people who are depressed and do not respond to antidepressants. My daughter was happy for the first time. She had whole weeks of feeling good and if something did trigger her she rebounded better and faster.

But I we agree that she did not have a solid footing in her recovery. She neglected to do the work and attend meetings. She struggled to find a sponsor and that was due mostly to the 12 step big book approach that didn’t recognize that my daughter was sober and in recovery. This push back from the recovery community impacted her greatly. They told her she got sober the wrong way even though one of the leading rehabs had adopted this program and believed it was helpful in preventing death and successful in getting opioid addicts in to recovery."

Medications for opioid addiction are critically important to get a leg up into recovery. They can prevent cravings, overdose, relapse, and death. They are a bridge, allowing the person to walk away from sure and excruciating withdrawals to a normal state of being. Medications settle the biology.

As we have argued elsewhere, medications, however, don’t guarantee recovery. That is the work of therapy, healthy living and insight. See the piece we recently published on our What’s News blog.

One place to get healthy living and insight is through self-help. A group process, a community, and the daily message of recovery, play an important role in sustaining such a massive behavioral change as quitting drugs and alcohol.

You mention AA. The official position of Alcoholics Anonymous and other 12 step groups is this:

AA members should not give medical advice to each other…No A.A. member should ‘play doctor’; all medical advice and treatment should come from a qualified physician. (See this publication)

While this is the official position of AA, there are plenty of experiences, such as your daughter’s, where this is not being followed by individual members of AA, especially when it concerns medications for opioid addiction which are themselves active opioids, like suboxone and methadone.

I’m sorry your daughter had this reaction from people in AA. It is very discouraging to be shepherded this far into lifesaving treatment only to be pushed away from additional lifesaving self-help.

I had a doctor/AA member tell me once: take what you need from AA and leave the rest. Whether it’s the talk of God or medications, there is so much support in self-help meetings, it is worth ignoring the things that aren’t helpful.

It is so good to hear how medications helped your daughter; how remarkable the change was in her. Putting the drugs aside gave you back your daughter. Please tell her that I understand what she went through in AA, but that I encourage her to persevere in finding either people in AA who are not stepping over a boundary, or a different type of self-help, such as Rational Recovery or Lifering (we list more in our Resource Supplement). As good as she feels with the help of medication, there is further to go to feel even better, to feel at peace with emotional struggles and confident in the face of life’s up and downs.



In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. You provide an excellent list in the Resource Supplement link to alternative groups besides A.A. May I suggest you add Refuge Recovery to the list. It is a mindfulness-based addiction recovery community that practices and utilizes Buddhist philosophy as the foundation of the recovery process. It is welcoming to all and recognizes that there are multiple perspectives and approaches to recovery from all kinds of addictions.

  2. It is not clear why shelleybobelly’s daughter attends AA. She mentions opioids but not alcohol as her daughter’s addiction. AA is very clear on its singleness of purpose. It is well known AA is an abstinence based program. Your quote, members should not give medical advice [or opinions] is also clear and known to the membership.. However, if the daughter is talking about her MAT at AA meetings, she is not respecting the singleness of purpose. (How else would the membership know?) It’s also not clear why the daughter is not going to NA. It’s more appropriate for someone with an opioid use disorder to attend NA meetings as well. MAT would be better understood at an NA meeting than at AA, though NA is also abstinence based, including alcohol which is considered a drug. It is absolutely correct to say “take what you want and leave the rest,” but that can be misused. Recovery is work and takes a willingness to follow the suggestions, go through the Steps with a sponsor, do service. I would advise shelleybobelly to read the 4th Edition of Alcoholics Anonymous, including the preface to better understand AA. It works if you work it.

    1. Agreed, it’s not clear. We don’t know if the daughter also drinks problematically. Many people with drug problems do go to AA though, rather than NA, because the meetings are much more plentiful and the population is less green (many more people with a lot of abstinent time in AA as compared to NA). AA is full of people who both drink and use drugs. You don’t have to raise the topic of MAT in a share to get the feeling you are doing something wrong. Sponsors and casual conversations can also lead to this conclusion. The bottom line is to find somewhere you are comfortable, whether it be a particular AA or NA meeting, or another type of self-help.

    2. My daughter attended AA and NA meetings. There are not as many NA meetings available in my area. She also has issues with alcohol as well. I am not here to bash AA but to simply tell you of my daughter’s experience and how it impacted her. She found it hard to find a sponsor and keep one because once they found out about the MAT they did not want to be her sponsor any longer. I do think it matters where you are living. I am in Texas and in this area they are not very understanding of MAT…in fact it has been my experience that they have a very ignorant view of MAT and that is a shame because I do think it helped my daughter a great deal. When it was first suggested while my daughter was in treatment to start a MAT program I was a bit hesitant and fearful but as I learned more and saw the results I fully supported it. She really should have stayed in the state and area she was in instead of coming home. There was a better aftercare there that helped manage her meds and there was a supportive community. AA can be a very judgmental group.

      On my daughter’s side she sacrificed her sobriety so she could work at a rehab by going off her subs. She didn’t put her sobriety first and didn’t have a strong program. Ultimately she relapsed and that falls directly on her shoulders but hopefully she can rebound and get back on track and learn something from what has happened.

      I am trying to see the positive and support her through this bad patch without totally losing hope at having to go back into treatment. It is a waiting game and I hope she can find sobriety before she finds death.

  3. Her prescriber should help her find a support group that welcomes people on MAT. There are also other recovery fellowships that are not the 12 steps that fully accept the use of MAT. A peer recovery center can be a wonderful place for peer support as well. Everyone deserves peer support for their use of medication to assist recovery! All paths to recovery need to be supported!