I was initially introduced to abstinence-based, twelve-step recovery programs at the age of 13 while in the first of what would be many adolescent institutional stays. I was taught by the professionals involved in my care as well as attendees of the meetings we would be shuttled off to in big red passenger vans that abstinence-based, twelve-step programs were the only way to recover. The message was clear and would be a consistent theme throughout a whirlwind of treatment episodes, juvenile justice system encounters and a return to the treatment system as a young adult – there is no other way, it’s all or nothing with substance use, any substance use would get me “kicked out” of treatment and ultimately, it’s “jails, institutions or death” without abstinence-based, twelve-step recovery.
When I entered into the behavioral health profession and got involved with recovery advocacy work early in my long-term recovery journey, I naturally carried all that I had been taught with me. There is truth to the idea that we “don’t know what we don’t know.” There is something to be said regarding how limited our own lived experience can be, particularly if we’ve only received limited information from the world around us. Because the idea had been so engrained in me since my youth that abstinence-based, twelve-step recovery programs were the only way to recover, it took several years for me to expand my thinking to a place of embracing that there are many ways to recover. Only through patient and loving mentors was I able to recognize how harmful my limited perspective could be to those I sought to serve. Only through the active pursuit of education, training and exposure to these other pathways to recovery was I truly able to open my mind.
While embracing many pathways to recovery beyond abstinence-based, twelve-step programs would go on to become a way of life for me, the idea of harm reduction was a tough holdout in my internal thinking. The idea of supporting people who choose to use alcohol or other drugs or who are rendered unable to abstain due to their active substance use disorder was sort of difficult for me to wrap my mind around. Years of messaging received that included words like “enabling,” “condoning” or “having to hit rock bottom before they can be helped” littered my thinking. I thought that I was doing a disservice by not promoting abstinence as the end goal. I mean, abstinence is the goal of recovery, isn’t it?
Well, it turns out abstinence isn’t always the goal. For many of us involved in recovery advocacy work, absolutely yes, sustained long-term abstinence for ourselves or our loved one is the goal - but for the majority of Americans who engage in substance use, abstinence is not their goal. Perhaps getting no more DUI’s is their goal. Perhaps not waking up sick in the morning is their goal. Perhaps abstaining from one substance but continuing non-problematic use of another is their goal. Perhaps moderating their use of a substance so that it is no longer problematic in their life is the goal. Perhaps just simply living a life that is meaningful and fulfilling to them is the goal. And for many, perhaps just staying alive is the goal.
For me, my path of personal and professional growth has led me to a place of truly embracing that abstinence is not always the desired end point, and to truly believe that’s ok. This recognition has in turn led to the realization that all of my recovery advocacy efforts should expand to ensure that we are not excluding people who do not have abstinence as their goal from the work that we do. This realization has also left me with an understanding that rather than a lack of facilitating abstinence-based, twelve-step program engagement for many, it is more so our failure to adequately support people wherever they are at in their use of alcohol or other drugs that could lead to “jails, institutions or death.”
At the end of the day when the dust settles, my desire as a recovery advocate is to support people and families with the avoidance of jails, institutions and death and to foster opportunities for personally meaningful and fulfilling lives as determined by each individual and their family. It is because of this that I have grown to fully embrace harm reduction strategies as being in total alignment and necessary to support in my work as a recovery advocate. It is my hope that everybody involved in the recovery advocacy movement is able to reach this place in their journey as well. Many lives depend on our ability to do so.