Remember Bob Forrest, Dr. Drew’s head counselor on Celebrity Rehab and Sober House—that tough-love kind of guy who looked and sounded like he’d been through the trenches (which, by he way, he has)? I didn’t hate the guy because he seemed to genuinely care about addicts; at the same time, he didn’t strike me as being an expert any more than the rest of us.
On a Pretty High Horse
Nowadays, he’s out from under Dr. Drew’s wing, having opened his own treatment facility and started describing himself as “one of the finest drug counselors living today.” The former rocker known for intoxicated rants and onstage antics is now in charge and unedited and it shows.
In a recent post, he joked that his blog ought to be named The Open Minded Report, because, as he described them, his writings were an antecedent to “close-minded Southern Californian AA Fascist[s].”
And it gets better from there.
The rest of the post is basically him shaking his fist at Big Pharma and railing against the dangers of harm reduction, which he strangely seems to define as drug replacement therapy. (This is actually not what harm reduction is— more on that in a minute). The gist of the post is that maintenance medications like Suboxone deprive people a chance at living a sober life (which Bob defines as “total abstinence”); they cause confusion among the 12-step community about who is sober and who is not; their existence and prescription creates an “irrational fear” of detox.
Bob, You’re out of Touch
Sure, I agree that the pharmaceutical industry has profit, rather than a patient’s interests at heart and yes, I respect that medication-based treatment as opposed to abstinence-based treatment is a thorny topic. But for a guy who’s presumably been through it to describe detox as an “irrational fear”? That’s just weird. And to ignore the fact that replacement medications like Suboxone have enabled a smoother detox and a bridge to sober living for many is willfully ignorant and just plain irresponsible.
Jennifer Matesa, for one, does a great job of reporting on the complicated debate while telling her own story of using Suboxone as a bridge to sobriety; she writes, “I might not be here today if it weren’t for Suboxone.”
It’s an antecedent, shall we say, to Bob’s rant:
There is no hell worse than being stuck on 24 or 32 milligrams a day of this stuff, with no hope of getting clean, enslaved to the poison machine your doctor put you on, a doctor who took the Hippocratic Oath, pledging, ‘I will do no Harm.’ Motherf#&!ing lying sacks of shit.
“No hope of every getting clean” is just wrong. You can successfully transition off of replacement medications like Suboxone—Matesa’s story serves as an example—and until you do, you are welcome to begin recovery, including 12-step, where the only requirement for membership is a desire to stop drinking or using.
Sober or Not Sober? That Is the Only Question
I’m not pro-Suboxone per se but I am pro-people on Suboxone feeling welcome into 12-step programs (and not feeling pressured to get off of it or like their time doesn’t count until they do). As far as Bob’s concern that drugs like Suboxone and Subutex cause confusion among the 12-step community: in my mind, there’s no confusion about who is sober and who isn’t. Because this is not a question I allow myself to ask. On the issue of medication, AA literature makes it clear that “we are not doctors.” As I tell my dog when we’re out on a walk and he goes to sniff a passing stranger’s crotch, “Mind your business, Spud!”
In other words, what another fellow alcoholic or addict may or may not be taking is not of my concern.
Personally, my definition of sobriety has changed throughout the years. In the beginning, it was don’t drink. As years progressed, I gave more consideration to my emotional sobriety. I’ve set more bottom lines and identified accessory behaviors to avoid acting out in other compulsive ways. At seven plus years sober, emotional sobriety means staying present, not avoiding feelings, practicing certain principles in all my affairs. If someone would have told me that all of this is what was required of me when I entered into recovery, I probably wouldn’t have stopped drinking.
I had a sponsor early on that dumped me because I was on medication for a medical condition it turns out I didn’t have—still, it wasn’t her call. I had another sponsor, years later, tell me that sex outside a committed monogamous relationship was akin to taking a drink. Ah, no. It is most definitely not. Taking a drink is akin to taking a drink. And even then, were that to happen, I get to decide what that means. Of course, I know Suboxone is not like taking an antidepressant—it’s an opiate, and I know that opiates get people high.
Progress Not Perfection
I think the real reason I’m bothered by Bob’s stance is because of the work I do at a needle exchange in Upper Manhattan. It’s the kind of place where heroin users are being encouraged to use clean needles (especially if they’re sharing) and condoms (especially when they’re selling sex). We hand out safer smoking kits and teach people about various risks so that they can make more informed choices. This is what harm reduction means: it means meeting people where they’re at and treating them with respect. It means supporting a heroin user who’s trying to not smoke crack or encouraging an addict to sniff rather than shoot up (if this is a better choice, according to that person). I know the people I work with sometimes go to 12-step meetings. Like anyone else at that meeting, they’re trying to improve their lives or just stay alive, one day at a time. I don’t disqualify and wouldn’t want to discourage these efforts.
Bob reminds me of those old timers you find in the back of the room, yelling on after their four minutes are long up about how the newcomer needs to take the cotton out of their ears and stick it in their mouths. I’m sure there’ll be things he says that I agree with but the tone of this particular post was unwelcoming, intolerant, and not helpful—certainly not the attitude of ‘Unconditional Positive Regard’ that Bob’s new rehab is supposedly all about.