This post was originally published on January 9, 2015.
A few years ago I was having a conversation with a friend who wasn’t drinking for an extended period of time because he was taking a medication that didn’t go well with booze. He’s not an alcoholic or an addict, although when he was younger he went through a phase of excessive drug and alcohol consumption that a lot of non-addicts go through—one that he essentially aged out of. We were reminiscing about a friend that had just committed suicide as a solution to his half-gallon-per-day vodka habit, and he said to me, “I’m glad we’re both in recovery.”
My immediate thought was to blurt out, “You’re not in recovery! You’re not even an addict!” Instead I just nodded in agreement. If he thinks he’s in recovery, I reasoned, what’s the harm? He isn’t an addict, and therefore doesn’t know what it’s like to be recovering from addiction. He now drinks responsibly and occasionally smokes pot, and recently told me that he was concerned because he had been having a single beer every night after work.
My friend’s ability to drink like a normal person is pretty solid evidence (at least to me) that he does not have what I and most of my friends that are in recovery have: a mental illness with a physical component that kicks in whenever a mind-altering substance is introduced to the body. I know, when I ingest anything addictive, I’m immediately going to want more of it, and the sooner the better. And if I can’t get it, it’s all I’m going to be thinking about consciously or unconsciously until I do, even if that means doing things that cause some form of physical, mental or spiritual harm to myself or others. I once heard a guy describe the illness this way: “Addiction is the relentless pursuit of a satisfaction that you will never achieve.”
All of this is on my my mind again because Time health and addiction writer Maia Szalavitz is out there with one of her trademark 12-step-attacking pieces. This time her focus is on how she thinks the time has come to “reclaim” the word “recovery.” She believes the term should be broadened to include those who don’t practice abstinence, even from their “drug of choice.” In her view, if a person’s drinking and drugging behavior is no longer causing a problem, and they’re able to drink and drug in moderation, then they should be able to claim that they’re in “recovery.” Here’s a passage that sums up her feelings in response to a definition of recovery by the Betty Ford Institute Consensus Panel (BFICP):
“Troublingly, however, the BFICP excludes everyone who may use alcohol or drugs responsibly. For example, an alcoholic who never drinks, but smokes pot once a month or so without compulsion or consequences is automatically excluded, as is someone who goes from dangerous drinking to moderate drinking. For me, such people, if they have sustained their moderation for the appropriate time periods, must be included in any sensible definition of recovery. I don’t see any reason to keep them out other than prejudice: If they are no longer engaging in addictive behavior related to substances, to me, they’re in recovery.”
Hmmm. Well, here’s my take: If alcoholics and addicts could “use alcohol or drugs responsibly,” they wouldn’t be alcoholics and addicts and therefore would not need to be in recovery. I don’t know any alcoholic who can smoke pot (or do any other substance) “once a month without compulsion” if he wasn’t already drinking. And if you can go from “dangerous drinking to moderate drinking,” that’s awesome, but you probably don’t fit any definition of alcoholism that I’m aware of. It’s like the line that I heard someone say when I first got sober: “I wish I wasn’t an alcoholic—that way I could drink all the time.” And that, my friends, is the twisted mindset of the alcoholic/addict.
While drinking like a normal person or taking drugs recreationally may be every alcoholic and addict’s dream, it’s just not realistic for me. And it’s not “prejudice” to think that people who are using substances aren’t in recovery. I don’t abstain from drugs and alcohol because I want to say I’m “in recovery”; it’s because I’ve got a long term demonstrated track record of having my life go horribly wrong when I don’t.
In my 30s, I put down the booze for an extended period of time and just smoked pot, but there’s no way I would define what I did as “recovery.” My life improved because I wasn’t drinking a quart of scotch every day, but I wasn’t exactly living the dream. I had no social skills without booze and mostly just got baked and watched TV when I came home from work. I wasn’t really living until I put everything down and got into, yup, recovery.
Szalavitz, a frequent critic of 12-step programs (despite getting clean and sober from her heroin and cocaine addiction in them when she was 23), challenges the definition of recovery by those programs as well as those of the BFICP, Hazelden, SAMSHA (Substance Abuse and Mental Health Services Commission) and a host of other medical and psychiatric organizations. Her gripe? They all include abstinence from alcohol, illicit drugs and non-prescribed medication in their definition. And while she makes some decent points about what the word “recovery” should mean, I can’t buy into a definition that doesn’t include abstinence from mind-altering substances. Just because you’re getting less fucked up doesn’t mean you’re in recovery.
One of the things that I’ve learned in recovery is this: consider the source. Szalavitz is by all accounts a terrific writer, but a lot of her work seems to be intentionally contrarian to a lot of theories of addiction recovery accepted by millions of recovering alcoholics and addicts in both 12-step programs and other treatment modalities (like CBT) that don’t follow the AA model. Clearly 12-step recovery isn’t for everyone and it certainly has its flaws; I agree with her on a lot of points that she makes (such as AA not being successful for people who are mandated to it). Still, a lot of what she writes is just plain fucking nonsense.
Consider another other recent title by Szalavitz: “Most People With Addiction Simply Grow Out of It. Why Is This Widely Denied?” Anyone in the addiction recovery field knows that bona fide alcoholics and addicts don’t just “grow out of it” (even though a lot of early life binge drinkers do) and that the disease is progressive—another point she often challenges in her writing. According to the Center for Disease Control, excessive alcohol use is the leading cause of preventable death in the US: we average 88,000 deaths per year–shortening the lives of those who died by an average of 30 years, and in 2012 alone, 43,819 people suffered drug induced deaths. That’s an awful lot of people who didn’t “age out” and who could have benefited from treatment.
Szalavitz’s main point seems to be that the recovery label should be extended to anyone who wants it, mostly because it carries some sort of cache in certain circles. “It’s empowering to say publicly that you are in recovery from addiction,” she writes. “But for some, recovery is a members-only club for people who are totally abstinent. That leaves most of us out in the cold.”
My opinion is this: if you want to say you’re in recovery while you continue to drink and smoke weed or take pills, that’s your business. My proposal? Let’s just each just do what we’re going to do and let the other do the same.
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