Addiction – History and Facts
The National Institutes of Health (NIH) which is part of the U.S. Department of Health and Human Services, estimates that 10% of the population will experience drug use disorder in their lives. In Canada where I live, the number is estimated by the Canadian Government/Statistics Canada as much higher at 21.6%. Addiction is a serious condition that exists in our society today but it isn’t a new problem. A hundred years ago, most addicts primarily abused alcohol due to the wide availability and social acceptability of the substance, but many other drugs were also available. The Sears catalog offered heroin for sale during the 19th century as an example of the ease with which you could find other drugs. Addiction, and the treatment of the disease looked very different a hundred years ago compared to today. Addiction was not seen as a disease but more as a moral failing, lack of character or weakness. Some addicts were put into institutions or jailed. The vast majority silently suffered in society until death took them. Many attempts have been made to help those who become addicted with the focus being on the worst cases. Some of the attempts have been misguided, like the development of heroin to treat morphine addiction in 1874. Today, treatment for addiction has mushroomed into a multi-billion-dollar industry. Are we further ahead or have we simply upgraded our addicts?
Alcoholics Anonymous Emerges
In the 1930’s a new movement offered real hope for those affected by alcohol addiction. Bill Wilson and Dr. Bob Smith, long time alcoholics, found sobriety. They were instrumental in starting the program known as Alcoholics Anonymous. Before Alcoholics Anonymous was an organization called the Oxford Group that laid the foundation for their recovery. Members of AA were able to repeat their success by seeking out fellow alcoholics. AA struggled tremendously as a fellowship until the twelve traditions were created which allowed individuals to work together in groups with the purpose of helping other alcoholics. For the first time a complete solution presented itself that many agreed was both effective and repeatable. Alcoholics learned spiritual principles in the twelve steps and applied those principles in the twelve traditions adopted by their groups. AA groups sprang up across the United States and to other parts of the world.
Narcotics Anonymous Finds Success
Unfortunately, AA did not offer much hope to drug addicts, but some found benefits in attending. By 1953 a second fellowship emerged that built on the success of AA by adapting the steps and traditions into what is known as Narcotics Anonymous. Both organizations have since grown tremendously, span the globe and offer separate methods of recovery based on the twelve steps and twelve traditions. While AA focuses on alcohol and continued sobriety, NA focuses on addiction and selfless service. Using substances might bring the addict to NA but ongoing recovery keeps members attending. Paramount are the efforts to help others recover and is an important part of NA. Narcotics Anonymous literature says ‘We meet regularly to help each other’ and is clearly a help others program, not a self-help program. For me, I believe that my chronic self-obsession is best treated with dedication to a greater cause.
The Minnesota Model
The unrelenting storms of change continued in other areas of the treatment industry as well. Many saw the early successes of AA and sought to incorporate the guidance of healthcare professionals. The “Minnesota Model” addiction treatment emerged in the 1950’s, where professionals would employ a group setting, aspects of the twelve steps, counselling and peer-based support. More than 80% of the treatment options available today use this model. Many treatment centres mandate attendance at twelve-step meetings.
Pharmaceuticals
Modern healthcare was transformed by the successes in the pharmaceutical industry. Penicillin and Insulin were wildly successful. Pain management drugs and treatments of many diseases were improved. The development of Disulfram (Antabuse, 1948) for alcoholism, Methadone (1964) for heroin abuse and hundreds of other drugs emerged to treat a wide range of mental health issues. Some would argue that these new classes of drugs are open to the same abuses by addicts but the benefits to others are clearly noted.
Today’s Addict
Today’s addict has a vast assortment of options available and a variety of recovery outcomes. What works and what are the potential outcomes of each person’s choices is often unclear in the early stages of recovery. Participation in twelve-step programs remains a common thread in most addicts’ journeys and those who manage the care of addicts. With so many options available, it has become impossible to determine the most successful path. Many addicts will advocate for what they believe in and doing so adds to the confusion. Recovery has evolved but so has the addict.
The Basic Text of Narcotics Anonymous
I believe that an amazing accomplishment ‘for addicts and by addicts’ is the production of the Narcotics Anonymous ‘Basic Text’ in the late 70’s and early 80’s. You can read a long version of the story behind the creation of the book at the Upper Cumberland Area of Narcotics Anonymous website. Narcotics Anonymous experienced tremendous growth during this time. The text distilled the experiences of thousands of addicts who worked on the book.
“for the first time in man’s entire history, a simple way has been proving itself in the lives of many addicts.”
Basic Text, Chapter 8, ‘We Do Recover’
Narcotics Anonymous was making an impact like nothing else before. The passage below points to the spiritual nature of the program. While some may reject the word God, often the Basic Text will use ‘Higher Power’. I believe that the word God is used to convey the idea of a greater consciousness present in our lives. Agnostics and atheists have found a place in NA. Spiritualty does not equal religion.
As we become more God-reliant and gain more self-respect, we realize that we don’t need to feel superior or inferior to anyone. Our real value is in being ourselves. Our egos, once so large and dominant, now take a back seat because we are in harmony with a loving God. We find that we lead richer, happier and much fuller lives when we lose self-will.
Basic Text, Chapter 10, ‘More Will Be Revealed’
A Warning for Addicts
The Basic Text includes a warning for members of Narcotics Anonymous.
“Some will resist. However, many will become the role models for the newcomers. The self-seekers soon find that they are on the outside, causing dissension and eventually disaster for themselves.”
Basic Text, most versions, Chapter 6, ‘Tradition 2’
And another warning.
“By the same token we have observed some members who remain abstinent for long periods of time whose dishonesty and self-deceit still prevent them from enjoying complete recovery and acceptance within society.”
Basic Text, all versions, Chapter 7, ‘Recovery and relapse’
Diversity is the strength of NA, and no one model for recovering or recovered addicts exists.
The Fellowship of Narcotics Anonymous
To maintain unity within Narcotics Anonymous it is imperative that the group remain stable, or else the entire Fellowship perishes and the individual dies.
Basic Text, Chapter 6, ‘Tradition 1’
The connection between myself and the Fellowship has been a priority in my recovery. During the best and worst moments of my recovery, I have always found time to connect with my home group. When I read literature and see the word ‘Fellowship’ I focus on my relationship with my home group. I can disagree with how a group functions, stop attending, and join a different group. No matter how much or how little a member has, what colour their skin, their religion, what their beliefs are or if they are clean, they can join any home group. The spiritual principles of being inclusive help me in all my affairs. It benefits my home group to have many different voices. I know other NA groups exist, and we are connected by our common purpose of carrying the message to the still suffering addict. This is all the Fellowship I need.
Addict 2.0
I was surprised by a letter written to the Fellowship on March 1st, 1983 by Sally Evans, President of the Board of Trustees. The complete letter can be found here. Excerpts from the document are below.
March 1, 1983
To The Fellowship of Narcotics Anonymous
Re: Changes/Deletions/Corrections in the Basic Text of Narcotics Anonymous
In November 1982 inacuracies were noted by the World Service Office of NA, in the basic text “Narcotics Anonymous” which was then scheduled for publication. At that time a special meeting of the Chairpersons of the three Service Branches of Narcotics Anonymous, WSC, WSB, and WSO was called. At that meeting the inaccuracies in chapter 6, involving traditions four (4) and nine (9) were corrected.
[several paragraphs not included]
We believe it was not the intention of those members of the Literature Committee who selflessly devoted 100’s of hours and $1,000’s of dollars to provide the fellowship with our book, nor those members of the Board of Trustees who personally worked on and reviewed the material, nor the fellowship who approved the book, to place the Service Structure outside the Traditions or the dictates of the fellowship.
We deeply regret the oversight and the controversy that has evolved around this material. We are, however thankful that WSO discovered these inaccuracies. To the best of our knowledge no other changes/deletions/corrections were made in the book.
In Loving Service,
Board of Trustees
Sally Evans
Chairperson, WSB
Thousands of members contributed, and tens of thousands of dollars were raised by the Literature Committee. The motion to adopt and publish the Basic Text has already been approved by the World Service Conference. I did not understand how disconnected these ‘authorities on NA’ were from the Fellowship. I learned an important lesson. Narcotics Anonymous has self-seekers who are only concerned with themselves. There are also members who remain dishonest or delusional, maintaining partial recovery and acceptance in toxic cliques. By creating a new class of addicts, the service structures have separated themselves from Fellowship. The division has invited others to take sides on what is or is not Narcotics Anonymous. Unity can only truly exist at the level of home group for me today.
What I learned has helped me personally, and I maintain healthy boundaries. No matter what my contribution or involvement with any project in or out of NA, I must always remain honest, open-minded, and willing to question everything. I welcome discussion with others. Regardless of my opinions, I maintain a connection with an NA home group. The principles I practice in society are the experiences I share at meetings. I remain vigilant as the disease of addiction is progressive.
We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions and death.
First published in the Narcotics Anonymous Little White Book, 1966, ‘Who is an Addict?’
Wow wow wow!!!! Awesome insight as always Mark