Archive for the ‘alcoholics anonymous’ Category

How HAMS Split Off From MM

October 4, 2009

“Breaking up is hard to do.”

It was quite inevitable that the harm reduction faction within Moderation Management (MM) would eventually split off from MM and move on to do its own thing. The events of the summer of 2006 merely served to hasten things along.

I have nothing but the utmost respect for the MM program; MM was the only place for me to go when I was seeking support for the changes which I was making in my drinking. However–MM was never a good fit for me–although MM is a good fit for many people.

My other great source of support and learning was needle exchange where I worked as a volunteer–however since my drug of choice was alcohol and I didn’t do any illegal drugs much less shoot drugs there was limited support available to me via this avenue as well.

First let us look at some of the things that the MM program is about:

The following is from MM’s website (http://www.moderation.org/whatisMM.shtml, accessed Oct 4, 2009)

What if moderation does not work for you?

After completing 30 days of abstinence (step two of the MM program) and then starting the moderation part of the program, you may discover that it is more difficult for you to moderate your drinking than to abstain. In this case, consider a self-management goal of abstinence. Some members of MM who choose abstinence remain in our program; others find an abstinence-only group to attend.

MM’s definition of moderate drinking is as follows according to the current MM trifold (http://www.moderation.org/images/tools/trifold2008_sample.pdf accessed Oct 4, 2009)

For Men:

No more than 14 drinks per week or 4 drinks per occasion.

For Women:

No more than 9 drinks per week or 3 drinks per occasion.

For All:

3-4 non-drinking days per week.

Current statements by MM are actually somewhat milder than the ones found earlier in MM–for example those found on this earlier trifold of MM’s which reiterate statements in the Kishline book (http://www.doctordeluca.com/Documents/MM%20Tri-fold.pdf accessed Oct 4, 2009)

MM is not for alcoholics, chronic drinkers, or those who experience significant withdrawal symptoms when they stop drinking. MM is also not intended for former dependent drinkers who are now abstaining. Chronic drinkers should consider contacting an abstinence-based support group. MM is intended for problem drinkers who have experienced mild to moderate levels of alcohol-related problems.

What I learned by volunteering in needle exchange was that it was essential to foster and encourage every positive change rather than to think about who was a “problem user” and who was an “addict”. Indeed–it would be nothing but bizarre to offer clean needles only to people who shot heroin in moderation but to tell those who exceeded some sort of imaginary moderate limit that they would not be allowed access to clean needles or other harm reduction resources because they were addicted and therefore needed an abstinence based program!

My harm reduction goal with alcohol was to drink a fifth of booze (17 standard drinks) safely at home one night a week and to abstain the other six nights per week–clearly a harm reduction goal when compared with the fact that I had previously gotten this intoxicated 4 nights per week–but also clearly at odds with MM’s definitions of moderate drinking.

I spent around four years from 2002 until 2006 working as an administrator for MM and during this time I introduced many harm reduction concepts which I had learned at needle exchange into the MM online community–these concepts were received with great enthusiasm by those who were unable to “toe the line” of the strict MM limits and who also did even worse if attempts were made to impose abstinence upon them.

Then around August of 2006 a faction arose within the MM online community which proceeded to viciously and sadistically attack anyone who failed to be either perfectly moderate or to be perfectly abstinent. I say a faction but it was primarily a single individual. Rather than banning these sadistic attacks the MM administration decided to ban swear words.

September 13, 2006 I created the modsabshr yahoo group as a subgroup of MM for people who wanted to escape the sadistic attacks and the censorship that was occurring on the main MM email group. I also resigned as administrator of the main MM email group at this point in time.

In December of 2006 I decided that it was a bit ridiculous for me to continue working a 40 hour work week running MM’s chat room since I had neither job title at MM nor even a nominal stipend from MM for doing so.

Therefore on January 15, 2007 I created the hamshrn yahoo group and thus founded The HAMS Harm Reduction Network as an entity independent of MM. HAMS was incorporated in the state of New York August 21, 2007 (the same date as our first live meeting by coincidence) and we were granted 501(c)3 status by the IRS November 15, 2007.

This is the first time I have spoken publicly about what happened since we split with MM way back in 2006. That is because I have finally calmed down a bit and can now speak objectively without flying off the handle and acting like an asshole.

MM is a good fit for a lot of early stage problem drinkers and many people have benefited from MM–if you are an early stage problem drinker then you may find that MM is a good fit for you, too. SMART is a good fit for rational abstainers and even the dreaded AA can be a good fit for some people who want to abstain and who have the right kind of personality type to fit with a 12 step program.

HAMS is a good fit for a lot of us who want to define our own programs and who want to make positive changes which might be quite different from moderation–HAMS also fits those of us who want to abstain or moderate in our own way.

Copyright © 2009, The HAMS Harm Reduction Network

AA and Terminal Identification-itis

August 5, 2009

There is a horrendous peer pressure on anyone who ever attends an AA meeting to renounce one’s identity as an individual and to identify with the group. And there is horrific social pressure on anyone who ever has a problem with alcohol to join AA in spite of AA’s lack or any track record of success. People who attend AA and insist on showing any trait of individuality are told that they suffer from a condition called “Terminal Uniqueness”–that if they insist that they have a personality of their own it means that they will drink and die.

People who do not have the sense to preserve their personal identities and leave AA often stay and become more and more miserable and depressed with each meeting. When the depression gets bad enough they commit suicide. If they don’t commit suicide they go out and drink and all the AA programming about powerlessness kicks in and they kill themselves or someone else by driving drink or die of alcohol poisoning or withdrawal.

What is it that these people really died of?

Terminal Identification-itis .

These people forced themselves to identify with AA and everyone there even if it killed them.

And it did.

At AA meetings you always hear it said that “we are all the same”.

In HAMS we know that everyone is different.

Copyright © 2009, The HAMS Harm Reduction Network

To the wives

June 6, 2009

This title of course is a take on a chapter in the AA ‘Big Book”. :-)   Everything that we are saying here holds true for any significant other or friend or family of any drinker–male or female.

Here at HAMS we have a saying:”perfectionism is the enemy of the good”

If your husband improves in his drinking habits then you need to support that no matter how small the improvement. It doesn’t matter if he drinks more safely, or cuts back or even quits–every positive change is a positive change and needs to be recognized as such.

If you keep demanding that your husband be perfectly abstinent because that is what he has to do to satisfy you the odds that you will make him actually become abstinent are infinitesimal. It is far more likely that his drinking will become far worse than it ever has before.

Alanon is poison. Demands for perfection almost always backfire and blow up in your face. If you want to see your husband dead in a drunk driving accident then go ahead and throw that Alanon shit and those demands for perfection in his face.

Alanon has probably killed more drinkers and broken up more marriages than any organization since AA itself.

If you really love your husband and want to see him get better then you need to recognize that better IS better and you need to encourage every positive change. Harm reduction may be just the thing that works for your husband.

People like Miller and Rollnick who invented Motivational Interviewing have taught us that the way to get people to change is not to nag them. It is to give them a chance to examine what they really want and to support them in making positive changes.

The life you save may be your husband’s.

Copyright © 2009, The HAMS Harm Reduction Network

Is PAWS an Iatrogenic Artifact of 12 Step Treatment?

June 5, 2009

Post Acute Withdrawal Syndrome–PAWS–seems almost entirely iatrogenic–in other words it is an artifact of the treatment modality which would not occur if people were quitting naturally on their own because they chose to instead of quitting through a 12 step treatment program and against their will because someone forced them to be there.

Just think of it–suddenly you are deprived of your favorite hobby in the world and told that you will NEVER EVER be able to enjoy it again. Isn’t this enough to make anyone miserable even if the hobby were knitting or reading comic books rather than drinking?

You are horribly shamed by your “recovery” group if you ever drink again.

You are forced to attend these godawful brainwashing meeting which are a torture in and of themselves and on top of that you are forced to believe in one of the sickest and most twisted theologies on record–the god of Bill Wilson’s 12 steps who has created alcohol to torture humainty and before whom we were all lost until finally god in his infinite mercy revealed the 12 steps to Bill Wilson who could now go and become the savior of humanity.

BARF BARF BARF BARF BARF!!

Sitting in AA meetings and listening to this sort of garbage is sure to make you sick–if you stay away from the 12 steps and if you quit by your own choice–whether cold turkey or through pharmacological extinction or through gradual reduction you will never have PAWS.

Brain disease my great aunt’s sweet patootie!!!

Copyright © 2009, The HAMS Harm Reduction Network

Why Do Doctors Want To Punish Us For Trying To Get Better?

May 29, 2009

Why is it that if we go to a Doctor to try and get a medication to help with a drinking problem that this can screw us up in trying to get insurance and even employment for the rest of our lives? The very fact that we are choosing to try and change for the better should speak in our favor and not against us. And why should Doctors suggest that we join the AA religion if we seek to get better even when we tell them that the AA religion violates our personal beliefs and has harmed us in the past? Prejudice is all–sheer prejudice.

I am posting the following exchange from the HAMS yahoo group on this topic with the author’s permission for those whom it might help.

*******************

This probably sounds like a stupid question, but how can one get a prescription for Naltrexone without going to a doctor, and risking to have “alcoholic” be forever on your medical records? I think that any other health problem to come in the future would be secondary to the label of having an addiction problem.

*******************

I asked the same question a few weeks ago.  I don’t think anyone had an idea for getting a prescription without going to a doctor.  There is the possibility of getting Naltrexone without a prescription, either by purchasing online (haven’t tried this yet, but if people can get Viagra online without a prescription, why not Naltrexone?), or by going to Mexico (last I checked, ten years ago, you could purchase any non-addictive pharmaceutical without a prescription in Mexico, and at low cost too), but then I believe you’re at legal risk while “smuggling” it across the border, and Mexico is dangerous these days as you’ve probably heard.

A third option I’m considering is going through a doctor here in the States, but hiding it.  This involves finding an old-fashioned GP type doctor; the kind who runs his own small practice out of a small office in a poor part of town, and hates working with insurance (They are still out there; I know one here in town, but he is getting old.  And notice I said “he”; doctors this old school are from the generation when virtually all doctors were men.)  Do not go to your usual doctor; do not involve your health plan; do not give your social security number.  Pay cash, and request confidentiality.  Since Naltrexone is fairly safe and is not addictive (it’s not like you’re looking up a new doctor for a Vicodin refill!), chances are, he’ll write you the prescription.  Hand carry the prescription to a single, family-owned pharmacy.  Not a chain, and not any pharmacy you’ve ever been to before.  For instance, I get a Prozac prescription from Rite Aid.  They have all my records and my health insurance info.  Any prescription I bring to *any* Rite Aid is automatically added to my records.  So find another old-fashioned family business.  Tell them you don’t have insurance and will just pay cash. &nb sp;With luck, your records at the GP and at the small pharmacy will never become part of your insurance records, since the insurance company won’t even know that you ever interacted with those two businesses, and won’t know to request records.  Caveat:  I haven’t tried this yet, but am thinking of it.  Anyone seeing a hole in this plan, please point it out.

It’s very sad that we have to be so sneaky to try and get better without screwing ourselves.  I for one usually have to purchase my health insurance as an individual (i.e. not part of a group or employer plan), and an “alcoholic” brand on my records (the Scarlet Letter!) would either make it impossible or unaffordable for me to purchase the minimal insurance that I need for emergencies…

Good luck!

****************************

Just wanted to give you an update on my earlier shared doctor idea

(how to get prescriptions for alcohol treatment medications without

screwing up your health insurance records). I finally bit the bullet

yesterday and made an appointment to visit my old fashioned, cash

only, sole practitioner family doctor. I’ve been having trouble

tapering off and finally decided that I wanted to try using valium to

taper off so that I could stop alcohol cold turkey. I also wanted to

get a prescription for naltrexone. I had (mostly) success. My doctor

was very understanding, sat down and talked with me for an hour, and

wrote me a prescription for a very small dose of valium which I hope

will allow me to be abstinent for a couple of weeks at least, to

detox. He also measured my blood pressure (a little high but not too

bad), and checked the size of my liver by palpation and by oscultation

(i.e. thumping over the liver area to find the size of the liver by

the type of solid or empty sound returned). My liver is not enlarged,

thank Goddess! I did not get my naltrexone yet, though, although I

expect I will next time I go in. He asked me if I were attending any

“meetings”. I said “no, I don’t like meetings, but I am part of an

online support group”. Turns out (unsurprisingly, since the whole

point of this exercise was to find an old fashioned, conservative

doctor) that he believes naltrexone works best in the context of AA

work, and he wasn’t sure that an online group would be enough, so he

recommended that I visit some of the local groups, and check in with

him in a month if I still want to try the naltrexone. Having been

educated by PCT and others, I didn’t bother arguing about the

usefulness of AA. Instead, since I don’t want to lie to the very

kindly older gentleman, I’ll visit two AA meetings, and if I still

want the naltrexone in a month, I’ll go back and say that I’m now

going to meetings *and* my online group, that I’ve stopped or greatly

reduced my alcohol intake, but I still want the back-up help of the

naltrexone.

I then took the valium script to a small family pharmacy, and paid

cash (no insurance records that way). I’m looking forward to detoxing

for a bit, and do expect that I’ll be able to get the naltrexone, if I

want it, in a month.

Based on this experience, I would add one thing to my earlier advice:

participate regularly in HAMS chat, which, after all, is a *meeting*,

IMHO. Then if you’re asked about going to meetings or etc, you can be

prepared to say that you are regularly attending meetings of your

alcohol use support group. I could easily have said this myself if I

hadn’t been surprised (caught off guard) by the question. Now I’ll

have to suffer through two AA meetings. Well, perhaps it’ll be

educational; I’ve never attended an AA meeting, though I tried OA a

couple of times in the past (and did not find it helpful). Now at

least when you AA veterans complain, I’ll know what you’re talking

about! ;-)

Cost for the hour exam was $85, and the valium cost $15. I expect my

next office visit, in a month, will be shorter and cheaper. If it all

works, it’ll be money well spent, even just on reduced alcohol

purchases…

Wish me luck!

Copyright © 2009, The HAMS Harm Reduction Network

Addiction Genetics and Nazi Race “Science”

March 27, 2009

The politics of genetics has been used throughout history to create scapegoats and to oppress various segments of humanity. Tremendous efforts were made in Nazi Germany to establish Rassenwissenschaft–race science–as a legitimate science. Tremendous efforts were made to prove that Jews, Gypsies, and others were genetically different, subhuman, and curable only by extermination. All these efforts failed because they had no basis in reality–they were nothing but political artifacts intended to satisfy hate.

The more things change the more they stay the same. Today’s political forces have decreed that the drunkard and the drug addict are somehow fundamentally different from other human beings. These hate mongers have declared that the drug user and the drunkard comprise a subhuman, racially inferior underclass whose basic human rights are not protected under the Constitution of the United States of America.

The “addiction gene” or an “alcoholism gene” is such a hot political prize that its discovery has been announced with great hoopla at least a dozen times in the past couple of decades. The problem was that in every single case the scientists announcing this great discover had to recant–for the simple fact that the evidence did not back up their extravagant claims. Most serious geneticists know that the “addiction gene” is a chimera, a will-o’-the-wisp which does not exist–but an innocent public still sits and awaits the discovery of the mythical “addiction gene”.

The simple fact is that there is no such thing as a “disease” of “addiction” or “alcoholism”. People use what means they have to cope with difficult situations. Sometimes the only means that they have is drugs or alcohol; sometimes it is the case that drugs and alcohol are just so readily available. Anyone can adopt a maladaptive coping strategy under difficult enough circumstances. Genetics has nothing to do with it. Period.

The really sick and diseased people in the United States of America today are the ones who promote the Nazification of science by promoting the idea that drunkards and drug addicts are genetically different from the rest of us. These people are doing nothing short of what the Nazis did in Germany–giving the general public a scapegoat to blame their troubles on–and setting up a new race science and a new racially inferior subhuman subset of humanity–all based on a tissue of lies.

One of the worst results of this new scapegoating has been the consistent stripping of this supposedly “genetically diseased” group of people of their most basic and fundamental human rights under the Bill of Rights of the Constitution of the United States –to wit:

The Eighth Amendment to the Constitution protects people in prison in the United States from “cruel and unusual punishment”. However, people in treatment programs for “addiction” or “alcoholism” are not given the same protections as criminals. Therapeutic Communities and “tough love” programs based on Synanon often force adults to wear nothing but diapers and call them big babies. Men are forced to dress as women for weeks at a time for the “crime” of saying hello to a woman. Occupational therapy includes things like scrubbing toilets with toothbrushes for 8 hours a day.

The First Amendment right to freedom of religion is respected in prisons–prisoners in the United States are not forced to believe in God or attend religious services against their will.

However this is not true in drug and alcohol “treatment” programs where inmates are browbeaten and threatened with a horrifying death from drug or alcohol use unless they accept a “Higher Power”–and not just any “Higher Power”–but one that fits the steps of AA. Can a door knob be a higher power? Only if you can make conscious contact with a door knob like step 11 requires. Inmates in 12 step treatment programs are also forced to attend AA meetings against their will–a violation of the first amendment rights of anyone who feels that AA meetings violate their personal religious freedoms.

Then we have the Salvation Army which as a part of their “occupational therapy” makes the inmates in their treatment programs work eight hours a day in their thrift shops and pays them two dollars for the whole day. And I thought slavery was ended with the Emancipation Proclamation. I guess the laws against slavery don’t count if you are one of those “genetically diseased” alcoholics or drug addicts. Like the sign hanging over Auschwitz said “Arbeit Macht Frei”–work will set you free.

It is long past time that we start treating human beings as responsible adults with the basic unalienable human right to decide what they want to put into their own mouths. “No more drug war” means “no more war on drug users”.

No one should be considered subhuman because of what they choose to put in their mouths. No one should be stripped of their unalienable basic human rights based on what they choose to put in their mouths.

The war criminals are those who wage the drug war–not the drug users who are the innocent victims of the war on drugs.

Copyright © 2009, The HAMS Harm Reduction Network

AA and Harm Reduction

November 5, 2008

Hi all–I am posting this paper which I had to write for my addictions counseling class at The New School:

 

On Monday, October 27, 2008 I attended AA at St. John’s Episcopal Church, 139 St Johns Place, Park Slope, Brooklyn. I chose this particular venue because I have been employed as sexton by St John’s for the past two years and hence it is a physically comfortable space for me. I also knew that this was a rather large (50 to 100 people) open meeting which has a reputation for being somewhat laid back. This was actually two meetings for the price of one, the first was a “Beginners Meeting” which started at 6:30 and this was followed at 8:00 by a “Topic Meeting” which it turned out was an anniversary meeting.

 

One man came up to speak to me between the two meetings and I explained that I was there as an observer to fulfill a requirement for my CASAC. This man asked what populations I was interested in working with me and I explained that my primary interest was in harm reduction. He replied that this was a good thing since not all people were open to total abstinence. It was a welcome change for me to hear this since on many occasions I have been attacked by AA members for my work in harm reduction.

 

What I really learned from attending AA as an observer is that an observer cannot really comprehend what it is like to attend AA/NA as a person seeking help for a problem with alcohol or drugs. Hence I must speak a bit about my personal experience.

 

I was raised in the Evangelical Free Church of America which is essentially a religious cult–what Chaz Bufe has referred to as “cult lite”. This was an organization which ruled through fear in an attempt to suppress all normal human pleasure. From my earliest memories I remember being bombarded by the threat of eternal damnation and burning in hell forever. And what were the things that would lead one to burn in hell forever and ever? Drinking, dancing, playing cards, going to movies, smoking or believing in evolution. Not to mention extramarital sex or sexuality or the worst sin of all–a failure to believe–even though there was an absence of evidence. And of course all the Episcopalians and Catholics would go to hell because they worshiped idols (i. e. had religious statuary) and used demon alcohol in communion. By age 13 I had read Darwin and was an atheist and later read Spinoza and became a pantheist. I escaped that cult.

 

Later in life I was suffering from depression and loneliness and was drinking too much in response to this. I did not like the way in which I was drinking and sought help to change it. I encountered AA.

 

AA is in my experience another incidence of “cult lite”. AA has almost exactly the same cultish features as the cult which I had escaped as a child. AA rules its members through fear, but rather than the fear of hellfire it is a fear of a horribly alcoholic death. In point of fact people coming to AA are threatened with a horrible alcoholic death unless they come to believe in God. To quote the chapter “We Agnostics” from the AA “Big Book”, “To be doomed to an alcoholic death or to live on a spiritual basis are not always easy alternatives to face… after a while we had to face the fact that we must find a spiritual basis of life—or else.”

 

For me personally attending AA had an extremely negative effect. I went from having a moderate drinking problem to having a severe drinking problem. I found myself having to drink every time I left and AA meeting and finally after leaving one meeting I went on a bender so bad that five days later I came out of it with severe and life threatening withdrawal. I had to check into Ramsey County detox in St Paul to get some valium in my system before I died of a stroke or a heart attack. And it was at this point that I realized that I had to leave AA or die.

 

I found some support and friends in alternative groups and I began to get better. I used art therapy and online support to deprogram myself from AA. And once I had thoroughly rejected their path I began to find myself in control of my drinking. And with the help of CBT and Stoic Philosophy I began to feel happy and in good mental health. Volunteering in needle exchange during this period also taught me the essentials of harm reduction.

 

I have met many, many people whose drinking became worse while they were attending AA and who were only able to achieve successful moderation or successful abstinence after leaving AA.

 

However, certain other experiences of mine have convinced me that AA may perhaps not be a bad match for everyone; some people may actually find it valuable. When I founded HAMS Harm Reduction for Alcohol one of the people I invited to join our advisory board was Rae Eden Frank who was my former boss at Access Works, the Minneapolis syringe exchange. When we invited Rae to be our guest speaker in our online support group we were surprised to find that she was a member of NA. However, she explained to us that for her harm reduction and the 12 steps were entirely compatible. Harm reduction keeps people alive when the 12 steps can do nothing for them. If and when people decide to abstain the 12 steps are one possible option which they can follow.

 

Ultimately what I learned from this experience of attending an AA meeting is that the time has come for an end to the hostility between AA and other approaches. AA’s “Big Book” says, “Upon therapy for the alcoholic himself, we surely have no monopoly.” It is unfortunate that far too many people working in the chemical dependency treatment industry feel a need to use everything from lies to coercion to torture to attempt to force clients to succumb to the 12 steps.

 

I feel that it is time for all of us to realize that different people need different approaches. It will be good for people from 12 step programs and people from other approaches to join hands and to try to offer each individual a choice of what treatment approach will best benefit that individual. If we all work together some of the abuses of the 12 step system can reform themselves from within.

 

Copyright © 2008, The HAMS Harm Reduction Network