A crutch is something that you lean on for support during a period of recovery.  You sprain your ankle, and use a crutch to help support your weight while you heal.

I have to shake my head in disgust when I hear AA and NA members criticize Suboxone treatment as a “crutch.”  What is a 12-step group if not a crutch?  And isn’t that a good thing?  If it promotes health, safety and recovery, then let’s offer our congratulations not our criticism.

Let’s visualize someone we love picking themselves up off the ground after being knocked down once again by their addiction.  They are a little unsteady on their feet.  Everything hurts.  They begin to walk, but you notice a severe limp.  It looks like their legs may give out beneath them at any moment.

Somehow they make it to a doctor who gives them Suboxone.  Let’s visualize that as a crutch.

The person you love walks out of the doctor’s office in better shape than when they walked in.  With the help of their crutch, they are a little more stable.  You can see that they move forward more easily, and you notice something new when you look in their eyes -the hopelessness and the desperation are gone, and in their place is a growing sense of confidence.

As the person you love grows stronger and starts to heal, you notice more changes.  They go to work every day.  They never had the physical or emotional resources to hold a job when they were using.

And guess where else they go that they weren’t going before?

To 12-step meetings!  And when they walk out the door of the AA or NA meeting, you notice once again that something else is new.  Now, instead of walking with the help of one crutch, they are walking with the help of two!

They are more stable than ever.  How could they not be when they have two crutches instead of one?  They move forward with increasing speed and confidence.

People in medication-assisted treatment do often face criticism and prejudice when they attend 12-step meetings.  Sometimes they are even told they are not allowed to speak.  Sponsors sometimes pressure them to discontinue Suboxone treatment, or reduce their dose.

Many Suboxone patients learn not to disclose that they are in medication-assisted recovery to avoid being stigmatized.  Others give up going to 12-step meetings altogether.  It’s a shame.

So, there is some irony in the results of  a recent study that shows that suboxone patients are more likely to attend 12-step meetings like AA or NA than their untreated peers.

Of course they are!  People who seek Suboxone treatment are seeking recovery.  And those who succeed in getting Suboxone treatment are in better shape to make it to 12-step meetings than their friends who are actively using, or cycling wildly between detox and relapse.

I bet even more Suboxone patients would benefit from the extra crutch 12-step groups offer if 12-step group members made a bigger effort to welcome them, support them and refrain from criticizing their “other crutch.”

I’m not saying that Suboxone treatment, 12-step groups, or a combination of both are right for everyone.  I’m just saying that we should all be careful before we start knocking the crutches out from under anyone.  People can get hurt.

p.s.  Not only did the study show that Suboxone treatment was associated with increased attendance at self-help group meetings, but suboxone treatment was also associated with abstinence, stable employment, and improved mental and social functioning over an 18 to 42 month period.  Nice!

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