How do you feel about abstinence based recovery programs?

recovery
#1

So my fiance is involved in an abstinence based methadone clinic. We use CBD or marijuana to help her manage cravings, depression and help her eating and sleeping habits. She tested positive for marijuana at her clinic, being an abstinence based program they’re now threatening to enroll her in a halfway house…a halfway house is a ridiculous idea…it will only cause more problems, interupt her job and ultimately cause her more stress and trigger her addiction. How have you guys dealt with abstinence based programs? Are there other programs that have been okay with using CBD to manage the addiction? Or what can we do to in the long term to make CBD or medical marijuana an integral part in aiding addiction recovery?

#2

So this is a tough one - thanks for raising @Dean_Acton ! Love to hear how others have dealt with specifically around methadone and MAT for opiate addiction.

I say tough because I believe this is where the traditional treatment systems are letting us down! To me, it just doesn’t make sense to turn away someone from getting treatment and help when they need it most (when they are using substances!) But I must caveat this by saying I don’t know enough about methadone treatment and how it works medically etc. This is more coming from a philosophical view.

And - let’s be real - marijuana can be problematic (like anything used in excess) but compared with heroin?! I think we’re making progress here! Recovery is a really long process and tools that make it easier to stay the course are good right? If the objective is to get there eventually. Abstinence overnight is such a tough ask I think. But tell us how your thinking is evolving here too - love to hear more!

Also, halfway houses get a bit of bad press in the news. So I would be careful to make sure it’s a great one if it gets to that point. If it is a great one then and you can see an extra level of support being useful then it could be OK.

#3

Hi @Dean_Acton, I’m interested in this topic because my son is on suboxone and they have a similar viewpoint except in his case, testing positive for opiates- they were telling him he would have to start getting daily methadone instead if he couldn’t get off the heroin (taking it even while on suboxone too and cycling back and forth).

What’s interesting is that their approach seems to have helped him get serious about stopping the heroin and he’s been testing negative for the past month-plus and continuing on suboxone, so yay for that! However, I truly don’t understand how it helps to lump marijuana in with all other substances especially when it’s been legalized in many places.

I think we have to be advocates for our loved ones and speak up for their safety and well-being if programs don’t seem to be supportive of those things. Abstinence only is a nice concept, but what about folks who aren’t able to maintain it? We know this is a chronic, relapsing condition.

I was ready to move my son to another doctor who could continue him on suboxone because I think that is in his best interest for now. But as I said, the ultimatum worked in this instance to give him extra motivation.

Also please help me understand how the halfway house would interrupt her employment- my son is looking for housing and I thought Oxford house might be an option, but he has a full time job that he enjoys.

#5

My fiance has tested positive for opiates or marijuana in the past, she’s been threatened with a halfway house, threatened to be dropped from the program so I don’t think it’s having any real lasting effect as an ultimatum. @Julie_Smith I actually don’t know much about half way houses to be honest, she’s lived in one year’s ago after rehab from what she’s told me but she definitely doesn’t want to go back to one. It may not interrupt her employment, I’ll have learn more about them. I just think based on our experience with CBD or marijuana, she does so much better with her recovery and it’s not like she gets crazy with and does it all day, just at night to sleep and eat.

#6

I have a lot of feelings about abstinence based recovery programs, mainly surrounding how they attempt to create a “one size fits all” approach to recovery, when one size does not fit all! Does a soldier coming back from war struggling with PTSD and increased alcohol use need the same recovery treatment as a 20 year old smoking too much marijuana as a way to feel more similar to his peer group, or a 30 year old who is addicted to opiates they were prescribed following knee surgery? Simple answer: no.

In regards to CBD - at this time there isn’t enough research as it relates to addiction to be able to say whether or not it should be included in treatment, but I have absolutely seen it help those struggling with extreme anxiety and sleep difficulties. Just like any supplement or vitamin, I recommend speaking with your healthcare specialist about CBD use.

In regards to marijuana - a lot more research needs to be done as it relates to long-term effects on the brain, body, and behavior. I echo what @polly mentioned:

Yes, it’s better than heroin but many times people in treatment for one substance begin using another and I’ve personally seen that lead to either problematic use of the new substance or return to the original substance. However, this doesn’t always happen again honing in on the no one size fits all idea. More on marijuana can be read in this article.

Now back to the main question of abstinence based recovery programs. I worked at an outpatient abstinence based program for many years, however we fully supported Medication Assisted Treatment (MAT), and if clients tested positive for anything the primary goal for me would be to help them gain insight and understanding as to why they may have used some other substance, educate them, get them to a higher level of care if needed, refer them to a program that would better suit their needs if we couldn’t support it, and reevaluate their individualized treatment plan to address this new need. If the facility has zero tolerance and doesn’t meet the substance user where they’re at, and work with their motivation, kicking them out could unfortunately lead to continued substance use in addition to putting up another barrier to seek treatment again in the future.

Simply put: some are good, some aren’t. If you have any other specific questions I’ll be happy to help!