The end — how demands of complete abstinence and the shame around all substance lead to relapse and death end
When Jillian awakened, she felt refreshed. As she looked around her room and calculated where she was, she remembered the night before.
Heading to get her coffee started, she watched the moments rise through her mental fog, to the surface. Then, she saw it — the joint.
Processing this, she assessed its reality.
She had six months clean after years of heroin addiction. Dreams of getting high were common and she would often wake up wondering if they really happened. But this felt different.
By the time she finished her morning routine, she knew. It did happen. She smoked a joint the night before with her childhood best friend.
Her thoughts raced between assessing how it made her feel and fearing what her sponsor, Jen, would say.
Jillian’s peers had made it out like the world ended when you used any substance, but the world hadn’t ended at all. In fact, it felt exactly the same. She still had no desire to use it and was looking forward to doing step work with Jen that evening. Even more, after the magic of last night, she was looking forward to it more than the day before.
Upon meeting with Jen, she immediately confessed.
Although a berating was expected, her sponsor was not reactive at all. She simply nodded as she listened.
“So what’s the problem?” Jen asked.
Sarah looked at her in astonishment and frustration. Jen had a way of leading Jillian to her own answers instead of giving them, but this did not feel like the time.
Jen looked back with confidence.
“Did you shoot dope?”
“Do you want to shoot dope?”
“So, what’s the problem?”
Jillian hesitated… “But everyone…”
“Stop right there”, Jen interjected, “We are not talking about everyone — we are talking about you.”
At that moment, Jillian’s sponsor would give her the best advice that she wouldn’t take — the advice that could have saved her life.
“This is where you recognize the difference between the program and the fellowship. Because, as you know, not everyone in the fellowship practices the program.”
Jillian nodded in understanding.
“What does it take to make an AA meeting?” Jen asked.
Happy to have done her homework well, Jillian gave a half-smile.
“Two people who have the desire to not drink are required, and a coffee pot is preferred.”
“Exactly”, said Jen.
“So anyone can make a meeting, and anyone can form a group in the fellowship. Practising the program is not required. Just because people who go to meetings say something, doesn’t mean it is true for you. This is what we mean when we say, ‘take what you need and leave the rest.’ ”
Jen was calm, but Jillian started to become frantic.
“What do you mean? Everyone says it! They say I have to pick up a new chip. Oh my god, I cannot believe I did this.”
Jillian started to cry as Jen started to explain.
There are many pathways to recovery. The 12 step program is only one and it claims no hold on the ultimate truth. But within that paradigm, there are certain closed-minded beliefs that some members and groups have taken to the extreme. One of which is complete abstinence from all substances for every person in recovery.
Jillian squinted her eyes.
“But I thought when we went over my discharge plan together, you said it looked good. One of the items was complete abstinence.”
Yes, it was. And that was a good plan for various reasons. If you use any substances in early recovery, you run the risk of depending on that to ease the pain. If you do that too much, you might not put in the necessary work to recover and instead, lean on a substance to feel comfortable in your own skin. Doing that for some time would surely lead to a full-on relapse. But smoking a joint and eating too many tacos isn’t necessarily going to do that. You see, some people cannot use anything psychotropic, ever, or they will pick up their DOC that same day. But not all people are like that. There is no one path to recovery that works for everyone. There are many different pathways, that vary depending on each unique individual.
Jillian wasn’t convinced.
“But Fred always says it and he sponsors more people than Jesus. They say that many people have tried doing it a different way, and it never works. Plenty of people tried it and share about how it didn’t work and they ended up back at square one — hopeless and defeated.”
Jen gave a wise giggle as she grinned.
“Of course, sweetie. Because the people who find success a different way don’t come back to the rooms to tell us about it.”
Something clicked, but something was still out of alignment for Jillian.
“But honesty is the spiritual principle of the first step, isn’t it?”
Jen raised an eyebrow.
“Yes, but the steps don’t work alone, my dear. Only together.”
Jillian felt like she was failing the quiz or her sponsor had gone off her rocker as she sat there, answerless.
“Except?” Jen questioned.
Jillian’s lightbulb went off again.
“Ohhh! Except when to do so would injure them or others.”
Jillian’s sponsor stood up, excited, and threw up her hands.
She was always filled with excitement when she was able to help Jillian connect the dots of things. She smiled and started pacing as she did when she would summarize what they had found.
You see, one through eight are between you, your higher-power and your sponsor. Nine through twelve are your maintenance steps, and they apply to your relationship with the rest of the world. You have done your work, told me about it, and we will take the inventory. But that is our business and should not involve the fellowship — just like you don’t do your fifth step with the whole fellowship. And in step nine, we learn that amends is only suggested when doing so would not injure them or others. The only person you may owe amends to is you, and telling everyone would only injure you by bringing shame and damaging your relationship with the fellowship. If you shot heroin last night, we would be having a different conversation.
Jillian scooted forward in her chair.
“So you are saying I don’t have to pick up a new chip? But how am I not being dishonest if I smoked pot since my clean date?”
Jen laughed out loud.
I won’t even begin about Bill Wilson and his escapades with LSD; you will do that research later. But a requirement of complete abstinence is found nowhere in AA’s literature or its history. Actually, you will learn that acknowledging it as an AA member is a violation of Tradition five. AA has no opinions on outside issues, including the use of substances other than alcohol. It has but one primary purpose. This is the same reason you do not talk about your heroin use in an AA meeting — it is an outside issue. What’s next — are we going to ask people to pick up a chip for buying a scratch-off or sleeping with a prostitute? No. It is not black and white, and that is why it’s not everyone’s business. You get to choose if you want to announce your personal inventory to the world.
By the end of the one-on-one, Jillian felt confident, and the veil of complete shame had been lifted. Off to the 8 o’clock meeting she went. She had no clue that it would be the last meeting she would ever attend.
After the meeting, she sat at the picnic table with her closest AA friend, Pam.
Pam was a newer friend, but a close one nonetheless. She was the first friend Jillian made in recovery. They sat together outside of the church, where they had a meeting with about 20 other AA members. In the end, they did a sobriety countdown and birthday cake, so standing up for her six months was heavy on Jillian’s mind.
Pam laughed and told the story of why David always stands up for twenty-four hours — even though he has like ten years. Jillian felt a drop of the magical feeling she had felt the night before — the feeling of shared purpose and camaraderie.
She couldn’t help herself, and before she knew it, she told Pam the whole joint story — including the conversation with her sponsor.
Pam did her due diligence and informed Jillian that her sponsor was insane and if she didn’t count her joint as a relapse, start over, and pick up a new chip, she would be building her recovery on a foundation of lies — which would ultimately lead to her full relapse and death.
Before Jillian could explain further, Pam’s ride showed up and off she went into the night.
Jillian went back and forth with herself on her walk home but ultimately concluded that Pam was right. She was a failure. All her hard work from the past six months was flushed down the drain, and here she was — a relapser. A newcomer again.
She had seen the glances that relapsers received — she knew the routine. She heard how people talk about them.
Perhaps they were right, and it was her fault. Maybe she hadn’t done the work right, and that was why it happened — because she had no real recovery.
Then came the thoughts that would end her life.
If I didn’t even use and I have to start over as a relapser because I smoked a lousy joint, I might as well get high. I have zero days clean anyway. There is one thing that will take away my guilt and pain — even if just for a moment. Either way, I have one day clean tomorrow.
Then came the famous last words of any person who is lost, again, to the grips of addiction.
Instead of going home, Jillian walked to the dope house around the corner. She decided to use it one last time. Tomorrow, she planned to start over and pick up a new chip.
It would be her last time because she had never been clean and had no clue how much dope her body could handle. The only advice she had received about using again was not to do it.
She overdosed in the dope house and died on its bathroom floor.
This story was inspired by real events, and its purpose is to demonstrate how demands of complete abstinence result in high relapse rates and death by overdose.
According to the Substance Abuse and Mental Health Services Administration, also known as SAMSHA, the definition of recovery is as follows:
“SAMHSA has developed a working definition and set of principles for recovery.Recovery is defined as: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
In this light, recovery is a “process of change”. Complete abstinence from all substances is not mentioned in this set of principles. In fact, medication-assisted treatment, aka MAT, is recognized by SAMSHA as a crucial pathway to recovery — especially for those who are opiate dependent.
Cannabis is a popular and often suggested choice for many who have not been able to maintain abstinence from opiates.
Jillian was in recovery and she had made amazing progress. His life had changed, completely. Her well-being was at an all-time high. She was on her way and her opportunities were endless.
Like many others, Jillian may not have picked back up if not for the shame she felt from the rooms — the only place she had found that made her feel worthy.
Many things contribute to the culture of recovery shame in the 12-step programs, but demands of complete abstinence and the shame that is forced upon members who do not maintain it makes the top of the list.
Written by Holly Kellums
Originally published on Medium.com
Featured image by dissx