Throughout the years I've agonized when working with dual diagnosis clients who attend Alcoholics Anonymous (AA) or any of their sister programs. Too often there are well-meaning people in the groups who take it upon themselves to give psychological or medical advice. All too often, this results in tremendous damage. One of the major offenders is the idea that any member of AA, CA or NA who is taking psychiatric medications is not "clean and sober". Not only is this bad advice it's not the official policy of AA.
But let me start with an example. A picture really is worth 1000 words.
Imagine working with a client who is struggling with Paranoid Schizophrenia. He finally, with the help of a good doctor and appropriate medication, takes back his mind - and his life. He comes into the office, smiles and converses with administrative staff. He describes going out with friends and enjoying his life again. Then he goes to an AA meeting. Someone there tells him that taking psychiatric medications is a "crutch" and he is not "clean and sober". He takes this to heart and stops his medications. He immediately decompensates and becomes paranoid, reclusive, combative and miserable.
I wish there were an imaginary scenario. Unfortunately, it is not. I've seen this many, many times and it is always heartbreaking.
What is most troubling of all is that this is not the policy of Alcoholics Anonymous. This is just someone's opinion being foisted off on unsuspecting people. While I am not a big fan of AA, fair is fair and the way they address sobriety and medication is very appropriate and sound. If you, or someone you love, is struggling with mental illness and substance abuse and are attending an AA support group it is important to know what that policy is.
I strongly recommend the pamphlet printed by Alcoholics Anonymous, "The A.A. Member - Medications and Other Drugs". It is available on their website and explains their official viewpoint on medications and sobriety. In this pamphlet, AA states it is their policy that "No A.A. Member Plays Doctor." As for taking medication,
"It becomes clear that just as it is wrong to enable or support any alcoholic to become readdicted to any drug, it's equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems."
I've recommended to clients that they take a copy of this pamphlet with them to meetings to ward off well-meaning members with contradictory opinions.
With that said, I do agree that people can develop substitute addictions and abuse psychiatric medications to replace illegal drugs or alcohol. But that is a completely different topic. The purpose of this article is to address clients who are taking non-addictive, psychiatric medications appropriately and as prescribed by their doctor for the treatment of mental illness. This in no way compromises their sobriety and may be absolutely necessary to preserve it!
Many, many clients I've worked with started using drugs and/or alcohol to treatment symptoms of mood disorder, schizophrenia or PTSD. Antidepressants, mood stabilizers and antipsychotics are not readily available "on the street". Nor do we have good educational programs to teach people the symptoms of mental illness. There is also a great deal of stigmatization surrounding mental illness. So people use what they can get their hands on to treat emotional or mental symptoms - and this can become the roller coaster ride of addiction.
Once sober, it is absolutely imperative that they treat the mental illness which drove them to drugs or alcohol to start with. If these original symptoms are not treated it puts the client at serious risk of relapse.
If you are someone struggling with mental illness and substance abuse issues it is important to work with a counselor and a psychiatrist who understand both. If your family member or your substance abuse counselor or your AA sponsor does not understand this, please refer them to this article.