Alternatives for 12 step ?

  1. Hey all, I am working in an inner city ER with frequent flyers. THere is this middle aged man always found passed out on the road. We admit him, he goes through detox and starts to drink right after discharge. I've really started to bond with him. He says that AA doesn't work for him because he is a quiet loner and three meetings a day plus sponser calls turns him away from the program.

    I had suggested the program for general addicts, is it allanon? Can't recall, social work had set it up. Well he's back again. Now I know I can't help everyone, expecially until they are ready. But ARE there alternatives to sobriety instead of a super structured environment such as AA?

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    About Zookeeper3

    Joined: Aug '07; Posts: 1,385; Likes: 3,029
    Travel nurse; from US
    Specialty: 17 year(s) of experience in ICU, ER, EP,


  3. by   Meriwhen
    There's SMART, which is more cognitively-based than spiritually-based.
    Self Help Substance Abuse &amp Addiction Recovery | SMART Recovery

    NA is Narcotics Anonymous. That encompasses addiction to almost any drug including alcohol.

    Al-Anon (and Nar-Anon) is for the families of alcoholics. While your patient would certainly not be turned away from a meeting, it's also not the ideal fit for him. It's more for those who are, for lack of better words, one step removed: not the actual addict but those whose lives are affected by the addict's addiction.

    You and your patient also have a few misconceptions about AA. Assuming there are no court orders, etc. stipulating otherwise, he does not have to attend 3 meetings a day. He does not have to get a sponsor. He doesn't have to sign up for sober calls. He does not have to be an active participant in meetings. He does not have to work the steps. Granted, these things can be of immense value in his recovery, but they are not mandatory. His recovery is solely in HIS hands, and it's what he is willing to make of--and do for--it.

    All one needs to join AA is a desire to stop drinking. AA doesn't force anyone to do anything they don't want to do. He can sit in a daily meeting for years without saying a word, and he will still be welcome at the next meeting. He can relapse every night of that year and he will still be welcome at the next day's meeting.

    Suggest to him that he just attend one meeting a day. That's it: just attend. If he wants to participate, yay. If he doesn't, yay. If he doesn't like one meeting, have him try another meeting. But have him just go with no other strings or commitments attached, and see what that does for him.
  4. by   athena55
    You hit the nail on the head when you said "Now I know I can't help everyone, expecially until they are ready"
    Sounds like he is not ready, yet.
    As Meriwhen stated, "His recovery is solely in HIS hands, and it's what he is willing to make of--and do for--it"
    Just my 2 cents
  5. by   Sonny Boy Thompson
    There's some alternatives to twelve steps.
    Last edit by TheCommuter on Aug 6, '12 : Reason: unapproved website link
  6. by   Zookeeper3
    Thank you so much. I'm an ICU and ER nurse. I had no idea about AA, great information, thank you! Normally social work sets these things up, but we are doing more and more without resources lately. I really appreciate your time!
  7. by   QuarterLife88
    Rational Recovery programs.
  8. by   Nici_StudentRN
    Do you have any connections with primary providers that are within your hospital network?

    The reason I ask this is because many of these offices have referral coordinators whom are aware of special services such as ETOCH programs that are in the community. Although in my experience these tend to be providers offices that have a higher demographic of low income patients.

    I actually do this very thing myself in the family med office in which I work. It is my responsibility to seek out and network with a variety of agencies and specialists offices to provide to our patients. We have a VERY HIGH Medicare/Medicaid demo in our practice and it is becoming increasingly difficult to find providers and agencies that will take these individuals :-(

    I agree with previous posters stating that when he is ready is when he will be ready but I also believe that as long as you make it clear to him that you are there to assist him when he is ready he will be more likely to come to you when he is ready. He states he is more of a loner and if he trusts you that says a lot. There is nothing wrong with seeking out to help people, that is why we chose this profession, is it not?
  9. by   BostonTerrierLoverRN
    Those of you who know me, know I just don't discuss my history of Opioid Addiction. Very few of my friends on here only know bits and pieces-as Meriwhen can attest(who is EXTREMELY knowledgeable in addiction, ETOH abuse, Chemical Dependency, and Behavioral Nursing; I know from her mass of past posts).

    I don't hide my past, and it's not that it's because I consider it personal, but because those memories are marinated in pain, guilt, and loneliness.

    My dependency eventually cost everything I held dear: a paid off New Orleans French Quarter Condo, followed by my career (at the time), followed by my dignity, followed by my beloved wife, and ending in a spiral to complete isolation. I didn't drug with others, I used in private from the moment my Rx's turned from treating physical pain, to self medicating the pain of my brothers sudden death at 17(I 15), a verbally abusive mother suffering from bipolar d/o, and my best friends suicide a year later battling similar addictions in private. After that, having a very liberal prescribing MD, I bottomed. I learned how to get Hydromorphone Ampules ordered from Czech Republic, and it went on for years without anyone knowing as I appeared to be successful, at 25 receiving my MSN and NP-yet at the height of my career, running 3 mission clinics in Eastern Europe, along with healthcare correspondence with the UN, I was at the PIT of my addiction.

    I overdosed in my Apartment in Prague, and awoke 2 1/2 months later from a coma, to learn I had lost my career I loved with the Church, and therefore my income. I Detoxed, and spent 90 days in rehab. I never understood the 12 Step program ( I know it works for many many many people, but I couldn't find healing with them). I, a spiritual person couldn't make them work for me. I needed the safety and abstinence rehab offered, and then 3 mos later I walked out knowing I hadn't changed anything! I wanted my old life back! I didn't know how to live any different. I knew I would be loose everything now if I went back, now I was "outed" as an addict, but I would have to find a way to truly enter "recovery" mode.

    I worked at a grocery store, and by the grace of God and Paxil managed to stay sober until I was given a copy of "The Alcohol and Drug Addiction Cure," by a nurse i confided in that nothing in me had changed except i was currently "clean." Note this book goes against everything we're taught about addiction as a disease. I'm not telling you what to believe. I'm not saying Addiction isn't a disease. All I am saying is applying and working through the book, I have faced 5 years now, the loss of my wife to infidelity, rebuilt my wealth to 10 fold as before my "fall," and never relapsed even after I donated bone marrow, and a kidney to my cousin, I threw away 3/4 of my leftover pain medications twice without a second thought, or any cravings.

    I do as a rule abstain from mind altering drugs, but I don't crave anything-even now when I feel bad, feel lonely, or desire to feel better. The book made since to me, and I credit my life to it. I really feel like I was given a second chance. Up front, I had NO faith, hope, or expectation another book could help me, but the Recovering Nurse who gave it to me knew if I read and applied its simple steps, I'd recover to full health, she was right. I have also seen it save 5 more lives since then-all have been relapse free. These people have been to Detox countless times, rehab, sober houses, meetings(which I have NEVER attended since discharge) and only the book helped.

    I'm not saying it is a miracle, just that for me-it worked. I honestly think it was written by a Rich Man who "was" money driven, profit happy, and just looking for the next easy buck, (says it was for his self and son's health)-all I am saying is-YOU ARE READING THIS, BECAUSE I READ THAT BOOK AND APPLIED IT, otherwise-no one here would know me.

    I wouldn't have survived the Anhedonia and PAWS of longterm opioid withdrawal. I am truly a new man, the book CAN work, and we wouldn't be throwing out the 12 steps because both he and I tried and failed them-or-is their just a small possibility they failed us? That's all I'm saying.

    If his addiction is left in his hands, I think we all know the 3 possibilities-I once shared them. JAIL-DEATH-INSTITUTIONS. I'm so glad this is done now, I hope this helps you help him, it is an "Alternative."
    Last edit by BostonTerrierLoverRN on Nov 12, '12 : Reason: iPhone format fail
  10. by   BostonTerrierLoverRN
    Just wanted to add a clarification I didn't make in the above post. I do believe addiction is a mental disease. I believe the 12 steps and AA/NA have saved many lives and that post was in no way to sway anyone from using or advising them. This program is free to addicts, and I have the UTMOST respect for Dr. Bill. He is a hero in my book. I just needed to bring that out. I mean the Process of the book I read helped me. (As an Alternative)
  11. by   suejgee
    SOS or Save Our Selves is a secular alternative to 12-steps. It's focused on self-empowerment rather than the higher power concept. I've found, in my own recovery, the notion of powerlessness to be counter-productive. This is not to say it doesn't work for many, but I don't believe it works for everyone. Perhaps the patient you're referring to could benefit from SOS -- just google Save Our Selves and it will take you to all the SOS links available. I know it worked for me. I've been sober for fourteen years without a relapse. Good luck!
  12. by   Sadala
    I'm wondering if your guy has access to a computer... I think a lot of the groups you'll find (and a couple have already been mentioned above) that aren't in the 12 step framework are probably mostly accessed online unless someone lives in a larger city, and then they might have more variety. And then there are some rehabs that are non 12 step based. And there are some cognitive therapists who work with addiction in a non 12 step based format.

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