Randy Withers, LCMHC
Table of Contents
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Last Updated on July 7, 2022 by Randy Withers, LCMHC
Do you struggle with drug or alcohol addiction?
If you do, you’ve probably heard of Alcoholics Anonymous, the largest community support group in the world.
AA is a great choice for many, but what happens if you give it a try and decide that it’s not right for you?
Have you heard about SMART Recovery?
What Is SMART Recovery?
SMART Recovery is a nationwide network of support groups for people who struggle with addiction. It’s one of the largest support systems in the world, rivaled only by 12-Step Programs like Alcoholics Anonymous.
“SMART” is an acronym that stands for Self-Management and Recovery Training. It is a secular organization rooted in science. Specifically, it uses Rational-Emotive Behavioral Therapy (REBT) and non-confrontational motivational methods to help members make positive changes in their lives.
Is There Something Wrong With Alcoholics Anonymous?
Alcoholics Anonymous has saved the lives of hundreds of thousands. So has Narcotics Anonymous. And if they work for you, then keep going.
The only problem with AA is that it doesn’t work for everyone. One of the reasons why is that 12-Step programs promote a faith-based approach to recovery.
That’s great if faith is important to you. But what if it’s not?
Peer-reviewed studies like this one and this one and this one have shown that 12-Step Programs are only successful for 10–15% of the people who have tried them, which begs the question: why do they only seem to work for a fraction of the people who try them?
Logic dictates that we try to understand what it is that works about them and what it is that does not. Addiction is, after all, a condition that is chronic, progressive, and incurable.
12-Step programs treat the spiritual components of addiction, but they fail to address critical things that impact our ability to recover, like co-occurring mental illness.
And the culture of these programs is such that even talking about mental illness is frowned upon. The prevalent belief is that a spiritual deficit exists, which is what one should focus on changing.
Maybe that’s why 12-Step Programs are only successful a fraction of the time.
Perhaps the treatment of mental illness is a bit more complicated than remaining abstinent. Most drug addicts self-medicate. Should we not be treating the conditions that keep so many in active addiction?
It is true that 12-Step Programs get the lion’s share of press, but they aren’t the only game in town. SMART Recovery® has been growing in popularity for years.
5 Facts About Smart Recovery
1. It’s okay to talk about mental illness.
The National Institute on Drug Abuse (NIDA) and The Substance Abuse and Mental Health Services Administration (SAMHSA) report that 20 million adults in this country have a substance use disorder. And of those 20 million, about half have a co-occurring mental health disorder, which means that they are also dealing with some form of depressive, anxiety, mood, or psychotic disorder.
Frank discussions about mental health tend to be frowned upon in 12-Step meetings. It has something to do with the 12-Step belief in a Higher Power and the power of The Program.
The idea is, if you’re working the program the way you should, your sanity should be restored and you get to be a productive member of society. Frankly, overt discussions about mental illness disrupt that narrative.
Zealots often claim that you are not working the program to the best of your ability if you were still depressed or manic or any of the other things that come with mental illness. This is from AA’s Big Book:
“Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way.”
Alcoholics Anonymous
And from NA’s Basic Text:
“We have never seen a person relapse who lives the Narcotics Anonymous program.”
The Basic Text, Narcotics Anonymous
SMART Recovery®, on the other hand, recognizes mental illness is separate from addiction. It acknowledges that psychiatric distress often keeps people using and endorses the use of therapeutic interventions such as Rational Emotive Behavior Therapy (REBT) to address the symptoms.
2. SMART Recovery® uses evidence-based interventions and prescribed psychiatric medication.
This might be the single biggest difference between SMART Recovery® and 12-Step Programs, which make a point of separating themselves from “professional services.” It’s even against their guidelines to have trained clinicians involved in meetings.
NA, for example, believes that “the therapeutic benefit of one addict helping another is without parallel.” That sounds great, and for many it’s true.
But what if you need more?
12-Step Programs are populated by sick people helping other sick people. This works for some, but why is it a bad idea to use evidence-based therapies or even prescribed medications in the fight against addiction and co-occurring mental illness?
Many members of NA and AA despise the very mention of medication. Some would go as far as to say you are not working an honest program if you are using any drug, prescribed or otherwise.
Total abstinence from everything.
When you consider that 47,000 die in this country every year from suicide, 90% of whom had a mental disorder, it is alarming to see a support group taking such a cynical attitude towards professional intervention.
While it is not a good idea for a recovering heroin user to take narcotic painkillers when Advil would do, this belief gets a bit murkier when you start looking at mental illnesses such as Schizophrenia and Bipolar Disorder.
3. SMART Recovery® recognizes the complexity of addiction.
Drug addiction takes many forms. Many people who suffer from addiction claim they can get addicted to anything — heroin, crack, sex, soap operas, you name it. Others have their one drug of choice and never had problems with anything else. Some addicts forego drugs and find themselves addicted to shopping, gambling, work, or sex.
SMART Recovery® accepts that addiction is a complicated, multi-faceted disease. Some people require medication; some don’t. Some people require hospitalization; some don’t. Some people need therapy; others need accountability, direction, structure, or all of these things, or none.
Sometimes addiction is self-medication for depression. Sometimes it’s more on the Obsessive-Compulsive (OCD) spectrum. Sometimes people truly are physically addicted to a drug, as is often the case with opiates and heroin. Sometimes it’s more psychological. Often, it’s a combination of several factors.
Faith in a higher power is certainly helpful. But is it enough?
4. SMART Recovery® is based on science, not spirituality.
At 12-Step Meetings, you’re supposed to say “Hi my name is “X,” and I’m an addict.” It’s weird if you don’t. The idea is that we have to accept who we are. But is it possible that we can change?
SMART Recovery says yes.
SMART Recovery® discourages the use of labels such as “alcoholic” or “addict.” It has a scientific foundation, not a spiritual one. It promotes self-reliance over powerlessness. Meetings are discussions where members talk with one another. Meeting attendance is encouraged for months, sometimes years, but not a lifetime.
The basic assumption with 12-Step groups is that you attend those meetings for the rest of your life.
Even if that is the right thing to do, how realistic do you suppose that is?
If you’re seeing the same therapist five years later, you really have to ask yourself if any work is actually being done. Wouldn’t the same thing be true with support groups?
Finally, the concept of “powerlessness” is problematic for many. It’s also a HUGE part of the 12–Step philosophy.
We have to admit that we are powerless. Only then can we admit we need help.
That’s true, but the problem is that people tend to use powerlessness as an excuse for all sorts of things, including relapse.
SMART Recovery® advocates self-reliance, which is the cornerstone of any modern treatment modality. If we are to get better, we will need to lean on others at first, but eventually, we are going to have to lead our own lives.
5. SMART Recovery Offers Meetings Online and In Your Community
The Coronavirus Pandemic has forced many addiction support groups to hold meetings online. Thousands of face-to-face meetings have shut down indefinitely.
SMART Recovery is no exception. Many of the local community meetings are on hiatus for now.
But SMART Recovery pioneered the concept of online support groups for addiction treatment. They’ve been holing meetings online for years.
SMART Recovery Online (SROL) is a wonderful online community where members help one another recover from addictive behaviors. It offers daily online meetings, message boards, and a 24/7 live chat.
These online resources are available for free 365 days a year. You can learn more about them by going here.
They also offer trainings for anyone who wants to start their own meeting. Whether you are a volunteer or a professional, you can learn how to run a SMART Redovery meeting in about two months.
If you’re interested in learning more, visit their Smart Recovery Training page.
Final Thoughts About SMART Recovery
In 2005, I went to rehab for drug addiction. I also started attending Narcotics Anonymous. I’ve worked the 12 Steps. I’ve had a sponsor and I’ve sponsored others. These days I’m a licensed substance abuse counselor, so I have the benefit of both personal and professional experience. Here’s what I have learned:
Recovery is holistic in nature. It is far more complicated than just not using. It’s about mental and physical health. It’s about setting goals and achieving them. It’s about avoiding toxic people and relationships. It’s about diet. It’s about spirituality and service. It’s about finding a job that you love and a partner that you adore. It’s about prayer and sacrifice and education and practice.
But mostly, it’s about connection — connection to others, connection to our world, connection to ourselves. People who are connected to the world in which they live tend to be more mentally healthy than those who live in isolation. Those who are mentally healthy tend not to become addicted to drugs and alcohol.
If you struggle with addiction, take a long, hard look at how you relate to your world and have the courage to make changes where needed. We do recover, but only if we have the willingness to do what we must to make it happen.
To learn more about SMART Recovery, visit their website.
What do you think? Please leave a comment below.
References
- SMART Recovery – Official Website
- If Not AA, Then What? SMART Recovery and the AA Alternatives
- How Does SMART Recovery Work?
Hi Randy, I enjoyed your website! I am a professional in the field of psychiatric and mental health, and addictions/recovery. I love the field; working with individuals and families to grow by learning healthier ways of thinking and behaving is rewarding work. I seek to learn about new advances in the field, and my perspective continue to be enriched by professional and personal experience. I like that you question treatment modalities- like the commonly promoted 12 step model. It has numerous shortcomings…As does SMART, and any program (Women for Sobriety, SOS)…the one that will work best is the approach that an individual will USE ) I provide education re: the different pathways to recovery, including the pros and cons of each and try to help an individual choose the approach that will best support their goals…
Hey Susan, thanks for your comment! If you’d ever like to write an article for me, I’d be happy to publish it. Be well!
Did you hear the news about Ben Affleck? It looks like he relapsed. Did you hear about that? Very unfortunate… Sobriety is a tough process. I know first hand.
Great article….Thanks for sharing this with us.
Top Tips For Overcoming Opiate Addiction
Randy, clearly there are benefits to both 12 – Step Programs and SMART Recovery. The percentage of anyone with a substance use dependency issue is extremely low, regardless. What is known, however, is that involvement with some form of community support group greatly increases one’s chances of success of maintaining remission from substance use. It is pretty obvious that you use biased generalizations and verbiage to sway your reader.
Thank you for your feedback, but I’ve been a member of Narcotics Anonymous for almost 17 years. I assure you, I am quite familiar with the benefits of both organizations.