The Twelfth Step

The month of September is annually identified as "National Recovery Month" whose primary sponsor is, appropriately, SAMHSA (Substance Abuse and Mental Health Services Administration). There has been a special focus on the subject throughout the country, which is a good thing.

Many people in recovery adhere, in some way, to the famous "12 Step" program originally envisioned in 1935 by the founders of Alcoholics Anonymous, Bill Wilson and Dr. Robert Holbrook Smith. You might not know it, but there is a Narcotics Anonymous (NA) fellowship, formed in 1953 by Jimmy Kinnon in California. In 1993 (before the "outbreak" of the opioid epidemic), there were over 13,000 NA groups holding over 19,000 meetings in 60 countries. As of May 2016, there were over 67,000 weekly meetings in 139 countries. Obviously, NA's growth mirrored the spread of this man-made tragedy.

In case you've heard about 12 Steps but never knew what they were ...

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

The enhanced discussion on recovery this month prompted me to think about how the United States is doing on the continuum of 12 Steps.

Because I have been actively engaged in the issue of opioid overuse/misuse/abuse since 2003, I have seen the evolution in our country's consciousness about the issue. From something nobody really knew about (other than those caught in the snare) to something with constant news coverage. From a "solution" that was presented as addressing the "under" treatment of pain in the mid-1990's to the "over" treatment of pain by turning people into zombies. From just an issue with opioids to an issue that now also includes abuse of benzodiazepines and heroin and elephant tranquilizers. From a problem for "somebody else" to a problem that is highly personal to 44% of Americans. So in regards to Step 1 for the U.S. - √.

In a recent sermon at my church, North Atlanta Church of Christ, I heard a profound insight. Recovery doesn't occur until Steps 4 (an unvarnished self-inventory) and 5 (confession to others). It is different to identify you have a problem than to actually admit it to others. Until you go beyond identification into the realization that change is required - with specifics - and are willing to be accountable to making those changes, recovery really hasn't started. The White House published "Epidemic: Responding to America's Prescription Drug Abuse Crisis" in 2011 that created strategies to be used by the Office of National Drug Control Policy. The CDC published earlier this year "Guideline for Prescribing Opioids for Chronic Pain" (side note: contrary to what I've heard from some doctors, while these guidelines are addressed to primary care settings, THEY ARE APPLICABLE TO ALL PRESCRIBERS (yes, I'm shouting) regardless of their specialty or setting). In April "more than 60 U.S. medical schools pledged to teach new federal guidelines for prescribing opioid painkillers." This Summer the U.S. Surgeon General launched #TurnTheTide and followed that up by sending a letter to 2.3M American health professionals clearly requesting accountability. New York was among several states to enact new laws specifically to address opioid and heroin. So in regards to Steps 4 and 5 in the U.S. - √.

Which leads us to the Twelfth Step - pay it forward. Don't let the end of September mean the end of your focus on recovery. As a country. As a community. As individuals. We are on the road to recovery. If you have been successful in your recovery (granted, it's a daily battle) or have not (yet) needed recovery, help others. If you're still in the midst of recovery, be with others. If you need recovery, seek others.

Don't assume someone else is going to fix this problem. It's OUR problem and will only be resolved by US.