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Sarah had been clean for three years when her doctor diagnosed her with severe anxiety and recommended medication. At her next Narcotics Anonymous meeting, she felt conflicted about sharing this news. Would taking prescribed medication mean she wasn’t “clean” anymore? The warm support she usually felt in her recovery home suddenly seemed uncertain.
Sarah’s situation highlights one of the most nuanced and sometimes contentious issues within NA communities: what exactly does “complete abstinence” mean when it comes to medication? Let’s explore the questions many members like Sarah face.
NA’s official literature has evolved on this topic over the years. The organization formally recognizes that medication use is a personal decision between a member and their healthcare providers.
From NA’s “In Times of Illness” booklet: “We make a distinction between drugs used by drug replacement programs and other prescribed drugs. NA as a whole has no opinion on the practices of medical professionals. Decisions about medication are personal and should be made in consultation with one’s sponsor, healthcare professionals, and one’s Higher Power.”
This position acknowledges that NA is not a medical authority and shouldn’t interfere with medical treatment. However, interpretations of this stance vary widely across NA communities.
“The important thing to remember is that NA’s official literature doesn’t condemn necessary medication use, even though individual members might express stronger opinions.” – Addiction counselor who works with 12-step programs
Several factors contribute to why medication remains controversial in some NA circles:
Historical context: NA emerged when understanding of addiction and mental health was less developed. The emphasis on complete abstinence developed when distinctions between therapeutic medication use and drug misuse weren’t always clear.
Personal experiences: Many members have histories of misusing prescribed medications or using prescriptions to justify continued drug use.
Core NA principles: The foundational concept of “complete abstinence” can be interpreted in different ways, leading to debates about what substances “count.”
Varying interpretations: Some members believe any mind-altering substance compromises recovery, while others distinguish between therapeutic use and misuse.
This creates an environment where medication discussions can become charged with deeply personal beliefs about what recovery means.
Not all medications generate equal concern in NA communities. Those that typically spark the most discussion include:
Psychiatric medications: Particularly those treating anxiety, depression, or ADHD. Medications like benzodiazepines (such as Xanax or Valium), stimulants (like Adderall), and some antidepressants generate more discussion because they affect brain chemistry or can have addiction potential.
Pain medications: Opioid pain relievers create particular concern due to their similarity to commonly misused substances.
Medication-Assisted Treatment (MAT): Medications like methadone, buprenorphine (Suboxone), and naltrexone used specifically to treat opioid addiction remain among the most debated topics.
Sleep aids: Due to their mind-altering properties and potential for dependence.
Medications treating physical conditions without mind-altering effects (like antibiotics or blood pressure medicine) rarely generate controversy.
NA meetings vary dramatically in their approach to medication discussions:
Traditional/conservative meetings may:
Progressive/contemporary meetings often:
These variations mean that a member might find completely different responses to medication questions depending on which meeting they attend.
“I’ve been to meetings where mentioning my antidepressants made people uncomfortable, and others where members openly discussed the role of medication in their recovery journey. It’s like they’re two different worlds sometimes.” – Member with 7 years clean
5. What about medication for co-occurring mental health conditions?This question represents one of the most significant evolutions in NA discussions over the decades.
Traditional viewpoint: Some old-school thinking suggested that all emotional and mental health issues would resolve through working the steps and maintaining abstinence.
Contemporary understanding: Modern NA literature and many groups now recognize that co-occurring mental health conditions:
The growth in understanding mental health has shifted many NA communities toward more accepting attitudes about psychiatric medications when prescribed and taken appropriately.
A member speaks: “When I came into recovery, I stopped taking my bipolar medication because I thought that’s what ‘clean’ meant. Six months later, I was hospitalized during a manic episode. Today, I take my medication, work my program, and have eight years clean. Both components are essential to my recovery.”
Medication-assisted treatment for opioid addiction—using medications like methadone, buprenorphine (Suboxone), or naltrexone—remains among the most debated topics in NA.
Traditional NA perspective: Many traditional meetings view MAT as substituting one drug for another, not as “complete abstinence.”
Medical perspective: The medical community generally considers MAT an evidence-based treatment that significantly reduces overdose deaths and helps stabilize lives.
Evolving middle ground: Some NA members and groups are developing more nuanced positions:
This remains a challenging area where medical best practices and traditional recovery wisdom sometimes conflict.
The concept of “clean time”—the period since last drug use—becomes complicated when prescribed medications enter the picture.
Traditional interpretation: Some NA members believe that using any mind-altering substance, even as prescribed, resets one’s clean date.
Contemporary view: Many now distinguish between:
Therapeutic use: Taking medication exactly as prescribed for legitimate medical conditions
Misuse: Taking medication other than as prescribed (higher doses, more frequently, for effects beyond intended treatment)
The majority perspective is shifting toward counting clean time based on freedom from drug misuse rather than all substances.
A sponsor shares: “I tell my sponsees that being honest about medications is more important than debating clean time. If you’re taking medication as prescribed, being transparent with your doctor about your addiction history, and not seeking mind-altering effects, you’re living in the spirit of recovery.”
For NA members facing medication decisions, these practices help navigate the challenges:
Be completely honest with both medical providers and recovery supports:
Explore non-medication options when appropriate:
Ask about alternative treatments
Consider if therapy might help alongside or instead of medication
Utilize healthy coping mechanisms learned in recovery
Use medication exactly as prescribed:
Avoid self-adjusting dosages
Don’t use medication to get high
Have accountability around medications if needed
Find supportive recovery environments:
Seek meetings where members have experience with similar challenges
Consider having a sponsor who understands medication issues
Build a recovery network that supports your complete health
Unfortunately, some NA members do experience judgment or misunderstanding about necessary medications. If this happens:
Remember NA’s principles: NA’s traditions emphasize that:
Seek understanding: Sometimes sharing educational resources like NA’s “In Times of Illness” booklet can help inform others.
Find supportive meetings: Not all NA meetings share the same perspectives. Explore different meetings to find more accepting environments.
Focus on commonalities: Emphasize shared recovery experiences rather than differences in approach.
Consider additional support: Some people benefit from combining NA with other recovery supports like therapy, doctor-supervised care, or additional support groups.
“After feeling judged at one meeting about my anxiety medication, I found another NA group across town where several members were navigating similar situations. Finding the right recovery home made all the difference.” – Member with 5 years clean
Like any community, NA continues to evolve in its understanding and approaches:
More medical information: Newer NA literature shows greater understanding of medical conditions and appropriate treatment.
Generational shifts: Younger members often bring more contemporary understandings of mental health and medication.
Regional differences: NA communities in different geographical areas often have varying perspectives on medication issues.
Growing nuance: Many members now focus on the difference between therapeutic use and misuse rather than absolute positions.
Continuing dialogue: NA World Services continues to develop resources addressing medication questions in recovery.
These evolutions suggest that while debate continues, the trend moves toward more nuanced understanding of medication’s role in supporting overall health in recovery.
The heart of NA remains supporting each other in freedom from active addiction. While debates about medication continue, most members agree that honesty, open-mindedness, and willingness remain the foundation of successful recovery—regardless of individual medical needs.
“Recovery isn’t about following someone else’s rules perfectly—it’s about finding a way to live free from active addiction while becoming the healthiest version of yourself. Sometimes that includes medication, sometimes it doesn’t. The key is honesty.” – NA member with 15 years clean
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