Editorial Comment:  The other community recovery groups

I discussed the various cultures of both addiction and recovery from addiction this past week, at the International Doctors in Alcoholics Anonymous (IDAA) conference in Knoxville, Tennessee.  Most of the topic was dedicated to the conceptual utility of a cultural model in providing effective interventions and structured treatment for addictions. But it also offered an opportunity to look briefly at what else is available, in addition to twelve-step programs, as community mutual assistance organizations.  Such knowledge is an ethical and professional imperative. 

I’ll give a more inclusive and more extensive discussion at several future programs, including the California Society of Addiction Medicine meeting this fall.  So, what I provide below is intentionally abbreviated.  Each deserves a separate discussion beyond simply a website, and additional review can be found in Miller, S. (Ed.) Principles of Addiction Medicine, 6^th Ed. 2019; we may choose to review them individually in more depth, in future editions of ASAMW. Regardless of the respective effectiveness or inutility of each of these programs, I believe it is obligatory for addiction physicians to know something about their structure, philosophy, and availability. Knowing about and endorsing these programs are two quite separate things.  More to the point, patients will come to addiction doctors for more than solely as experts in 12-step process -  just as they should expect more than simply a pharmaceutical prescription.

• Women for Sobriety (WFS)  https://womenforsobriety.org/new-life-program/ 
• Self-Management and Recovery Training (SMART) Recovery https://www.smartrecovery.org/
• Secular Organizations for Sobriety (SOS)http://www.sossobriety.org/#introduction-section
• Moderation Management (MM) https://www.moderation.org/#
•  Oxford Groups (yes, still operational) https://www.lakeviewhealth.com/blog/oxford-group/
• Rational Recovery https://rational.org/index.php?id=1 
• MMTPs (most methadone clinics meet the criteria for a culture, as distinct from individual buprenorphine providers)
• Therapeutic Communities (Synanon, Hilltop)  (no single website, just no single philosophy)
• AA & NA, and others in what may be called the League of Anonymity (12-step based), for example:  Sex and Love Addicts Anonymous, Gamblers Anonymous, Meth Anonymous, Cocaine Anonymous; and, by extension, Alanon, Alateen, Nar-Anon (not the same as “Narconon”).

- W. Haning, MD, DFAPA, DFASAM