Stop the Stigma: Why is the 12 Step Program Anti-Medicine Assisted Treatment (MAT)?

Stop StigmaThere is a multitude of misleading information on the internet and beyond regarding medicine assisted treatment (MAT) for heroin and opiate addiction.  Regrettably, many people who both lead and attend 12 step program treatment developed and provided by Alcoholics Anonymous (AA) and its sister program Narcotics Anonymous (AA) are against Methadone, Suboxone, Naltrexone (Vivitrol and ReVia), etc.  But why is this the case?  Why do many 12 steppers (those who attend the 12 step meetings) have such a problem with the MATters (those using medicine assisted treatment to conquer heroin addiction)?

Medicine Assisted Treatment: Stop the Stigma

Regrettably, the stigma and stereotypes related to addiction and various treatment modalities isn’t going away anytime soon.  Methadone centers are still being picketed and many people (not just those who attend the 12 step program) consider the matters (MATters) “unclean”, “dirty” and “not sober”.  This simply isn’t the case.

This community supports medicine assisted treatment (and any recovery option that takes those suffering from addiction off of heroin) and when done right, those undergoing treatment can live normal, healthy and constructive lives and thus, we believe, they are in a state of active recovery, not active addition.  This includes medications such as Methadone, Suboxone and Naltrexone (Vivitrol and ReVia)

In many cases, it’s the few abusing a program that ruin the reputation of a particular treatment modality.  However, using medication as directed by a licensed physician is NOT the same thing as getting high.

Isn’t Medicine Assisted Treatment (MAT) Trading One Drug (Heroin) for Another (Methadone, Suboxone, Etc.)?

Stop StigmaMedicine assisted treatment can be considered drug replacement therapy.  But there is a huge different between an unregulated, illegal drug that’s often mixed with other toxic chemicals far more dangerous than the heroin itself (such as fentanyl) and a regulated medication prescribed and administered by a licensed physician.  Furthermore, ethical doctors and programs will work with each recovering addict and slowly taper them down off their medication as appropriate so the end result is freedom from all substance use.  Methadone, Suboxone, Naltrexone, etc. are far less dangerous than heroin and MATs are sometimes part of a program that includes counseling (both individual and group) modalities.

But Isn’t Undergoing MAT just a “Crutch”?

Addiction is a disease and the “sick” need a “crutch” in order to heal.  Would you advise a man or woman with a broken leg and a cast to throw down their crutch and walk on it?  Absolutely not!  So why would you advise someone suffering from addiction to stop what’s proven scientifically to work better than going cold turkey and cease using medicine assisted treatments?

Every treatment modality can be considered a crutch.  That includes the 12 step program.  But there’s nothing wrong with a crutch.  Life is burdensome and we often require help and assistance in some way to overcome them.  We were not meant to carry our burdens alone.  In fact, people were designed for community.  That’s why the 12 step program can be helpful.  Medicine is another valuable tool that can also be beneficial to those who feel they want and need it.  Is it a crutch?  Yes!  But it’s a necessary one.

Can MATs be Combined with the 12 Step Program and/or Other Treatment Programs?

Absolutely yes!  In fact, we strongly recommend using any and every available recovery tool at your disposal.  But be careful.  It’s often advised not to mention you are on any medicine assisted treatment at 12 step meetings because you may be quickly discouraged and advised to stop using medication.  What’s more, those advising patients to stop taking their medication are typically not medical professionals nor are they licensed counselors.

Dangers of Advising “Matters” to Stop Their Use of MATs Like Methadone, Suboxone and Naltrexone

There is plenty of research and statistical evidence demonstrating the success of medicine assisted treatments in conquering heroin addiction.  Many people feel they need that additional assistance to reduce withdrawal and cravings while they learn to make better lifestyle choices and reinvent themselves.  Thus, advising anyone to stop using medication prematurely could have detrimental effects and could cause someone in recovery to relapse, which can lead to overdose and death.  So unless a medical professional who knows and understands your individual biological and psychological makeup, be cautious about taking advice to stop taking your medicine.

Judging What Really Works The Right Way

clinical trialPeople typically turn to their own personal experiences or quote the experiences of those they know to determine what’s true and try to convince others they are right.  But while one’s own experience may be valid for them, experiences are different for everyone.  So how does one conclude what works and what doesn’t?  There are 2 ways to judge if something is true or not.

1. Find Clinical Studies / Scientific Evaluation – Have any studies been conducted?  If so, what are the variables and what are the results?  Are there any contradictory studies?

2. Evaluate a Multitude of Experiences Not Just Your Own – if someone else’s experience is different than yours, than your experience can’t be 100% true.  Are all experiences exactly the same?  Then there’s a pretty good chance you are right

Given that clinical research demonstrates statistical evidence that MATs work for percentage of people and are proven more effective than going cold turkey, then one must determine that MATs at least work for some people.  Given that many have shared both positive and negative experiences with various MATs, one must conclude that MATs at least work for some people.   The same applies to the 12 step program.


Each individual’s genetic and psychological makeup is unique and as a result, there is no one-size-fits-all approach to treating heroin addiction.  The 12 steps is an excellent program but it’s not for everyone.  Medicine Assisted Treatment is a lifesaver but it doesn’t work for all.  What works for some doesn’t work for everyone.

Written and Published by,

William – Publisher and Founder of Kill the Heroin Epidemic Nationwide™


8 thoughts on “Stop the Stigma: Why is the 12 Step Program Anti-Medicine Assisted Treatment (MAT)?

  1. Pingback: There is no chemical solution to a spiritual problem? - Kill the Heroin Epidemic Nationwide

  2. Not everyone affiliated with 12 step programs are against medically assisted treatment. Although everyone has their own opinion, in the groups I attend, most members are very knowledgeable and understanding about MAT. I, like many, believe “to each his own”. I also believe that each addict has to do what works for them.

  3. I’ve been attending NA for little over five years, and yes there are many members against MAT’S. Couple things, first you stated NA is the sister program to AA. NA is in no way related to the other fellowship, completely independent. Second as far as MAT’s are concerned it is really no one’s business what a individual is doing to keep dope out of there body. Addicts do not have to announce they are doing MAT’S in meetings. I do feel however it should be discussed with there sponsor. It’s not like the addicts in the rooms are talking about the pain meds they are doing when they suffer with chronic pain. One more thing I would rather be taking suboxone then doing dope. At least you are not out there with the risky behavior to get the dope. And if you choose to go to the rooms you can use that to start learning to get your life back together spiritually. That’s the point of NA to learn to live by spirtual principles…the only requirement for NA is “the desire to stop
    using”. I can go on forever. I think it’s great that this website supports MAT’S cause if was not for that type of treatment a lot of addicts would and will die from the horrors of addiction.

    • Confused Addict,

      Thank you for sharing your thoughts and opinion. While I agree and understand that Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) were both founded by different people, NA was modeled after AA which is why I refer to them as sisters. The principles are virtually the same as is their view on MAT.

      I do agree that it’s nobody’s business as to whether or not someone is on medication. The problem I personally have however, is the stigma associated with someone who decides out of their own volition to announce that they are utilizing medicine assisted treatment (MAT) to help them conquer heroin or opiate addiction. I personally don’t like the idea of having to go into a meeting knowing that someone can’t be 100% truthful about a program their involved in that helps them in their road to recovery. While nobody has to mention that they are utilizing MAT, if they choose to, they shouldn’t be chastised or crucified for it. If anything, I’d prefer to see an attitude of “if it’s working for you, good for you”. After all, we wouldn’t expect someone to walk into a MA (methadone anonymous) meeting and openly say they are also a member of NA and then be chastised for that, right?

      AA, NA, MAT and other methods such as CBT (cognitive behavioral therapy), IOP (Intensive Outpatient Program), individual and group counseling modalities, etc. have all been proven effective. What works for some doesn’t necessarily work for others. I think all of these programs are great. But I also feel that in order for them to be most effective, the recovering addict should be able to speak about all the modalities that have and are working for them.

      The above said, I agree with your assessment of medicine assisted treatment. Harm reduction is a key principle with MAT that many people forget when they make the misleading statement “you are just replacing one drug with another”.

      This website supports any and all treatment modalities that work. That includes Narcotics Anonymous. My only problem with them, in my opinion, they need to recognize that addiction is a disease and that medication is sometimes needed to treat a disease. “Complete Abstinence” is great, but where does one draw the line? If Suboxone, methadone or naltrexone (legitimate medications) don’t make someone clean, I suppose someone taking Zoloft for depression is also unclean. Caffeine is a drug as well yet they serve coffee at many NA meetings I’ve attended. And what about the person who has the occasional glass of wine with dinner? Is that acceptable for the individual who never had an alcohol addiction?

      At the end of the day, we believe that the spirit of the law is more relevant than the letter of the law. We believe in complete abstinence too…but we interpret this very differently. Medication prescribed and used as directed by a physician / medical professional does not count and thus, people using MAT as directed are clean. This of course, is just my opinion.

      Peace and Love,

      William – Founder and Publisher of this Community

  4. Thank you so so much for posting this story. I’m six years clean and sober with the help of methadone maintenance and councling. The councling is just as important. I will slowly tapper of my medicine until I’m off and then I will be off but not cured. I’m always going to be an adict but with the help of meetings and councling I will stay sober. Thanks again. M.A.T has been a God send. It saved my life. It’s a shame it has such a stigma.

  5. Well I’ve been around the AA program for 40 years and the AA rooms are becoming much more acceptable to drug use than they were day 20 years ago. I am glad the article said that Methadone, or the other alternatives are to be tapered down to 0 over time. Otherwise I wouldn’t agree with the substitute drug. I do think clean and sober means no drugs nor alcohol.

    • Steve,

      Thanks for sharing your opinion. While we do think its ideal that medicine assisted treatment (Methadone and Suboxone namely but even Naltrexone) should have an end-point. However, there are some individuals that we believe are an exception. I have spoken to some individuals who have been on MAT (medicine assisted treatment) for a long time and they are desperately afraid that they will go back to using heroin if they quit using MAT. As a result, I feel that Suboxone and/or Methadone (if used as directed by a medical professional) is much safer and better than someone trying to quit MAT only to end up back on the streets shooting heroin. I also believe that someone who is on MAT and following the program as directed is clean and sober. I recommend reading the article “Methadone and Suboxone: The Brutal Truth About Medicine Assisted Treatment“.

      Peace and Love,

      William – Publisher of this Community

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