Prayer and Medication: Can they work together?
What is the best way to stay clean from drugs? What is the best way to quit using drugs in the first place? Is it prayer? Or, is medical treatment best? Maybe, it is some combination of prayer and medication.
Prayer is a common theme that underlays most of the 12 steps of NA. The the word, “prayer”, is only mentioned once in the steps. However, if you work the steps, your sponsor will likely instruct you to pray each time before putting your pen to paper. Prayer and having a connection with a higher power is an important part of recovery.
What about medication?
Specifically, what about medications that treat addiction? Methadone, Suboxone and naltrexone are medications that doctors use to treat addiction. Yet, 12-step programs preach abstinence. They stay out of involvement in medical treatment unless it comes to medical treatment for addiction.
If addiction is a disease, why is it treated differently from other diseases by the 12-step fellowships? A schizophrenic patient would not be told to stop his meds. Neither would a diabetic. Yet, an addict is not allowed to fully participate in recovery if certain medications are taken for addiction.
Then again, doctors do not prescribe meds like Suboxone for “addiction”.
Suboxone is often prescribed to treat F11.20. This is the diagnosis code for opioid use disorder or opioid dependence. The medical field does not use the word, “addiction”. You can make a strong argument for the unfairness of NA getting mixed up in the medical affairs of certain members.
Imagine an NA member named Joe. Joe gets up in front of his NA home group to accept his one year medallion, celebrating one year clean. He speaks about his success and mentions that he is prescribed Prozac for depression. The crowd is quiet. No big deal. A lot of recovering addicts take psych meds. It’s a war out there. Then, Joe says that he also takes Suboxone Film 8mg/2mg, once daily. Now, there is an uproar. What? Suboxone users are not clean! Take away this man’s medallion. Give him a white chip!
But wait, there’s more.
Joe shouts above the crowd that he is prescribed Suboxone off-label for the purpose of managing his chronic back pain. Joe was in a car accident ten years ago. He says that his doctor tried many different meds and found that Suboxone worked best for the pain. Now, a long-time member with many years clean stands up in the crowd. He yells for the crowd to quiet down. He tells the group to read the pamphlet, In Times of Illness. Medical treatment is an outside issue. As long as the medicine is not for addiction. Joe gets to keep his year and his medallion. He can now chair a meeting and even represent his group at the monthly area meetings.
Now, Caren gets up to accept her one year medallion right after Joe. Caren got clean at the same time as Joe. The members of the group fondly remember the two coming in from treatment and starting at this very meeting one year ago. Caren starts her acceptance speech by saying how relieved she is. She is happy to hear that the group is accepting of Joe’s medication use. Caren also takes Suboxone film 8mg/2mg once daily. She says that the treatment center started Suboxone to get her off of heroin. Her doctor felt that it was best to maintain treatment for at least the next year.
Again, the crowd goes wild with outrage and uproar. No, no, no Caren! It does not matter that you take the same exact medication at the same dose as Joe. Now, the group is involved in medical decision making for Caren. The conclusion is that Caren is taking her Suboxone to treat addiction. This is a no, no. Caren’s medallion is yanked from her hands by the nearest senior member. Sorry Caren, you do not get to chair meetings or represent your group at area. In fact, you can’t even make the coffee or set up the chairs before the meeting. You are not clean. Unfortunately, you take Suboxone for addiction.
Caren, with tears streaming down her cheeks, raises her hand. She shouts above the noise of the group that this is not fair. “I do not take Suboxone for addiction! I take it for opioid use disorder and opioid dependence. My doctor codes my diagnosis as F11.20. This code is not for addiction. I should be allowed to keep my year just like Joe”.
Now, Bill stands up to speak. He is a long-standing, respected member of the group with 35 years clean. Bill happens to take methadone 40mg daily for chronic pain. He takes pride in the fact that his dosage has not been increased in over 40 years. But, Bill’s medical treatment is not in question here. Bill says to the group and to Caren, “I know this code F11.20. I know all about these substance use disorders. It is the same thing as addiction. Joe’s condition is coded as G89.2, just like mine. That’s chronic pain, an outside condition as per the literature. Caren takes her Suboxone Films for addiction. Joe is clean and Caren is not.”
Caren walks out of the room angrily, mumbling swear words. She slams the door behind her. The group calms down now. The outsider is out of their midst now. Imagine the nerve of Caren to think she can claim clean time while taking Suboxone. Joe reminds those members sitting next to him that his situation is different. He takes Suboxone for an off-label condition that is not addiction-related. They nod in agreement.
Caren later relapses on heroin and she overdoses. Unfortunately, Caren did not realize that her tolerance would be lower after a year. Caren’s mother wants to know what happened. She angrily drives her car over to the medical doctor’s office. She reviews the medical chart with the doctor.
Why did the doctor recommend that Caren go to NA meetings? Clearly, there was a conflict with taking Suboxone and going to NA. The doctor explains that NA meetings are a part of recovering from addiction. Treatment centers take their patients to NA meetings. NA members even bring meetings to the treatment centers. In fact, the courts often make drug offenders go to NA meetings and get a paper signed after attending each meeting.
Then, Caren’s mother asks, why did the doctor put her on Suboxone in the first place if NA was going to have a problem with it. The doctor tells her that It is because Suboxone treatment has the highest rate of success of any form of treatment for opioid dependence. Caren’s mother asks the doctor why he couldn’t have coded Caren’s visit as G89.2 only. Caren did, in fact, have chronic pain issues as well. The doctor shook his head. Caren’s insurance would only cover Suboxone for an F11.20 diagnosis.
Prayer and Medication: They can work together with care.
This story is completely fictional. It is also preposterous. Yet, real life stories do play out similarly to Caren’s story. Medical treatment and spiritual programs of recovery sometimes clash over the issue of what NA calls “replacement medications”.
During these early decades of modern treatment for opioid use disorder, it is important that we take care in navigating the world of recovery, which is not all on the same page. These issues are very serious because of the deadly nature of misusing opiates and opioids. If you are receiving medical treatment, talk to your doctor before making any changes to your treatment. Do not allow people who are not your doctor to make medical decisions on your behalf.