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Second Class Citizenship: Narcotics Anonymous and Buprenorphine

I do everything I can to help connect my addict patients with the recovery support community. However, I am concerned when some members of Narcotic Anonymous, who regard buprenorphine as a barrier rather than a boon to recovery, mistreat patients to whom I have prescribed buprenorphine. My patients are, of course, encouraged to attend meetings, but are treated as second class citizens and told that they should preferably stop taking the medication, or at least not let anyone know that they are taking it. I believe that following either of these recommendations can endanger recovery. Based on earlier experiences, I am confident that Narcotic Anonymous can change and accept this new medication. Until they do, recovery for people taking buprenorphine is being threatened. (See my previous post, “Heroin Addiction:  2 Barriers to Using Buprenorphine in Treatment.”)

One of the missions of Kolmac is to leave the addiction field better than we found it. In pursuit of this goal, we are working to correct what I believe to be a serious mistake some in Narcotic Anonymous are making. We have joined an effort to provide an alternative to groups that are against buprenorphine as a proper treatment for opioid-dependent patients. One such NA group, called “In Times of Illness,” already exists. It is located at Dee’s Place – an innovative community agency in East Baltimore that provides a variety of support to addicted people.

This NA group regards people, who have been prescribed buprenorphine and who are abstaining from all other psychoactive substances, as being in full recovery. The members are treated in every way the same as people not taking buprenorphine – allowed to celebrate anniversaries, lead meetings, and sponsor other Narcotics Anonymous members. These are important, basic recovery support activities offered to all members of 12-step programs. Two years ago, I had the fortune to meet Dee, the program founder, whose voice was full of determination when she asserted that she was not going to let anyone treat the addicts at her center as second class citizens.

I am glad to have found considerable interest for establishing a similar meeting near the Towson office of Kolmac. Not being in recovery myself, I cannot participate directly in the process, but I plan to do everything that I can to help it flourish. I encourage other professionals who are as concerned as I am about this problem to consider supporting meetings such as this, and I would appreciate hearing from anyone who is aware of similar activities already underway.

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