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For the Professional This page is for the professional who needs information
about Narcotics Anonymous. It is a presentation for the International Council
on Alcohol and Addiction's 37th International Congress on Alcohol and Drug Dependence
at the Narcotics Anonymous: A Commitment To Community
Partnerships Abstract: Narcotics Anonymous, an international,
community-based association of recovering drug addicts, provides peer support
to other addicts who desire a drug-free outcome. We are fully committed to
collaborating with professionals and community organizations with similar
goals. This paper identifies key factors affecting NA's
interactions with others, points out means by which professionals can contact
Narcotics Anonymous, long-established means of direct interaction between NA
and professionals, a number of programs designed to facilitate client
introduction and entry into Narcotics Anonymous, and a description of what
clients will find when they attend NA meetings and meet NA members. The paper
addresses a number of areas where professionals may encounter difficulties in
relating with Narcotics Anonymous, and closes by identifying ways to resolve
any problems that may arise when interacting with NA. Narcotics Anonymous is one of the world's oldest and
largest associations of recovering drug addicts. The NA approach to recovery
from drug addiction is completely nonprofessional, relying on peer support.
We believe the NA program works as well as it does primarily because of the
therapeutic value of addicts helping other addicts. Narcotics Anonymous is organized locally as
self-governing, self-supporting groups adhering to a common set of
principles, adaptations of the Twelve Steps and Twelve Traditions of
Alcoholics Anonymous. Local NA groups are organized worldwide via NA's international delegate assembly, called the World
Service Conference, and secretariat, the World Service Office, headquartered
in The first Narcotics Anonymous meeting was held in 1947 in
A framework for NA community engagement The Narcotics Anonymous commitment to community
partnerships can best be understood within the context of NA's
Twelve Steps and Twelve Traditions. Our Twelfth Step for personal recovery
encourages every individual NA member to try "to carry [the NA recovery]
message to addicts". Among our Twelve Traditions are certain guiding
principles for NA's engagement, as groups and as an
organization, with others in the community: Our mission as an organization is to communicate to
addicts in the community that we may be able to help them learn to live
drug-free, recover from the effects of drug addiction, and establish stable,
productive lifestyles Our public relations activities strive to attract addicts
to Narcotics Anonymous without being overtly or unduly promotional. Our membership is open to anyone who wants to stop using
drugs, regardless of the particular drugs they have used. There are no
social, religious, economic, racial, ethnic, national, gender, or
class-status membership restrictions. We maintain a policy of "cooperation without
affiliation" in our inter-organizational relations. This policy allows
us to work with others in the community without becoming involved in a manner
which might distract us from our mission. This means that: We will neither explicitly endorse nor oppose other
organizations or approaches to the problems associated with drug addiction. We will not allow other organizations to use the
Narcotics Anonymous name for their programs. We will not provide funding for other organizations, nor
will we accept funding from outside our own organization. We will take no position on any public issues, even those
related to drug addicts or addiction. Narcotics Anonymous has only one mission: to provide an
environment within which drug addicts can help one another stop using and
find a new way to live. We are not an antidrug or
prohibitionist organization, nor do we take any position concerning
decriminalization or legalization. We are neither for nor against
free-needle-and-syringe exchange programs, drug-replacement clinics, or other
efforts to reduce drug-related harm. We will work with anyone to provide
their clients with our services, without interfering with their therapeutic
regimen or client relationships. We encourage anyone likely to be interacting frequently
with Narcotics Anonymous to become familiar with the book on our Twelve Steps
and Traditions, It Works: How and Why. The book is available from our World
Service Office. Means of contact with NA There are two points of contact with Narcotics Anonymous
at the local level: NA groups, and NA service committees. Narcotics Anonymous
groups hold the actual recovery meetings where drug addicts interact with one
another. Our service committees coordinate volunteer activities for a number
of NA groups in a community, district, or country. There are three ways to make contact with local NA groups
and committees. Many NA communities have telephone contact services.
Their numbers are usually listed in the NA Phoneline
Directory, available from our World Service Office. Local telephone contact
numbers are also often listed in the local telephone book or through the
telephone company's directory assistance service under the name "Narcotics
Anonymous." Local NA chapters that have been in existence for some
time usually publish local meeting directories that show the days, times, and
places where Narcotics Anonymous groups meet and sometimes give additional
information about specific meeting formats. You can get a local meeting
directory either by visiting an NA meeting or by calling the local NA phoneline. If no means of contacting local NA groups or committees
can be found, contact our World Service Office. Using the worldwide group and
committee registration information we maintain for our fellowship, we will be
able to tell you how to contact the nearest NA community. There are two basic kinds of Narcotics Anonymous
meetings. Anyone from the community may attend an "open" meeting to
see for themselves what Narcotics Anonymous is like. "Closed" NA
meetings, however, are meant for attendance by addicts only. Be sure to ask
the phoneline contact or check the meeting
directory to see whether the meeting you are planning to attend is "open"
or "closed" before visiting. Direct NA interaction with professionals and the
community Narcotics Anonymous communities have two primary ways in
which they regularly interact directly with professionals and the community.
NA public meetings are sometimes held to present NA on a broad scale to an
entire community. Local NA public information committees also make regular
presentations to community organizations, treatment administrators and
clinical staff, policy makers, and researchers. Narcotics Anonymous has a strong interest in cooperation
with addiction researchers to independently study the nature and
effectiveness of our program. However, we have had difficulty establishing
such relationships so far. Our fellowship has a very strong interest in
maintaining the personal confidentiality of its members. We also need to
discuss how to connect a researcher with NA interviewees without inferring an
outright endorsement by NA of the researcher's organization or compromising
the autonomy of local groups and service committees. Our World Service Office
is eager to discuss innovative ways to cooperate with researchers in
surmounting these challenges. One direct contact between NA and professionals is in the
Narcotics Anonymous meetings that are sometimes started by nonaddict treatment staff, health care professionals,
social workers, educators, and others. We actively encourage professionals to
support Narcotics Anonymous in their local communities and to start NA
meetings in communities where there is no Narcotics Anonymous as yet. We have
two cautions to offer in regard to such meetings: NA meetings started by nonaddict
professionals should be turned over to the addicts themselves as soon as
possible. One of the key reasons Narcotics Anonymous works as well as it does
as an organization is its independence. New NA members should be encouraged
to take responsibility for their own NA meeting as quickly as they can,
without compromising the stability of the meeting. The professional who
started the meeting should then take an outside support role in relation to
the new NA group. When NA meetings are held on the grounds of a treatment
facility or in a professional's offices, special care should be taken to
explain the distinction between the facility and Narcotics Anonymous. It
serves everyone well to maintain the distinction between professional
therapeutic facilities and NA's nonprofessional,
addict-to-addict approach to recovery. When an NA meeting is held in a
treatment facility or a therapist's offices, some explanation should be made
to those attending that the NA group is simply meeting there but is not a
function of the facility or therapist. Client interaction In local communities where Narcotics Anonymous is fairly
well established, we offer a number of services designed to make for easy
interaction between your clients and our fellowship. Though we generally do not take a primary role in
interventions, we do offer something called a "Twelfth Step call"
that could be used as a follow-up to an intervention. If your client agrees,
you can call the local NA phoneline and ask that a
couple of experienced NA members visit your client to explain the NA program.
To avoid confusion, it may be advisable to have your client call the phoneline him or herself. Local service committees regularly organize panel
presentations of the NA program for client groups and correctional inmates in
residential facilities. These are organized by "hospitals and
institutions" committees and are known within NA as "H&I
panels." If you would like an H&I panel
conducted for your clients, call the local NA phoneline
and ask for a return call from the H&I committee chairperson to make
arrangements. Narcotics Anonymous meetings welcome visits from your
client groups—in fact, our literature says that "the newcomer is the
most important person at any meeting." If you would like to take a
client group to visit an NA meeting, just call your local phoneline
and find out when and where the nearest meeting is being held. If you are
bringing a large group, you may want to ask the person answering the phoneline whether the meeting you are considering will be
able to accommodate your group. Many Narcotics Anonymous meetings are accustomed to
identifying some person who will sign attendance verification cards for
persons in outpatient treatment or on judicial referral. You should be aware
that at some NA meetings, the person signing the card may take a special
effort to emphasize to the client that this is being done as a service to the
client, not because of some direct affiliation between your organization and
Narcotics Anonymous. You should also be aware that in other NA meetings, it
is not customary to sign attendance cards because of the local perception
that doing so creates too great an appearance of affiliation between NA and
other organizations. If you have any questions about this service, you should
call the local NA phoneline. If the person on the
line cannot answer your questions, ask them to have either an ASC (area
service committee) or RSC (regional service committee) officer or the public
information committee chairperson return your call. If you have sufficient confidence that Narcotics
Anonymous could be helpful for your clients, you can encourage them to ask
experienced NA members—"sponsors"—to help them engage in our
recovery program. All they need to do is listen carefully at NA meetings
until they hear someone with whom they identify, preferably someone of their
own gender. Once they've found someone, they should ask that person if they
can talk further with her or him. If all seems well, they should then simply
ask that person to sponsor them. The person may decline—perhaps because they
are already sponsoring a number of people, perhaps because they do not feel ready
for the responsibility. If they accede to the request, the sponsor will help
your client work through NA's Twelve Steps and
offer her or his own experience as a backdrop to the NA program; these are
the only services offered by sponsors qua sponsors. Sponsors do not charge
any fees for the services they render their sponsees. Finally, probably the most important service we can offer
your client is the environment of the Narcotics Anonymous group: a place
where other drug addicts can offer first-hand hope of recovery to your client
based on their own direct, personal experience. The NA group atmosphere is
intensely social; if your client has difficulties in this area, you may want
to specially prepare him or her for the first NA meeting. Once your client has
made a firm connection with an NA group, usually by attending that group's
meetings regularly for a number of weeks, your client will be able to count
on twenty-four-hour personal support from NA contacts made in the meetings.
Narcotics Anonymous members not only expect requests from newcomers for such
help—they actively encourage these requests, seeing their work with new
members as integral to their own recovery. NA membership silhouette Who will your client meet when she or he attends an NA
meeting? Unfortunately, we cannot give you a detailed demographic profile on
the NA membership in your country today, for reasons already discussed when
we considered research problems above. We do have some information, however,
from an informal poll taken in 1989 of 5,000 Narcotics Anonymous members—a
silhouette, if you will, rather than a profile: Age 11% of our members are under 20 37% are between 20 and 30 48% are between 30 and 45 4% are over 45 Gender 64% of our members are male 36% are female Meeting attendance 50% of our members attend at least 4 meetings per week Initial referral 47% of our members were introduced to Narcotics Anonymous
through a treatment facility or while incarcerated 29% were introduced to NA through another member 24% were introduced by a community professional (doctors,
attorneys, clergy, judges) Different types of NA meetings There are a number of kinds of Narcotics Anonymous
meetings. When referring a client to NA, you may want to inquire about these
factors first. Meetings vary in: Format. Some of the formats of which we are aware are
open discussion, topic discussion, newcomer meetings, and studies of NA
literature. Size. Some are large (100 or more); some are very small
(5 or less). Smoking. Some meetings have tobacco smoking; others do
not. Special focus meetings. Some meetings are intended
specifically for women or for men. Some meetings are targeted especially at
lesbians and/or gay men. Other meetings have their own special focus,
intending to offer extra identification to those seeking a point of entry
into Narcotics Anonymous. Length of meetings. Most meetings of which we are aware
are either sixty or ninety minutes in length. Degree of participation expected. Speaker meetings
require almost no participation; discussion meetings may require some, though
not everyone is asked to participate in the larger meetings. *Open/closed meetings. As we discussed earlier, some NA
meetings allow nonaddicts to attend, though usually
not to participate. Only at closed meetings can your client count on finding
addicts only. Potential difficulties between the NA program and your
treatment regimen There are a few points where the Narcotics Anonymous
program, or the local variety thereof, may conflict with your treatment
philosophy. Rather than evade these points, we prefer to state them in the
open so that you can make informed decisions about referring clients to
Narcotics Anonymous. Disease concept. Narcotics Anonymous views addiction as a
disease. We use a very simple, experience-oriented disease concept. We do not
qualify our use of the term "disease" in any medical or specialized
therapeutic sense, nor do we make any attempt to persuade others of the correctness
of our view. The disease concept works well as an analogy by which our
members can understand their condition: When treated, addiction can be
"arrested" but not "cured." Untreated, addiction has
effects similar to a disease. Total abstinence. The experience of our members has been
that total, continuous abstinence from all drugs has provided them with a
reliable foundation for recovery and personal growth. However, abstinence is
not in itself the sole goal of our members; more importantly, we seek a
comprehensive change in attitude and lifestyle. "Relapse" is seen
as a sometimes necessary part of the overall addiction/ recovery process for
many individuals. Relapsers are not
"shamed" but are encouraged to pick up the pieces, learn from their
experience, and move on. Narcotics Anonymous views alcohol as a drug, and we
find the "drug of choice" designation irrelevant to our program
since we focus on the disease of addiction itself, not any particular drug or
drugs. The use of psychiatric medication and other medically indicated drugs
prescribed by a physician and taken under medical supervision is not seen as
compromising a person's "clean time." Regarding the use of nicotine
and caffeine, members are encouraged to consult their own experience, the
experience of other members, and qualified health professionals. Other twelve-step programs. Narcotics Anonymous makes a
clear distinction, based on very different program goals, between itself and
other anonymous fellowships—for instance, Alcoholics Anonymous and Cocaine
Anonymous. Some anti-professional sentiment. Though NA as a movement
takes no such position, we have noted that some Narcotics Anonymous members
bear some antagonism toward professional therapists and psychotherapeutic
concepts. We cannot speculate on the reason for such antagonism. Thankfully,
this antagonism is not an overwhelming feature in the life of the NA groups
where it can be found. Spirituality. The Narcotics Anonymous program has a
distinctly spiritual orientation, with a theistic bent to most of our
literature. We are neither sectarian nor religious, but we are not
antagonistic toward organized religion—at least not as a movement. Some of
our members, however, are atheists and/or anti-religious. Our
English-language Twelve Steps and Traditions refer to God as a masculine
person, though our fellowship is currently engaged in a discussion of this
matter. Problems with local organization, groups? It is quite possible that, if you have a long-term
association with Narcotics Anonymous, you or your clients may run into a
problem with NA members sooner or later. If you do, we suggest that you
contact the local NA phoneline as we have already
indicated and ask for an ASC or RSC officer or the PI chairperson to give you
a return call so that you can discuss the matter with them. If you do not
succeed in contacting anyone in a responsible position in the local NA
community, feel free to contact our World Service Office. The world office
may be able to untangle a communication knot or mediate a dispute for you. Summary Narcotics Anonymous does not claim to
have all the answers for every drug addict in every community, nor do
we believe that all other approaches to the problems associated with
addiction are necessarily without merit. However, the members of 20,000 NA
groups in 70 countries have been successfully applying the Twelve Step
program to their own drug addiction since 1947 and are ready to offer their
experience to other addicts seeking a drug-free outcome, recovery from the
effects of addiction, and a stable, productive lifestyle. Narcotics Anonymous
has a long tradition of cooperating with professionals, government, and
community organizations to address the needs of addicts. Most local NA groups
and service committees are prepared to welcome visitors and client groups,
follow up on professional interventions, make presentations to residential
clients or prison inmates, sign attendance verification cards, connect
clients with individual NA "sponsors," and welcome clients into the
recovery atmosphere of the NA group. Our members cover a broad demographic
range and we have a number of different types of meetings, so most clients
will usually find something in NA in their local community they can make a
connection with. We have identified a few points where the Narcotics
Anonymous program may conflict with your treatment regimen so that you can
make informed decisions when referring clients, but we hope these conflicts
will be minor, few, and far between. Our primary message is that, together,
Narcotics Anonymous and others in the local community concerned with drug
addiction can help addicts find a new, more satisfying, more productive way
to live.. |
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