NA GROUPS AND MEDICATION

This is NA World Board Approved Service Material

As outlined in In Times of Illness, the choice to take pre­scribed medication is a personal decision between a mem­ber, his or her sponsor, physician, and a higher power. It is a decision many members struggle through. It is not an issue for groups to enforce. This pamphlet is not intended to speak to members about the personal decision of whether or not to take medication, nor is it trying to convince mem­bers to have different opinions about the use of medica­tion. What this pamphlet does address is that groups are often better able to carry the NA message and welcome anyone to a meeting when members come together to discuss this issue. Each group is autonomous, and this pamphlet is simply meant to provide groups with a tool for how to have their own discussions. In these discussions, we must remember that regardless of our personal opinions, decisions, and experiences, our Twelve Traditions remind us that the use of medication is an outside issue for NA groups and that all addicts are welcome in NA.

The information here is intended for NA groups as they consider how to address this issue. As a part of this discus­sion, drug replacement is addressed in a separate section because NA’s philosophy of complete abstinence differ­entiates a drug used as a replacement from prescribed medication for other mental or physical conditions. We hope the following approaches will help groups in their efforts to preserve unity, welcome members, and create an atmosphere of recovery.

Our common welfare should come first;
personal recovery depends on NA unity.

Tradition One

When NA groups consider the topic of medication, in­cluding the use of prescribed medication for surgery, injury, illness, and medication for mental health, we can begin by acknowledging the complexity of the situation. Those who take medication tend to feel judged and treated as if they don’t belong in NA, while others believe a member’s decision to share while taking medication compromises a meeting’s atmosphere of recovery. Some members have seen friends who’ve taken medication relapse, and some have seen friends who’ve taken medication stabilize and stay clean. In spite of the strong feelings and opinions we may have about the issue of medication, groups must stay focused on how they can welcome members and carry the NA message of recovery.

Following are examples of some of the challenges groups face around the topic of medication in NA meetings:

• Some of us are being told that if we take meds we are not clean and should not share at meetings. Does this mean that those of us who suffer from depression should just disregard what our doctors are advising, even if we only take our meds as prescribed? Do I even belong in this fellowship?
• A member in our group is taking medication and sharing during the meeting. We’re upset because we’re afraid this will disrupt the atmosphere of the meeting. Should the group ask this person to refrain from shar­ing until they stop taking medication?
• We have a member who is an addict and who is obviously mentally ill. When he is on his medication he is quite functional, but occasionally he stops taking his meds and all hell breaks loose. He thinks being totally abstinent will make him a full-fledged member. What should we tell him when he asks us if he’s clean?

No matter what our personal opinions, observations, or experiences may be about the use of medication, the focus of the NA group must be on how we can work together to carry the NA message in our meetings. The Tradition One essay in It Works: How and Why reminds us that, “just as anonymity is the spiritual foundation of our traditions, the unity spoken of in the First Tradition is the practical foundation on which we may build strong and successful groups.” With unity as our practical foundation, we find that our relationships with one another are more important than any issue that may arise to divide us. No problem or disagreement is more significant than our need for each other’s support.

CULTIVATING UNITY

The question for NA groups to consider is how to wel­come people and carry the NA message in a variety of situ­ations. Our unity and our primary purpose can guide our efforts in welcoming members and creating an atmosphere of recovery. In this way, we can help members use the NA program to apply recovery principles to their lives, regard­less of their situation. Following are some examples of the ways groups can strive to be unified and welcoming in the face of a variety of challenges:

• When group members freely share their own recovery and trusted servants welcome other members, groups are usually able to carry the NA message in a variety of potentially challenging situations.
• If someone shares a message that seems to compromise the atmosphere of recovery, group members can attempt to gently re-establish the meeting’s focus after that person has shared. This doesn’t mean group members should correct or clean up what has been said, but they can freely share their own experience, strength, and hope, offering an additional perspective.
• Carefully choosing a chairperson or secretary who is able to help maintain an atmosphere of recovery during a meeting can also help. If necessary, this group leader can help refocus the meeting by announcing a five-minute break or by asking the group to join in a prayer. A loving and inclusiveattitude on the part of the leader and group member is usually the most effective way to move through these situations.
• The group can reflect on how it can practice principles such as tolerance, love, and compassion in situations that might cause concern. Considering ways to respond to these potentially frightening situations with compassion and tolerance, rather than reacting, can better allow the group to maintain an atmosphere of recovery and carry the NA message.

GROUP DISCUSSIONS

One of the most effective ways a group can work to re­solve these challenges is by discussing its primary purpose. A discussion focused on how group members welcome people to NA can help clarify what the group is respon­sible for and what it is not. A group discussion can also help members become aware of how they treat those who come to meetings. For example, if a group has an unwel­coming attitude toward new members who take medica­tion for a medical condition, that group will likely alienate the very people it’s trying to introduce to the NA message. Discussing questions like the ones below can help group members consider ways to maintain an atmosphere of recovery in potentially challenging situations:

• What does our group do to help new members feel welcome? How can our group better welcome newcomers?
• What can our group do to create and maintain a strong atmosphere of recovery?
• What can our group do to foster unity?
• What can our group do to help ensure that all members (especially some of our more challenged members) feel accepted and valued?

SERVICE AND THE USE OF MEDICATION

Another issue groups often grapple with is whether a member who is taking medication is eligible for ser­vice to the group or within the service structure. Groups should exercise judgment in deciding if a member is able to perform the task associated with the service position, not whether a member is taking medication. If a member seems acutely unstable, he or she would be unsuitable for a service position, regardless of whether that member is taking medication.

DRUG REPLACEMENT

By definition, drug replacement is used for a differ­ent reason than prescribed medications for mental or physical health. This distinction makes drug replace­ment a separate issue for us in NA. When it comes to those who participate in drug replacement, it is helpful to remember that our Third Tradition clearly states that membership in NA is established when someone has a desire to stop using or when they choose to become a member, not when they are clean. No matter what the issue, groups are still charged with the goal of welcom­ing each person who walks into a meeting.

EXAMPLE

The courts have mandated NA meetings for those on drug replacement. Some of these addicts are sharing at our meeting. Is this an outside issue? What about our message of complete abstinence? We want to do the right thing, but we are concerned that the newcomer will get the wrong message. It’s life and death we’re talking about!

Some NA members are confused or even intolerant of those on drug replacement due to what they see as a contradiction between drug replacement and the NA principle of complete abstinence. Some of us are fearful when those on drug replacement want to share or speak on behalf of NA. It may be helpful for all of us to remember that many addicts on drug replacement eventually do get clean, stay clean, and find a way of life they thought was unobtainable before coming to NA. This process doesn’t always occur when an addict at­tends his or her first meeting—getting and staying clean is often a decision that’s made after attending many meetings over a period of time.

Because NA a is program of complete abstinence, groups do sometimes limit the participation of members on drug replacement to ensure the clarity of the NA mes­sage. Yet, we must balance this limited participation with the idea that membership in NA comes with a desire to stop using, not abstinence. As the Tradition Three essay in It Works: How and Why reminds us, “Desire is not a mea­surable commodity. It lives in the heart of each member. Because we can’t judge the sole requirement for mem­bership, we are encouraged to open wide the doors of our meetings to any addict who wishes to join.”

Opening our doors to these members means that groups take the time to discuss this issue and find ways to make everyone feel welcome. Each group is autono­mous, and a group’s conscience will ultimately determine the level of participation of those on drug replacement. Some groups may decide to encourage those on drug replacement to serve as coffee or tea makers, or as a clean-up person, instead of holding leadership positions. These commitments may encourage a desire for com­plete abstinence through allowing these members to feel a part of NA.

The reality is that some groups already permit those on drug replacement to share and lead meetings, while others do not. Although we may not endorse this level of participation, we can simply acknowledge what exists and consider ways to encourage every member to get clean and find the hope and recovery that are possible in NA. The real question groups are left with is how to honor the NA philosophy of complete abstinence and still welcome addicts in our groups and meetings. What is most important is that we don’t let our fears get in the way of our group’s ability to carry the NA message of hope and freedom.

The only requirement for membership
is a desire to stop using.

Tradition Three

One of the most challenging aspects of this issue is that while an NA group is free to ask those who have used that day to refrain from sharing in the meeting, groups don’t decide what “using” means for an individual member. The use of medication is an issue that many members have strong personal feelings about, but a group is not there to enforce, endorse, or oppose members’ personal opinions. Any member—those who take medication and those who feel taking medication is inappropriate—has a responsibil­ity to not represent their personal feelings and opinions as the opinions of Narcotics Anonymous as a whole.

In NA, we purposely attract people who are ill, unstable, and in need of help. Our challenge is to continue to prac­tice tolerance, patience, and love, so that we create an atmosphere in which those who want to recover can do so. Many of us have watched as NA meetings become weighed down by disruptions, controversy, and negativity around this issue. Yet, when these challenges are addressed through incorporating the spiritual principles of our pro­gram, groups often become stronger and more focused as a result. Recovery is often a demanding process with many ups and downs, and NA groups tend to experience similar challenges. Yet, it is these struggles that allow us to grow as individuals and as groups. Narcotics Anonymous is here to help addicts find a new way of life, and joining NA means becoming a part of a lively and diverse fellowship. As our First Tradition reminds us, “Our relationships with one an­other are more important than any issue that may arise to divide us.” Keeping this in mind allows our groups to best serve all addicts seeking recovery in NA.

This is Board-approved service material.

Service pamphlets should be used by members, groups, and service committees as a resource rather than being read in an NA meeting.

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