CEFS 691 Week 6 DB Forum 3 (NA) Example

Discussion Board Forum 3 (NA): Thread and Two Replies

CEFS 691 Substance Abuse: Diagnosis, Treatment and Prevention, Discussion Board Forum 3 (thread and two replies)

Thread by [Student Name]

The prompt, the meetings described and the classmates' posts are composites standing in for the course's own forum, with no NA member identifiable; the textbooks, Scripture and published studies are real; the requirements follow Liberty's public course guide for CEFS 691.

Thread

At the second NA meeting I attended, one member said she was on a medication for opioid addiction and recalled feeling judged for it at another group. The group around her responded warmly, but her comment stayed with me, because it captures a tension many of my future clients will face: NA counts recovery in clean time, while the strongest medical treatment for opioid addiction involves daily medication.

Both sides have evidence, and a counselor who hears only one will give clients incomplete advice. Galanter et al. (2013) reported that the NA members they surveyed had been abstinent close to six years on average and that almost half had sponsored others, evidence of how much lasting support the fellowship gives. White et al. (2016) went further, calling NA an overlooked asset that clinicians and policymakers rarely mention when they plan for opioid addiction. At the same time, Wakeman et al. (2020), analyzing claims for 40,885 adults with opioid use disorder, found that buprenorphine or methadone was the only treatment pathway associated with lower risk of overdose and serious opioid-related acute care, a 76 percent reduction at three months and 59 percent at twelve.

The evidence does not ask counselors to choose between NA and medication; it suggests that many clients need both. Capuzzi and Stauffer (2016) describe recovery as multidimensional, with medical, psychological and social supports working together, and Miller and Rollnick (2013) remind counselors that clients decide their own path. In practice, I would help a client on medication find NA meetings known to be welcoming, prepare them for a possible unkind comment, and encourage them to keep both supports. I would also coordinate with the prescriber, with the client's consent, so that the medical and mutual-help parts of recovery reinforce rather than undercut each other.

Paul writes that the body has many members and that the eye cannot say to the hand, "I have no need of you" (English Standard Version Bible, 2001/2016, 1 Corinthians 12:21). Recovery, too, has many members, and a counselor's task is to help them work together.

Classmates: how would you respond if a client's sponsor urged them to stop their medication?

Reply to Chloe

Chloe, you noticed, as I did, that the NA meetings you attended had many more young adults than the AA meetings, and you wondered whether young people stay involved in twelve-step groups long enough to benefit. Research on emerging adults offers some answers. Kelly et al. (2013) tracked young adults leaving residential care and found better substance use outcomes both for those who attended twelve-step meetings and, beyond that, for those who took part actively through sponsors and service. Attendance alone was helpful, but active involvement added to it.

That suggests counselors working with young adults should encourage not only attendance but connection: finding a sponsor, taking a service role, or joining a home group. Capuzzi and Stauffer (2016) note that young adults often face developmental pressures, such as finishing school, finding work and forming relationships, that compete with recovery, so practical help fitting meetings into a busy life may matter as much as encouragement.

The young members I heard spoke most warmly about friends they had made in the fellowship, which fits what the research says about social networks and suggests that for this age group, belonging may be the strongest pull.

Did the young adults you heard describe having sponsors, or did they seem to attend without deeper involvement?

Reply to Marcus

Marcus, you wrote that several NA members described jail and prison, and you worried that clients with criminal records might feel the stigma of their past even in recovery. I heard the same stories, and I also heard how the fellowship seemed to reduce that stigma rather than add to it. Members spoke about their records openly and without shame, and others nodded in recognition. Capuzzi and Stauffer (2016) describe stigma as one of the major barriers to recovery, and a group in which a criminal history is ordinary rather than shameful may lift some of that weight.

For counselors, the practical barriers remain real, including employment and housing. Miller and Rollnick (2013) emphasize affirming a client's strengths and efforts, which may be especially important for clients who have been defined by their worst choices. Counselors can also link these clients to reentry programs and to employers known to hire people in recovery.

The NA speaker who carried meetings into a jail showed what restoration can look like: a person once defined by his record now spending his time helping others leave that life behind.

Do you think clients with records would feel more comfortable at NA than in counseling, at least at first?

References

Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). Pearson.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Galanter, M., Dermatis, H., Post, S., & Santucci, C. (2013). Abstinence from drugs of abuse in community-based members of Narcotics Anonymous. Journal of Studies on Alcohol and Drugs, 74(2), 349-352. https://doi.org/10.15288/jsad.2013.74.349

Kelly, J. F., Stout, R. L., & Slaymaker, V. (2013). Emerging adults' treatment outcomes in relation to 12-step mutual-help attendance and active involvement. Drug and Alcohol Dependence, 129(1-2), 151-157. https://doi.org/10.1016/j.drugalcdep.2012.10.005

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.

Wakeman, S. E., Larochelle, M. R., Ameli, O., Chaisson, C. E., McPheeters, J. T., Crown, W. H., Azocar, F., & Sanghavi, D. M. (2020). Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Network Open, 3(2), Article e1920622. https://doi.org/10.1001/jamanetworkopen.2019.20622

White, W. L., Galanter, M., Humphreys, K., & Kelly, J. F. (2016). The paucity of attention to Narcotics Anonymous in current public, professional, and policy responses to rising opioid addiction. Alcoholism Treatment Quarterly, 34(4), 437-462. https://doi.org/10.1080/07347324.2016.1217712