I’m grateful to Harm Reductionists for introducing me to the concept of “stability”. Harm Reductionists suggest that stable drug use is better than chaotic drug use and that any changes in the direction of stability are worth acknowledging and celebrating.

 Though I chose a path of abstinence years ago, I recently started to consider stability in my own life. What am I finding stressful and what could I do to make things better? Who or what things throw me off balance? What choices would add to my stability? I’ve also begun to use the concept of stability in my coaching practice with clients recovering from addiction. I ask, “What can you do that would increase the stability in your life?” I’ve begun to see stability as a guiding light.

 When I joined a 12-step program years ago I was introduced to the Serenity Prayer. The prayer was useful to me—I could understand the advantage of accepting things I cannot change and having the courage to change the things I can—but serenity itself never appealed to me. I really didn’t understand what serenity was, or why I should want it. Serenity seemed rather like complacency and that sounded dangerous or boring. I’m quite sure that if I had been introduced to the Stability Prayer when I quit drinking it would have been a much better prayer for me. Maybe because I was a child of chaos.

I grew up with neglect and trauma and I knew what chaos was. When I left home I eventually figured out that drinking and drugging added to the chaos in my life. I knew that drinking too much led to having sex with men I didn’t know, which added to shame, which added to misery. I knew that having a boyfriend who spent the rent money on drugs resulted in chaos. I knew that having a boyfriend who tried to kill me was more chaos and misery.

 I still remember when my best friend asked me if I would help her raise her son. I told her that we both drank too much and were too fucked up to raise a child. She turned her boy over to her parents, which was the better choice though she hated it. And I hated it too.

 It was my growing dislike of chaos that eventually got me to stop drinking and drugging. I didn’t quit when things were at their worst. I quit when I had a good opportunity to improve my life and was afraid my drinking/drugging would ruin it. 12-step recovery did a lot to help me stabilize. I worked all the steps and learned the Serenity Prayer.

Yet I think a Stability Prayer would have been way more practical for me to orient around. As it was I floundered in recovery for many years. It took me a good ten years to learn how to be a functioning self-supporting adult. It might not have taken so long if I had set my sights on stability. These days, I say the Stability Prayer while others are reciting the Serenity Prayer. Just one word is different, and yet for me that one word keeps me heading in the direction of positive change. Here it is. Try it—you might like it.


God, grant me the stability

 to accept the things I cannot change,

courage to change the things I can,

and the wisdom to know the difference.


A recovery coach walks into a greeting card store…

That was me a few days ago. I needed a card for a friend who's turning 50 and decided to go the humorous route. There I stood in front of a display of cards designed to tickle the funny-bone and all I felt was sad.

Greeting card.jpg

One card after another celebrated the use of alcohol, more specifically, the reckless use of alcohol:

"I'm outdoorsy, meaning I like getting drunk on patios"

"You deserve an alcoholiday"

"Something about today wants me to be hungover tomorrow"

And it doesn’t end with greeting cards.

Wine lists now dwarf menus. Cocktails are having a moment. As is whiskey. And craft beer. No wedding would be complete without a signature drink that “says something” about the bride and groom. Time for some corporate team-building? Forget rock-climbing, let’s go for a pub crawl! Running to stay fit? Reward yourself for completing that grueling 5K with a beer garden at the finish line. There are plaques to hang in our kitchens, t-shirts, baseball caps and even baby clothes, all announcing our “drinking problem” to the world in a nudge-nudge, wink-wink kind of way.

Baby shirt.jpg

I could go on.

No, really, I could.

But you get the idea.

Or do you?

If not, you’re not alone.

To be clear, I’m not against alcohol. I don’t advocate on behalf of abstinence (unless this is what my client has identified as their goal). I’m a pragmatist. Alcohol has been part of the human experience for millennia, prohibition didn’t work, and drinking in moderation is relatively harmless. My problem isn’t with alcohol per se, my concern is that we’re dancing around the elephant in the room: problematic drinking is on the rise and we don't know how to talk about it.

Maybe this is what’s really fueling the cultural obsession with all-things-alcohol (aside from the very powerful, very well-resourced alcohol lobby – fodder for a future blog). May-be the greeting cards and cheeky aprons and upscale wine tastings are a way for us to accomplish two things:

Normalize our relationship with alcohol. If we can dress it up, make it fun, make it mandatory, may-be we can side-step, indefinitely, all those annoying facts about safe drinking limits, links to cancer, diseased livers, blackouts, and car accidents. I mean, how bad can it be, really, when my infant looks so cute in that onesie?

Solidify the pact we’ve made with each other. I don’t have to question my drinking as long as I can look around the room and see co-workers, wedding guests, sorority sisters, aunts and uncles, community leaders, church members, book club pals, and pretty much everyone else in my orbit doing the same thing I’m doing.

It takes a lot of courage to initiate a conversation about a social construct as [seemingly] intransigent as alcohol, yet a 2015 study published in the Journal of the American Medical Association (JAMA) revealed that 30% of drinkers in America* are troubled by their pattern of alcohol consumption. That’s about 70 million people. That's a conversation worth having.

So here's what I'm proposing: Let’s give the elephant a poke. Let’s figure out how to talk about alcohol in a way that doesn’t clear the room. Let’s be honest about what alcohol is, how it affects us, how it hurts us, and yes – how it helps us. Let’s not assume to know what needs to happen next (sobriety? moderation?) until we can talk honestly, intelligently, and compassionately about what’s happening right now.

This blog was written by Lianne MacGregor MA, Med, ACC.

*According to the 2015 National Survey on Drug Use and Health (NSDUH), 70.1% of Americans over the age of 18 report having consumed alcohol within the previous year.

Money: Financial Inventory, And A Slip (originally published in 2002)


I never learned about money until I sobered up. I was 29 and didn't know the first thing about managing money, much less earning it. For years, I had borrowed cash from my parents and never paid it back. I waited until the bank called me before depositing money to cover my checks.

My first brave act toward financial independence was to have a kindly bank teller show me how to balance my checkbook. It was scary to admit I didn't know how use a check register or read a bank statement. I left feeling very grown up. For the first time I could say where I spent my money: coffee, candy and cigarettes (the first three steps!).

My sponsor insisted I include a financial inventory on my fourth step. I put on paper all my awful money secrets. She said that a 12-step group was "an expensive club to join," and my mistakes with money were the dues I paid to hit bottom and sober up. With my fifth step came the first hint of relief from shame about money.

I spent years improving my understanding and handling of money. I watched Wall Street Week in Review and learned about stocks and bonds though I had nothing to invest. I subscribed to the Tightwad Gazette, washed my baggies and reused tinfoil. I earned money by training horses but was still dependent on my mother. My new sponsor, Lois, insisted that I get a job. She told me I would never feel truly adult unless I was able to support myself. She was right.

Since then my own relationship with money improved immensely. My business has grown nicely. I support myself in a lifestyle I enjoy. Moreover, I've become very excited about exploring money and consciousness. I've developed techniques to help people heal and shift their relationship with money. Coaching clients about money issues is now one of my specialty areas. I've helped many folks increase their income and have sane and empowered financial lives. So how could someone this together have a financial slip?

Mine was the direct result of moving too quickly. I was sprinting toward my goal of being debt-free. I didn't follow my own rules ("Take my advice, I'm not using it!"), and I forgot to keep ample cash in reserve. When the unexpected happened, I was not prepared. A dead computer and dental work called for money I didn't have because I had paid it all out to credit card companies. So what did I do? I pulled out my plastic and doubled my debt.

Yikes! The moral of the story: if you want to get out of debt, pay yourself first and have ample cash on hand for emergencies and the unexpected. In addition, one more thing: Stop creating debt.


I've made the decision not to debt one day at a time. Sound familiar? Folks in recovery often get themselves in serious financial trouble while stone cold sober. My best intentions to get out of debt were not enough. I have to change my actions. I have to put away my credit card.

I no longer spend more than I earn. I have decided that if I can't pay cash for it, I don't need it. I've put the universe on notice that my needs must be met within the bounds of my income. Not using credit cards requires faith and discipline. I have to trust that I’ll be okay. As a man at a meeting once said, "If your outgo exceeds your income, your upkeep and your ego will be your downfall." In my case, fear would be my downfall. I have to keep the faith as I take action to remain solvent.


How would you describe your relationship with money? Do you have good money habits? Do you pay yourself first? Yes, even if you are self-employed. Even if you have a pile of bills. Pay yourself first. Do you save for unseen events or emergencies? Do you make decisions about money based on your values and goals?

A fun and useful book about money is How to Get What You Want in Life with the Money You Already Have by Carol Keeffe.

This blog post is an excerpt from Alida’s e-book: The Corner Where Addiction and Recovery Meet: Essays about money, sex, relationships and getting past “one day at a time” thinking in early recovery.


Trauma is the Gateway to Addiction

The first time I heard the gateway theory of drug use was in the 1960’s in California. My older brother was on the high school debate team and was practicing his rebuttal to the proposition that marijuana use leads to hard drug use. His rebuttal was that mother’s milk leads to drug use, since all the hard drug users had started out on mother’s milk.

There is still talk today about “gateway drugs” which is not surprising since drug use, especially hard drug use (meth, opiates) has sky rocketed in the last decades. What’s behind this surge in drug use?

Going to Pot


Politicians especially like to suggest the gateway theory that pot use leads to heroin or meth. The theory suggests that if we are tough on marijuana then use of harder drugs will decrease. That simply hasn’t happened. The war on drugs seems to have increased the use of drugs. We have seen meth use sweep across the country and opiates have now killed more people than the AIDS epidemic did.

Law enforcement likes the pot gateway theory because being able to bust people for pot possession makes their job easier. So we continue to fill jails with pot and other drug users. Why is punishment not helping? Punishment doesn’t work because trauma, not pot nor mother’s milk, is behind the explosion of drug use in America. That is what the ACE study has revealed.


ACE stands for Adverse Childhood Experiences. The ACE study is a large longitudinal study co-sponsored by the Center for Disease Control (CDC) and Kaiser Permanente. It asks about ten types of negative childhood experiences and then tracks health outcomes.

The ACE study began in California when 17,337 people enrolled in Kaiser Permanente’s (a large managed healthcare provider) volunteered to take the ACE quiz and have their health tracked. About half the volunteers were female; 74.8% were white; the average age was 57; 75.2% had attended college; all had jobs and access to good health care through Kaiser Permanente.


The ACE questionnaire is simple. It asks about ten types of adverse experience that occurred before the age of 18 including physical neglect, emotional neglect, intimate partner violence, mother treated violently, substance misuse within household, household mental illness, parental separation or divorce, and incarcerated household member.

Each type of adverse experience is worth one point. You get one point whether the experience happened once or many times. As the ACE points add up so does the probability of drug addiction, suicide, social challenges, and a host of other health problems.

Life Sucks

The results are astounding, that’s why the CDC got involved as a co-sponsor of the study. 62% of the U.S. population have an ACE score of one or higher. According to the CDC, for every additional ACE score, the rate of number of prescription drugs increase six times, and early initiation into illicit drug use increases as well. Suicide risks increase. ACEs in any category increased the risk of attempted suicide by 2- to 5-times throughout a person’s lifespan. Women with high ACEs have more risky sexual behaviors, including early intercourse, having had 30 or more sexual partners, and perceiving themselves to be at risk for HIV/AIDS.

ACEs relate not only to alcohol abuse & illicit drug use, sexually transmitted diseases and suicide but also to:

  • Chronic obstructive pulmonary disease
  • Depression
  • Fetal death
  • Health-related quality of life
  • Ischemic heart disease
  • Liver disease
  • Poor work performance
  • Risk for intimate partner violence
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

ACE related research also shows that trauma predicts difficulty in regulating emotions and behavior, and that children with higher ACE scores struggle to learn and get along in school. Adverse experiences also tend to cluster, meaning that if you have one adverse experience you are likely to have another. Does this mean every alcohol or drug user has a high ACE score? No, there are alcoholics who have low ACE scores. There are also people with high ACE scores who function well. But such people are the exceptions and most with high ACEs can expect a life of poor health, drug abuse, and lower functioning.

It’s Not the Pot

We are still looking for the causes of addiction. We would still like an easy fix like keeping pot out of the hands of children. But the facts are that traumatic experiences, whether in childhood or adulthood, increase depression and anxiety. Trauma intensifies the need for self-soothing.  Trauma leads to the over-use of alcohol and other drugs.  We also need to understand that punishment for drugs increases the rate of addiction because punishment itself is traumatizing.

Next time you hear someone talk about gateway drugs, tell them about the ACE study, and tell them that trauma is behind most addiction. Tell politicians that reducing the stress on families will reduce trauma and drug use, and lower medical costs. Tell them it’s not pot (or mother’s milk) that leads to addiction, it ACEs. Show them the ACE study results. Help them connect the dots between trauma and addiction.    

Refuge Recovery: A Buddhist Approach to Recovery

From guest blogger: Sarah

This is the final piece in a series on recovery support options.

One of my stated reasons for not seeking help for my addiction to alcohol was that AA’s emphasis on powerlessness and surrendering to a Higher Power did not work for me, and it seemed to be the only support that was readily and widely available. Ultimately, my physical addiction to alcohol reached a lethal point so I ended up in treatment in the Pacific Northwest. I have come to believe this is one of the best locations on the planet to land if you are in early recovery.  Seattle is a kind of recovery “jackpot” where you can access any modality of addiction treatment available and almost every kind of recovery support community out there - and this is where I first learned about Refuge Recovery meetings.    


Refuge Recovery is an abstinence-based program and addiction recovery community that practices and utilizes Buddhist philosophy as the foundation of the recovery process. Drawing inspiration from the core teachings of the Four Noble Truths, emphasis is placed on both knowledge and empathy as a means for overcoming addiction and its causes.  Meetings are peer-led and begin with a meditation, followed by a reading and then shared reflections from members of the group about the reading and how it relates to their own recovery, in the present moment.  Unlike 12-step meetings, people only identify themselves by their name, not as an addict or alcoholic.   

There are a growing number of Refuge Recovery meetings throughout the world, and in many locations in the US.  They have meetings both in person and by phone, and a searchable website to help you find one near you.  And if you don’t find one in your area, you can easily start one. You will also find a wealth of resources on their website including suggestions for meeting formats, inventory worksheets, podcasts and other resources.  

My first thought after learning about Refuge Recovery was “I wish I had known about this sooner.” I can’t help but wonder if I would have had a chance at sustaining sobriety sooner, had more recovery support options been readily available to me.  Who knows.  I do know that I’m happy to know about it now.  I know I’m happy that I got treatment.  I know I’m happy I learned how to make the 12-step program work for me through the course of that treatment (and am eternally grateful for it!). And I’m happy that my recovery can continue to deepen and expand into other communities like this one. 

Why I love AA

This is the second in a series on recovery support options.


I’ve noticed that people assume that I am against AA because I support and write about harm reduction, which includes not just abstinence but also moderation and reducing harm from ongoing use. In truth I am a twelve-stepper, but like AA co-founder Bill Wilson, I believe that many problem drinkers are not ready for abstinence or the effort it takes to work the twelve steps. I believe that encouraging a problem drinker to track and moderate their drinking will help them see if it is possible. If a problem drinker tries to moderate and finds that they can, as Bill Wilson said, my hat is off to them. Kudos!  If they find that they cannot limit their drinking I believe that knowledge will make them more likely to want to stop. If they find they can’t moderate and chose to continue heavy and harmful drinking, then the principles of harm reduction can help them lessen the damages of heavy drinking to themselves, to their families, and to their community. If you want to learn more about harm reduction click here. One last thought: it is with some trepidation that I break the 11th tradition of AA (anonymity at the level of press, radio, and films.) My belief is that AA is presently secure and stable enough to tolerate such a breach, and that should I get drunk AA deserves credit for the 34 years of continuous abstinence that I have acquired thus far with its help.

Why I Love AA, Let Me Count the Ways

First off, I love Alcoholics Anonymous the way you would love a weird uncle, your favorite one and the one people say you are most like. AA is full of odd balls, people you would never meet anywhere else. I was 29 years old when I joined in the 1980’s and once I got over the age and gender differences (mostly men, everyone decades older than me) I found a seat as comfortable as an old feather couch. I realized that odd balls are the norm in AA and that I fit right in. That was lucky because I had drunk my way into early late-stage alcoholism and desperately needed a place to rest.   

I also love AA because it gives me hope for humanity. It is a marvelous experiment in non-governance and democracy. As Bill Wilson wrote, “So long as there is the slightest interest in sobriety, the more unmoral, the most antisocial, the most critical alcoholic may gather round him a few kindred spirits and announce to us that a new Alcoholics Anonymous group has formed. Anti-God, anti-medicine, anti-our recovery program, even anti-each other—these rampant individuals are a still an AA group if they think so.” Wow! No one can throw me out of AA. AA is the only group I have ever known that is founded on absolute tolerance and which empowers each individual to claim it as its own if they chose to.

I love AA because it is both simple and deep. You can work the AA program just enough to stop drinking or you can use it to advance yourself to sainthood. It works fine either way. I love that the goal of AA is nothing short of a “complete psychic change” and that they provide a way to achieve such a change via working the twelve steps. AA’s 12-step program can help a person move from drunkenness to sobriety, from selfishness and self-centeredness to being of service to others; from running on self-will and self-propulsion to being guided by a higher power and supported by a community, a fellowship.   

I like that AA delivers. I was raised by atheists and scientists and was taught not to take things on trust. So as a senior in college I did my research project on the effects of the 4th and 5th steps (moral inventory and admitting wrong) on self-esteem. It was an 80-person study and there was a surprising difference between the self-esteem of those who had worked the 4th & 5th steps and those who had not. Working those steps tripled self-esteem on average.   

I like that the two founders were so different. Dr. Bob was a steady quiet man while Bill Wilson was a brilliant creative screwball. Between the two of them they sorted out a way out of chronic alcoholism. Before they came along we were destined to die as drunks. Before them the best the medical community could do for alcoholics was aversion therapy, electroshock therapy or permanent commitment to a sanitarium (if your family could afford it).

I love AA meetings. Where else could I hear the inner workings of so many minds and hearts? Last week I heard a man describe how he used honesty to con people. He said, “I would go into great detail about something bad I did so they assume I am that honest about everything.” I am often surprised by people in AA. I started a women’s speaker meeting once and learned that the gal I had sat next to for months played the saxophone in a symphony. My sponsor turned out to be a world-class knitter. (Now I’m a knitter too.) I especially love that there are all sorts of meetings and types of meetings. In some cities there are meetings so rough you would warn your sponsee not to go to them. Some meetings are run by a “preaching deacon” who wants tells you what to do. Those meetings I avoid. My favorite meetings are those where homegroup members have a sense of humor, and where there is a wide spread of time in the program. I need to learn from new comers and have the support of old-timers (even though I am one!).

Perhaps most of all I have loved the people I have gotten to know in AA. That includes Tattoo Bob, a yo-yo champion and metal worker, who was proud that people assumed him to be an ex-con (he wasn’t), and Dwight, who I though was a college profession but turned out to be an elementary school teacher. Dwight has a dry and exquisite sense of humor. I was touched to learn that he had taught several adults to read so they could read the AA literature on their own. And Jimmy D, a man who scared me deeply when I first met him. He wore a crew cut, was a butcher by trade, and had the voice of an Army sergeant. One day when I had six months of sobriety, Jimmy D. put his hand on my should and announced to some other old-timers, “I think this little girl is gonna make it.” That was a profound moment for me. I still cry when I think of it.  I’m lucky I made it. I’m lucky Jimmy D. and the other old timers cared enough about a young hippie like me to make me feel welcome.

These days there are a lot of other alcohol support groups. I’m glad they exist.  I don’t think many of them existed when I needed help. I’m lucky I thrived in AA—not everyone does—and I’m glad I am still sober after all these years. AA is worth giving a serious try. No one feels comfortable entering a room of strangers, so don’t expect to like it at first. Try a variety of meetings and stick with the one you like best (or hate least) for a month or two or three. If it doesn’t help find another support group such as SMART or Refuge Recovery. (My friend J.J. found that AA made him want to drink so he quit on his own. He has a few decades of sobriety now.)  In this day and age there is no need to die a drunk, although many do.

I like AA best of all the support groups because it provides social, spiritual and moral change and a way to stop drinking. Alcoholism is a lonely disease—your best friend is your bottle, and AA provides friends who don’t drink. Spiritual change is optional in AA. More and more meetings for atheists and agnostics are being formed. I had stepped onto a spiritual path before joining AA and found that it improved my relationship with God. That said, my favorite meeting is one for atheists, agnostics and “freethinkers”.  Moral change is important for alcoholics. It isn’t that alcohol is evil, it’s that as a disinhibitor. We do shitty things under the influence, and feel badly about what we did. AA gives us a way to let go of that burden and the self-loathing that goes with it. AA is how I not only stopped drinking but also how I became a good and useful person. So thank you, Bill and Bob.  

StopDrinking on Reddit

This is the first of a series on recovery support options.

I heard about the StopDrinking conversation group on Reddit from one of my recovery coaching students. I checked it out and was surprised that it had more than fifty thousand members. That was eleven months ago. Now StopDrinking (SD) has more that ninety thousand members. Why is this conversation group so popular? Is is effective? Here is what I found.

Round the Clock

One distinct advantage of StopDrinking is that you can find support at anytime of day. Think you're the only one awake at 3 am and wanting a drink? Type a post and within minutes you’ll receive encouraging words. Bored with sobriety on a rainy Sunday afternoon? Read about other people’s struggles and remember why you don’t drink, or post your angst and read the responses.

Self Study

Not all of the members are currently sober. Some come simply to observe or “lurk”, to find out if other people have found a way to stop drinking and, if so, how did they do it? StopDrinking offers a comprehensive overview of what others did to stop, what got in their way, what it’s like to relapse, and how long someone has gone without drinking.  Many members use a badge that gives a day count. Some SD members watch for months or years before giving abstinence a try.

AA’s Grandchild

While StopDrinking has no relation to Alcoholics Anonymous, SD certainly has learned from AA experience. Both have a singular goal of not drinking. Both support anonymity. Both use a “one day at a time” approach. Both are supportive and encouraging. Both encourage speaking in “I” statements and sharing experience, not advice. (I got dinged once for saying “That’s scary!” to one woman’s very high blood alcohol level at time of DUI.) StopDrinking differs from AA in that it offers no specific way to stop other than doing just that. “I will not drink with you today” is SD’s supportive slogan that many end their posts with. There are no steps or traditions, just the wisdom and support of the members. I rarely see the word “alcoholic” or “alcoholism” on StopDrinking posts. Some members make reference to “meetings” but those may be SMART meetings, or Refuge Recovery, or Celebrate Recovery, or AA meetings.

What Members Like Best

I asked members what they like best about the SD community. I got 16 answers and will post a few here. One person with a star badge for four month of sobriety says, “I joined this community a few months before I actually stopped drinking. It gave me the push I needed to finally take the first step, help with resources to keep me firm on the path... and comfort in knowing that I'm not alone on the journey.”

Another says, “This is the most useful [tool] for me. Reading, posting, commenting, connecting, commiserating, celebrating - all of it helps.” 

An observer said a few days ago, “I see all the excuses I've made for years. I'm not sober yet, but I know I want to be and I've been able to take days and weeks between drinks. I loaded up with sparkling water and I stopped buying beer. I avoid situations where I might get trashed. I have extreme respect for my sober friends and I see them as examples for my life. All of this is due to being exposed to an environment where everyone is encouraging me, everyone had been there before, and everyone knows I'm not perfect.” His/her badge now says two days.

Another person wrote, “This is my main support group and I don't use anything else. What I like best is the camaraderie. We all have one goal in common and we help each other achieve or maintain that goal. I don't feel weird or out of place when I talk about what led to my sobriety, or what my life was like when I was still drinking because we all have our own horror stories. Sometimes I will comment when I am feeling strong, and hope that my comment will reach someone who may be struggling. Because when I am struggling, reading through stories and comments makes me feel strong again.”

From another with four months, “The badge is a big, big motivator. Seeing others having to reset keeps me scared and honest. The honest stories about slips, relapses, sobriety struggles, and realities, both good and bad, of not drinking. I like that it's called "stop drinking" rather than "sobriety" because for many of us, we aren't ready emotionally on day one or day ten to say "sober" is just "not drinking for now". That is a very important distinction to me and I think to many others as well. There is complete lack of the judgement, sniping, and second guessing that goes on in a lot of communities. It's almost 100% support and that is wonderful. The tips and tricks I learned from seasoned members have been SO helpful. "Play the tape" has saved my raggedy butt many, many, many times.”

One of These Days

StopDrinking provides a safe place for those not drinking today, and encouragement for those who are hoping  to be able to stop someday soon. Some members have 2 days or none, some have years and years. StopDrinking didn’t exist when I needed help. If it had I might have stopped years sooner. I’m glad it exists, the StopDrinking family on Reddit. My hat is off to you, and I won’t drink with you today.

Harm Reduction May Have Saved My Life

I didn’t hear about harm reduction until I had more than a decade of 12-step recovery. Like many 12-steppers I found the idea of harm reduction scary and threatening. Still, I strived to be open-minded and to avoid contempt prior to investigation, so I read several books on the topic. In doing so I found that I had actively practiced harm reduction as a young drinker and drugger and that it probably saved my life.

According to Wikipedia, the central idea of harm reduction is the “recognition that some people always have and always will engage in behaviors which carry risks, such as casual sex, prostitution, and drug use,” and the main objective of harm reduction is “to mitigate the potential dangers and health risks associated with the risky behaviors themselves.”  Dangers and risks are considered in terms of affect on the individual, the family, the community, and society at large.

Dr. Norman Zinberg’s model of Drug, Set, and Setting.

Drug Set Setting.jpg

One of the important things I learned while reading about harm reduction was Dr. Norman Zinberg’s model of Drug, Set, and Setting. Zinberg did not believe that drug effects are simply a function of biochemistry. He believed that problems with drugs and with drug experiences result from interaction between the three areas. Solutions can be found by making positive changes in these areas. Let’s look at each of these areas and then I’ll describe the choices I made that kept me alive.  

Drug refers to the type of drug itself, potency, purity or what it is cut with, route of ingestion, legality.

Set (originally “mindset”) refers to the person, including characteristics of race, culture, support, mood, beliefs, emotional strengths or weaknesses, coping skills, motivation, health, gender, body size, etc.

Setting refers to when, where, and with whom one uses, what sort of support exists, stresses in one’s life, attitudes of others toward use - including political and cultural.


Let’s start with Drug.  I was 14 years old the first time I saw someone passed out with a needle in his arm. He was in a friend’s apartment and I remember looking carefully to see if he was dead. When I saw he was breathing I wondered if I should call an ambulance, but that might not be the right thing to do. Fortunately he woke up moments later. Even so, I decided that I would not shoot heroin or use needles.

I came to the same conclusion about methamphetamines, then called “speed,” which I rubbed into my gums a few times and liked the effects. Several of my friends got strung out on speed. I watched them lose weight and develop paranoia. I quit using speed after my friend Eddie, a splendid fellow, got so crazy he thought we were being followed. We were taking a walk together and he took me through so many alleys and roundabout detours that I got lost. When we got to his friend’s apartment I had no idea where I was. Eddie split soon after and I was in the embarrassing situation of having to ask for a ride home. I wasn’t old enough to drive.

One time when I was eighteen or so, I was drinking in a downtown bar that had an upstairs disco dance floor. Sitting at the bar, I watched a friend climb the spiral staircase only to see him pause halfway up then fall backwards down the stairs. I spent the next twenty minutes asking his friends what he had taken. I wanted to make sure I never took what he had taken. It turned out he had taken “sopers” also known as Qaaludes, a barbiturate-like drug so destructive it was actually taken off the market.   

The one drug I didn’t know to be afraid of was alcohol, though a friend died choking on his own vomit - his friends didn’t know to lay him on his side.


Set, especially mindset, was something I considered when using LSD. The first time I tripped was at a Janis Joplin concert, and while I had a pleasant experience I could see how it could be awful if you weren’t in a good mood. After that I was selective about when, where and with whom I tripped on LSD. I only used LSD occasionally and with careful planning. I didn’t like to drink when I was tripping and I wanted to be in a safe place for the whole experience.  The last time I took LSD I was on a beach in Florida with a friend. Our plan to spend the night in a tent ended around 4 a. m. when the no-see-em bugs invaded our tent and bit us until we left. My friend had been drinking and so I drove until we got onto a very long bridge. Looking ahead, the converging lines of the bridge narrowed down to a pinpoint. I was afraid to drive into the nothingness and came to a stop in the middle of the bridge. I was shaking. My drunk and tripping friend had to take over the wheel. I would be afraid of driving on bridges for the next decade and never used LSD again.


Setting, especially with whom and where I drank and drugged, was an important part of how I avoided harm. As William White describes in his new book, Recovery Rising, I was aloof “from all but a small circle of friends with a high threshold for deviance.” My friends over the years were an interesting assortment of artists, musicians, bikers, lawyers, gays, and hippies. They were typically four to ten years older than me and a bit protective. They didn’t want me to get in trouble (especially when I was a minor) for their sakes as well as mine.

Setting, in terms of where I drank, became a problem for me as I got older.  I was a daily drinker by the time I was seventeen. Men began trying to pick me up in bars and often succeeded. I solved that problem by changing the setting of where I drank. I started drinking in gay bars because the men weren’t interested in me and I wasn’t interested in the women. I had standards for those I chose to drink with. If they couldn’t hold their liquor, if they slurred their words, if they got obnoxious or violent, and especially if they were bad drivers when under the influence, then I wanted nothing to do with them.  Despite those standards I would drink heavily and harmfully until I had drunk myself into early late-stage alcoholism by the age of twenty-nine.

It never occurred to me that it would be alcohol that would take me to my knees. I didn’t think of it as dangerous. I didn’t make sensible rules for myself such as “don’t drink when you’re angry or tired.” That said, I’m lucky to be alive. My drinking buddies (except for two) are either dead or in AA. My drug-using buddies are mostly dead also, including my sister. They died of overdoses, suicide, Hep C, etc. Still, somehow, despite my excesses and the company I kept, I was able to survive. I believe its because I practiced harm reduction—even though I had never heard the words.

A Philosophy About Addiction

I am in the process of articulating a clear philosophy about addiction and its causes and cures.  This is a first draft of that philosophy.

1. People take drugs for a variety of reasons — especially to feel or function better. So many Americans (more than half) use legal or illegal drugs that drug use is now the norm. 

2. The medical society (not the legal system) should be the first responders for those who overuse or get in trouble with alcohol and other drugs. Medical care, not punishment, is needed.

3. Earlier and better care and earlier — and better education — is needed. Useful education, not just warnings, and not punishment, will help drug users make better-informed and safer decisions about their use of drugs. Better care includes recognizing and responding to the brain health needs of our citizens.

4. The explosion of drug use, which started in the 1950’s and blossomed in the 1960’s, reflects societal angst and biopsychosocial needs. When human needs are met, drug use decreases. A reduction of drug use will only happen when our citizens are happier and feel more secure.

5. Not just dealers make money off of drug users. Pharmaceutical companies promote drug use and make billions, as does the liquor industry. Many others owe their living to drug users, especially within the legal and forensic systems, including judges, lawyers, parole officers, privately owned prisons... The same goes for treatment centers.

6. The War on Drugs is a misnomer; it should be called “The War on Drug Users” because it is a war on half of American citizens. War is an alienating activity. It requires making some group the enemy — in this case drug users. We alienate drug users by labeling them as criminals and putting them in a cruel and unusual environment called prison. Prison is a highly stressful environment that causes PTSD and teaches anti-social behaviors. Prison sentences for drug use damages not just individuals but families and communities. Racism is often an element in who gets punished for drug use.

7. There is evidence that a stressful infancy or childhood creates changes in the brain that predisposes many to drug addiction and other diseases. Unless basic societal changes are made — including redistribution of wealth, access to education, meaningful employment, recreation, and safety — we will continue to have rampant drug problems throughout society.



From Lousy to Pretty Darn Good: The Fine Art of Recovery Coaching

I once got referral from a therapist about “Beth”—a 19 year old who had relapsed after in-patient treatment for drug addiction, including alcohol, pot, and meth. I was told that Beth was on several medications for bi-polar, ADD, etc., that she lived with her divorced mother, was unemployed and currently drinking and smoking pot, and had a history of cutting. Would I be willing to coach her?

Beth doesn’t sound like an ideal coaching client, does she?


Help with Addictions

People call me when they know someone who needs help with recovery from addiction. I coach people to decide whether they want to stop using alcohol or other drugs, or make a plan to cut back. I coach people to decide if they want to use 12-step or other social support, whether they want to go to treatment, or make changes on their own. I help those who stop, cut back, or are coming home from treatment, to stay on track and achieve goals that are now options in recovery.

I saw a lot of red flags with Beth. I’m a professional coach, a recovery coach, and so I screen every client. The screening standards I learned is that to be considered coachable, the potential client must be able to participate in the generation of solutions and strategies and be able to engage in self-discovery. They also need to be able to relate to the coach as an equal partner, or, if they are young as Beth was, and not inclined to see adults as their equals, to understand that equality is inherent to the coaching relationship and over time recognize and cultivate the power of their equality. Beth agreed to meet by phone. The first time we talked she was scraping out a pot pipe, hoping to get a buzz.

Getting High—Choice or Compulsion?

We talked for a few minutes about the futility of trying to get high on the residue from a pot pipe, and also about the difference between choice and compulsion in regard to drugs. We set a time to talk about the possibility of working together. Neither of us were sure that coaching was suitable or a good idea, Beth because she already had a therapist and a psychiatrist, me because I didn’t know if she was coachable.

To Coach or Not to Coach?

Many coaches assume that a person who uses alcohol or other drugs addictively is simply not coachable. They think coaching is about helping people get from good to great, and they forget that addiction affects all levels of society. Addiction is not restricted to any class, race, religion, or level of intelligence. There are many high functioning people who drink too much, or use other drugs excessively. How can a coach know who is coachable? By screening each prospective client.

A Place of Her Own


I teach my Recovery Coach students to screen all their clients. Here is how I screened Beth: When we met I asked her what she would most like to change about her life; what, if she achieved it, would make her feel satisfied with her life. Beth thought for a moment and said that if she lived in her own apartment, rather than with her mother, she would feel much better about her life. I asked her what would need to happen for her to live on her own. Beth said she would need to take her own meds (her Mom was waking her up to take them on time) and get a job.

Beth was jazzed about getting help to move to her own place so we talked about how we might work together. We discussed what was expected in coaching and agreed to give it a try. I let her know that I would not be able to coach her if she came to calls intoxicated, missed calls, or did not seem to benefit from coaching.

Progress Report

That was four years ago. It took a few months to get her on her feet and employed. Today Beth lives on her own and has three full years of abstinence and participation in Alcoholics Anonymous. She is an excellent employee and last year she finished a yearlong trade school with high marks. She still has a psychiatrist and a therapist; I am still her Recovery Coach. I am proud to have coached her from lousy (using drugs, sleeping all day, unemployed) to pretty darn good (drug-free, industrious, employed). Beth loves being clean and sober and having a Recovery Coach. We are working on the next phase of her life. I think of it as the phase from pretty darn good to great.

The Personal and Professional Potential of Addicts

The ICF defines coaching as “partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.” Active addiction drastically interferes with reaching personal and professional potential. Recovery Coaching helps people deal with the barriers caused by active addiction and move forward personally and professionally. Those who resolve their addictions have the potential to get from lousy to great. It may take time to get to great, but it is entirely possible, and with the help of a trained Recovery Coach, it happens more quickly with fewer setbacks.

The Advanced Skills of Recovery Coaching

To be effective as a Recovery Coach it is important to have advanced skills in coaching to increase motivation and confidence. People whose lives have been affected by addiction often have below average self-esteem. Their motivation can waiver along with their confidence. Persons facing addiction or in recovery need to be coached by persons who are effective at finding and leveraging strengths and can be patient with those whose beliefs about themselves change from day to day and week to week.

Coaching From "Who Me?" to "Free at Last"

It is also important to be able to coach change effectively all the way from denial (“Who me?”) to thinking about it (“Yes, but…”) to setting recovery goals (abstinence, harm reduction, etc.), and on to planning, action, and maintenance (“I’m free at last”). And sometimes relapse and starting over. Relapse is common in persons trying to change their habits with alcohol and other drugs, yet there is promising clinical evidence that coaching reduces relapse.

Developmental Coaching

Those who want to work with addiction recovery clients must also be prepared to coach both general development and awareness. People who have spent years living in active addiction often have gaps in their development. They may be very good on the job but a poor communicator at home. Or they may have great interpersonal skills but be lousy at handling money. Recovery Coaches work with their clients to leverage their strengths while identifying the places where they struggle. We also coach to increase awareness of choice and responsibility so our clients can identify and meet their needs, rather than turning to addictive substances when uncomfortable feelings come up.


Professional Recovery Coaches are highly trained coaches with advanced coaching skills that make it possible to help persons facing addiction make significant progress towards good and great lives. We screen our clients for coachability and only work with those who can identify achievable goals and co-create the coaching relationship. Recovery Coaches have advanced coaching skills in building motivation and confidence, and in coaching for awareness and development.

Learn more about me and my experience as a coach.

Learn more about Recovery Coaching and upcoming trainings