Perspective: Breaking the Stigma of Mental Illness in Addiction Recovery

by Christopher Crumb


I facilitate what are known as Double Recovery Meetings for people who have been dually diagnosed with concurrent disorders. Concurrent Disorders means a diagnosis of a mental illness (one or more) and an addiction (one or more).

Double Recovery started with an alcoholic from New York with schizophrenia named Howie V. He was sober in AA for about 14 years when he decided to start a 12-step program specifically for people like him – dually diagnosed. For a while the meetings were listed in the NYC local AA Meeting List pamphlet. However, when it was taken to the AA membership for a vote, they decided that it violated the Third Tradition of primary purpose; i.e. “The only requirement for membership is a desire to stop drinking.”

Bill Wilson wrote the steps and he suffered from depression all his life. He and Howie V. were trailblazers. We now need to blaze new trails and break the stigma of mental illness by informing and educating ourselves and others about it.

People with mental health issues have very specific needs in recovery. There are many of them in the “regular” 12-step meetings of CA, AA, and NA. They show up in Al-Anon, ACoA, Coda and other 12-step meetings too. You may work with them. Often these folks will not talk about their mental health issues due to stigma and misunderstandings. Just as there is stigma around mental illness in society, so there is in 12-step groups as well. The rooms mimic society in many ways. I think the single-mindedness of purpose in AA and NA has contributed to it too. Education is what is needed. Stigma busting!

Here is a story I have heard directly. A newer member of AA who had been doing well suddenly disappeared for a time. When he showed up again he told someone he trusted how he had fallen in with a group of AAs who encouraged him to go off his meds. Their reasoning was, “You have to be clean of everything.” He had been convinced by them to do so with disastrous results. When he became very unwell, not one of those people visited him in the psychiatric ward. This was 22 years ago.

Since doing this kind of work I have heard other stories of 12-step members being encouraged or influenced into going off their psychiatric medication or being judged as “not clean” by some other members or being told not to discuss it in meetings. It does happen and we should not ignore it.

We must never get in between the person who is concurrent and their doctor. We are not doctors. AA literature clearly states, “No A.A. member should “play doctor”; all medical advice and treatment should come from a qualified physician.” [AA conference-approved pamphlet “The AA Member: Medications and Other Drugs”]

So many people have told me that without their medication they would not stand a chance. Who are we to decide or convince otherwise? It is unbelievable to me that anyone who is not a doctor would try to convince someone into going off meds. It is risky and dangerous: people have been known to take or attempt to take their own lives.  If someone wants to go off or change their meds they really do need to do it in conjunction with their doctor. It can be done, but must be done carefully and under medical supervision.

If you know or meet someone who is dually diagnosed and new to recovery, you can be of benefit to them by welcoming them and reminding them what the AA literature states on medications. Look out for them when they are at your meeting.  Help them feel safe if you can. Remember that people can sometimes be easily led astray, especially when they are vulnerable due to their mental illness.

You can also educate yourself and others about mental illness, which will help you to help people who have this challenge. There is a lot of good material online, in book stores and at the library. I also suggest finding accounts written by those who have suffered through it directly or, better yet, meeting and talking to people who have. You could volunteer at a mental health care facility or put on a service meeting there. You will learn from their experience, strength and hope. I know I have.

The more you can read and learn directly, the more you will realize that these “diseases of the brain” are very complex and persistent. We still know only a little about the brain. So please take the time to learn. Someone’s life may one day depend on it.

My job is not to encourage nor discourage medication or psychiatry. I support people in their decisions about the treatment of their mental illness and their alcoholism or other addictions. At the end of the day each must choose what to do. Hopefully it will be an informed decision, with the help and support of others they can trust.

Double Recovery meetings are regularly held at various locations in Toronto, including Renascent. A list of Double Recovery meetings is available here.

About the Authors

Contributors to Renascent’s Blog share their stories of addiction and recovery and/or their professional expertise.