What alternatives are out there to Alcoholics Anonymous and Narcotics Anonymous?

Tuesday 29 October, 2024.

What’s the first drug support group you can think of? I bet it’s Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), right? There’s guaranteed to be a local chapter near you, which is great. These meetings are effective for a lot of people who want to go cold turkey and, while they may not involve professional therapy, they’re based on a completely free-of-charge peer support model.

The jury is still out on how effective AA and NA are but a 2020 review of research on recovery options, which looked over 27 studies involving over 10,000 participants, suggested that these programs lead to longer lengths of sobriety than other treatments such as cognitive behavioural therapy (CBT), which is what a private psychologist will likely teach you.

For some people, however, an absolutist abstinence framework may not work, nor the requirement in AA and NA meetings to believe in a higher power. AA and NA are programs rooted in religion, God and abstinence. It’s not for everyone. That’s not to say that it’s better or worse than the other alternatives out there. We’re simply recognising people who use drugs are a very diverse bunch! Different people, different needs. Plus, members of AA and NA chapters sometime don’t appreciate people attending if they are using medications, such as methadone or bupe, to assist in their recovery. Unfortunately, stigma remains an issue for people who choose to use these meds to get off drugs.

Others yet may want to give up using drugs constantly but they’re still open to occasional recreational use. There are also people who may prefer a women-only support group or a culturally-safe space for Aboriginal people.

In recent years, a range of new free options have emerged such as Hello Sunday Morning, an online tool and service, and Sober in the Country/Bush Tribe, an online peer support group for people in regional and remote areas of Australia.

In this article, however, we’re giving an overview of two alternative programs to AA/NA: SMART Recovery and MARA (Medically-Assisted Recovery Anonymous).

MARA — Medication-Assisted Recovery Anonymous

Our friends at WHOS (We Help Ourselves) have teamed up with MARA International to support Australia’s first MARA chapter. MARA is a 12-step program specifically designed for people who choose medication-assisted treatment for substance use disorders.

The central idea is non-judgemental peer support. Participants run the meetings themselves; WHOS has simply provided rooms for attendees to use. It’s not only a form of “aftercare” for rehab residents in WHOS programs, a way for them to develop a support base for when they leave, it’s a great way for the general public to form new social networks with like-minded people. The meetings are open to all! They’re also accessible. There’s no homework involved, just good yarns.

This MARA chapter is popular among current participants. One participant Mick explains, “I got a place to go and I won’t be judged and that’s the biggest hurdle done. If you feel comfortable somewhere, you can get somewhere and have a normal life.”

Another participant called Kurt tells Users News that MARA helps him “not feel alone on the methadone program”.

“Being on methadone is looked down upon by some people and other 12-step fellowships and being a part of MARA, I feel accepted and able to share my journey with others.”

Most MARA chapters connect over Zoom as the program has originated in the United States, but people around the world are catching on and signing up. So far, the Australian MARA chapter has only met once in person in Lilyfield, Sydney.  MARA participant Mick is confident that program will “take off” in Australia, suggesting it’s only a matter of time. He wants to see other drug rehab services and clinics advertise the group.

He says “there aren’t enough” chapters in Australia and he wants to start his own chapter when he heads home to Newcastle (Australia) to help support others like him.

“You get a lot more vulnerable face-to-face and you can yarn afterwards,” Mick explains. “Not everyone is computer literate either.”

SMART Recovery (Self-Management and Recovery Training)

SMART Recovery chapters are a lot more common in Australia. SMART Recovery is a group for anyone who uses drugs that wants to set goals and make changes. That may or may not include full abstinence. At SMART groups, you’re unlikely to find the usual AA/NA chat around how many days sober you are and what your drug of choice is.

Here is a firsthand account that a SMART Recovery participant gave to The Level, a drug harm reduction organisation in New Zealand:

We talk about our goals in the group. Some people want to go for a walk once a week or cut down coffee. Any number of things. They might spend that time instead reflecting on their journey and start thinking about themselves a bit. What self–care looks like… Through these groups, I’ve had to learn a lot. I’ve tried a lot of sneaky routes around addiction and realised that for me abstinence is the best way to go about it. But it’s so much more than just the drug use. We talk about the involvement of my health, my sanity, my goals, my relationship with my kids. 

Like MARA, SMART Recovery gives you room to grow without needing to worry about condemnation from peers over any misstep or self-shame. For some people, this kind of self-management is the key to success.

Click here to find a SMART Recovery group near you.