Great conversation. MM's mention of detox reminds me of my earlier assertion that the industry needs to change, and the influence of RR/AVRT strategies could help. When someone needs supervised detox due to risk of medical complications (heavy alcohol or benzo use, for example), they find themselves in the system and are thus most often steered toward the very methods RR is against. Thus, my point that RR could help those who stumble (or catch a ride by ambulance or police car or parole officer) into the system.
About dual diagnoses: I was drunk and miserable, and I risked home detox because of my job. All I knew at the time was I was sick and tired of being sick and tired. And I was miserable.
It didn't even occur to me until about a month of sobriety that I may have had a co-occurring disorder, and the anxiety I experienced may have been due to detoxing after decades of drinking and drugging, or probably equally true, drinking and drugging was fueled by anxiety in the first place. Regardless, in retrospect, I met criteria for PTSD, probably a major depressive episode, maybe adjustment disorder, and perhaps an anxiety disorder - who knows? I've read up and now I don't think I no longer meet criteria for any of the above.
And I didn't use medications or seek help of any kind. Maybe I should have, but I didn't. Pride. Job. Fear. Cussedness.
But my point is that even without psych meds or even just therapy, there was no way I was going to be able to effectively self-treat or receive effective professional treatment until I was clean and sober. Once I was sober long enough to level out and begin to understand my symptoms without alcohol and other drugs - only then could I start making progress - mostly via meditation and mindfulness - toward emotional stability.
And that required commitment to permanent abstinence, plus another 18 months or so before I could truthfully say I had recovered from substance use and mental illness (if we must call it that).