Dual Recovery Anonymous is a self-help organization providing 12-step peer-support meetings for people with co-occurring mental health and substance use disorders. Dual diagnosis is common and can lead to experiences of overlooked psychological issues, stigma, and alienation in traditional recovery groups.
Dual Recovery Anonymous (DRA) groups provide support for the unique needs of individuals with mental health challenges who are working to overcome an addiction.
- People with substance use issues and mental health conditions face unique challenges in recovery
- Dual Recovery Anonymous is a support group for dual diagnosis that utilizes the Twelve Step principles.
- These types of groups show positive outcomes for people with dual diagnosis in supporting recovery and improvements in quality of life.
Understanding Dual Recovery Anonymous (DRA)
Dual Recovery Anonymous (DRA) is a support group offering regular meetings to people with a dual diagnosis of both mental health and substance use disorders. Like many other support groups, such as Alcoholics Anonymous (AA), DRA uses the 12-step program to help people in recovery. [1] Similar groups include Dual Diagnosis Anonymous (DDA) and Double Trouble in Recovery (DTR).
Statistically, around half of all people with a substance use disorder (SUD) will experience a mental illness (MI) at some point in their lives, and vice versa. This is known as dual diagnosis. [2] People in SUD recovery can utilize support groups to help in their recovery journey. These groups offer a safe space for people to discuss their experiences in recovery, including their triggers and challenges. They offer a community of people with shared experiences, who can support one another in maintaining abstinence and reducing the impact of SUDs on general well-being. [3]
This can be crucial support for many people in recovery. However, for people who experience co-occurring mental health conditions, these support groups might not be as beneficial.
Research shows that people with dual diagnosis are likely to feel alienated in SUD support groups and may experience reduced empathy and understanding. Groups like DRA are specifically for people with dual diagnosis, and aim to address both conditions concurrently, ensuring that members feel adequately supported and understood. [4][5]
Is DRA evidence-based?
DRA is not a formal treatment for addiction or mental illness, and so isn’t considered an evidence-based practice. While there is limited formal research evaluating its effectiveness, anecdotal reports suggest these groups can lead to improvements in both SUDs and MIs. [4][6]
Even though support groups are not formal treatments, a great deal of research supports their effectiveness, especially when combined with treatments like psychotherapy. For example, studies show that people attending support groups experience reduced release rates, improved social connectedness, and improved quality of life. [3]
Who it is for
DRA is for people who experience both substance use issues and mental health diagnoses. Membership does not depend on a professional referral or a previous utilization of professional services. As such, it could be used as an aftercare option for people who have completed a treatment program or for those who are receiving other forms of professional treatment. Because DRA is peer-led, it is not a substitute for professional treatment and should be used in conjunction with behavioral therapy and/or medication. [1]
As such, the group is for people who have:
- A diagnosis of both substance use issues and mental health conditions.
- A commitment to recovery in both areas and the ability to attend regular meetings.
- A desire to connect with others in recovery for added support.
How Dual Recovery Anonymous works
Key aspects of DRA include: [1]
- 12 Steps: DRA is modeled on the Twelve Steps of AA, adapted to meet the needs of individuals with a dual diagnosis. This is focused on spiritual concepts and belief in a “higher power”, although members are encouraged to adapt these concepts to meet their own beliefs. The Twelve Steps promote acceptance, rebuilding relationships, taking responsibility, working toward change, and preventing relapse.
- Two requirements: DRA states that their only requirements are “a desire to stop using alcohol and other intoxicating drugs, and a desire to manage our emotional or psychiatric illness in a healthy and constructive way.”
- Peer-led: DRA meetings are facilitated by people who have experienced dual diagnosis and are in recovery themselves. This allows members to discuss with people who have shared experiences, thereby creating a community of understanding and empathy.
- Equal focus: Meetings focus equally on the members’ substance use issues and mental health conditions, supporting recovery and relapse prevention in both aspects.
- Non-clinical: DRA meetings do not involve professionals and therefore do not include clinical advice or treatment. Some groups can offer contact details of specialist services to their members, who can be contacted for specific treatment support.
Benefits of DRA
Self-reported benefits of DRA or DDA include: [4][5][6]
- Increased feelings of acceptance by other group members, regardless of MI or SUD diagnoses.
- Reductions in SUD and MI symptoms.
- Improvements in social functioning and sense of community.
- Improvements in self-esteem, self-acceptance, and hopefulness for the future.
- Peer-led support, from people with a range of backgrounds and experiences.
- Option to get a sponsor, who serves as a mentor to help people work through the 12 steps.
- Improvements in quality of life.
- Reduced suicidal ideation and rumination.
- Improvements in attitudes towards and compliance with prescribed medications or professional treatments.
Limitations and considerations
Potential limitations and considerations of DRA include:
- The 12-step approach focuses on spirituality and a higher power, which might not align with the personal, spiritual, or religious beliefs of all individuals.
- Although support groups such as DRA can be beneficial in recovery, they do not replace professional treatment.
- Discussions around mental health medications could potentially hinder or confuse some aspects of substance use recovery.
- DRA meetings might be less accessible or less widely available than other traditional support groups like Alcoholics Anonymous or Narcotics Anonymous.
DRA vs. Other support groups
| DRA | AA | SMART Recovery | |
|---|---|---|---|
| Focus | Mental health focus is equal to substance use focus | Little or no focus on mental health, primarily substance use, and higher power | Focus on addictions and self-empowerment |
| Goals | Abstinence and medication adherence | Abstinence | Abstinence and independence |
| Peer-led | Yes | Yes | Trained facilitator |
| Format | 12-step, spiritual focus | 12-step, spiritual focus | Scientific focus with evidence-based techniques |
How to find DRA meetings
People can search for available DRA meetings on the DRA website, which provides a state-by-state directory.
DDA online meetings can be found on the DDA website, which displays information about available online meetings for people in the US and a website for people in the UK.
Other dual diagnosis recovery support groups may be available across the US.
When to seek professional treatment
Support groups like DRA are not a substitute for formal treatment by a licensed professional, and cannot treat a mental health or substance use disorder. People should seek professional treatment if they are experiencing serious impacts from either or both SUDs and MIs, such as:
- Significant impairments in daily, professional, academic, or social functioning.
- Employment or housing security becomes affected.
- Suicidal ideation or behaviors or risk of harm to self.
- Aggression or violence toward others.
- Significant impacts on physical health.
Professional treatment can involve therapeutic and medicinal interventions to improve substance use issues and mental health. Specialist dual-diagnosis treatment is available to address these issues concurrently.
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