Letter to the Editor
I wanted to write to you to express my support for the article by and opinion of Brooke Feldman, MSW. In “Smoking Bans and SUD Treatment — A Social Work Perspective,” Feldman wrote about patients in Philadelphia who enter Medicaid-funded substance use disorder (SUD) treatment. These patients must agree to join a smoking cessation program while they are in inpatient treatment, and the treatment centers are obligated to prohibit patients from smoking.
As a student who is currently seeking my bachelor’s degree in social work, I found Feldman’s assessment of the policies affecting patients and treatment centers related to the Code of Ethics fascinating to read. Her writing has helped me to not only evaluate different perspectives of the issue but to reinforce my understanding of the Code of Ethics. Looking at a current, real-life situation from the standpoint of a social worker, rather than reading a case study from a textbook that is possibly fiction, made a real difference in my assessment of the situation.
Just like Feldman, I am also a person in recovery, and my sobriety is what lead me towards my realization that I should have known all along that I wanted to become a social worker.
As someone who has been through inpatient treatment and a detoxification center, I wholeheartedly do not support the policy of forcing patients to quit smoking upon entering treatment. I remember the night that I decided to go to treatment. No one forced me. No one talked me into it. I had realized that I had no control over even one aspect of my life. I had gotten to a place where the only thing that made my unhappiness feel different was to do something to make me feel even unhappier—drugs and alcohol. I was finished. I could not live like that anymore. I had two choices; I could continue on this same path, heading towards losing everyone that I loved and losing everything that mattered to me, or I could allow myself to die inside, get help to achieve sobriety, and start all over.
I am now about two years sober. In my time in treatment, and my time in sobriety, everything about me changed. I had to learn who I am all over again. I had to find my voice and learn how to talk to people again. I needed to learn how to live life as an adult and be responsible, for a second time. I have made it this far because I went to treatment for the right reasons, which I’ve learned are pretty standard, from my time in Alcoholics Anonymous (AA) and discussing sobriety with other men in my fellowship. If a person is serious about getting sober, if they want to survive and live a new life, if they fully surrender themselves to alcohol and drugs and admit that they cannot control them, they deserve to be able to enter treatment. And they deserve it whether or not they want to quit smoking.
Admitting defeat to addiction is terrifying. If letting patients smoke gives them just one sense of normalcy to get them through it, let them smoke. The city of Philadelphia cannot expect people to give up every single piece of their lives all at one time, just because it is a healthier way of life. I guarantee that every smoker knows just how bad smoking is for their health.
Of course, patients should not be able to smoke anytime they wish. Just like I experienced in my treatment center, there are certain times in which you must follow a routine, which works very well for people with mental health and SUD issues. Smoking can be a part of that routine.
Another message in Feldman’s article that I would like to support is that treatment centers can still provide instruction and have resources for patients who want to quit smoking. I strongly suggest that treatment centers do not do what mine did, which was to push cigarettes onto you and try to get people to smoke.
In AA and Narcotics Anonymous, there is a phrase used often, “One day at a time.” A person entering treatment is already giving up the life that they know to recover from addiction. Allow them to take it one day at a time, and hopefully, quitting smoking will be next on their list.
Thank you for this article, and the many articles that you share in your magazine. The variety of topics that you cover reminds me of the many options that I have in my social work career, and also reminds me why I chose social work in the first place.
Thank you for this thoughtful letter and sharing candidly your own experience and how it informs your perspective on this important topic. And congratulations on your achievement of two years of abstinence. Best wishes moving forward!