By Joe Gerstein, MD, FACP


Like the minor wave that precedes the tsunami, the first call came in early March from Roger Weiss, Professor of Psychiatry at Harvard Medical School and Chief of Addictions at McLean Hospital in suburban Boston. He broke the news to me gently: all 6 weekly SMART Recovery meetings at McLean Hospital had to cease and desist because all visitors to the campus who were neither staff nor patients/clients would now be barred from entry. I realized SMART Recovery would need to move massively online amid COVID-19

As volunteer advisor to SMART Recovery/Massachusetts, I am often the point of contact within the organization. I immediately contacted the facilitators of the four SMART Recovery meetings, the SMART Family and Friends meeting and the facilitator who visited the Detox Unit to present an Introductory Presentation each week and told them not to show up for their meeting. I advised them to contact participants if they had any way to do so, and to contact the central office in Ohio to obtain a ZOOM license.

SMART Recovery is a 501c3 organization founded in 1994 to support mutual-aid groups using the evidence-based, MAT congenial, SMART Recovery 4-Point Program in free, weekly meetings, facilitated by trained volunteers, mostly peers, who have used the program successfully. A Central Office in Ohio, and thousands of volunteers, support a network of 3,600 weekly meetings globally, in 27 countries, and 2,300 in the US.

Then, came the real tsunami wave. Email after email, and call after call, rattled onto my devices advising me that almost all hospitals (24 hospitals and rehabs in MA host SMART meetings), churches, veterans’ facilities, prisons, jails and Community Recovery Centers which hosted SMART meetings were halting face-to face meetings. This was an extremely disturbing development knowing the crucial importance of group cohesion and support to those attempting recovery from an addiction. Together, with the intrusions of the other depredations of the COVID-19 epidemic, the combination produced a toxic concoction for those trying to avoid their addictive propensities.

Fortunately, SMART Recovery has had an active online community for over 20 years on, known as SROL. Initially limited to a meeting list, message board, chat room, and a library of recovery materials, the evident impact on group cohesion was made clear to my skeptical assessment of its capacity, when it attracted 40 participants from all over the US to an unprogrammed meeting at a resort in the Poconos in the Summer of 1997, after only 1 year of operation.

In or around 1999, a number of online group recovery meetings were started on the website. Initially, these were text-only meetings. A couple of years later, an audio format was introduced. By then, the number of online meetings had grown to twelve. The number of online meetings continued to expand as demand grew, and an attendance verification component was added. By 2016 there were thirty meetings, with the addition of three Family and Friends meetings.

Repeated breakdowns in the program that was supporting the meetings led the organization to substitute the newer ZOOM format about a year ago. This was a complex (and expensive) task, but was instituted and monitored by one of our Board members who was formerly the IT Director for a Fortune 500 company and was completed with only a few minor glitches. A huge re-training project was required for the thirty online facilitators, in the intricacies of the ZOOM system. However, we now had a video element available and a smartphone capacity.

When the calamitous closings began to spread like a wildfire, it was all hands-on deck in Mentor, OH. An immediate decision was made at an emergency Board meeting to reach into the Reserve Fund (a crucial element of the financial solidity which enabled SMART to carry a Platinum Rating from GuideStar), as merited in this crisis situation.

Employees were reassigned from their routine tasks to a task force to immediately list meetings which no longer had a venue available, and was listed as on hiatus. As ZOOM licenses were acquired for a meeting, and the facilitator accessed the training video which was developed for the three-times weekly live training sessions, the designation was changed to “now online.” Four hundred “local” ZOOM meetings were put online within three weeks, and after urgent requests, new trainees were found to increase the number of “national” online meetings to fifty.

Unfortunately, some of these “national” meetings were inundated by 200-300 participants during the transition, not an ideal number for a SMART Recovery meeting which is meant to be interactional. A couple of local online meetings were “ZOOM-bombed” by interlopers, but luckily, this was a rare occurrence. Some meetings decided to introduce passwords for participation that needed to be obtained from the facilitator prior to the meeting.

UK SMART Recovery and SMART Recovery Australia, also support online meetings, and these are now integrated with the US/Canada meetings, so that meetings are available virtually “around the clock.”. SMART Recovery moves massively online amid covid-19!

Generally speaking, the transition for participants from Face-To- Face to ZOOM meetings has been smooth. Some people have struggled with, or have been intimidated by the technology, but this is actually more complicated for the facilitator than the participant. Facilitators often “go to the whiteboard” to demonstrate one of SMART’s 14 TOOLS and this can be accomplished in the ZOOM format’s share function. Although only 25-40% of the participants in the “national” meetings turn on their cameras, 90%+ do so at the “local” online meetings. Uptake by participants has been ragged because although some groups maintain google groups or Facebook sites where the new URLs can be posted, some had no means of direct communication and had to wait for the switch from “on hiatus” to “online”, which sometimes took up to 7 days.

“Poor Little Rhode Island, the smallest of the 48” as the old song says, was the first state to successfully move all of its eight meetings online.

Of course, for those who do not own a smartphone, or do not have access to a broadband connection capable of at least 25 Mbps transmission, the regular ZOOM format is not going to be accessible. However, there is a capability of phone-in participation, although not with the video component. Occasionally, a meeting in an indigent geography has chosen to preserve the face-to-face format as the only reasonable way to continue the meetings, using meticulous cleaning, masks and social distancing.

What the long-term outcome of SMART Recovery’s move massively online amid covid-19 will be on the popularity, or even, on the existence of Face-To-Face meetings once they are safe again is conjectural. We will have to wait to see. “Passing the hat” is now kaput.

For a listing of SMART Recovery online meetings, go to and enter your zip code for local meetings. For the “national” meeting list go to

Dr. Joe Gerstein is the Founding President of Smart Recovery