Tag Archives: Treatment

Let Rational Heads Prevail

By now many people have heard or read the article, “The Irrationality of Alcoholics Anonymous.”  As a member who has remained sober for over 26 years my first reaction was how dare they trash something I love.  I also need to disclose I am a professional who has almost 30 years of experience working with addiction.  You can say I have mixed feelings when it comes to this article.  Given that, I remembered a quote in the book Alcoholics anonymous Appendix 2, The Spiritual Experience, which says,  “There is a principle which is a bar against all information, which is proof against all arguments, and which cannot fail to keep a man in everlasting ignorance – that principle is contempt prior to investigation.”  So despite my conflict I decided to read the article with an open mind.  After all isn’t that one of the tenets of the 12 step programs?

The article challenges the paradigm of treatment in the United States.  I don’t have any issue with that challenge.  We have acquired a vast amount of knowledge since the first book of alcoholics anonymous was written.  I also believe it is responsible to seek out new methods for the people with addiction who are not responding to the 12 step model.  I have been in too many meetings and after meeting, meeting, where the members question the commitment of others who relapse or continue to relapse. The article states there is a much lower success rate which suggests a higher rate of relapse for people in Alcoholics Anonymous. So , lets compare that with the relapse rate of another chronic illnesses, Type 1-Diabetes. This chronic illness has anywhere from 30-50 percent relapse rate. Even if one follows a strict regimen for treatment one cannot completely control their blood sugar.  Could you imagine someone questioning the willingness of someone who has a relapse in their blood sugar by saying, “well you just have to surrender to your blood sugar before you can get better?” If your doctor said something like that you would find a new doctor. In the 12 step programs we say that all the time.

One of my complaints I have always had with members of the 12 step program is their own lack of understanding of the illness.  In the article when they review the “experts” in the field of addiction and some of them only have a high school diploma. Alcoholics Anonymous says it should remain forever non professional, but treatment centers are not making that claim.  They base their treatment on the 12 step model as the preferred and most effective treatment.  Treatment centers should not be selling the 12 step program because it’s not theirs to sell. I believe one thing needs to be clear for members in Alcoholics Anonymous or any 12 step program: Just because you are an alcoholic and/or drug addict, that does not make you an expert on addiction!   If that hurts your feelings then maybe one of the four inventories it discusses in the 12 steps and 12 traditions is in order.

The reality is Alcoholics Anonymous has not professed itself to be the only answer to alcoholism.  Read some of these following statement from the Fourth edition of Alcoholics Anonymous:

  • “We do not like to profess anyone an alcoholic”
  • “If anyone who is showing inability to control his drinking can do the right- about-face and drink like a gentleman, our hats are off to him. Heaven knows, we have tried hard enough and long enough to drink like other people!”
  • “By no means do we offer it as the last word on this subject, but so far as we are concerned, it has worked with us.”
  • “If you are as seriously alcoholic as we were”
  • “If you wish you can join us”
  • “If he does not want to stop drinking, don’t waste time trying to persuade him”

Hardly a force feeding of the Alcoholics Anonymous program.  As a matter of fact Alcoholics Anonymous, if anything, has been watered down by treatment centers. Commonly used phrases like, “don’t have a relationship for a year” or “fake it til you make it,” are no where to be found in the text of the Alcoholics Anonymous, but are said in meetings every day.  In many places AA meetings resemble group therapy more than they do AA meetings. Alcoholics Anonymous states, “we have no opinions on outside issues,” but it’s members do. Too often Alcoholics Anonymous is judged by the individual members.  They are not representative of Alcoholics Anonymous as a whole.  Even the preamble of Alcoholics Anonymous states it is a “fellowship,” not treatment.  It is not Alcoholics Anonymous who is professing it’s success, it’s the members who attribute their success to Alcoholics Anonymous.

One of the complaints the article had was the lack of ability to research Alcoholics Anonymous.  Bill Wilson did not write the text of Alcoholics Anonymous with metrics for research, he wrote it because he wanted to help alcoholics. It was identified that remaining abstinent from alcohol Let’s remember prior to Alcoholics Anonymous there was nothing for alcoholics to sustain recovery from alcoholism.   Alcoholics Anonymous found a way to help many people over the years.  It has helped me remain sober for some 26 years.  Do I believe that we need to continue to find methods to help those who experience addiction-most definitely.  We have only begun to scratch the surface.  I have heard so many times, “the only answer to alcoholism is in the first 164 pages of Alcoholics Anonymous.”  Anyone who makes that statement has not read the first 164 pages.  Bill Wilson never believed that and searched for answers over the years outside of the program he developed.  He never stopped trying to find out how to make recovery better for alcoholics.

Did Alcoholics Anonymous believe they had all the answers?  On page 163 of the text they say, “Our book is meant to be suggestive only. We realize we know only a little.”  Alcoholics Anonymous is what it is, a support group for people who want help for their alcoholism.  It is the professionals job to educate court systems, employers and others as to what is available for recovery.  I’m sure “more will be revealed.”

The Face of Addiction

Many of you may have heard of Johnny Manziel, the Cleveland Browns quarterback who was their number one pick in the 2014 NFL draft.  Prior to being drafted, Manziel’s off the field issues with substance use and poor decision making were well chronicled prior to the draft.  Recently, Manziel checked himself into treatment for substance use.  At 22 years old you would think getting help for his substance use, being the number 1 draft pick, and a contract to play NFL football would be a bright future for Manziel.

Enter the world of the NFL.  There is another quarterback, Marcus Mariota, coming out of college that the Brown’s show interest.  The issue isn’t whether Mariota may be a better quarterback than Manziel, it’s what the Cleveland Brown organization said about Mariota that is of interest.  They stated, “”In light on what’s gone on with Manziel…there is a tremendous amount of fear for the future here and a very strong consideration of going and get somebody – especially Mariota, who they really like and they think would be a proper face for the franchise and a guy who is far more dependable than the guys that they’ve had there so far.”  Proper face of the franchise? That is basically saying that we do not want an alcoholic or drug addict’s face as our club’s poster boy. Something tells me that if Manziel had cancer or heart disease that phrase would not have been used. Why?

The why is easy to explain.  Addiction is still defined by the behavior and not the illness.  The symptoms of addiction are such, the wreckage to family, jobs, and friends leaves them feeling hurt, angry, resentful, and defeated.  Since we judge the behavior, we reinforce that addiction is willful.  The user meant to make those decisions that caused their current circumstance.  The addicted person hears phrases like, “why did you do that,” and “why don’t you just stop,” and my personal favorite, “you have so much potential.”   What if we said to a person who was diagnosed with cancer “why do you have cancer, can’t you just stop?” people would look at us like we were out of our mind.

You may say, Mike, you are comparing apples to oranges.  No.  I am comparing symptoms of two medical conditions.  Until the idea that the symptoms of addiction need to be treated like an illness and not willful behavior then our effectiveness in treating addiction will be limited.  Just because treatment may include behavioral change does not mean that addiction is behavior.  The type of behavior that is exhibited with many addicted individuals already has a diagnosis, Anti-Social Personality.  Experience tells us that when addiction is treated, the Anti Social behavior can be alleviated. I realize I am making some generalizations about Anti Social Personality and behavior, but if we rely on much of our experience, treating addiction brings about a change in a person not only in behavior, but in attitude, thought and spirituality.

The Cleveland Browns have a great opportunity to educate the rest of the NFL and our society.  Sadly, they are like many of us in today’s culture-they seem to be looking to either photo shop or replace his face.  Having been a recovering person for more than 26 years,if it’s all the same to you I will keep the face I have.