Alcoholics Inscrutible
I’m here for two reasons. First, because despite little press, alcohol is a crucial part of wine. I’ve written about its beauty – how beyond lightening the heart it also adds body and carries aromas – but I can’t just ignore the nasty fact that my delight is someone else’s seduction into hell.
Second, there’s Jack, a very dear friend, who was pulled off the streets near death a few months ago. He’s become an AA convert, so I’m also here to support him and find out more about the organization that seems to have washed, dried, ironed-out and neatly folded his brain.
I also want statistics: percentage of pain-in-the-ass problem drinkers versus chemically-dependent alcoholics. Outcomes of various approaches to treatment. But to my fact-seeking, AA offers only dogmatic mumbo-jumbo, not surprising from an organization that sprung from a 19th century religious movement.
As part of Jack’s support system, I’m expected to attend my own groups: al-anon and family weekends. I keep thinking of Oscar Wilde’s explanation of why he quit socialism: “It takes too many evenings.” If they’d give me the curriculum, I offer, I’d learn it a lot faster at home. They respond with a classic bit of debate-defying propaganda: my resistance to the group experience proves that I need it.
AA’s very anonymity precludes much scientific scrutiny. Yet reasoning people, who would surely demand a second opinion if told to turn their diseased pancreas over to God, just assume it works. More than half of AA-goers drop out in the first year. Only 25% of the remaining achieve long-term abstinence. But according to AA’s circular logic, this is no indictment of their method, just of members who don’t “work the program.”
The AA party line – alcoholism is a disease you’re powerless over, therefore accept a higher power and abstain for life – is questionable. If it’s a disease, why treat it like a behavior? Science, for instance, has been striding ahead with the disease model, tracing genetic links and developing new medical treatments. In place of cruel old drugs like Antabuse, which merely fixed it so an addict couldn’t get pleasure or relief from his poison, newer drugs, including Campral, Topiramate, Baclofen and the West African psychedelic Ibogaine, actually ease withdrawal pain and cravings.
Ironically, while traditional AA scripture denounced even so much as aspirin as a crutch, its meeting rooms are always strewn with coffee cups and ashtrays. Java and butts don’t make you beat your wife and miss work went the justification, and besides, quitting everything at once is too hard. New research, however, suggests the clean sweep may work best. To AA’s credit, their policies on both cigarettes and psych-meds are evolving.
But tonight the room is a cloud of smoke. I’m trying to keep my mind open and my nostrils closed, nevertheless, I seem to have walked in on a roomful of zombies. Manchurian candidates, shorn of personal mojo, they speak in slogans: Once an alcoholic, always an alcoholic. Always recovering, never recovered. One drink, one drunk. The Word according to the Big Book – a document as quaintly fused in the 1930s as more famous scriptures are in biblical eras – is not so much read as recited in a mindless sing-song, which comes as an especially creepy surprise from Jack, an actor whose dramatic reading skills have aced many an audition.
Speakers ramble on, repetitive and often incoherent. Since human contact is purportedly a key to the cure, I’m surprised at the lack of interaction. No supportive feedback along the lines of, “Gee, that must have been hard for you!” Just the congregational chorus: “Thanks, Jack.” It’s less group therapy than Catholic confessional crossed with the sort of Maoist self-criticism that abases the person and glorifies the mysterious Higher Power, which, by the way, can be anything from Yahweh to a motorcycle.
Being both analytical and un-hypnotizable myself, I’ve always found groupthink profoundly irritating. “Don’t you realize,” I want to shout, “It’s you making the changes, not Rumplestiltskin?!” I’m bothered by a paradox as enormous and unacknowledged as the proverbial elephant in the living room: You’re told you have a disease that makes it impossible to control your drinking. Yet in order to be in treatment, you must abstain. So if you’re in treatment, by definition, you must be in control.
While I chafe, an astounding thing is happening to Jack. He arrived at the meeting tense, shaking, aching for a drink. But after he stands up – I’m Jack I’m an alcoholic Hi Jack – and “shares” for four minutes, his body relaxes and a peaceful, beatific look settles over his face. Clearly AA helps some people: those who find relief in religious ritual along with a hefty helping of former atheists who have a profound spiritual conversion. AA also teaches coping skills, like what to do about cravings and how to get back in the saddle after a relapse. Badass drinking buddies are replaced with a community of sober fellow-travelers, preoccupied with the issues of drinking and not-drinking for life.
And make no mistake, it’s a life sentence. According to AA, your choice is abstinence or “jails, institutions, and death.” Numerous studies, though, have shown that former drunks can moderate their drinking. As for the purported loss of control following a priming dose of alcohol, one experiment bought abstinence from drunks for as little as $7 a day plus TV privileges.
Statistically, short-term therapy and one-time interventions are also at least as successful as meetings-for-life. And contrary to the long-held view that people who start drinking young are doomed to chronic alcoholism, it turns out most college-age bingers quit chugging once they graduate and start jobs or families.
The mother of recovery plans though, leaving all other treatments in the dust, turns out to be no treatment at all. The vast majority of habit kickers – including a third of problem drinkers and more than 90% of the forty-four million Americans who quit smoking – did it on their own. The number of self-curers is triple or more the successes of AA and other treatments combined. But these are individuals without organized PR, so we seldom hear about them.
In contrast, users who are court-ordered or sent by an employer to AA do worse than those left on their own. Evidently, free will and incentive are more important than which program, if any, you choose.
Statistical trends don’t help the individual addict with his own quirky case, though, so I welcome all approaches to the table. I wish AA would be less coy about its agenda and perhaps submit itself to the rigorous studies that could make it clear whether it really works in big numbers, or just gives that impression. Either way, it has my eternal gratitude if it works for Jack, who is presently clean and alive and quite certain God loves him.
