Pubdate: Wed, 09 May 2001
Source: Village Voice (NY)
Copyright: 2001 Village Voice Media, Inc
Contact:  http://www.villagevoice.com/
Details: http://www.mapinc.org/media/482

THE PREMIER 12-STEP PROGRAM HAS A KILLER DRUG PROBLEM

AA Unmasked

I came into Alcoholics Anonymous 15 years ago. I was always made to feel 
that I was not allowed to share about my drug addictions. There was an AA 
old-timer who would rap on the table to stop the sharing about drugs. So I 
shared as an alcoholic and didn't identify as an addict anymore. I was 
about nine years sober when I started relapsing. I did everything I could 
get my hands on . . . prescription drugs, alcohol, speed, coke, and 
downers. My drug use took me to depths I didn't know existed. I could have 
died. -- Angela F.

For 66 years, AA has been the refuge of last resort for millions of 
desperate alcoholics who have hit bottom. AA has always been free for the 
taking, and as testament to its revolutionary Twelve Steps, its program has 
been successfully adapted over the years to over 40 12-step fellowships. 
But throughout AA's 66 years runs a history of mistreatment of 
non-alcoholic addicts and dually addicted alcoholics that is not in keeping 
with AA's own criteria for membership and the spiritual principles the 
program espouses.

Built into AA's Twelve Traditions, which are the spiritual guidelines for 
all AA groups, is a flaw, born of the limitations of its time. AA's Fifth 
Tradition dictates that each group's primary purpose is to help the 
"alcoholic who still suffers." Many groups follow this literally, not 
allowing dually addicted addicts to openly share (talk) about their drug 
use without relating it to alcohol. As a sign at a Boston meeting says: "We 
only talk about Alcohol here!"

Late last month, at AA's 51st annual General Service Conference held in New 
York City, the "issue of people sharing about problems other than alcohol" 
was at the top of the agenda. The Conference took action to emphasize in 
its literature to health care professionals (from whom AA estimates it gets 
40 percent of its referrals) AA's primary problem: people coming in with 
addictions other than alcohol. As a General Service Office staffer 
speculated after the delegates departed, "A lot of groups . . . are at 
their wits' end about what to do about this issue. There are those who say 
if you keep letting these guys in here, AA is going to pot."

Recently, at a meeting I attended in Wilmington, North Carolina, a man -- a 
regular at that meeting -- raised his hand. He said he needed to share 
about problems he was having with a prescription narcotic he was taking for 
an injury. It had been stated at the start of that meeting (as it is at 
meetings throughout the country): "In keeping with our primary purpose, 
please limit your sharing to your problems with alcohol." The man was 
immediately interrupted by the leader and told he could not "share about 
drugs," and someone else was called on. He wasn't the only person in the 
room that night having an issue with prescription drugs, but after what 
happened to him, I decided to suffer in silence. (I had tried to find a 
Narcotics Anonymous meeting, but they weren't listed in the phone book or 
with the local police.)

This phenomenon is not exclusive to so-called backwaters of addiction 
enlightenment. For more than two years, I regularly attended a liberal AA 
meeting that caters to the Hollywood writing community. I was yelled at in 
the meeting when I shared about plans to do this piece, and was reminded 
that it was an AA meeting -- "addicts" didn't really have any business there.

The irony is that people talk about everything in AA -- all the ugliness 
and degradation that comes with the abyss of alcoholism and the struggles 
of living sober. As one member put it: "You can talk about wanting to kill 
your mother, but you wouldn't want to offend anyone by talking about 
marijuana!"

'Pure' Alcohol

Why are we insisting that people not talk about drugs if it's part of their 
problem? It's mass denial in AA, and it's faulty thinking. Most people in 
AA are dually addicted. Alcohol was just a symptom‹it's a recovery program, 
for Christ's sake! -- M.M., "pure" alcoholic, 22 years sober in AA

The policy that "The only requirement for membership is a desire to stop 
drinking," which is stated in AA's Third Tradition, has wounded AA. Nothing 
demonstrates this as clearly as the organization's declining membership.

In 1939, cofounder Bill W. boasted in the AA bible, Alcoholics Anonymous 
(a.k.a. "The Big Book"), that "AA's membership is growing at the rate of 
20% a year." According to the General Service Office, there has been no 
membership growth in AA for over 10 years, while Narcotics Anonymous (NA) 
has grown, and AA's most recent count indicates that membership is 
declining. Asked about this, a GSO spokesperson said, "AA's primary purpose 
is not changing, and it's not going to change. . . . We adhere to our 
historical and spiritual history. We will not adjust for fear of not being 
here."

Bill W. could not have known in 1935 that alcoholism and drug addiction are 
the same disease. To say someone suffers from alcoholism is like saying 
someone suffers from heroin-ism, cocaine-ism, or marijuana-ism. Alcoholism 
is not a disease separate from addiction. Says Dr. Milton Birnbaum, 
director of addiction medicine at STEPS and a member of the American 
Society of Addiction Medicine, "Alcohol is a drug. The basic behavior 
characteristics are the same for alcoholics and those addicted to other 
drugs. It's the same disease. There is no difference." In 1989 the American 
Medical Society on Alcohol and Other Drug Dependencies changed its name to 
the American Society of Addiction Medicine for this very reason (though AA 
still uses its oldest name, from the 1970s‹the American Medical Society on 
Alcoholism‹in one of its current pamphlets).

Bill W. himself emphasized that AA should seek guidance from the medical 
community. So why ignore the virtually unanimous research? "We don't get 
into a drug is a drug is a drug," AA's GSO spokesperson told me. "It's not 
in keeping with our primary purpose." When I cited Dr. Birnbaum's opinion 
that addiction covers alcoholism as well as other drugs, she replied, 
"Well, maybe it does in his field of work, but not in Alcoholics Anonymous."

Still, what's the point of attacking AA? After all, addicts who aren't 
comfortable in one AA meeting can find another one, or go to NA.

But AA's blind spot on the subject of addiction does matter. AA meetings 
outnumber NA meeting (the next largest 12-step fellowship) three to one. AA 
estimates that it has about 100,000 meetings worldwide and a membership of 
about two million, compared to NA's estimated 28,000 meetings and 500,000 
membership.

Many areas outside of major U.S. cities have only AA, and even in areas 
that have NA, most addicts will end up in an AA meeting by default. In the 
court system, for example, what fellowship to mandate for drug and alcohol 
offenders is left to a judge's discretion. AA gets, by far, the most 
referrals. "Older judges are still sending addicted persons to AA," noted 
the spokesperson for the NA World Service Office. "It's got better 
credibility, for lack of a better word. And for many judges, AA is all they 
know."

Take what happened to Los Angeles addict Bruce M. "When I was arrested for 
driving under the influence," he explains, "the judge gave me a choice: 100 
days in jail or 100 AA meetings. No one ever asked me if it was alcohol I 
was under the influence of. In fact, I was high on a number of drugs."

What's more, an addict's first meeting is crucial. It's hard enough for 
newcomers‹ashamed and destroyed by drugs‹just to walk in. Nor are they well 
equipped to judge whether they're getting what they need. A bad experience 
can result in a relapse. And a person's next high on drugs can always be 
the last.

"When I walked into my first meeting, that was all I could do," said Bobbi, 
who has 12 and a half years in AA. "People pulled me in and made me a part 
of the meeting. I saw other people who were told not to share as addicts. 
It turned them off, and they said they would never come back. So many 
people. Some I've seen at meetings of Cocaine Anonymous or Narcotics 
Anonymous. The ones I haven't seen again, I don't know what happened to 
them. If I had been treated that way, I would not have come back, and I 
would be dead now."

For a long time AA was all male, virtually all white, mostly Protestant, 
mostly middle-class, and all "pure" alcoholics. And drug addiction wasn't 
the only blind spot. AA historically discriminated against African 
Americans (who were only allowed in as visitors until the mid 1940s, and 
then were encouraged to start their own meetings) and women.

The AA book Pass It On notes that "even Dr. Bob [an AA cofounder] had 
expressed uneasiness about admitting women to AA membership when the first 
few appeared." Alcoholics Anonymous is still gender-specific to men 
throughout (despite social changes over the last 50 years, purists refuse 
to alter even one word Bill wrote). The only chapter for women is titled 
"To Wives."

Women have made some strides in AA since Dr. Bob, but the fellowship's 
racial demographics continue to reflect its racist origins. As of a 1998 AA 
survey, an estimated 34 percent of members were women, and AA was 88 
percent white.

But what has never evolved is AA's blind spot with drugs.

If Bill had found drugs, he'd have done them, and AA would be a different 
place today. -- K.W.

Bill W. did find drugs. He took LSD in 1956, and did so regularly for at 
least two years. Pass It On recounts that "he was enthusiastic about his 
experience." There are old AA rumors that Bill did this in an attempt to 
ease his chronic depression or to test it as a possible cure for alcoholism 
(which at first some scientists thought it might be). In fact, Bill W. took 
LSD for the same reasons many hippies later did. He happily turned on 
non-alcoholic friends and his non-alcoholic wife: "I have felt free to give 
it to Lois, and she had a most pleasing and beneficial experience. It was 
not the full dose, and I expect shortly to try that on her. Though she 
doesn't necessarily connect it with the LSD, there is no doubt she is 
undergoing a very great general improvement since even this mild 
administration."

Other AA members were less than thrilled with Bill W.'s experimentation, 
but like him, they continued to see alcohol and drug use as unrelated. They 
never thought he lost his 22 years of sobriety and neither did he.

"In AA you could say, 'I shot dope today,' " commented Terry R., founder of 
Narcotics Anonymous in New York, "and they'd say, 'But you didn't drink!' "

According to AA's GSO, "There is only one definition of sobriety" in AA, 
and it's the one Bill W. gave in the 1958 AA pamphlet, "Problems Other Than 
Alcohol." It reads simply: "Sobriety‹freedom from alcohol." And the program 
is limited by it, since AA cannot tell anyone they are not sober if they 
use drugs, although AA members generally may believe otherwise. An AA 
spokesperson told me, "It's an outside issue. They are free to decide if 
they're sober or not. We talk about drinking. That's it."

Bill Turns On

The main reason given for talking only about alcohol is "identification," a 
concept argued forcefully by C.I. With 42 years of sobriety, C.I. is a 
powerful AA figure in the mold of Bill W. He founded in L.A. what may be 
the single largest AA group in the world, boasting 1200 members, with a 
reputation for sobering up the lowest of low-bottom drunks.

Says C.I., "Since AA is based so much on identification rather than 
information, it is imperative that alcoholics talk about their experiences" 
and that alcoholic-addicts should "glide over their drugs" when they share. 
For more than 27 years, he has worked with skid-row addicts, and says, "I 
still get no empathy from hearing a guy who talks about shooting up drugs. 
I understand it intellectually, but when a guy gets up and talks about why 
he drank and what drinking did for him, that brings an empathetic bond."

But what of the alcoholic who shared in a meeting that he "shot whiskey and 
drank morphine." Would C.I. identify with him?

The basic thing we all have in common is not how we used drugs or whether 
they came in a glass or a needle; it's the similar behaviors we manifest 
and the feelings that motivate them: the isolating, lying, denial, and 
unmanageability. It's the mental and physical cravings, obsessions, and 
compulsions‹and these cross substance lines.

Otherwise, how could a wealthy wine connoisseur identify with a 
beer-drinking truck driver? Or a movie mogul who snorts cocaine relate to 
low-income crack users who prostituted themselves? As one addict accurately 
noted, "The disease doesn't care if you're from Park Avenue or a park 
bench‹and it also doesn't care if you drank it, shot it, snorted it, or 
smoked it."

In NA, they prove daily that alcohol addicts, heroin addicts, cocaine 
addicts, and others can identify with each other and recover together. They 
urge everyone to identify as an "addict," regardless of their drug of 
choice, and they stress listening for similarities instead of differences 
since "Our stories may be different, but the feelings are the same." And 
what they find‹what we all have in common‹is the experience, as Bill W. 
most aptly described it in "The Big Book," of "incomprehensible 
demoralization," which is where all our addictions take us regardless of 
drug of choice.

Smoke and Mirrors

I'd like to see who would be left if you took all the addicts out of 
AA‹just crotchety old men smoking cigarettes and drinking coffee, and no 
newcomers! -- K.W.

In 1983, 31 percent of AA respondents said they were also drug addicts. By 
1989 it was 42 percent. After that, the General Service Office stopped 
asking. Said a GSO spokesperson, "We don't ask that question anymore. It's 
not in keeping with our singleness of purpose." Another GSO spokesperson 
said, "Finding out how many addicts are in AA serves no purpose to serving 
the alcoholic."

Talk about needing a reality check: A 1998 federal study found that just 26 
percent of clients in treatment for substance abuse related only to 
alcohol. When the Betty Ford Foundation opened in 1982, 72 percent of its 
clientele named alcohol as their sole drug of choice. Today it's 10 
percent. The same trend is reflected across the country, from Gracie Square 
Hospital's detox on Manhattan's Upper East Side to the C.L.A.R.E. 
Foundation in West Los Angeles, which serves 90,000 people a year‹90 
percent of whom, according to a spokesperson, are dually addicted.

As Terry R. puts it, "AA is like the King's English. It may be the purest 
form, but it's not what the majority of people are speaking."

A section of Chapter 5 from "The Big Book," which is commonly read at the 
beginning of every meeting, says, "Some of us have tried to hold onto our 
old ideas and the result was nil until we let go absolutely." Bill W. is 
referring to the change in thinking necessary to recover, but the principle 
applies to the program itself.

Following the recent move at the New York conference, the GSO staffer 
attempted to focus the issue: "Sharing about drugs‹that's a problem. AA is 
looking for some way to solve this problem." Though how they'll ever do 
this by censoring the majority of their members is a bigger problem.

In addition to AA's self-inflicted wounds, the fact that many addicts are 
now finding homes elsewhere is limiting the program's growth. Given these 
developments, NA may well be in the 21st century what AA was in the 20th.

M.T. is a screenwriter and producer, and the author of the book A 
Sponsorship Guide to 12-Step Programs, published by St. Martin's Press. She 
was born and raised in Manhattan, where she got clean in 1988. She now 
lives and works in Los Angeles and is an active member of the NA and AA 
fellowships.
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