When the world is too dark
And I need the light inside of me
I’ll go into a bar and drink
–the Pogues/Streams of Whiskey
There are, essentially, no truly effective treatment programs for drug or alcohol dependency. AA was created in the late 30’s and it remains the basis for pretty much all current drug and alcohol treatment programs. In 1992, the National Institute on Alcohol Abuse and Alcoholism studied 42,000 Americans. 4500 of them had been dependent on alcohol at some time. Of these 4500, only 27% had ever had any treatment, and a third of them were still abusing alcohol. Of those who had never had treatment, only a quarter were still abusing alcohol
So why is AA so often mandated by the courts in spite of the fact that people treat their own disease just as effectively as either AA or other 12-step based programs? Well, there isn’t really anything else.
Why aren’t there any other options? I have no idea. For some reason, we’ve never managed to progress beyond 12 step programs in spite of their limited efficacy. My conspiracy theorist brain thinks that companies making money off of our repeated trips to rehab facilities are quashing any more successful treatments so they can keep getting their patients back for treatment over and over.
One of the things that got me thinking about this is that it’s football season and we all seem to do a lot more drinking this time of year in my social group. That makes me think about the many addicts I’ve known over the years.
Also, James Frey has a new book out. Frey, if you recall, wrote a wildly successful book several years ago called “A Million Little Pieces” about his addictions and subsequent legal troubles and treatment in an inpatient rehab. There was eventually a shit storm when it was revealed that he’d made a lot of the stuff in his book up. I enjoyed the book, and although I don’t know anything about being in rehab I liked Frey’s take on 12 Step programs. His opinion was basically that he was NOT powerless over drugs and alcohol and that it was ultimately up to him to deal with it himself. He was also convinced that there was no reason he should not be able to moderate his alcohol consumption with enough will power instead of giving up alcohol entirely. That really resonated with me–putting someone in a position of eternal victim-hood like AA does seems like it would be emotionally crippling. And a lifetime of meetings to reinforce your dependency on the higher power that’s supposed to save you? It makes me cringe.
As an atheist, I’ve always wondered what I would ever do if I need treatment for drug or alcohol addiction. I don’t believe in a higher power. Any higher power. Also, saying that I’m powerless over anything seems…just instinctively wrong somehow. Wouldn’t empowering addicts to fight against their addictions with medical/psychiatric assistance be far more productive than just telling them to throw up their hands and say that they’re helpless? Certainly thinking that (what is to me) an imaginary entity is going to save me doesn’t seem like it would be helpful in the long term. One atheist recovery site recommends replacing “higher power” with “reality” when attending AA, but the fact remains that AA is a religious group whose core belief is that you need to submit to God to remain sober. And that submission is forever.
One thing everyone (except James Frey) seems to agree with is that an addict will never be able to moderate his or her consumption. So what do you do if your addiction is something that you have to have on an at least occasional basis, such as food or sex? Abstinence is simple. You know exactly how much heroin you can have if you’re a recovering addict–none. Same for vodka–none. How much dinner can you have if you have an eating disorder? You can’t be abstinent from food for long.
How do you achieve the equivalent of food sobriety?
Or maybe food and sex addiction are just a bunch of hooey.
That’s very possible.
To be continued, I bet…