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I guess my take on AA has always been that it gives people a reason to turn their lives around, and AA is not necessarily the reason itself that people get better. I have had friends and family recover with abstinence-only treatments for their addictions, and have also had a close family member die because they couldn't give it up.

I'm often reminded of the David Foster Wallace passage from Infinite Jest when I think about people who need to break 100% free from their addictions:

“--and then you're in serious trouble, very serious trouble, and you know it, finally, deadly serious trouble, because this Substance you thought was your one true friend, that you gave up all for, gladly, that for so long gave you relief from the pain of the Losses your love of that relief caused, your mother and lover and god and compadre, has finally removed its smily-face mask to reveal centerless eyes and a ravening maw, and canines down to here, it's the Face In The Floor, the grinning root-white face of your worst nightmares, and the face is your own face in the mirror, now, it's you, the Substance has devoured or replaced and become you, and the puke-, drool- and Substance-crusted T-shirt you've both worn for weeks now gets torn off and you stand there looking and in the root-white chest where your heart (given away to It) should be beating, in its exposed chest's center and centerless eyes is just a lightless hole, more teeth, and a beckoning taloned hand dangling something irresistible, and now you see you've been had, screwed royal, stripped and fucked and tossed to the side like some stuffed toy to lie for all time in the posture you land in. You see now that It's your enemy and your worst personal nightmare and the trouble It's gotten you into is undeniable and you still can't stop. Doing the Substance now is like attending Black Mass but you still can't stop, even though the Substance no longer gets you high. You are, as they say, Finished. You cannot get drunk and you cannot get sober; you cannot get high and you cannot get straight. You are behind bars; you are in a cage and can see only bars in every direction. You are in the kind of a hell of a mess that either ends lives or turns them around.”

The prescription is always abstinence, and almost universally any suggestion that moderate drinking might be possible for some is met with scorn and anxiety.

My understanding is abstinence programs are for those that have tried to moderate and cannot.

To quote AA:

Ch. 3 More About Alcoholism... For those who are unable to drink moderately the question is how to stop altogether.

Ch. 3 More About Alcoholism... We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself, step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.

It also seems strange to suggest naltrexone as an alternative to aa.

From living sober:

AA. members and many of their physicians have described situations in which depressed patients have been told by AAs to throw away the pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from schizophrenics, manic depressives, epileptics, and others requiring medication that well-meaning AA friends often discourage them from taking prescribed medication. Unfortunately, by following a layman's advice, the sufferers find that their conditions can return with all their previous intensity. On top of that, they feel guilty because they are convinced that "AA is against pills." It becomes clear that just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it's equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.

I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?

However, I strongly suggest, as do you, for those suffering to seek out help and consider all options.

>My understanding is abstinence programs are for those that have tried to moderate and cannot.

I hope I did not suggest that abstinence is not the correct answer for some. It just isn't the answer for all, which is what is generally taught in AA. And the quotes from Chapter 3 are not serious, in the sense that if a newcomer to AA says something like, "Maybe I can drink moderately," the answer is pretty much always, "How did you end up here then!?" (Frequently, the answer is, "The judge told me I had to come in order to avoid jail.")

>It also seems strange to suggest naltrexone as an alternative to aa.

Living Sober was written before naltrexone was invented. I have known a number of folks who were prescribed Valium and similar drugs in the '60s and '70s and '80s who became addicted to both Valium and alcohol.

Further, the Living Sober quote suggests medication may be appropriate, but "alcoholism" (or whatever the DSM-5 calls it now) is often the main diagnosis, with any other diagnoses placed as subordinate to that main diagnosis. The implication is, "Stop drinking and the rest will go away," which is frankly bullshit. The Orange Papers (for all its many flaws) has a good section on this.

>I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?

This is not from the literature, but rather from my observation over many years. Many times I have heard it suggested that AA is "basically christian" or "based on christian principles" but the reality is that it is based on what is properly called "Buchmanism" (for Frank Buchman, the founder of the Oxford Group). There is a tinge of christianity to it, but it is based on works (staying sober) rather than on grace.

This is why many moral failings in AA are glossed over with, "Nobody's perfect! Just stay sober and you'll be OK!" That is an appropriate response to dealing with a medical issue -- for example, a heart patient may also be a greedy, corrupt thief. The moral failing does not generally have any bearing on the treatment of the cardiovascular issues. So why are alcoholics taking moral inventories and making amends and confessing their shortcomings to others?

In other words, is it a disease, or is it a moral condition? If it's a moral condition, then let's not call AA's solution "christian," because it is not. If it is a disease, then let's treat it like one rather than using the twelve steps.

> sverige:

> In other words, is it a disease, or is it a moral

> condition? If it's a moral condition, then let's not call

> AA's solution "christian," because it is not. If it is a

> disease, then let's treat it like one rather than using

> the twelve steps

I think that in AA alcoholism itself is considered a disease, with at least two components: an allergy of the body; and an obsession of the mind. The disease of alcoholism is considered to have far-reaching effects which are best dealt with by two things: staying sober and working the 12 steps and thereby having a spiritual experience.

I'd say it's analogous to someone who's had a heart attack. The immediate crisis needs to be addressed at an emergency room. Then there are lifestyle and diet changes that need to happen, too. The heart attack might have been the initial problem that precipitated the crisis, but the lifestyle issues are the real cause.

AA is a big organization, and there are certainly different interpretations, but I think it's fair to say that alcohol is certainly seen as the problem, but the underlying cause of the problem is seen to be the lack of a spiritual lifestyle. Hence the two-pronged approach. Very often Christianity is used because it's what's familiar. But I'd hardly call AA a Christian organization.

>I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?

The message is the opposite. It's sobriety comes through salvation.

1 We admitted we were powerless over alcohol - that our lives had become unmanageable.

2 Came to believe that a Power greater than ourselves could restore us to sanity.

3 Made a decision to turn our will and our lives over to the care of God as we understood Him.

It's not clear to me from your comments that you've read the article-- especially "It also seems strange to suggest naltrexone as an alternative to AA". Is it just because it's an 'evil drug' or am I missing something?

Also, I feel you're misunderstanding the "moderation" that the article speaks of. The AA literature you quote is about someone who is actively dependent in a bad way trying to moderate themselves. The "moderate drinking might be possible for some" line is about returning to a life of moderate drinking in the future.

interesting post; so how did you end up dealing with your issues post AA?

The short version is that I became a christian. Since that time, the mental health issues I had previously have dissipated. These included diagnoses by various sorts of mental health doctors that included alcoholism, drug addiction, clinical depression, and later bipolar disorder. Lord knows there were probably other diagnoses that could have been applied as well.

In addition to AA and NA, I have also taken various medications for depression and mania, and have been through all sorts of talk therapy. I have not taken any of those medications for over a decade, I no longer go to meetings or therapy, and, among other things, I have found that I can drink in moderation. I drink very occasionally, maybe once every few months, at social occasions.

I cannot claim that anyone who becomes a christian would have the same experience. I do not know that. And I am aware of weaknesses in those areas that used to cause me so much trouble, but I can also say that they are not debilitating the way they were previously.

When I left AA and NA, I went around to all my old meetings and told my friends there why they would not see me any more. There were some very interesting conversations, to say the least. I wish them no ill will, but as I said above, I would not recommend those groups to someone in trouble. I wouldn't say not to go there, but I would not send them there as a first option.

I don't really have any pat advice to offer anyone struggling as I did, beyond, Don't give up. Yes, it's painful, but don't give up looking for solutions. (And as someone else said here, taper taper taper if you're trying to detox.)