Jump to content
The End of my Addiction
Chuck

Articles from The Atlantic (2015) and Harper's (2011) critical of AA

Recommended Posts

Chuck

Articles from two prominent progressive American magazines, highly critical of AA and underscoring the need for a wider variety of treatment options. Harper's is very reactionary and intellectual but The Atlantic is more even-keeled. In the Atlantic article the writer tries Naltrexone and reports positively on its effects.

The Atlantic April 2015 "The Irrationality of Alcoholics Anonymous"
"J.G. says it was this message—that there were no small missteps, and one drink might as well be 100—that set him on a cycle of bingeing and abstinence.... He felt utterly defeated. And according to AA doctrine, the failure was his alone. When the 12 steps don’t work for someone like J.G., Alcoholics Anonymous says that person must be deeply flawed."

Harper's January 2011 "The Drunk's Club: A.A., The Cult That Cures"

  • Like 1

Share this post


Link to post
Share on other sites
Molly78

Thanks for those links, Chuck.

The Atlantic's article is really well balanced - & it mentions baclofen in a positive way! What's depressing is the comments at the end - all of which are an argument for or against AA. No one seems to have picked up the references to actual "treatments", or at least no one has commented on them.  Typical that AA is the predominant option in the US, whether you love it or hate it!

  • Like 2

Share this post


Link to post
Share on other sites
Chuck

Ohmigod the comments - I didn't even see those - yes what a typical sh*tshow. Yes, AA is still the knee-jerk reaction of most practitioners in the US, but slowly that tide is turning, luckily - paralleling the widespread legalization of marijuana (cannabis). One of the peculiarities of American culture is how much we value innovation yet at the same time remain so mired in tradition, a certain Victorianism still pervades so much of how we think and act, even in medicine where you'd think they'd be so innovation-forward. I guess everything's a work in progress...

  • Like 2

Share this post


Link to post
Share on other sites
Ne1

@Chuck

Thank you! I hadn't read either of these before. I've just read the Harper's Bazaar article. I really related to what he wrote. The things he describes about AA (the good stuff) are some of the reasons I miss going to AA. And the things he describes, the hypocrisy about medications and the attachment to the steps, are the reasons I felt I could not go to meetings. This article changed my mind about going to meetings, though. First of all, I love the camaraderie and some of the steps. (Not the first one, unfortunately. I am not, "powerless over alcohol." It's kind of hard to do the steps if you have to skip step one. And that's not the only one I can't take.) But I feel like I have something to offer, given the stuff I've read over the years, about medication but also about alcoholism treatment in general. Imagine what would happen if we all went to meetings and explained how baclofen (or naltrexone, cameral, ADs etc) worked. We might not be invited back, we might be belittled, but surely there would be some people that got online and looked it up and found EOMA (hopefully)!

Forgive the impulse to share my thoughts about what Martin wrote! 

It is clear that he had Dr. Levin prescribe for him, which makes me think he was one of us, or a silent lurker, on MWO: 

"My first psychiatrist, meanwhile, believed alcoholism was an entirely physical phenomenon that could be cured with purely chemical means. Find the right pills, and you will no longer be an alcoholic. After our initial few sessions, he would do ten-minute phone interviews with me once a month—seventy- five dollars “a visit”—and then call the pharmacist. Soon my brain was so addled with drugs that I was falling asleep in my ofice and in meetings; a colleague commented on my “drooling”; and I descended into a depression that was qualitatively unlike any sadness I had ever experienced, even after my father’s death or before my suicide attempt." 

He states that he took baclofen for 6 months until his cravings were under control. 

The following comment is very much like Ameisen's theory (and really, it seems so obvious that it's hard to fathom it is taking so long to be realized by treatment providers):

My own view-in-progress is that there is no such thing as alcoholism as a disease or an allergy or a condition, but that alcohol is a very effective and potentially addictive medication for a whole host of psychological and neurobiological problems… That is, different persons, according to their psychological history and their neurochemistry, tend to become addicted to the drug of alcohol with greater ease or celerity; others may have a relative resistance to (and/or less need of) the drug. 

I'm going to stop saying it's a disease. It's not. It's a symptom of something gone awry in brain chemistry. That makes it a symptom. (Obviously.) I can see that so clearly in my husband, actually. He's the guy that back in the day would swear that he didn't have anxiety. He just called it stress. But the stress, too, was a symptom of his anxiety. Mostly. Not always. Anxiety-related-stress is clearly the reason he's drinking now! And even calling it anxiety has always irked me. It's so much smaller than that. It's insidious. It's not what other people call anxiety when they're freaking out because of something dramatic in their lives. It's the chronic dysfunction of something in our brains. (Amygdala, the prefrontal cortex in general, dopamine, GabaB, B vitamins…All of the above. Who knows? We don't yet.) 

Martin wrote:

"A.A. is the world’s largest functioning anarchy, and on the whole it performs astonishingly well." 

If ONLY WE COULD MAKE IT WORK, IMAGINE HOW POWERFUL IT WOULD BE?!?!? (The pun of that statement was not intended but is kind of brilliant. There's an AA saying, "It works if you work it, so work it because you're worth it.")  

In one of those articles, it says that there are 97,000 meetings world wide. Just imagine what would happen if AA actually changed with the times and adopted new science into the traditional AA model. The power! The reach! The number of people with alcoholism that could be effectively treated! It's overwhelming to think about. And just fucking depressing, too, since AA is so steeped in a tradition that values (religious) dogma over science.

Share this post


Link to post
Share on other sites
Chuck

I'm glad you liked the articles so much! I just re-read the Harper's one for the first time since it was published. So much to say I don't know where to begin.

Bill W., the forefather of AA - he was an LSD user? First reaction: what a hypocrite! Second reaction: the Wikipedia article on it matches almost verbatim what I want to say about Dextromethorphan! He pre-stole my idea! Haha. But seriously, it's so disingenuous how behind the scenes he was tripping on LSD and keeping mum about it. Great that he discovered an alternative remedy. Not great that he kept it largely to himself and told the world the was chemical-free. Which brings me to what @Ne1 said about AA probably frowning upon our use of medications. Re-reading this article taught me a lot about AA. Interesting how there's such a culture within it (the old-timers, the 8-o'clockers, the thumpers), but most striking is how cult-like it is, loosely quoting Martin on page 37. It seems to work largely through tautologous insistence - this is true because we say so, this is true because it's in the book, we believe it because we've made ourselves believe it - and by extension the categorical exclusion of anything else, anything not canonized in the texts. Too bad. I must say that, at the risk of offending, I sometimes feel slightly sorry for AAers. Like Rob M. said, you remain an addict, your new addiction is AA. Granted there is an immense array of personalities and experiences, but by focusing solely on what you don't do, no longer do even if you haven't done it in decades, it self-limits. What about what you do? Where's the change? Where's the growth? Ironic and again deplorable that Bill W. did find a constructive, affirmative remedy in the form of LSD but kept it to himself (or was it the other way around - was he afraid to share it because he feared, rightfully, that he would be shamed? Was he a victim of his own creation?). I have an uncle who is a 25+ year member of AA and every Christmas my dad makes a chocolate cake with a Grand Marnier glaze. My dad demarcates with toothpicks two slices that are booze-free, even though the actual amount of ethanol in each slice is no more than a few drops. And I see my uncle staring at it, mostly inscrutably, but with some form of hate. He doesn't hate the cake. He doesn't hate the ethanol. He doesn't hate the embarassment of the toothpicks. I think he hates the dissonance - the deep-down feeling that he could have a regular slice with no problem, could a quarter teaspoon really undo a quarter century of self-control, versus the indoctrinated belief that if he does, he's now a ticking time bomb, a failure, and the past 25 years have been for naught. I love my uncle so much and support him no matter what, but when I see that resentment peeking out from his expressionless face, it makes me sad. It makes me feel that he's been wronged. Lied to. Trapped. AA, then and now, would absolutely frown upon our choices to use medicines (or let me use a less euphemistic word - drugs!) to detach from ethanol. And I'm pretty sure that will never change. After all, for the members, it's no longer about alcohol. It's about AA. Which brings me to my conclusion about how important this work we do is. Even just participating and writing in these forums. It's tremendous. Alcohol abuse, disease or not, traps us. But AA, in my opinion and again apologizing for any offense, just places us in a different - albeit happier - trap that lies in the shadow of our former trap. The more we spread the word about these drugs, more people will learn that not only can they escape the trap, they can truly be free.

  • Like 1

Share this post


Link to post
Share on other sites
Ne1
11 hours ago, Chuck said:

AA, then and now, would absolutely frown upon our choices to use medicines (or let me use a less euphemistic word - drugs!) to detach from ethanol. And I'm pretty sure that will never change. After all, for the members, it's no longer about alcohol. It's about AA. Which brings me to my conclusion about how important this work we do is. Even just participating and writing in these forums. It's tremendous. Alcohol abuse, disease or not, traps us. But AA, in my opinion and again apologizing for any offense, just places us in a different - albeit happier - trap that lies in the shadow of our former trap. The more we spread the word about these drugs, more people will learn that not only can they escape the trap, they can truly be free.

I think AA then would have been more amenable to medications. I read somewhere, some-long ago, that Bill W. believed that there would be a medical solution. I don't think he hid his use of LSD, either. I think it was indoctrinated out. 

AA must change or it will die. By definition. We just haven't reached the tipping point, yet. I mean, if the pope can change some fundamentals, there is hope for AA! It may just die out because people see there GPs, take a pill and get on with life. 

I agree, that we are doing God's work (pun!) by writing about our experiences where they can be found by the world. 

  • Like 1

Share this post


Link to post
Share on other sites
Ne1
On July 20, 2016 at 8:58 AM, Ne1 said:

 

My own view-in-progress is that there is no such thing as alcoholism as a disease or an allergy or a condition, but that alcohol is a very effective and potentially addictive medication for a whole host of psychological and neurobiological problems… That is, different persons, according to their psychological history and their neurochemistry, tend to become addicted to the drug of alcohol with greater ease or celerity; others may have a relative resistance to (and/or less need of) the drug. 

I'm going to stop saying it's a disease. It's not. It's a symptom of something gone awry in brain chemistry. That makes it a symptom. (Obviously.) I can see that so clearly in my husband, actually. He's the guy that back in the day would swear that he didn't have anxiety. He just called it stress. But the stress, too, was a symptom of his anxiety. Mostly. Not always. Anxiety-related-stress is clearly the reason he's drinking now! And even calling it anxiety has always irked me. It's so much smaller than that. It's insidious. It's not what other people call anxiety when they're freaking out because of something dramatic in their lives. It's the chronic dysfunction of something in our brains. (Amygdala, the prefrontal cortex in general, dopamine, GabaB, B vitamins…All of the above. Who knows? We don't yet.) 

I gave this a lot of thought after I wrote it. I think I was wrong, and so is he. It IS a disease. And labeling it such is not semantics. It's vitally important. 

"A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism. The causal study of disease is called pathology. Disease is often construed as a medical condition associated with specific symptoms and signs." (Google) 

If something is wrong with a group that shows similar dysfunction in biological and/or psychological processes then it's disease. We have proof from MRIs and a lot of other valid, quantifiable, qualitative research that says that people with alcoholism share certain dysfunctions in hormones and brain chemistry. 

Type-2 Diabetes is a perfect comparison. Both diseases are a function of genetics, epigenetic and choices.

It's ridiculous that he doesn't want to call it a disease and I think I'm going to write him and ask him why he came to that conclusion when what he wrote is the definition of disease. Because I'd really like to know. And apparently, I have more time than I think I have and want to waste it trying to convince someone, over the internet, that his choice of words is crucial, and wrong. <sigh>

Now that I've written that out, I return to the fact that Dr. Ameisen wrote that alcoholism wasn't the disease, it was a symptom of the disease. And now I'm all kerfuffled about what to label it, because he was also right. 

People who have the same chemical or hormonal dysfunction that we do, but don't have access to alcohol, can't have alcoholism, but have something wrong with them, too Unless alcohol is needed to complete the picture? 

pffft. More thought is needed. Plus, I feel like I'm going to read this tomorrow and think I'm an idiot and want to delete it, but can't. :-/

 

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Restore formatting

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...