For hundreds, if not thousands of years, alcohol has been a part of society. The fledgling alcohol treatment phenomenon has taken off in the twenty-first century and is now a multi-billion dollar a year industry. Centuries ago there were treatments and groups to deal with ‘inebriates.’ Alcoholism was considered a moral issue for the longest time. The Temperance movement, Prohibition, and institutionalization have all had their day. Alcoholic Anonymous is perhaps the most well-known program for alcoholics since its inception in 1939. A.A. meetings have been the mainstay of peer led recovery support.
A LOOK AT THE NUMBERS
Alcoholics Anonymous now boasts over 2 million members (estimated, because membership is, of course, anonymous), and over 120,000 worldwide locations. A.A. is the model by which all subsequent 12-Step programs use as a foundation of their own programs. There are now over 50 “Anonymous” groups worldwide.
A.A. has a success rate of less than 5%, often quoted at less than 3%, for groups that are anonymous it is somewhat difficult to get accurate figures. The rate is going to vary somewhat depending on the criteria of success.
Modern treatment centers will boast that their success rates are as high as 80-95%. Beware, this is not realistic. This figure is most likely to be the number of people who graduate their program, not how many remain clean and sober once they leave.
Self-reported recovery rates are difficult to gauge. Relapse rates are as high as 50-70% within the first few months. Depending on the substance of choice, these rates can be higher.
A QUICK HISTORY OF A.A.
It is well known that Bill Wilson and Dr. Bob were the founders of modern A.A, after a split from the Oxford Group. Formalized in 1939, the first official meeting of Alcoholics Anonymous occurred in Akron, Ohio May 18, 1939. The first edition of the Big Book was published in 1939.
As it progressed, A.A. became the place to go for mutual support for those who labeled themselves as alcoholics. The alcoholics were maintaining sobriety, working together, and taking the message to other alcoholics.
William L. White (1998) in the book Slaying the Dragon states that “A.A. has a distinctive place in this history. No mutual-aid movement other than A.A. involved such large numbers of alcoholics, spread to so many corners of the earth, sustained itself so long, and so profoundly shaped the evolution of alcoholism treatment” (pp.127). To date, A.A. is one of the most well-known peer support groups for recovering alcoholics.
A.A. is self-sustaining through the 12 Traditions. World headquarters are in New York. General Service Office estimates there were over 2 million members in 2017 and over 120,000 groups worldwide. A.A.may be self-sustaining at certain levels, but it operates like a juggernaut at World level.
THE DISEASE CONCEPT
In 1956 alcoholism was officially recognized as a disease by the AMA. Alcoholism could then be treated in medical and hospital settings. This opened up treatment to the masses. Post-1956, treatment centers sprung up everywhere.
Up until recently treatment centers revolved around and pushed the 12-steps, A.A., the disease concept and medical model of treatment. In-house and community 12-Step meetings are the norm. 12-Step meetings are everywhere.
WHY GO TO MEETINGS?
One of the first things you learn in treatment, or in A.A. is abstinence. You cannot be in recovery without stopping your substance use. There is little use in trying to convince someone under the influence to stop drinking; no matter what declarations they make about wanting to stop. You cannot talk sense to a drunk!
When you are actively using your substance of choice, you are no doubt running amok. You have no schedule, no responsibility, no routine, and are not taking care of your health or hygiene. You are obsessed with getting and using your substance of choice.
You need a routine and a schedule to replace the dysfunctional life you have been living. Going to meetings has several purposes.
Meetings occur at regular intervals. In a larger city, you can find meetings as early as 7 am, at noon, and several in the evenings, 7 days a week. If there isn’t an A.A. meeting there are other 12-step groups you could go to in a pinch.
Regularly attending meetings teaches you responsibility and to show up and be accountable to others. You will find friendship and fellowship at meetings. You will build a solid support group who will stick with you through anything.
The premise is that you are all at A.A. to stay sober and to actively work a program of recovery.
You will find a sponsor who will work the steps with you and mentor you in early recovery. They are the ones you check in with if you feel stressed, are dealing with compulsions and cravings, or need to bounce an idea off someone.
As you work through the steps you are actively developing self-awareness and identifying thoughts, feelings, and emotions that are keeping you stuck.
As you get to the 12th step, you will be working with other alcoholics just entering the rooms. Therefore, the program continues to self-perpetuate through “attraction rather than promotion,” which means, the newly recovered alcoholic eschews the benefits of the program and pulls new members into the rooms.
Treatment programs, medical facilities, courts, jails and institutions all recommend and provide 12 step meetings in their facilities. You will see people handing in slips of paper to get signed at meetings as proof they attended.
Your sponsor will decree that you must make yourself useful in the rooms. Making coffee, cleaning up, handing out literature, greeting people, or passing the basket around are some of the tasks up for grabs. After 6 months you are encouraged to begin chairing meetings.
WHAT YOU LEARN
You learn that you are not alone. You will see people from all walks of life and hear stories that will have you feeling very grateful you didn’t go through that.
You will have a bunch of people who you can call when you feel shaky. There will always be someone willing to go to a meeting with you, to drive you, or to talk to you.
Responsibility, reliability, and ability to follow direction will be learned early on. Your sponsor will tell you to regularly call people and to call them at a certain time. This gets you in the habit of reaching out when things are good to check in, making new connections and building self-esteem. There is a saying in the rooms about the “thousand-pound phone”.
Chips are given out for recovery milestones. The first being the 24 hours chip, then the 30, 60 and 90 days, 6 months, 1 year, and each year thereafter. This gives you something to work toward and to be recognized for your efforts, and to make you feel proud of your milestones.
THE FIRST 3 STEPS
Working the steps with a sponsor will teach you ways to be mindful of your thoughts, feelings and actions, and how to align yourself with the principles of recovery. Your sponsor will act as a guide.
The first three steps have you looking at your life and how unmanageable it has become because of your drinking. This gives you a starting place.
You will be introduced to being judgmental, selfish, self-centered, resentments, laziness, dishonesty, fear, control and any number of negative traits that you use to protect your addiction.
STEP 4 AND BEYOND
The next few steps are where you look deeply into events that have shaped your life, how they have caused problems, how you have reacted, and what particular negative character ‘defect’ you have employed to cope.
You then share all of this with a sponsor and ask for it to be removed (by your higher power).
The next step of writing a list of people you have harmed and be prepared to to make amends to them, whether they accept your apology or not, is a doozy. Not for the faint of heart.
The final three steps have you keep a handle on your negative traits on a daily basis. This requires mindfulness and the ability to admit when you are wrong. Basically, you need to live based on your core values and treat others kindly and honestly and make a swift apology when wrong.
The last step has you working as a sponsor or with other alcoholics as they go through the program of A.A. Helping others an integral part of giving back.
The word God is liberally sprinkled throughout A.A. literature. Given the religious ties of the Oxford Group and subsequent A.A. group, God was predominantly featured as a sign of the times.
If you have a problem with the God concept or that of a Higher Power that can “restore you to sanity”, then A.A. might be a stretch for you. Although A.A. is a Spiritual program, there are several steps and prayers that rely on God to solve your problems and create a “spiritual awakening”.
The Big Book has a chapter to the agnostic. All new-comers are encouraged to think of a power greater than yourself as something as simple as a doorknob or a light bulb (This is bordering on ludacris)! Or use the larger A.A. group as a higher power because they collectively have a lot of sober time between them, and knowledge of how to stay that way.
There is a reason why there is a 24-hour chip, other than to welcome newcomers. Relapse is rife among the A.A. community. If you stick around long enough you will see the same people coming back for a 24 hours chip time and time again.
You will also experience the phenomenon of people rolling into meetings drunker or higher than a kite. It happens. It is quite disturbing when you have a drunken person disrupting a meeting. Usually, the person will be quietly escorted out, or the police will be called.
There will be a few homeless people who hang out in the rooms for a hot cup of coffee and a snack. Sometimes a mental illness will prevail and they will be disruptive. A lot of the time, they will sit quietly and not bother anyone.
Being in recovery does not guarantee sanity! As much as the Big Book and Steps would have you believe. Just putting a “cork in the jug” does not guarantee a well mind. Mental illness left unchecked and untreated will manifest regardless of sobriety. There will be those people in the rooms.
FINDING YOUR HOME GROUP
Not every meeting is equal. Make sure to try a number of locations and times until you decide which meeting will be your home group. There are many choices as far as gender groups, sexual orientation, beginners, young adults, Big Book study, speaker meetings, open meetings, closed meetings, depending on your location.
Look for meetings with people around your own age, who are sober, and have the type of lifestyle you would like to have. People that you can relate to, and who make sense when they speak.
There are some locations that are literally filled with old men who have sat in the rooms for 20+ years and have done nothing else with their lives. They sit there and bitch and moan about life, having never really jumped in and taken advantage of sobriety and opportunity.
Now, these locations are perfect for those people. If you are middle-aged and trying to rekindle a career, family, or mid-life goals, this group may not be for you. Of course, you can learn about not drinking from these people too, it’ll be a different generation.
THE 13th STEP
A danger to all in early sobriety is the 13th Step. This is where members of a group will swoop on newcomers and cozy up to them in an attempt to get laid. You will bask in the attention, not recognizing the danger.
This is predatory behavior, not even remotely ok in the rooms, and should be avoided like the plague. Do not engage in flings or relationships until you have a firm and successful grasp on your recovery and your life.
Your core group and your sponsor should be the same sex as you. This is to keep inappropriate behavior to a minimum.
There are those people who love to engage in no strings attached flings, or ‘have’ to be in a relationship to feel whole. This undermines recovery. While you are having the time of your life with a fellow A.A.er, you are not working on yourself. Setting yourself up for failure will have you relapsing before you can pass go.
Although A.A. purports to be self-sustaining and does not advertise in press, radio or film, many movies and books depict A.A. meetings as dark, dingy, smoky and iffy. The rooms are often basements in churches with peeling paint and scuffed floors. Cold hard metal chairs are laid out and there are faded Steps and Traditions on the walls.
Of course, there is some truth to this. Depending on your State and location of meetings, there is always a smoke-free option. Or, smoking has been outlawed in a number of States inside any business buildings.
Take it with a grain of salt. But yes, some meetings follow the stereotype. Some don’t. There are locations where meetings are held on beaches with bonfires, in parks, or other charming locations.
Once again, check out a bunch of meetings and locations until you find one that you are comfortable in. But put your butt on a seat somewhere, and keep it there!
THE BIG BOOK
Keep in mind that the original Big Book was written in the 1930s. There have been minimum changes and updates throughout the last 80 years. Essentially, the stories in the back of the book get updated, but the original 164 pages do not change.
The Big Book is incredibly out of date and often hard to relate to. The word ‘God’ appears 134 times in the first 164 pages. Other words depicting God are liberally found on each page, several times over. Again, not for the faint of heart if you struggle with the God concept.
The Big Book is a slog. You are instructed to read the first 164 pages of the Big Book and then call your sponsor. At the rate that some people read, this call will come sometime never. Bad idea. And a perfect way to turn people off A.A. within the first hour of attendance.
Charles Bufe (1995) in Alcoholics Anonymous: Cult or Cure declares that “At present, fully a third, probably over 40% of A.A.’s members are – or at least were originally coerced into attendance (by the courts, prisons, employers, and professional diversion programs). As well, more than half a million Americans per year are forced into 12-Step “treatment” by these same agencies.” (pp. 7).
These are significant numbers of people who are introduced to recovery through requirements to attend A.A. To this day 12-Step meetings are a mainstay of treatment programs. A good portion of treatment clients hate it. The repetitive nature of the opening readings of any meeting, and the holding hands and reciting the Lord’s Prayer at the end is just too much voodoo for a lot of people.
If you stick around in the rooms long enough, you will become accustomed to the repetitive nature. In-between, you are likely to hear something helpful, or something you absolutely do not want to be, do, see, hear or think about.
When you see a signature sheet pass by the in money collection bucket, be assured someone has been sent to meetings and has to have proof to show for it. Once their required number of meetings elapses, these people disappear from the rooms until next time.
However you end up in the rooms of A.A., you will get some recovery out of it, even unwantedly. A little bit of A.A. goes a long way and kinda ruins the next high.
Getting young people into the rooms on their own is difficult. Unless there is a young person’s group for the under 25’s it is hard to relate to older or middle-aged people who have a lot of life experience, but none of the current generation.
Each generation gets further away from the 1930s when this program came about. A.A. is at times irrelevant in this day and age. A.A. has not kept up with the times. It is rooted in 1930’s America. I believe that relevancy is a major issue for A.A. at this point.
In A.A. you are not supposed to bring up, admit, or lament drug use. A.A. is just for alcoholics and as such, nothing else is to be mentioned. That is not realistic in this day and age. To find a pure alcoholic is like finding a needle in a haystack. Most people have poly-addictions, and a good portion is dual-diagnosed.
Only treating one aspect of the illness is detrimental to overall health. Integrated treatment and whole person-centered treatment is the norm. In some groups, even taking medication for mental health disorders is frowned upon, and any ‘mind altering’ medications are completely rejected. This is very dangerous for people who suffer from chronic pain or psychological disorders.
Some groups are more open about other issues. Find the group who supports overall wellness, and considers alcohol as just one aspect of treatment. Alcohol happens to be a legal drug and should be considered one.
The most irritating, and often observed aspect of A.A. is the ritualistic opening of meetings, which contributes to a cult-like feeling. The reading of the steps and traditions and daily readings at every single A.A. meeting can take up to half an hour. Every single meeting, forever and a day. It gets old, fast.
And the end is also the same ritual, a circle, hand holding, and the Lord’s Prayer. And finally the tag line “Keep coming back, it works.” (Remember 28 Days with Sandra Bullock)?
And then there are the people who can never shut up. They go on and on and on, every meeting, about the same damn thing, in length, loudly, and blindly.
There’s always at least one pain in the ass A.A. member. Same story, same whining, same poor me, screw you attitude.
If you are lucky the shares are kept to 10 minutes or less. If you are not, there is no time limit and the meeting will not be done for hours. It’s going to get on your nerves.
A meeting could be an hour, or an hour and a half. That is what a chairperson is for. To moderate the meeting and shut people down when they babble. If you are lucky. Meetings are supposed to be an hour.
ANONYMOUS MY ASS
You are expected to introduce yourself by name and as an alcoholic every time you speak at a meeting.
At a big meeting, usually, the floor is opened for anyone who has a burning desire to talk. A topic will usually be picked from daily readings.
If it is a small meeting, your name will be taken and you will be called on, whether you like it or not. A.A. says this is “not to embarrass you, but to get to know you better”. Yeah right!
It is horrible to be put in the spotlight, especially as a new-comer. You are allowed to pass. Don’t be forced into talking about something you have no opinion on, or can’t relate to. You do not have to say a word unless you want to. Don’t be intimidated into it.
THE BOTTOM LINE
Just because the 12-step program has worked for legions of people throughout the ages, does not mean that it still holds as much weight or relevance as it once did.
Modern treatment holds a more holistic approach. The new norm is Integrated treatment, where all diagnoses are treated concurrently in order to lessen the symptoms of all of them for better outcomes all around.
A.A. treats alcoholism as a spiritual malady. Maintaining that God will remove all the character defects and will keep you sober. If you follow the steps.
There is a mass of opinion based blogs, books, scholarly articles for and against A.A. and the 12-Step community. You can find any number of supports for your own opinions.
The relapse rate is as high as 50-70% in early recovery. That is very high. Avoiding relapse is a priority. Running to a meeting whenever you feel shaky is a must. Get among your support group when you are experiencing a strong emotion.
In early recovery, A.A. and other meetings are incredibly important for you. The first year is a blur and a time in which you are still learning how to live sober. You need support groups. You need to be in the rooms.
Later on, when you have strong recovery and life is ticking along, you can decide how many meetings and what meetings to go to. For some, A.A. and 12-step meetings are life-long, consistently, every week, forever.
For others, once a week, or dropping in occasionally works great. You need to remain in recovery. Meetings are a part of that.
There are several alternatives to A.A., some are agnostic, some spiritual, some based on Cognitive Behavioral Therapy, some gender-based. There is a type of meeting out there for everyone.
Grab your Big Book, your dollar bill, and head to an A.A. meeting.
Or, grab your car keys and head to your support group or therapy of choice.
But, remember, you cannot do this alone. You need a tribe.
- Charles Bufe. (1998). 2nd ed. Alcoholics Anonymous: Cult or Cure. Tuscan, AZ: See Sharp Press.
- Stanton Peele. (1995). Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control. San Francisco, CA: Joney-Bass Books.
- The benefits of A.A.: https://www.addiction.com/in-recovery/12-step-recovery/meetings/
- William L. White. (1998). Slaying the Dragon: the history of addiction treatment and recovery. Bloomington, IL: Chestnut Health Systems / Lighthouse Institute.
- Alcoholics Anonymous Membership survey 2014: https://www.A.A..org/assets/en_US/p-48_membershipsurvey.pdf
- List of 12-Step programs. worldwide: https://sobernation.com/list-of-12-step-programs/