Recovering alcoholics can benefit from Al-Anon

R.J. has been clean and sober and an active member of Alcoholics Anonymous for 20 years. He lives the Twelve Step program each day, one day at a time. He attends AA meetings faithfully, reads the literature, meditates, and asks his Higher Power for guidance. He has told his story many times and listened with loving acceptance to the stories of others, as AA members are encouraged to do. He thought nothing about addiction could surprise him at this point in his life and recovery.

Then he discovered his 20-year old son had a drug and alcohol problem. "I felt so stupid," he said. "I know this stuff, and it never entered my mind that my son was using. He was the good boy, the one who got straight A’s. He knows I’m a recovering alcoholic and that his mother (my ex-wife) is a practicing one. I thought knowing about us would keep him sober. But he got to a point where he seemed paralyzed; he couldn’t stay on track. One day I said, sort of in passing, ‘You act like you’re on drugs.’ He said, ‘I am.’ When I asked what kind and he said he’d tried ‘just about everything,’ I was stunned. I didn’t know what to do."

Not knowing what to do, R.J. did nothing the night of his son’s revelation except listen. "I told him I wouldn’t preach or yell, but I asked him if I could tell him when I heard him giving me the ‘standard’ addict’s lines like, ‘I have it under control.’ He said I could, and we talked until 4 a.m."

Next, R.J. sought help from others. His first impulse was to issue an edict telling his son not to come around until he got straight, but a counselor at work cautioned that things could get worse if his son felt abandoned, with no safe places or safe people to turn to. "She suggested I establish clear rules so he wouldn’t come here high or use here, but let him know that I love him and I’d do whatever it takes to help him when he’s ready."

When a long-time friend (also a recovering alcoholic) suggested going to Al-Anon, R.J. said he was "blown away" by the idea. Like many recovering alcoholics, he had always viewed Al-Anon as a Twelve Step mutual-help group for "them"–the family and friends of the alcoholic–and AA as the Twelve Step group for "us"–the alcoholics who affected their lives.

R.J. and his friend went to an Al-Anon meeting where they were the only men. He confessed that he was very nervous at first but said the familiar Twelve-Step meeting structure eased his anxiety. "Then I said, ‘I’m an alcoholic–the reason you’re here–but now I need help.’ It broke the ice, and they welcomed us with so much warmth and generosity."

Because it is not unusual to have more than one problem drinker in a family, it makes sense that recovering alcoholics can also be affected by another’s alcohol or drug use, and that they could benefit from the fellowship and support of Al-Anon. Except for one word in Step Twelve where Al-Anon has substituted the word "others" for AA’s word "alcoholics," the Steps of the two groups are identical.

"At AA we learn that we’re powerless over alcohol. At Al-Anon you discover that you’re powerless over others," explained R.J. He thought the Al-Anon members he met also gained by meeting two recovering alcoholics who embrace the same Twelve Step philosophy they do.

R.J. said it was a profound experience to view addiction "from the other side of the fence" at Al-Anon. "It struck such a chord when a woman there told me I’ve got my story, but my son is still writing his. I can tell him about my path and show him a path exists, but I can’t walk it for him."

Al-Anon meetings are held in 115 countries, and there are over 24,000 Al-Anon groups worldwide. For more information visit http://www.al-anon.alateen.org/.

Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden, a nonprofit agency based in Center City, Minn. "Copyright © 2003 Hazelden Foundation. All rights reserved." Any other use of the Web site or the information contained here is strictly prohibited.

At Amazon; How Al-Anon Works for Families & Friends of Alcoholics

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1. AA & 12-Step Treatment
2. AA Can Help Most Alcoholics
3. Al-Anon offers new life
4. Alcohol and Anxiety
5. Alcoholic Defense Mechanisms
6. Alcoholics Anonymous and Nursing
7. Alcoholism Treatment in a Nursing Home
8. An Introduction to Medication for Alcohol Dependence
9. Anti-craving Drugs
10. Binge Drinking & Brain Damage
11. Brief Intervention in Emergency Room is Effective
12. Brief-TSF Description
13. Characteristics of Children of Alcoholic
14. Common Problems in Recovery
15. Counseling and the 12 Steps of AA
16. COUNSELOR CHARACTERISTICS
17. Craving Reduction
18. Depression & 12-Step Programs
19. Developing Willingness to Change
20. Dropout from 12-step self-help groups
21. Effects of gambling addiction
22. Foetal alcohol disorder linked to crime:
23. Free Training Alcoholism Anti-craving Medication
24. Gender Matching Hypothesis in Alcohol Treatment
25. Helping Alcoholics
26. Humility and Surrender
27. New Zealand’s spiritual aspects in 12-Step Treatment
28. Painkiller abuse
29. PTSD and Alcohol Addiction
30. Recovering Alcoholics Effective in Helping Others
31. Recovering People Working in the Recovery Field
32. Recovery through the Twelve Steps
33. Research Evidence for TSF
34. Risky Partners and Domestic Violence
35. Self-help Reduces Healthcare Demand
36. Sleep problems affect alcoholism recovery
37. Slogans for everyday life in AA
38. Spiritual assessment
39. Stages of an Eating Disorder
40. Strategies for Dealing with Common Problems
41. Strategies for Dealing With Crises
42. Strategies for Dealing With Denial
43. Symptoms of alcoholism
44. The 12-Steps Promote Acceptance of Addiction
45. Treating Alcoholism as a Chronic Disease
46. TSF Description
47. Twelve step programs
48. What about partners of alcoholics?
49. What About This Spiritual Awakening Thing
50. Women and the Twelve Steps of AA
51. World view change in Adult Children of Alcoholics

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A Few Basic Facts About AA

Alcoholics Anonymous is well-known as an organization for people who want to stop drinking. At the same time, there are some points about A.A. that may be unclear to the general public and even to professionals working to help problem drinkers.

Founded in the United States in 1935, when one alcoholic discovered he could stay sober by helping another alcoholic, Alcoholics Anonymous now has more than two million members in some 180 countries.

A.A.’s sole purpose is helping people recover from the disease of alcoholism, and it has no affiliation with any other group or organization. Members anywhere in the world can come together to form an A.A. group, of which there are an estimated 106,000 worldwide.

Among other facts about Alcoholics Anonymous are:

Membership is free. A.A. groups usually pass a basket around at meetings to cover the cost of renting the meeting room and for other incidental expenses, such as coffee.

A.A. is not a religious organization; it is not allied with any religious organization, and requires no religious belief as a condition of membership. Members include Catholics, Protestants, Jews, Muslims, Hindus, agnostics, and atheists.

A.A. does no recruiting. The only requirement for membership is a desire to stop drinking. There are no other requirements to be met, no initiation fees to be paid, and no forms to be filled out. It is completely up to anyone considering joining A.A. to determine if they have a problem with alcohol and whether they will deal with it in Alcoholics Anonymous. A person becomes a member of A.A. simply by deciding they want to be a member.

A.A. groups are autonomous and run by the members themselves.

A.A. is not a temperance society. Members acknowledge their inability to drink safely but have nothing to say about the drinking of others. It is a principle of A.A. that it has no opinion on what are termed outside issues.

A.A. is not affiliated with any hospital or rehab, or any other such facility. No professional services of any kind are offered or performed under A.A. sponsorship.

A.A. meetings take several forms, but at any meeting there will be alcoholics talking about how drinking affected their lives and what life as a sober member of A.A. is like.

Anonymity is respected. Newcomers can turn to A.A. with the assurance that their attendance at meetings will be kept private.

“Open” Meetings of A.A. are meetings which anyone may attend to observe how A.A. works. “Closed” meetings are reserved for those with a drinking problem.

Contacting A.A. Information on how to find local A.A. meetings can be found in telephone directories and at numerous Internet sites, including www.aa.org.

From; About AA; A newsletter for professionals, Spring 2007.

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Alcoholic is good and sober; Sentiment change in AA.

An alcoholic is a stigmatized, deviant identity.

This longitudinal study of 55 Alcoholics Anonymous (AA) participants found that even chronic alcohol abusers viewed alcoholics negatively, in keeping with normative understandings.

However, following mandated AA attendance, there was significant change in social sentiments for alcohol-related concepts and meanings for feelings and objects related to drinking, as sentiments became similar to AA subculture understandings.

In AA "an alcoholic" is good.

Sentiment change, AA ideology, and the implications for identity and normative behavior are discussed.

Section headings in this article include:

(1) theoretical background in the development of meaning;

(2) alcoholism and AA; and

(3) sentiments and sentiment measurement.

Research report; Thomassen, L. Alcoholic is good and sober: Sentiment change in AA. Deviant Behavior, 23(2):177-199, 2002.

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The AA Recovery Program

The relative success of the A.A. program seems to be due to the fact that an alcoholic who no longer drinks has an exceptional faculty for “reaching” and helping an uncontrolled drinker.

In simplest form, the A.A. program operates when a recovered alcoholic passes along the story of his or her own problem drinking, describes the sobriety he or she has found in A.A., and invites the newcomer to join the informal Fellowship.

The heart of the suggested program of personal recovery is contained in Twelve Steps describing the experience of the earliest members of the Society:

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.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Newcomers are not required to accept or follow these Twelve Steps in their entirety if they feel unwilling or unable to do so.

They will usually be asked to keep an open mind, to attend meetings at which recovered alcoholics describe their personal experiences in achieving sobriety, and to read A.A. literature describing and interpreting the A.A. program.

A.A. members will usually emphasize to newcomers that only problem drinkers themselves, individually, can determine whether or not they are in fact alcoholics.

At the same time, it will be pointed out that all available medical testimony indicates that alcoholism is a progressive illness, that it cannot be cured in the ordinary sense of the term, but that it can be arrested through total abstinence from alcohol in any form.

From the AA FACT FILE. This document also is available on G.S.O.’s A.A. Web site: www.aa.org

Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism

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Principles of management of substance-abuse disorders

With empathy and positive management, many alcohol and drug dependent people can be liberated from their addictions.

• Establish a working/therapeutic relationship
• Identify the patient’s current level of drug use (drug type, daily dose, frequency of use); check for multiple drug use
• Determine the patient’s “readiness for change”
• Help the patient weigh up the costs (and benefits) of their continued drug use (affordability, health effects, legal consequences, effects on relationships, job, family)
• Contrast with the benefits of a drug-free lifestyle
• Establish an “environment of safety”
• Encourage the patient to cut down or stop using drugs
• Negotiate appropriate (and attainable) goals with the patient
• Discuss strategies to achieve these goals
• Identify the situations in which the patient is likely to use drugs and the factors that will make it difficult to change the pattern of use
• Provide positive reinforcement for goals achieved and arrange appropriate social supports
• Discuss HOW to cease substance use (i.e., detoxification)
• Inform the patient of the symptoms that are likely to occur and discuss strategies for ameliorating them
• Facilitate working through grieving for the losses sustained due to former lifestyle choices
• Discuss strategies for coping without drugs, including involvement with self-help groups
• Remember that relapse is common
• Identify any gains made during the previous attempt and encourage the patient to try again
• Examine the factors that led to the relapse and discuss strategies to deal with them
• Discover why the substance-oriented lifestyle developed (optional)

Research extract from; Tobie L Sacks and Nicholas A Keks. Alcohol and drug dependence: diagnosis and management. Medical Journal of Australia Practice Essentials #14.

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Alcohol and drug dependence approach

Synopsis – diagnosis and management

An empathetic and non-judgemental attitude to the patient is required when managing drug dependence problems.

Careful assessment to establish the nature and extent of drug use must precede any attempts at management (more than one consultation is likely to be necessary).

The active cooperation of the patient in any management plan is essential, as the patient’s readiness for change will be a powerful influence on the success of any intervention.

Goals for stopping or reducing drug use must be agreed with the patient and must be attainable. Abstinence from drugs will not be every patient’s goal; harm reduction (through education to avoid collateral risks or efforts to cut down on drug consumption) is a worthwhile objective.

Detoxification is only part of the process. Many lifestyle adjustments are required to maintain a drug-free existence, and these changes may require social support and/or psychological therapies.

Relapse is common but can be used as a learning experience. Patients who relapse into drug use should be encouraged to try again.

With empathy and positive management, many drug dependent people can be liberated from their addictions.

Research extract from; Tobie L Sacks and Nicholas A Keks. Alcohol and drug dependence: diagnosis and management. Medical Journal of Australia Practice Essentials #14.

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Dual dependence

An assessment of dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems.

Aims: The study investigates severity of alcohol dependence among drug misusers. Specifically, it investigates the inter-relationship of alcohol and drug dependence and associations with alcohol consumption, drug consumption and substance-related problems.

Design, setting, participants: The sample comprised 735 people seeking treatment for drug misuse problems, who were current (last 90 days) drinkers.

Measurements: Data were collected by structured face-to-face interviews. Dependence upon illicit drugs and upon alcohol was measured by the Severity of Dependence Scale (SDS).

Findings: Three groups of drinkers were identified:

• non-alcohol-dependent drug misusers (63%);
• low-dependence (19%); and
• high-dependence (18%).

Many drug misusers were drinking excessively and alcohol dependence was related to patterns of alcohol and drug consumption.

Alcohol use is an important and under-rated problem in the treatment of drug misusers.

High-dependence drinkers were more likely to drink extra-strength beer; they were less frequent users of heroin and crack cocaine but more frequent users of benzodiazepines, amphetamines and cocaine powder; they reported more psychological and physical health problems. The SDS was found to have good reliability and validity as a measure of alcohol dependence. SDS scores for alcohol and drug dependence were unrelated.

Conclusions: Alcohol use is an important and under-rated problem in the treatment of drug misusers. A comprehensive assessment of alcohol use among drug misusers should include separate assessments of alcohol consumption, alcohol-related problems and severity of alcohol dependence.

Research report; Gossop, Michael; Marsden, John; Stewart, Duncan. Dual dependence: assessment of dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems. Addiction, Volume 97(2) February 2002 p 169-178 [Research Reports]

The Dual Diagnosis Recovery Sourcebook : A Physical, Mental, and Spiritual Approach to Addiction with an Emotional Disorder

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Twelve Step recovery is spirituality at its best

Nancy Kehoe, Ph.D., is a Massachusetts psychologist who for 20 years has trained mental health care providers to tend to the spiritual as well as the psychological needs of their clients. At a Hazelden Women Healing conference in April, Kehoe emphasized that although spirituality and religion can be integrally linked to mental health, the therapeutic community is usually reluctant or ill-equipped to explore these areas with clients — even though doing so could greatly enhance and speed up their recovery.

Understanding how people image God or a Higher Power and what role spirituality plays in patients’ lives can give therapists valuable information for diagnosis and treatment, Kehoe said.

Mental health professionals can learn much from Alcoholics Anonymous, an organization founded on the premise that recovery and healing involve body, mind, and spirit, she says. Life is out of control for people who struggle with substance abuse or other addictive behaviors, and the first step toward recovery is acknowledging that healing requires more than willpower.

"Most people try to live by self-propulsion," says AA’s Big Book, "Alcoholics Anonymous," the basic text of Twelve Step groups. But to recover they have to "quit playing God." "We are not saints," says the Big Book. "The point is, that we are willing to grow along spiritual lines. The principles we have set down are guides to progress."

That spiritual progress is not about religion; it’s about accepting that you need help from a source outside yourself to recover from addictive practices. The "Higher Power" who guides in the recovery journey is defined by each individual. It might be a spiritual being, it might be nature, or it could be a God of traditional religions. As the authors of the Big Book put it, "To us, the Realm of the Spirit is broad, roomy, all inclusive; never exclusive or forbidding to those who earnestly seek."

While recovering people are encouraged to pray or meditate for guidance and wisdom, they don’t expect a Higher Power to do all the work of recovery for them. And members of Al-Anon understand that prayer alone can’t make a husband or a mother or a child stop drinking or using drugs. An addict has to want to recover, and has to take that first step for him or herself. In the meantime, Al-Anon members discover that while they cant control the actions or inactions of their loved ones, through the help of their group and their Higher Power, they can learn how to care for themselves in healthy ways that will enrich their own lives and spirits.

Twelve Step recovery is spirituality at its healthiest. Recovering people are told to honestly examine their character defects, and to then make amends to those they have harmed. This "relational" approach is not the same as the religious concept of doing penance, explained Kehoe, because it requires individuals to interact with those they have harmed in order to right a wrong. In Twelve Step recovery, making amends is a process that involves inner reflection, accountability and action.

Recovering people also learn how to deal with shame and guilt in ways that nurture their spirits. They grow to understand that shame is feeling bad about who you are, while guilt is feeling bad for what you’ve done. They often find that it is easier to forgive others than to forgive yourself, but with time, integrity, hard work, and the help of a Higher Power, you can make amends even to yourself.

Kehoe said that Twelve Step groups have also discovered how rich traditions, ritual and community — resources that have renewed peoples spirits throughout history — can aid in the recovery journey. Mutual-help groups are communities in which people gather to tell their stories and listen to another’s story with respect and without judgment. Certain rituals such as reading a meditation for that day, checking in with each other, and taking turns sharing a problem or concern, are familiar practices that unite and comfort. In Twelve Step groups, all participants are equal, and all have the common spiritual goal of recovery.

The Spirituality of Imperfection: Storytelling and the Search for Meaning

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Response to Slips and Relapses

Slips and relapses are considered normal and even expected parts of early recovery, as are frequent urges to drink.

The 12 step model regards addiction as an illness characterized by compulsion that overwhelms individual willpower. Until the client is solidly connected to a 12 step fellowship, he or she is expected to experience difficulty sustaining sobriety even with the best of intentions.

The primary purpose of the review part of the Brief-TSF session is to assess the client’s recovery and to evaluate urges and slips and how the client dealt with them. This material becomes an important context in which the facilitator gradually shapes greater involvement in AA.

Typically, a pattern is discerned in slips. For example, it is common for a client to stay clean and sober for 1 or 2 days after a meeting and then to slip. Identifying this pattern (often with the aid of a calendar) can help to reinforce the importance of active involvement in AA.

In some circumstances a pattern of frequent slips despite attendance at meetings will lead the facilitator to recommend inpatient treatment.

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