Scientific Research Shows Effectiveness of 12 Step Based Treatment

May 11, 2017 alcoholdrugsos

For years, I worked in the addictions treatment field and taught graduate courses in addiction at a local university. I also was, and still am, a strong, impassioned proponent of ongoing involvement in 12 Step Programs (e.g., Alcoholics Anonymous, Narcotics Anonymous) as an integral part of the traditional modalities of addiction treatment such as cognitive behavioral therapy, group therapy, and other research based interventions. However, until about ten years ago, the only evidence of the effectiveness of the 12 Step Programs was dismissed by academics and mental health professionals as “anecdotal”, that is, reports based on stories by those directly involved in recovery such as 12 Step Program members, or on non-scientific surveys of AA or NA members, or statistics from treatment centers. Therefore, for the past 40 years or so, the only evidence of effective addiction treatment based on adequate and well controlled clinical investigations has supported treatment that did not include 12 Step Program involvement.

Happily, there is now increasing evidence, based on studies using valid scientific methodology, that the most effective treatment for addiction will include ongoing, significant involvement in 12 Step Programs, along with the traditional interventions such as cognitive behavioral therapy, and other evidence based interventions. For an excellent summary of the evidence for the effectiveness of 12 Step based treatment, please go to this resource published by Hazelden Betty Ford Foundation, entitled, Recent Research Offers Compelling
Support for the Effectiveness of Twelve Step-based Treatment
Comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 05/11/2017.

Risk Factors for Problem Drinking in Seniors

Researchers at University of Georgia, American Geriatrics Society Journal, recently reported that seniors (1600 individuals ages 57-85), with chronic multiple health conditions and depression were at a high risk of developing into probl m drinkers. This research is reported to be the first to document a link between chronic health problems, with depression, and consequential problem drinking in seniors.

The study found that seniors with multiple ongoing health conditions and depression were five times more likely to become problem drinkers than seniors with such health conditions and no depression. The summary of the study in the January 12, 2017, issues of ScienceDaily (www.sciencedaily.com/releases/2017/01/170112110038.htm) stated:

“’These findings suggest that effective training in screening and referral for mental health and alcohol use issues for health care providers of older adults may better serve the approximate 4 million older adults who currently experience problem drinking in the U.S.,’ said Orion Mowbray, assistant professor at the UGA School of Social Work and lead author of the study.”

Add these findings to the fact that most seniors tend to develop greater sensitivity to the effects of alcohol as they age, and often are taking multiple prescribed, and over-the-counter, medications that can interact adversely with alcohol, for their chronic health conditions, it is important for seniors, and those that care for, and about, them to exercise caution in their use of alcoholic beverages.

As always, comments are invited on this post. Jan Edward Williams, Alcoholdrugsos Services, Ltd., http://www.alcoholdrugsos.com, 01/17/2017.

Some Observations on the Problem with Research on the Effectiveness of the 12 Step Programs

Researchers tend to reject assertions based on human experience, often referred to as "anecdotal evidence" because supported by individual observations or experience and not buttressed by scientific investigations. Therefore, the scientific research literature tends to discount experience of members of 12 Step self-help groups such as Alcoholics Anonymous and Narcotics Anonymous, who have achieved abstinence and sobriety. Even more confounding for those in scientific circles is the spiritual aspect of these 12 Step Programs, which is also often viewed with intense suspicion. The research mostly concludes that there is little definitive scientific proof that the 12 Step Programs are more effective than other approaches such as cognitive behavioral therapy. However, according to research, the best hope for recovery from  alcoholism, is through use of recognized therapy such as cognitive behavioral therapy, coupled with regular (the longer the better) attendance of programs such as Alcoholics Anonymous. Unfortunately (in my abstinence-biased view), the research into recovery from drug addiction, especially opiate addiction, supports treatment using methadone and suboxone (using legal, long lasting opiates instead of illicit opiates, with counseling and medical support), rather than abstinence based treatment and use of the 12 Step Program known as Narcotics Anonymous.

As one who has worked as an addiction counselor for over 37 years, and as a professor teaching graduate courses on addiction for over 24 years, and as an individual in longterm recovery from addictive disease with intimate knowledge of 12 Step Programs, I have looked at the research on the effectiveness of the 12 Step programs, pro and con, and have arrived at the following conclusions about such research that, admittedly, are colored by my bias in favor of the spiritually based 12 Step Programs:

1) Researchers, with a few wonderful exceptions (I can furnish citations), do not understand the spirituality of the 12 Step Programs;
2) Most researchers do not understand the powerful healing effects that arise when individuals with the same life-threatening disorder help one another at meetings as well as through the relationships of home group members and sponsors, though the researchers may use fancy terms such as universality, role modeling, and the like to explain such dynamics; and, finally,
3) The vast majority of researchers do not have the personal experience of addiction and recovery using the 12 Step Programs that, I believe, would allow them to understand how these programs work, thereby enabling them to construct scientifically valid investigations to evaluate the effectiveness of the 12 Step Programs.

I realize that these observations are driven more by my personal and professional experience than by scientific evidence, but so be it.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 09/22/2016.

Addiction Recovery Tip, Easy Does It, But Do It!

From time to time I will present here samples of my Addiction Recovery Tips (available by email; click on Get Help at top of www.alcoholdrugsos.com page). Here is one. Easy does it, but do it! is a slogan oft used in 12 Step recovery, whose second part is as important for the newcomer to recovery in the Twelve Step Programs, such as Alcoholics Anonymous, Narcotics Anonymous, or Al-Anon, as the first part. Maintaining emotional balance by not getting too upset or too excited helps one to avoid relapse. HALT is a useful tool in this regard: Don't get too Hungry, too Angry, too Lonely, or tooTired.

The AA Grapevine of July 1948 has its own unique take on the slogan, Easy Does It, in the language of that time, just three years after the end of World War II (I was 10 years old then):

"Fortunately, this is a saying which can be tested easily. It does not have to be accepted on faith alone. Anyone can find out for himself whether it works simply by trying it himself. Suppose a problem has arisen. Suppose it is the old urge to reach for the bottle. Or suppose the problem is one of those byproducts of alcoholism which continue to come up long after the urge to drink has gone. The reaction of the alcoholic, and of more than a few non­alcoholics, is to fight the problem, to worry about it, to get into a stew. The tension begins to mount. Emotion runs wild. Self control is slipping rapidly.

"That’s the usual sequence. It can be broken if in the midst of it, the victim sits way back, physically and mentally, and relaxes. First he must relax his muscles, because that’s the easiest to do. Then he must relax his mind, by directing his thoughts to pleasant subjects, to a reminder that others have succeeded and so can he, to mental pictures of peace and success. If he will but direct his mind away from the problem, he will find a new source of strength rising up within him.

"At least that is the way it has worked and still works for others. The individual who has learned how to relax has already advanced a long way towards happiness and success.

"Relax and enjoy A.A. Relax and enjoy life. "Easy Does It." If you don’t believe it, try it."(http://silkworth.net/grapevine/easydoesit.html)

However, there ARE things the recovering person must do: like sleep, eat, pay bills, go to work, attend AA, NA, or Al-Anon meetings, get a sponsor and listen to him/her, and don't pick up a drink or drug, or have an emotional relapse into trying to control the uncontrollable, even if your posterior falls off, to name but a few. So, easy does it, but do it!

As always, comments are welcomed. Jan Edward Williams,AlcoholDrugSOS Services, 07/12/2016.

Key to Spirituality in 12 Step Addiction Recovery

Is it necessary to believe in God to recover from an addiction through use of the 12 Step Programs such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon (12 Step Program for those in a relationship with an alcoholic), Nar-Anon (addict), and other such programs? My answer is: "No, you do not, at least in the beginning." However, I suggest that one's chances of developing and maintaining a long term mentally healthy, balanced, and serene recovery will be enhanced with willingness to seek and find a source of spiritual strength.

First a word about those new to recovery who take the position that they know all about God, theology, and organized religion and have had an excellent relationship with God, and, therefore, need not work to improve their relationship with God in order to stop use of drugs of alcohol; often these folks are clergy or religious who have developed a drug or alcohol addiction. I suggest to these individuals that they look at how, by definition, addiction had proved more powerful than their own efforts to control it, and has proved somehow resistant to their requests for help from God to do so. Usually, with guidance, these individuals will come to see that drug or alcohol use has come between them and God because of their own self-centeredness that is powered by the relentless demands of addiction. It is almost impossible for a drug or alcohol addicted individual to have an intimate relationship with another person or with God; drugs or alcohol become the addicted individual's God.

The key for all individuals suffering from addiction, including clergy, to beginning a successful recovery through the 12 Step Programs using spiritual principles can be found inAppendix II of the book Alcoholics Anonymous; this quotation from that Appendix sums up in a few words what is needed:

"Most emphatically we wish to say that any alcoholic capable of honestly facing his problems in the light of our experience can recover, provided he does not close his mind to all spiritual concepts. He can only be defeated by an attitude of intolerance or belligerent denial. We find that no one need have difficulty with the spirituality of the program. Willingness, honesty and open mindedness are the essentials of recovery. But these are indispensable.

'There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance—that principle is contempt prior to investigation.' (Herbert Spencer).”

In my experience anyone can find recovery support in the 12 Step programs, if he or she is willing to have an open mind and is willing to seek a source of spiritual strength, or, as phrased in 12 Step circles, a higher power, or God as you may understand him. It is vital to success in 12 Step programs that the new person put to one side any negative experiences and thoughts about organized religion; indeed, prior negative experiences do not have to be an obstacle to spiritual recovery in the 12 Step programs. One need only approach 12 Step meetings as a place to learn practical tools, including spiritual tools, to stay away from the first drink or drug one day at a time. or to avoid, one day at a time, trying to control another person's behavior (Al-Anon or Nar-Anon).

The best mind set or way of thinking for the newcomer to have is one of a student who seeks to find information that he/she can relate to, not looking for information that he/she cannot relate to; that is, to seek to compare in, not out. After attending, say, ten or so 12 Step meetings with an open mind, one should have had the awesome experience of hearing real people share real feelings that he/she can relate to, maybe even hearing a part of one's own story. The ability to relate to stories, experiences, feelings, in 12 Step meetings is in my view a spiritual experience that is the essence of spiritual recovery. In my personal journey in 12 Step recovery, I was intellectually opposed to anything I heard in meetings that even remotely sounded like God or religion. That intellectual position almost resulted in my death through drinking. At some point, I was able to really hear and relate to (and get chills of recognition) when listening to real people sharing from the heart. Being able to connect through the sharing in 12 Step meetings can be the gateway to finding a source of spiritual strength.

I invite comments from others about their experiences with spirituality in recovery. Jan Williams, 06/15/2016.

Recovery Tip: Live in the here and now.

In one of the daily meditation books that I read, I came across a quote that is familiar in its message to those in recovery from addiction who are guided by Twelve Step principles:

"The real enemies of our life are the 'oughts' and the 'ifs.' They pull us backward into the unalterable past and forward into the unpredictable future. But real life takes place in the here and now. God is a God of the present. God is always in the moment be that moment hard or easy, joyful or painful." --Nouwen, Henri. (1994). Here and Now: Living in the Spirit. Crossroad Publishing Company, page 18.

Of course, the Twelve Step programs talk about living one day at a time, at first, suggesting that the newcomer not take a drink or a drug just for today (or maybe just for this hour). Eventually, experience in applying spiritual principles leads one to realize that attending to the present, to what is happening in the moment, can be the key to serenity. A favorite question I try to remember when I am pestered by fear of the future or pain from the past is to ask: What bad thing is happening at this very moment? Usually the question brings awareness that the issue bothering me is from the past or the future, resulting in perspective and distance from the problem and the opportunity to apply spiritual principles, such as turning the problem over to God (my source of spiritual strength).

Over time in recovery and experience in use of spiritual principles, I have found the Nouwen quote to be true. The hard part is remembering to seek God's help in the moment of emotional, physical, or spiritual upset.

As always, comments are invited. Jan Edward Williams, 04/27/2016.

Selfishness, self-centeredness is the root of the troubles of the alcoholic

An article in Science Daily, published on the March 31, 2016, summarizing the results of a scientific study done at Case Western Reserve University, supports the frequently quoted statement from the basic text of the 12 Step Program of Alcoholics Anonymous (known as the Big Book or Alcoholics Anonymous) written around 1938, that self-centeredness is the fundamental problem of alcoholics, and also supports what has become a key to the success of the Fellowship of Alcoholics Anonymous from 1938 to date, namely, altruism, or, one alcoholic helping another.

Here is a quote from the article"

"Developmental psychologist Maria Pagano, PhD, found adolescents  with severe alcohol and other drug (AOD) problems have a low regard  for others, as indicated by higher rates of driving under the influence  and having unprotected sex with a history of sexually transmitted  disease. The findings also showed that they are less likely to volunteer  their time helping others, an activity that she has been shown to help  adult alcoholics stay sober."

The AA Big Book states:

"Whatever our protestations, are not most of us concerned with ourselves,  our resentments, or our self-pity? Selfishness - self-centeredness! That,  we think, is the root of our troubles That, we think, is the root of our  troubles. Driven by a hundred forms of fear, self-delusion, self-seeking,  and self-pity, we step on the toes of our fellows and they retaliate.  Sometimes they hurt us, seemingly without provocation, but we invariably  find that at some time in the past we have made decisions based on self  which later placed us in a position to be hurt. So our troubles, we think,  are basically of our own making. They arise out of ourselves,  and the alcoholic is an extreme example of self-will run riot, though he  usually doesn't think so. (Alcoholics Anonymous, p. 62)."

Refreshingly, since most researchers do not understand the effectiveness of AA, Science Daily article reports that the author of the study, Dr. Pagano:

"...believes that alcoholics and drug addicts may be hindered by a low awareness of how their actions impact others. "The addict is like a tornado  running through the lives of others," said Pagano. Even when they are in  recovery there is little indication that they understand how their actions  impact those around them. "This is part of the illness," she added. Helping  young people to get out of that self-centeredness in the service of others  helps them in the recovery process. Service to others is a big part of the  12-step Alcoholics Anonymous and Narcotics Anonymous programs."

I am always amazed at the wisdom and prescience of the authors of AA's basic text. Alcoholics Anonymous, who were able to capture the essence of alcoholism without the benefit of the modern science of the 21st century.

As always, comments are invited. Jan Edward Williams,AlcoholDrugSOS Services, 04/03/2016.

Basic Tips for Those New to 12 Step Recovery

Most individuals who have been advised to attend 12 Step programs such as Alcoholics Anonymous and Narcotics Anonymous or Al-Anon and Nar-Anon (the latter two are for those in relationship with an alcoholic or addict), will have conflicting thoughts and emotions. Some may think: "Oh, my God, so this is what I've come to, attending meetings with a bunch of losers." Or: "Not AA or NA; they'll be trying to convert me to religion." Fear, self-pity, anger, loneliness and a host of other negative feelings may be present. All of these thoughts and feelings are normal. I know of few who have welcomed the suggestion of attending 12 Step meetings with wholehearted enthusiasm.

After this sentence, I'll give some tips that I offer to those starting attendance of 12 Step meetings, but there are many more and I invite comments from anyone registered with this site.

1)The very first suggestion I have is that you, the newcomer, try not to drink or drug, or engage in any other  behavior bringing you to 12 Step recovery, before attending a meeting. The 12 Step Recovery Programs work better if you abstain.
2) Have an open mind. Try to listen without judgment to what you hear. If the information does not immediately appeal to you, just file it away in your mind; perhaps it will be useful later on in your recovery.
3) Compare in, not out. In other words, try to listen for information that you can relate to, rather than being on the lookout for information that you do not relate to.
4) Try to avoid an all or nothing reaction to what you see and hear. Remember that members of 12 Step Programs are not professional counselors but people like you who attend meetings to help themselves recover from drug or alcohol addictions.
5) Strive for willingness to stay away from the first drink or drug or the behavior you are powerless over (for example, rescuing the addict or alcoholic), just one day at a time.

There are many more tips I could provide here. I hope that members of this site and others who read the post will share their own tips for success in the 12 Step Programs. Jan Edward Wiiliams, 02/22/2016, www.alcoholdrugsos.com.

Use of Spiritual Disciplines to Support Recovery from Addiction

Addiction to drugs, alcohol, gambling, the internet (Facebook, games, pornography, etc.) is so powerful that many find that seeking a spiritual source of strength can enhance other measures such as therapy and counseling. We are, of course, speaking here of spirituality that can be found in organized religion but often is found outside of religions.

The 12 Step Programs such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, Nar-Anon, Gamblers Anonymous, to name a few, wisely refer to a source of spiritual strength, as God (as you understand God), a Higher Power, or a power greater than myself; so that each individual can approach spirituality in his or her own way.

Rather than trying to figure out the what, who, how of a Higher Power, my suggestion is to avoid definitions and to just go ahead with a leap of faith and begin reaching out to a spiritual source of strength. The motivation for this leap of faith usually comes from pain and suffering caused by addiction and repeatedly failed efforts to stop alcohol or other drug use or other addictive behavior through will power, therapy and/or counseling. Attendance of 12 Step meetings can also provide a demonstration of spiritual strength evidenced by members of these programs who have stopped their addictive behaviors for significant periods of time.

Spiritual disciplines, as defined here, along with abstinence and attendance of 12 Step meetings, can, over time, result in the individual coming to believe in their efficacy. So, consider setting aside a quiet time every morning to focus on the fact that you are in recovery and to make a conscious commitment to yourself each morning to be abstinent from drug or alcohol use, or other addictive behavior, for that day. If appropriate for you, add a request (prayer) to your source of spiritual strength for the ability to be clean and sober that day.

At night before retiring for the day, take a few minutes for some quiet time to review the day. If you have not picked up an alcoholic drink or a drug, or engaged in other addictive behaviors, you can be grateful for that miracle regardless of whatever negative or positive events that have occurred. It is indeed a miracle for an addict or alcoholic to get through a day without using. Again, if appropriate, add a thanks to your source of spiritual strength for a day of abstinence.

These daily disciplines on awakening and before sleeping can become basic recovery tools for you and form the basis for a spiritual awakening and evidence to you of the power of spiritual disciplines. As always, comments are invited.

As always, comments are invited. Jan Edward Williams.
www.alcoholdrugsos.com, 11/14/2015

More on Powerlessness as a Spiritual Tool in Recovery from Addiction

The First Step of the 12 Step Programs for alcoholics and addicts (Alcoholics Anonymous and Narcotics Anonymous) involves admitting that "we were powerless" over alcohol or other drugs and that "our lives had become unmanageable." This admission of powerlessness and unmanageability lays the basis for abstinence and recovery from addiction via a journey through the 12 Steps. Steps Two ("Came to believe that a Power greater than ourselves could restore us to sanity") and Three ("Made a decision to turn our will and our lives over to the care of God as we understood Him") provide a spiritual foundation for recovery. These three Steps have been given this shorthand: "I can't handle it; God (or other source of spiritual strength) can; I think I'll let God (or other spiritual source) do so.

This post suggests that learning to be on the lookout for incidents of powerlessness and unmanageability during a recovering individual's life can, by use of the spiritual principles summarized in the first paragraph, become a vital tool in maintaining emotional and spiritual balance, and, of course, abstinence and sobriety. Thus, the goal here is to try to recognize life situations over which one has little power and then to apply spiritual principles to those situations.

As everyone soon discovers, recovery from addiction does not provide immunity from the sometimes trying and traumatic realities of life. We all face such realities just like those fortunate enough to have avoided addiction. However, the point here is that recognition of incidents of powerlessness and unmanageability can trigger the individual to apply spiritual tools that worked in recovery from addiction. When serious life difficulties, such as, job loss, loss of a relationship, or diagnosis of a serious medical condition, occur, as they will, the recovering alcoholic or addict can recognize the situation as one where application of the well-learned spiritual lesson of Step One's powerlessness is appropriate; can take whatever action is indicated (look for a job, couples counseling, consult a physician); and then apply the spiritual principles embodied in Steps One, Two and Three: "Having take appropriate action, I now recognize I am powerless over the result of the situation and turn it over to God, a Higher Power, or other source of spiritual strength."

Not to be forgotten as an important spiritual tool is the value of sharing one's trials and tribulations with another trustworthy person. A passage in the meditation reader of Al-Anon (Courage to Change: One Day at a Time in Al-Anon II, October 1) has some helpful language applicable to this post: "If problems arise today, I will try to acknowledge them--and then put a little spiritual space between my problems and myself. If I can share about them with another person, I will further diminish their power. Recognizing that my life is unmanageable is the first step toward managing it."

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 10/01/2015.

Another Look at the Issue of Drug Addicts Attending Meetings of Alcoholics Anonymous

Should drug addicts attend meetings of Alcoholics Anonymous? My answer is, "Yes." However, I am aware of the controversial nature of this subject and that there are some complicated issues involved in drug addicts attending AA, including whether a drug addict who has not diagnosed himself to be an alcoholic, qualifies for AA membership.

I think a key point is this: The AA Traditions (Number 3) state that the only requirement for membership in AA is a "desire to stop drinking."; so, just on that authority, in my opinion, a drug addict without any history of problematic alcohol use, can become a member of AA without doing any violence to the AA traditions. For the following reasons, a drug addict in, or desiring to have. a solid recovery should have a desire to stop drinking: 1) alcohol is a drug; 2) use of alcohol will impair the recovering addict's judgment thereby making him/her more vulnerable to thoughts or occasions to use drugs; 3) either you are abstinent from all drugs of abuse, or you are not; and 4) use of any psychoactive agent including alcohol will tend to interfere with any spiritual relationship the recovering addict may have with a source of spiritual strength (Higher Power).

Bill Wilson, a co-founder of AA, however, came down on the side of not including non-alcoholic drug addicts as AA members, stating in a pamphlet titled, Problems Other than Alcohol (The AA Grapevine, Inc., February 1958):

"Our first duty, as a society, is to insure our own survival. Therefore, we have to avoid distractions and multipurpose activity. An A.A. group, as such, cannot take on all the personal problems of its members, let alone the problems of the whole world. Sobriety — freedom from alcohol — through the teaching and practice of the Twelve Steps is the sole purpose of an A.A. group. Groups have repeatedly tried other activities, and they have always failed. It has also been learned that there is no possible way to make nonalcoholics into A.A. members."

For the declaration that there is no possible way to make nonalcoholics into AA members, Bill Wilson cited how family members and nonalcoholic friends of AA were unable to relate to AA members and would have difficulty doing Twelfth Step work, not an argumentseemingly relevant to the issue of non-alcoholic or alcoholic drug addicts as AA members.

Although not wishing to appear presumptuous in arguing against a position taken by the founder of AA, an organization that has saved many lives including my own, I will go ahead and briefly address Bill Wilson's justifications of his position and apologize in advance for the lack of scientific research to bring to bear on this matter (there is very little).

Although citing the AA Traditions to support his position on non-alcoholics not being AA members, Bill Wilson does not even mention Tradition Three: "The only requirement for membership is a desire to stop drinking."

In the 57 years since Bill Wilson's monograph on this subject (the 12 Traditions were adopted in 1950), there has been, at least anecdotally, a significant increase in young AA members, an increase in young AA members with a history of both drug and alcohol addiction, and an increase in young members in AA who are non-alcoholic drug addicts. There is also some research (not altogether scientific) suggesting that the number of AA members under the age of 40 has grown to 26% (Alcoholics Anonymous Membership Survey 2014). AA does not have statistics on how many of the AA members under 40 have a diagnosis of both alcoholism and drug addiction or how many may be non-alcoholic drug addict members. There are data that document (available on request) that the vast majority of individuals 30-40 years of age or younger with a primary diagnosis of alcohol addiction have histories of problematic drug use (often marijuana) and that those in that age range with a primary diagnosis of drug addiction have histories of problematic alcohol use. So, one can postulate that a significant number of the 26% of AA members under the age of 40 (AAMembership Survey) probably have a history of problematic use of both alcohol and other drugs.

AA seems to have absorbed the increase in younger members with both alcohol and drug addiction without any of the threats to its survival that Bill Wilson feared over 57 years ago. There are over 115,000 AA groups worldwide, with an estimated 2,040,629 members (AA statistics). Anecdotally, in my experience, AA members with significant drug histories either place the emphasis on the alcohol portion of their stories when sharing at AA meetings or speak generally about their non-alcohol addiction. Some meetings make a statement at the beginning of the meeting that those present should confine their remarks to their experience with alcohol. This admonition seems, in my experience, to be effective.

I have not made an exhaustive study of AA literature and historical documentation and, of course, do not have data about the AA experience with alcoholic drug addict and non-alcoholic drug addict members across the U.S. I invite those with additional evidence, scientific or anecdotal, to add to this, now unduly long. post about the issue of drug addicts attending meetings of Alcoholics Anonymous.

As always, comments are invited, Jan Edward Williams,www.alcoholdrugsos.com, 09/06/2015.

Another "Quick Fix" Treatment for Addiction: Erase Memories that Can Trigger Relapse

A major cause of relapse in individuals recovering from drug addiction, specifically in the situation under discussion here, methamphetamine addiction, involves triggers associated with memories of past drug use.

A recent animal study, summarized in ScienceDaily for August 04, 2015, reports on an experiment involving injection of a chemical called blebbistatin into animals with laboratory induced methamphetamine addiction. One injection resulted in erasure of memories pertaining to use of methamphetamine. Scientists at the Scripps Research Institute in Florida stated that "The results [of the study] showed that a single injection of blebbistatin successfully disrupted long-term storage of drug-related memories--and blocked relapse for at least a month in animal models of methamphetamine addiction."

The scientists were excited because "... the effect of this novel treatment approach was specific to drug-associated memories (not affecting other memories), and the animals were still able to form new recollections."

In my opinion, drug companies and allied medical organizations tend to seek development of drugs that will quickly fix the problem of addiction. The most objectionable examples, in my view, include methadone and suboxone maintenance that approach treatment of opiate addiction through use of legal opiate substances. Less objectionable are approaches that involve administration of opiate antagonists such as naltrexone that block the ability of opiates to produce their addictive effects and seem to also help reduce cravings in recovering alcoholics. The advantage of opiate antagonists is that they do not produce a "high", as do methadone and suboxone.

The approach reported on in this post seems like science fiction but is consistent with the attempts by science to offer a quick fix for addiction. My preference for long term recovery is, of course, to aim for abstinence through the hard work involved in therapy and use of spiritual principles in the 12 Step Programs.

As always, comments are invited. Jan Edward Williams,www.alcoholdrugsos.com, 08/08/2015.

The Serenity Prayer: A Powerful Recovery Tool

Addictive disease, be it cocaine, heroin, alcohol, gambling, or other addiction, has a powerful grip on those suffering from it. Therefore, recovery from addiction must harness powerful measures to combat the power of addiction. Recovery tools can be lifesaving measures for recovering individuals. The Serenity Prayer is one such powerful recovery tool:

God grant me the serenity to accept the things I cannot change,
The courage to change the things I can, and
The wisdom to know the difference.

In my view, the Serenity Prayer, properly interpreted and used, can not only be a tool for addiction recovery but also a tool for ongoing mental health. Here is the way I interpret the Serenity Prayer and try to use it on a daily basis:

God, 

Grant me the serenity to accept the things I cannot change, OTHER PEOPLE AND MANY EVENTS IN MY LIFE,

Grant me the courage to change the things I can, ME AND HOW I REACT TO PEOPLE AND EVENTS IN MY LIFE,

and the wisdom to know the difference.

A recovering individual will face frustration and ultimately relapse by focusing on changing other people and many events in life and should focus on what he/she can change, namely, how he/she reacts to people and life. We always have the ability to address our own thinking (cognitions) and emotional and behavioral reactions to people and events. The folks in Al-Anon have a short phrase that encapsulates some of this: mind your own business. The wisdom comes from daily attempts, with success and failure, to apply the Serenity Prayer tool, from doing so without use of alcohol or other drugs, and from seeking the strength from God, or other source of spiritual strength, to persevere in the task.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 07/27/2015.

In Order to Keep It You have to Give It Away!

Recovery from drug or alcohol addiction using the Twelve Step Programs such as Alcoholics Anonymous or Narcotics Anonymous involves a lot of work on self, but a basic tenet of 12 Step recovery is summed up in this common guideline: In order to keep your recovery or sobriety, you must give it away. Or, put another way, using the words of the AA preamble: "Our primary purpose is to stay sober and help other alcoholicss to achieve sobriety." Here is how NA states this concept in their publication, Who, What, How and Why (White Booklet): "The newcomer is the most important person at any meeting, because we can only keep what we have by giving it away."

Often, members of AA or NA, even those with long term recovery, may feel that they are not good speakers, don't seem to have made great progress in working the 12 Steps of recovery, or in some other ways think they may not have anything to offer the newcomer or have anything "to give away." I ran across this quote in one of the daily meditation books I read, which is encouraging in its message that any individual in recovery may help another, even with only a smile directed toward another at a meeting:

"They might not need me;
but they might.I'll let my head be just in sight;a smile as small as mine might be precisely their necessity."--Emily Dickinson

As always, comments are invited. Jan Edward Williams, 06/22/2015,www.alcoholdrugsos.com.

Does Every Drink with Alcohol Constitute a Relapse for the Recovering Individual?

Here are a couple of scenarios to put this question in some context. I am at a party where liquor is served and pick up the wrong drink by mistake, take a swallow, realize that there was alcohol in the drink, and drink no more. Or, I am at dinner in a restaurant and discover after eating a slice of cake that it had alcohol in it. Or, I am a devout Catholic, Episcopalian, or member of a religion where wine is an integral part of worship and I partake of a sip of wine, say, once a week at my place of worship. In any of these cases, would the individual need to consider him/herself to have relapsed and need to have a new sobriety date?

My conclusion is that none of these scenarios constitutes a relapse (as long as the individual in the first two scenarios does not have more than one such "mistake", and the religious individual is not attending worship services many times a day). I know of one individual with long term sobriety who is a Catholic and partakes of the host in the form of wine (blood of Christ). I myself do not take the wine at communion; I do not trust my central nervous system (CNS) to recognize the blood of Christ rather than the wine. In regard to the mistake such as picking up the wrong drink or consuming food with alcohol, my view is that such incidents should not happen if the individual maintains a high level of awareness of the dangers of such situations. For example, I always question whether sauces for foods contain alcohol and decline them even though some think the alcohol is removed by cooking. Again I do not trust the reaction of my CNS to the taste or absorption of even minute amounts of alcohol. Similarly, at parties where alcoholic beverages are served, I suggest asking for closed bottles of nonalcoholic drinks or observation of the pouring of the ordered drink, and holding onto the drink to avoid picking up the wrong one.

As always, comments are invited. Jan Williams,www.alcoholdrugsos.com, 05/26/2015.

Tips for Those New to Addictions Recovery

This brief note is for persons new to recovery, whether just starting participation in 12 Step Programs such as AA, NA, Al-Anon, Nar-Anon or Families Anonymous, or just completing a residential treatment program, or just completing an intensive outpatient treatment program. The single most important tip for such newly recovering persons is to engage in some recovery activity every day. I refer here to daily attendance of 12 Step meetings, daily prayer and meditation (if you are open to this), daily readings of recovery literature (books with a page for each day of the year such as Daily Reflections (AA), One Day at A Time (Al-Anon), Today a Better Way (Families Anonymous), Days of Healing, Days of Joy (ACOA)), including the AA Big Book or the NA Basic text, daily contacts with others in solid recovery, weekly therapy (if that is part of your recovery), to name a few.

There is a reason that most treatment programs suggest 90 meetings in 90 days--the power of addiction is such that the newly recovering person needs as much support as possible. The research is clear: the longer a person continues to invest in daily contact with supports for recovery (just mentioned), the better the outcome in terms of abstinence. There is much more to be said to aid the newly recovering person. I invite comments. Jan Williams,www,alcoholdrugsos.com, 04/15/2015.

Are There Any Conditions on Your Recovery?

Are There Any Conditions on Your Recovery? Would It Ever Be OK For You To Drink or Drug? I am not talking here about necessary and needed medications prescribed by a physician and used as prescribed. I think it important for every individual in recovery from addictive disease to think deeply about, and to honestly answer, this question: If a particular eventuality should come to pass, would it trigger me to pick up a drink or a drug? Some such eventualities that I have encountered in working with recovering individuals include: going to jail. losing my job, my spouse, or partner, death of a loved one, or, being told of a fatal medical condition.

In my view, it matters little why an individual begins the recovery journey; many enter treatment and recovery for the job, significant other, for legal reasons, because of coercion from parents, etc. Being in recovery/treatment allows the individual the opportunity to break through denial and realize that abstinence and recovery are personally needed goals. At some point in recovery, the individual must be on the recovery path for reasons internal to him/her, rather than for external reasons of the type mentioned here. An external condition is likely to be resolved or removed at some point, thereby removing the reason and motivation for abstinence and recovery, resulting in relapse.

Once an individual has internalized abstinence and recovery as vital regardless of the external reasons initially bringing him/her to recovery, and has settled into a relatively stable abstinence based life, the realities of living will continue to happen as they do to all people. The ability to meet the sometimes harsh realities, such as loss of loved ones or devastating medical conditions, without resorting to use of alcohol or other drugs, will depend upon the strength of the individual's recovery program, including experience applying the tools of recovery, a strong relationship with a sponsor (mentor), and the recovery Fellowship, to name a few factors. Perhaps most important for long term recovery in the face of critical life events is a well developed relationship with a source of spiritual strength (God, Higher Power). The goal of the 12 Step Programs is to help the recovering individual to develop such a relationship.

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 03/19/2015.

Remember: Love the Newcomer to Recovery

One often hears in 12 Step meetings that the people in the rooms where AA or NA members meet "... loved me until I learned to love myself." It is important to remember how broken and fragile newcomers to recovery are; how guarded and self-loathing they are. A kind word of welcome can mean so much to the newcomer, even though he/she may not be able to verbalize its value. A simple, "Keep coming back; hope to see you again", or offering a telephone number, can be a gift of hope to the frightened individual new to the rooms of recovery.

I was reminded of the importance of welcoming and supporting the newcomer by the following quote that I read today in one of the daily meditation books that I read:

"Love bade me welcome; yet my soul drew back,
Guilty of dust and sin.
But quick-eyed Love, observing me grow slack From my first entrance in,
Drew nearer to me, sweetly questioning
If I lack'd anything... (George Herbert, English poet, 1593-1633)."

These simple words written by a 17th century poet, who lived to be less than 40 years of age, gave me goose bumps (or "piloerection", a more technical and sexier term) when I read them. So, let us remember to offer support to the newcomer to recovery.

As always, comments are invited. Jan Edward Williams,www.alcoholdrugsos.com, 02/25/2015.

Powerlessness: A Powerful Recovery Tool

The basic purpose of the 12 Step recovery program found in AA and NA is to help the addicted individual to connect with a spiritual source of strength and, thereby, find a way out of addiction. Powerlessness over alcohol, or other drugs, is the basic concept underlying recovery from addiction using the 12 Step recovery model.

As stated in the AA Basic Text ("Big Book"):

"Lack of power, that was our dilemma. We had to find a power by which we could live, and it had to be a Power greater than ourselves. Obviously. But where and how were we to find this Power? Well, that's exactly what this book [AA Big Book] is about. Its main object is to enable you to find a Power greater than yourself...(Alcoholics Anonymous,  page 45)."

A few years ago I came across some language in the New Testament that opened additional doors of understanding for me about acceptance and powerlessness, two related concepts that seem to be key to a serene recovery. My version of the biblical passage I am referring to is this: "In weakness power reaches perfection...for when I am powerless it is then that I am strong..." (12 Corinthians 8-10).

In the 12 Step Programs, the foundational Step is, of course, Step One: "We admitted we were powerless" over alcohol, or drugs, or whatever the behavior may be. As long as the addicted individual hangs onto even a vestige of belief that he/she can control, has power over, alcohol or other drug use, he/she is not open to the need for help, including spiritual help. Very simply, after years of struggle and pain trying to control ones alcohol or drug use, the fortunate individual will find that self-centered pride and self-sufficiency give way, allowing the individual to come to believe, that is, internalize in his/her heart that he/she cannot control (Has no power over) use of alcohol or other drugs, setting the stage for being open to help, at first from others recovering from addiction, and then to seeking a source of spiritual strength.

The power of powerlessness lies in the fact that recognition of a lack of power means that the addict or alcoholic is now open to asking for help. The serenity prayer says it all. God grant me the serenity to accept the things I cannot change (others and many events in life), the courage to change the things I can (me and how I react to others and events in life), and the wisdom to know the difference. Surrender to win is the 12 Step shorthand version of this post. There is infinite power in powerlessness. Recognition of powerlessness enables one to seek power from a source of spiritual strength.

As always, comments are invited. Jan Williams, www.alcoholdrugsos.com,  02/24/2015.

Recovery Tool: Live One Day at a Time

A good recovery tool for maintaining sanity, emotional balance, and, of course, abstinence from use of alcohol or other drugs, can be found in the concept of living one day at a time. Here is a well-known reflection from 12 Step Literature that can help one to focus on living one day at a time:

"There are two days in every week about which we should not worry;
Two days which should be kept free of fear and apprehension;
One of these days is YESTERDAY, With its mistakes and cares,
Its faults and blunders, Its aches and pains.

YESTERDAY has passed forever beyond our control.
All the money in the world cannot bring back YESTERDAY.
We cannot undo a single act we performed.
We cannot erase a single word we said.
YESTERDAY is gone.

The other day we should not worry about is TOMORROW;
With its possible adversities, its burdens, its larger promise.
TOMORROW is also beyond our immediate control.
TOMORROW, the sun will rise,
Either in splendor or behind a mask of clouds;
But it will rise.
Until it does, we have no stake in TOMORROW
For it is as yet unborn.

This leaves only one day - TODAY.
Any man can fight the battles of just one day.
It is only when you and I add the burdens of those two awful eternity's
- YESTERDAY and TOMORROW -That we break down.

It is not the experience of TODAY that drives men mad.
It is remorse or bitterness for something which happened YESTERDAY
And the dread of what TOMORROW may bring.

Let us, therefore, live but ONE day at a time. --24 Hours a Day."

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 01/31/2015.