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Monday, January 20, 2014

New Thinking On Women And Alcohol

(CoffeeCypher/Flickr)

Journalist Gabrielle Glaser argues that women in particular need an alternative to Alcoholics Anonymous. (CoffeeCypher/Flickr)

Alcoholics Anonymous is commonly considered the gold standard for helping people control their drinking problems.

But there’s a growing school of thought that there are problem drinkers who can cut back — as opposed to severely dependent drinkers who must cut out drinking altogether. There are new tools, such as medication and online support.

Journalist Gabrielle Glaser says women in particular need an alternative to AA. She’s author of “Her Best-Kept Secret: Why Women Drink — And How They Can Regain Control” and a recent New York Times op-ed “Cold Turkey Isn’t the Only Route.”

People are reluctant to seek treatment for it when the condition is mild or moderate.
– Gabrielle Glaser

Severely alcohol-dependent people should consider an abstinence program, Glaser tells Here & Now’s Robin Young, but research has shown there are far more mild to moderate problem drinkers than severe problem drinkers.

“We say, ‘oh if you have a drinking problem, you should be abstinent forever more,’ and not a lot of people want to do that. Not a lot of people what to say to themselves ‘I don’t ever want to have a drink again.’ It’s very frightening. So they don’t enter treatment and they develop worse and worse problems,” Glaser says.

The term ‘alcoholic’ is problematic too, she says, noting that scientists don’t use the term anymore, instead defining an alcohol use disorder on a severity spectrum.

“People are reluctant to seek treatment for it when the condition is mild or moderate, because they think, they believe, the AA narrative that you have to hit bottom. But that’s really just not true, that’s not what the evidence shows. That’s not what you would tell someone who’s eating too much and has rising cholesterol figures. You don’t say ‘hey buddy keep going with those bacon cheeseburgers until you have your first heart attack.’ You intervene when the condition is mild,” she says.

One program that offers an alternative to abstinence is Moderation Management, which recommends taking a 30-day break from drinking, and then using its strategies to change drinking behavior.

More Information & Resources

  • ModerationManagement.org: Why is a Moderation Program needed? (MM is a “behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes.”)
  • National Institute on Alcohol Abuse and Alcoholism: Tips to try (One of the nine tips is: “Keep track of how much you drink. Find a way that works for you, carry drinking tracker cards in your wallet, make check marks on a kitchen calendar, or enter notes in a mobile phone notepad or personal digital assistant. Making note of each drink before you drink it may help you slow down when needed.”)
  • National Institute on Alcohol Abuse and Alcoholism: What are symptoms of an alcohol use disorder? (This is an 11 question anonymous quiz that gives you feedback on your drinking use.)
  • National Institute on Alcohol Abuse and Alcoholism: What’s “at-risk” or “heavy” drinking? (For women, it’s more than 3 drinks on any day or 7 drinks per week.)

Guest

Transcript

ROBIN YOUNG, HOST:

Well have you already failed at your New Year's resolution? Experts say it could be because you've taken an all-or-nothing approach, but that's particularly controversial when it comes to drinking. Abstinence, admitting powerlessness over alcohol and giving it up has long been the only route for members of AA, but there's growing thinking that there are problem drinkers who can cut back, especially since there are new tools, like medication and online support.

And our next guest says women in particular need an alternative to AA because they often already feel powerless. Gabrielle Glaser is author of "Her Best-Kept Secret: Why Women Drink-And How They Can Regain Control." And she joins us from the NPR studios in New York with a look at women and drinking. And Gabrielle, why focus on women?

GABRIELLE GLASER: We know that women are far more likely to be diagnosed with depression and anxiety disorders. They're far more likely to have had eating disorders and to have been sexually abused. And those are four main risk factors for women.

YOUNG: Well, and more and more woman are drinking. You've got some stats: They're being stopped more for drunken driving than they were two decades ago; biggest consumers of wine.

GLASER: Absolutely. They buy about 70 percent of the 800 million gallons of wine sold in the United States every year, and they drink the lion's share of that. They are - middle-aged women are checking in more frequently to alcohol rehab programs, and that's very, very telling because it's very hard for middle-aged women with kids at home to disappear for a month.

YOUNG: Yeah, who will take care of their children, who will run the home? Now again, we understand, and you make it clear, that you understand that there is disagreement with the thinking of using outside tools, tools outside of AA. But also you say that there are some women for whom this does not apply.

GLASER: Absolutely. There are severe alcohol-dependent folks, and these are the people who need a shot of vodka in the morning to maintain, to steady their nerves. They have a flask at work. Of course these people need to be considering only abstinence. But what our epidemiological research shows, and we've spent a lot of money on this as a government, as taxpayers, we have interviewed 85,000 people about their drinking habits.

And what those two studies - one in the early '90s, one in the 2000s - what those studies showed, that among heavy drinkers, problem drinkers, people who are on the moderate to mild end of what's now being called alcohol use disorder, outweigh alcohol-dependent folks four or five to one.

YOUNG: You say these problem drinkers may be starting to drink secretly or planning their drinking or for women drinking more than four days a week or more than three drinks at one time.

GLASER: And those are the people for whom other and different alternatives may be best applied.

YOUNG: Let's take a look at some. You talk about the drugs that we've talked about on the program. Naltrexone, this was approved by the FDA in 1994. It blocks the signals released when consuming alcohol so you don't, what, get the mental benefits, the rewards from it.

GLASER: Right.

YOUNG: But you say that even Naltrexone is being used in a different way than many American doctors use it.

GLASER: Absolutely. American doctors prescribe it in general with the goal of abstinence. So they tell people, you know, take this drug, it's going to block your opioid receptors. You're not going to feel pleasure when you drink, but don't drink. And in Finland, where the national health care system implements a single program that they have found to be most effective, it's given with the prescription of you should take this an hour before you drink and then drink. And it's - the drug has been shown in many, many peer-reviewed clinical trials to be more effective when used that way.

YOUNG: The cravings diminish.

GLASER: The cravings diminish. The behavior becomes extinguished because the alcohol is doing nothing for you. It's not bringing you any reward.

YOUNG: Well, and this program that you write about in Finland is actually run by an American, John David Sinclair. His approach he called pharmacological extinction, the pharmaceuticals again make your cravings extinct. He claims that, and he claims success with that.

What are some other programs in particular that you find successful for women?

GLASER: Well, there's one called moderation management, which has been around for about 20 years, and it encourages people, again not people who are alcohol dependent but people who have found that their control is slipping away a little bit, they used to have two drinks, now it's three, maybe it's four, and I'm not saying that oh, that's a great way to drink, I'm simply saying, and the research will tell, that that's not what is technically classified as alcohol dependence.

So what moderation management suggests is that you take a 30-day break from drinking, and then you apply cognitive behavioral tools. You can get those online. You can get those in groups. You can get - and moderation management is free. And you apply those to yourself, and they reinforce what your thoughts are and your beliefs are about how you're drinking.

YOUNG: OK, a couple thoughts. If you can't do the 30 days without drinking, then you have a far more serious problem.

GLASER: Right, then you have a far more serious problem. If you can't even get through that 30 days, then of course moderation management is not for you.

YOUNG: So with that in mind, we'll link listeners to both the AA and moderation management websites. And at the latter, you can link to a government site with tips like drinking tracking cards you can keep in your wallet or measures to see real drink sizes. Hint, a coffee mug of wine is not one drink, it's more likely two.

Our guest is author Gabrielle Glaser, who by the way says she has no dog in this hunt, she's just dug into the research. What say you? Let us know your thoughts on cutting back instead of quitting at hereandnow.org. You're listening to HERE AND NOW.

(SOUNDBITE OF MUSIC)

YOUNG: It's HERE AND NOW, continuing our conversation with author Gabrielle Glaser about women and drinking. Her recent op-ed in the New York Times reignited a debate. It's titled "Cold Turkey Isn't the Only Route." She describes alternative to the AA model of abstinence, something very controversial, especially to loved ones of alcoholics who have been on the receiving end of the heartbreak and abuse they can dish out.

But Gabrielle says there's a distinction between dependent drinkers who can't stop and problem drinkers who are seeing their drinking creep up beyond four days a week and who outnumber dependent drinkers by four or five to one. One idea for them, she says, is reducing harm. So for instance, in Amsterdam officials are paying alcoholics with beers to clean up a park, and that's actually reducing how much they drink.

Another program, it's actually a movement, Moderation Management, a free online program with steps just like AA and support groups, but it's about cutting back on drinking, not quitting. And Gabrielle, as you well know, there's a doctor involved but the civilian founder of Moderation Management is Audrey Kishline. She left the program, said it didn't work for her. Thirty percent leave for the same reason.

She joined AA but then got drunk and killed a father and daughter in a traffic accident.

GLASER: Well, but remember, she had joined AA. She left Moderation Management. She put a note on her website in January of 2000 saying she was not a candidate for moderation, it wasn't working for her, and that she was leaving to join abstinence-only groups. She joined AA, and two months later, clearly abstinence was not working for her either because that's when she got really loaded and drove the wrong way on an icy highway in eastern Washington and killed that man and his daughter.

And it's incredibly tragic, but she was a candidate, obviously, for someone who should have stayed away from alcohol altogether. And a lot of this, what science calls low-risk drinking or a return to low-risk drinking, is something that you need to decide for yourself, and clearly she had decided that in January - hey, this isn't working for me. But neither was the notion of powerlessness over alcohol.

YOUNG: It sounds like, as you say, someone who really, really needed abstinence. Well, but for those for whom self-moderation seems to be working, moderateddrinking.com, what happens there?

GLASER: That is an app, a computer-based, Web-based app that allows people to track their drinking. It allows people to kind of have this mindful drinking that you mentioned earlier. And what it also allows people to do is a sort of cost-benefit analysis. Where does my drinking become a problem for me?

And it allows people to see that in black and white. And women especially, more than two-thirds of the users of that app, happen to be women, and this is an app that has been shown in two very well-regarded peer-reviewed journals to have great success in reducing the number of drinking days.

Reducing the number of drinking days is something again that's kind of anathema in our country. We say, oh, if you have a drinking problem, you should be abstinent forever more, and not a lot of people want to do that. Not a lot of people want to say to themselves, hey, I don't ever want to have a drink again. It's very frightening. So they don't enter treatment, and they develop worse and worse problems.

YOUNG: They do nothing.

GLASER: Exactly. And these programs, there's another one called I Self Change, you can download it on the iTunes store, these programs allow people to do this within the privacy of their own home. There's no stigma of going out and saying, hey, I'm an alcoholic. I think that word should be retired from our lexicon anyway, but that's just my two cents.

YOUNG: Because why? You point out alcoholism is a disease, and we don't force people to sit in rooms and say I'm an asthmatic.

GLASER: Right, but the word alcoholic and alcoholism is something that was promulgated by AA itself. And we've lumped together anyone with a drinking problem into that same rubric. Oh, well, they're an alcoholic. And actually, even scientists don't use that word anymore.

The term now in the DSM-V is alcohol use disorder, which encompasses a spectrum from mild to moderate to severe dependence.

YOUNG: DSM is?

GLASER: The Diagnostic and Statistical Manual of Mental Disorders. And in 1994, the DSM-IV came out with alcohol abuse and dependence. So alcoholism has not really been something that scientists have used for 20 years.

YOUNG: Well, and as you say, the main tool hasn't changed since 1935. Time to get some new ones. People can hear this and make their own decisions, but you know, I'm sure you've gotten reaction to the op-ed, people who are furious, have lost loved ones to alcohol, and they don't want to hear about a route that might give an alcoholic - still use that word - an exit.

GLASER: Right, which is actually tragic, because if you liken it, say, to depression - 30, 40 years ago, before Prozac hit the scene, we really had very few tools to take care of people who were severely depressed. If they were a threat to themselves and others, someone in their family could commit them, and they had electroconvulsive shock therapy in a hospital. They were sedated around the clock, and then eventually they were let out as very different people.

Nobody wanted to get treatment for depression because it was horrible. It was barbaric. And likewise with alcohol use disorder, people are reluctant to seek treatment for it when the condition is mild or moderate because they think, they believe the AA narrative, which says you have to hit bottom.

But that's really just not true, that's not what the evidence shows. That's not what you would tell somebody who's eating too much and has rising cholesterol figures. You don't say, hey, buddy keep going with those bacon cheeseburgers until you have your first heart attack. You intervene when the condition is mild.

YOUNG: Well, and we mentioned what the criticism is going to be and is, but I can also hear loved ones of people with alcohol disorder saying I'd give anything for them to reduce their drinking to maybe two days a week.

GLASER: Absolutely, and that's a harm reduction technique. And we need to offer different tools that have been shown to be so effective elsewhere. And in Canada, for example, harm reduction is offered as - and harm reduction is a series of strategies that allow people with negative behaviors to reduce the negative consequences of those unhealthy behaviors.

So the first one that comes to mind is needle exchange. The second one that comes to mind in terms of drinking is never drinking and driving, or drinking and setting a limit for yourself. This might sound like an enormous amount of alcohol to you and me, but never drinking more than four drinks.

If I had four drinks, I'd be on the floor, but some people have a high tolerance, and they schedule two days a month in which they can do that. And is it super-healthy? I'm not going to be the judge of that. Is it super-healthy if they don't drive? You bet it's a lot healthier if they don't drive.

YOUNG: And is it better than four drinks every day for the month?

GLASER: Exactly, exactly, exactly.

YOUNG: That's Gabrielle Glaser, journalist and author of "Her Best-Kept Secret: Why Women Drink-And How They Can Regain Control," on some of the new and controversial thinking in some quarters about drinking. Gabrielle, thanks so much.

GLASER: Thank you so much for having me.

YOUNG: So your thoughts. Are you surprised a problem drinker is more than three drinks a day or four days a week? Let us know. Weigh in at hereandnow.org. You're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.


Please follow our community rules when engaging in comment discussion on this site.
  • Laura

    I have a drinking issue, but AA did not make any sense to me. I needed to stop drinking, not make amends to others blah blah. I read “rational recovery” by Jack Trimpey and that was it! It sounds too simple but made complete sense to me. I stopped completely for 2 months, and now self-moderate.

    • Susan Jones

      Good for you. I am glad that your drinking didn’t cause issues for others that warranted an apology.

    • http://www.recoveringfromrecovery.com/ Lovinglife52

      The rational recovery book really helped me as well. I was fed up with AA and the people that go there, and it helped me move on and strengthened my recovery. I would always apologise if I felt I had been wrong when I was drinking and did not need a program to tell me to do this, it was just common sense. Many people in AA are criminals and lowlifes so I suppose that step was aimed at them.

      • Susan Jones

        AA mirrors society, Mike. I am sure there are criminals and lowlifes in the alternatives as well. Addiction doesn’t lend itself to the best of behaviors. Seems like a cheap shot.

      • Bruce Allen Woodward

        Calling the membership of AA criminals and low-lifes is more telling of yourself than that of AA members. Yes, I was a criminal and a low-life but because of AA I have been sober for over 30 years and have led a law abiding, productive life. I have learned through using the 12 steps that there are many things that I did when I was drinking and even before I started that made me what I was then. Fortunately, I’ve been able to clean up and make amends for those misdeeds and set my life straight. AA saved me and has saved many like me.

  • Beth

    But what is the “problem?” The Problem I’m problem drinking is never defined. I drink a glass of wine every night with dinner. What makes this a problem?

    • sooperfluous

      one glass per night is not a problem. read the DSM5s definition of problem drinking and addiction – there you can learn when things start to become problematic.

    • Bruce Allen Woodward

      I am an alcoholic. I KNEW when it became a problem. I think that most alcoholics would tell you that they knew when they crossed the line. People don’t just stumble into AA for kicks.

      • falcon20

        What is the problem with any of the methods? If YOU think that you MAY or DO have a problem, and SMART RECOVERY, MM, AA, your doctor, shrink, priest or standing on your head WORKS for you to stop or really control your drinking/drugging/eating/sex problem etc. then USE that. We are all different and therefore no one program will fit all. For me and my ALCOHOLISM, the AA program works and has made a wonderful difference in my life. Choose what works and stick to it. Just don’t kill yourself or anyone else while you are deciding.

        • Bruce Allen Woodward

          Hear hear!

    • Susan Jones

      Nothing unless it is a problem for you.

  • Ilene

    The “dog in this fight” is the rehab industry which wants anyone and everyone in their treatment programs bc it is their profit motives that determine their corporate financial rewards and they promote the 12 step programs (AA, etc) despite no data on the effectiveness of these programs. Would you treat any other “Disease” with a 12 step program – OCPD, cancer, etc? .

    • TJtruthandjustice

      AA costs a dollar a meeting (if you have it) and is not affiliated with any other entity, including the “rehab industry.”

      • rainbow

        They aren’t? Sounds like that river in Egypt is close by. Hmm…

        • TJtruthandjustice

          What’s that supposed to mean? Read it for yourself:

          Alcoholics
          Anonymous
          is a fellowship of men

          and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.

          The
          only requirement
          for membership

          is a desire to stop drinking.

          There
          are no dues
          or fees for A.A.membership;

          we are self-supporting through our

          own contributions.

          AA
          is not allied
          with any sect, denomination, politics,

          organization or institution; does not wish to engage in any controversy; neither endorses or opposes any causes.
          Our
          primary purpose
          is to stay sober and help other

          alcoholics to achieve sobriety.

    • Steve Flower

      One of the reasons the rehab industry loves promoting the 12-step programs is that they consider it a no-cost, no-accountability after-care program. And then, when the rehab patient fails, it can be the fault of the “defective” 12-step program and no fault of the treatment program. The same is true of courts and police who consider sentencing people to AA as the solution for drunk driving – which is a bit like saying Bible study is the solution for pregnancy. Both AA and Bible study may be good, but in both cases it’s much more helpful if the person involved wants to stop, first.

      • Hymie

        That’s always the case with AA. Tradition 3 states that the ONLY requirement for membership is a desire to stop drinking.

  • SC

    This discussion ignores so many of the insidious components of alcohol abuse / excessive drinking like the mental obsession with alcohol and drinking, binge drinking, blackout drinking, etc. The author and Robin Young simplified the many complex problems and almost make it sound like dieting. The problem with telling alcohol abusers that are not yet alcohol dependent that “reducing drinking days” is sufficient as a goal is that it is unrealistic and misguided. If people could successfully manage their drinking in this way, they would have done it – I guarantee that every last one of them has tried and tried many times over. Also, there is no way to ever guarantee that someone employing one of these “management” programs is not going to kill or injure people in a drunken accident on one of their drinking days. The conversation made it sound like this was somehow possible! People drink and make bad or reckless choices no matter how much they drink. I know many will disagree with me, but I think this is a very dangerous message to send to people of either gender who suspect or know that they have a problem with alcohol.

    • sooperfluous

      I think they made it clear that MM is not for everyone. It’s not for people who are already in the throes of full-blown addiction.

      • SC

        Yes, I agree that they kept saying that it wasn’t for everyone, but they -like you- only singled out people who are seriously alcohol dependent, which is the part that I disagree with. Not everyone who should abstain is in that category and this oversimplification ignores the progression of the disease / problem and reinforces the idea that only low-bottom drinkers who’ve “lost it all” really have a problem. That kind of message is what kept me drinking long after I should have stopped. I do honestly feel that people should do whatever works for them personally, though, but I think this kind of report requires more than this rather superficial treatment.

      • Susan Jones

        What if you are going to MM and haven’t accepted that you are in fact in the throes of full-blown addiction?

    • Anna

      Thank you SC for stating the truth. Gabraielle Glaser is mistaken in many ways. She doesn’t understand that “alcoholism” is a primary progressive illlness, not a disgrace or bad habit, and an alcoholic is a person who has no control over alcohol. She misunderstands “hitting bottom”. It doesn’t refer to any specific problem or incident in a person’s life; it refers to the moment when someone finally accepts that her attempts to control her drinking aren’t working, and accepts the need for total abstinence, one day at a time.l

      • lugal

        This is exactly the kind of sanctimonious, religion-tinged attitude that repels many of us from AA. If you have no control over your alcohol consumption, then by all means, abstain totally if that’s what works for you. Some of us choose to exercise control at a point where we still have it, and that may mean either abstinence, or *gasp* moderation. I don’t think Ms. Glaser misunderstood the concept of rock bottom at all — instead, she suggests that you don’t have to wait until you reach that point to do something about it.

        • SC

          In fairness to Anna, there was nothing religiously-tinged or sanctimonious in her response. Despite my agreement with Anna’s points, I think that the repulsion from AA that you reference is a real issue as well. Nothing’s perfect, but AA is a group of people struggling with a common issue that are doing their best to help and support each other. It is not a cult or a religious group or a strict all-or-nothing program. It is very forgiving and, like Anna says, accepts anyone with a mere “desire to stop drinking.” That is the one and only thing approaching a “requirement” and I have seen so many people helped immeasurably by this program even if they didn’t stop drinking right away.

        • TJtruthandjustice

          There is nothing sanctimonious about AA. If you don’t have a desire to stop drinking, you shouldn’t be in AA in the first place. Indeed, the only requirement for AA membership is a desire to stop drinking. People join AA because they have concluded that moderation is impossible for them. The program is not at all critical toward anyone who chooses otherwise.

  • Lugal

    I think this approach makes a lot more sense than total abstinence for all. I have watched my consumption go up in recent years, but it is still in the moderate area. Cutting back, keeping track of drinks, setting ground rules for how many drinks in a set period of time — all of these have helped me successfully cut back without resorting to abstinence. While AA may work for some, surely people realize that this is not a one-size-fits-all issue?

    • Susan Jones

      I have never seen AA as a one size fits all issue at all. It isn’t as if you go to a meeting and find several addictions being discussed. AA exists solely for the common problem of alcohol. You are very fortunate that the efforts you emply (which are also in the BB) have permitted you to stop it in time.

  • sooperfluous

    I think this is GREAT! Finally an alternative to AA that makes sense! While a person learns self-control, they just might find that they actually do not like alcohol altogether.

    • Susan Jones

      Finally? What do you mean, finallly? She agrees that at least MM is 20 years ol. Many alternatives are older than that and all are there for the finding. There have been pharm approaches for at least 20 years. None of this is new.
      “Like alcohol…” I liked what it did for me.

      • erinmalloy

        Susan, I think your responses here highlight the kind of push back moderation has faced from the AA community. “You are lucky…” that you don’t’ have to apologize. Who says you have to apologize and make amends in order to stop drinking effectively? AA. Is that science?

        “You are fortunate…” that you could stop in time. THAT’s exactly the point. You don’t have to find yourself in the gutter; waking up with a hangover too many days of the week can do it.

        I think the idea that that alternatives “are there for the finding” is a little unfair. I’ve looked and never found it. The preferred model in the US is the 12-steps. The pharmacological approaches have been around, but who hears about them?

        • Susan Jones

          Erin, I don’t think it is a pushback. I think it is an honest appraisal. There are fewer than 200 SMART meetings in this country that are available to people that aren’t patients or incarcerated. There are fewer than 20k SOS members WORLDWIDE. There are a couple of meetings in a city the size of LA. I don’t know how Lifering meetings there are, and there are very few Women for Sobriety meetings. None of this has anything to do with AA. But there is such a thing as the internet, and I really believe (as does my sponsor) that people have a responsibility to look and do some footwork. People do more homework on consumer goods than they do recovery programs. The preferred model probably has nothing more to do with anything than sheer availability. I would imagine if these alternatives were readily availably, they would be recommending them as well.
          As for making amends, much of the stepwork has to do with life repair. If you had situations in your life that you drank over, that is one of the things that the steps can help address. If you didn’t, then you didn’t.

  • Eloise Peterson

    I tuned in a little late in this discussion but my first reaction was, “This woman must be trying to sell a book”. What a crock….pardon the language…but she doesn’t have a clue. If one has a “drinking problem” the way to handle it successfully is to QUIT drinking…not to try to reduce alcohol intake. I have had personal experience in this. I learned from a friend, a recovering alcoholic, that one does not have to be an alcoholic upon joining AA. One simply needs to have “a desire to stop drinking”. This is where I was many years ago. This doesn’t make some of the AA members happy but…I didn’t jump into AA to please them. I joined to stop drinking though I didn’t at the time and still do not believe that I am an alcoholic…just smart to stop before I got there. My feeling at the time was that if anyone is concerned about their alcohol intake there is a reason for that…alcoholic or not. So, while one can play games it really makes more sense to stop with the support of a group of winners. I never did the 12 steps because I didn’t feel powerless. I felt I was not powerless but Smart !! This was in 1981. :)

  • kathyw272

    The whole idea behind alcoholism is that the individual cannot drink in ‘safety’. To me, that means that I never know if the first drink will lead to another and another and another, or I will be able to stop at just one. It seemed to me that Ms. Glaser thinks that one’s ‘bottom’ has to be ‘low’. Nothing could be further than the truth for many of us in recovery in AA. I had never lost a job, owned my own home, was a successful business professional, and was raising my daughter on my own. I was never arrested for drunk driving, was not a daily drinker, never attended a rehab and never had a physical dependence. But I had a mental obsession for alcohol which was only getting worse by the month. I was able to get the support I needed by attending AA meetings and following the suggestions I received from group members. That was a little over 25 years ago.
    I do not agree with Ms. Glaser that the term alcoholic or alcoholism are inappropriate or demeaning. I do not feel stigmatized because I am a successful recovering alcoholic. The term alcoholic accurately defines a condition which afflicts many people. And I also believe that the program of AA is still the most appropriate ‘treatment’ for alcoholics to date. If an individual is able to control their drinking thru meditation, counting drinks and moderation, then they are most likely not alcoholics in the first place. They are ‘normal’ drinkers who need to slow down. But if when being completely honest with oneself, one recognizes a pattern of craving and obsessing about the next drink, then that may well indicate a bigger problem. In this case the best and most successful remedy is Alcoholic Anonymous.

    • lugal

      I notice that several commenting keep pointing out the effectiveness of AA as if it is established fact, when (in fact) the program’s effectiveness has been the focus of controversy for a while now. There is no conclusive evidence that it is generally effective — it works for some, is detrimental to others. I would point you towards http://hamsnetwork.org/effective.pdf or http://www.thefix.com/content/the-real-statistics-of-aa7301 for starters, and encourage you to search on “effectiveness of AA” for more data. For devotees of the 12-step program, it seems to be anathema to suggest that another approach may be just as, or even more, effective for *some* people, even though there is plenty of anecdotal evidence to the contrary, and not a little scientific evidence showing that a moderate approach can be very effective: http://www.moderation.org/about_mm/research.shtml.

      • TJtruthandjustice

        It’s an anonymous program, and as a result very little research has been done on its effectiveness. Anyone who has been to a few months or years or decades of AA meetings knows that it work very, very well for many, many people.

      • Bruce Allen Woodward

        I hear in your post the same things I heard in the authors story, that is, that AA is a program that only is good for some very heavy drinkers. And, you say, without any factual evidence that AA is “detrimental to others”. In what way? I have never, ever seen AA harm anyone. Just because you may not agree with the 12 step programs it doesn’t mean that they don’t work or are harmful to anyone. I have been an AA member for many, many years and I have known many people who have come to our meetings and found that they were not really alcoholics. I have actually advised several people, especially young men who have had one bad experience of drinking to excess that they were likely just immature and not alcoholic. I can say that in some instances I was correct and these men straightened out their lives. In fact, our book says that if a man can control his drinking “our hats are off to him”. The one thing that I have learned from this program is that there are those of us who will NEVER be able to drink again moderately. To try would be to die, or at least we believe that the experiment would not be worth wagering our lives and sanity against something that if we were wrong, kill us. After all, “once you have become a pickle, you can never be a cucumber again”!

        • Kenneth Anderson

          I have seen huge numbers of people harmed by 12 step programs. AA has caused many people to increase their drinking to the point of death or near death. I nearly died of alcohol withdrawal before I got the good sense to leave AA. What kind of idiocy is it to tell people that alcohol is powerful and they are powerless. Theses days I spend most of my time helping people recover from AA before they drink themselves to death.

          • Susan Jones

            Why, Kenneth? What did AA have to do with your decision to go pick up not only a drink but a whole bunch of them? AA isn’t against medical help or medical detox.
            If you are drinking yourself to death, you are practicing ANY program, let alone that of AA.

          • Kenneth Anderson

            I was abstaining from alcohol when I started attending AA. I was drinking a liter of whiskey per day by the time I left. Because AA brainwashed me into thinking I was powerless over alcohol. Thank God I have been away from AA and been healthy for over ten years now. My story is very typical. Untold numbers of people increase their drinking because of AA. AA buries its mistakes in the graveyard.

          • Susan Jones

            I am only powerless over alcohol once I start drinking it. I am the kind of person that cannot predetermine that I am just going to have one drink and go home. That oesn’t mean, “Oh, I am powerless over alcohol so I should just tilt the bottle and be off to the races.” In fact, that is why I went to AA – to learn to how to live without it.

          • Kenneth Anderson

            If you are not powerless over alcohol then you don’t need AA or any higher power to stop you from drinking it. No where in the Big Book does Bill ever ay that you are not powerless til after you drink.

          • Susan Jones

            Hey, if I don’t pick up that first drink, I won’t get drunk. I don’t need Bill Wilson to tell me that but I got that in AA. I have a history of that kind of behavior. AA taught me to live life without drinking and to ENJOY it.

            I think I can take that from the BB, though. It does mention about doing controlled drinking. If I cannot control something, that does indicate a measure of powerlessness to me. Doesn’t matter what it is, either.

          • Bruce Allen Woodward

            I’m having a hard time understanding how AA has caused “huge numbers” people to drink more. The concept of powerlessness and the fact that a person seems to be unable to control their drinking does not mean, in any way that AA is at fault. It just means that they are an addict. If they become despondent over their inability to quit and then relapse and drink excessively simply proves the point that they are not in control (powerless) of alcohol.

          • Patsy

            Bob – I will try to explain how AA could be at fault.

            (When I use the term AA I am referring mostly to the 12 step approach. I also refer to AA as the individuals who make up AA. I am not speaking about “AA the Organization” because that is not how AA says it works.)

            I do not to take away the notion that AA worked for you – you aren’t drinking so it worked.

            I am going to question how effective AA is for the person who is relapsing or continues drinking. AA claims that “It Rarely Fails”. This is a false statement. This is a false statement for any alcohol program. Unfortunately getting people to stop drinking is proven to be quite difficult.

            This is how I find AA at fault. When someone is relapsing or continues to drink the response to them is to attend another AA meeting, provide service, seek your higher
            power, work the steps or something similar. This might work from some, but for others it doesn’t. The problem is this individual never get the help that they desperately need. Perhaps what they need is professional help. Perhaps AA is just not working for them. Unfortunately many people think that the only help available is AA and we hear “It Rarely Fails”. AA members do not and are encouraged not to provide any options except the 12 steps.

            That is how I see AA at Fault.

          • Bruce Allen Woodward

            Patsy, you are referring to the statement in the book “Alcoholics Anonymous” that says “rarely have we seen a person fail who has thoroughly followed our path”. That isn’t a statement of absolute success. It says that if you closely follow what has worked for us for close to 80 years you have a very good chance at succeeding. I have found that to be a true statement in my life for over 30 years. I have seen people get sober using other means, such as religion, psychotherapy, or such but AA is what worked for me and still works for untold numbers of others. Nor do we not use the help of professionals in the medical community.
            AA has a policy on that subject and can be found in our committees on Cooperation With the Professional Community (C.P.C.)

            Our literature also says that “there are a great many professionals who may provide assistance, do not be afraid to use them”.

            I have never and I’ve never heard anyone else encourage the practice of telling someone who is struggling to use only the AA program. I’ve used therapists and I’ve suggested to others at times the use of them. The use of therapy by our members is so common in AA as to be considered normal behavior.

          • Patsy

            Thanks Bruce for the literature

            If this is the best you have to offer you made it more clear . me that AA is not interested in offering anything but the 12 steps. The title of the literature did not fool me.

            Anyone can google: M-41I Cooperation With the Professional Community Workbook

            The workbook is a “How To” book on how to get professionals into the AA fold.

            I encourage others to read this and make up your own mind.

            Here is a sample from page 27 of the workbook:

            “The purpose of our A.A. Committee for Cooperation With the Professional Community is to be “friendly with our friends” in all walks of life, so that the A.A. message of personal recovery can reach more of those who need and desire our help

            Simply stated, Alcoholics Anonymous is a worldwide Fellowship of more than two million men and women who help each other maintain sobriety and who offer to share their recovery experience with others. Anyone who thinks he or she has a drinking problem is welcome at an A.A. meeting.”

            Here is the Origin and Purpose of C.P.C.

            “Our Twelfth Step—carrying the message—is the basic service that the A.A.

            Fellowship gives; this is our principal aim and the main reason for our existence.

            Therefore, A.A. is more than a set of principles; it is a society for alcoholics in action.

            We must carry the message, else we ourselves can wither and those who haven’t been given the truth may die.”

          • Bruce Woodward

            Patsy, of course AA is going to share it’s way of approaching the recovery from alcoholism. That in no way means that it is antagonistic to or opposed to the understanding of other means. We, by our Traditions cannot be allied with any outside institution or group, whether it is religious, medical, scientific, or otherwise. But we can be helpful as far as it goes with them understanding us and our positions on alcoholism. I hope that you find what you are looking for. We can help if you would like to stop drinking and live a normal, productive life. We also respect you if you find your own way to care for these issues.

          • Patsy

            Bruce – the literature you presented speaks for itself: http://www.aa.org/pdf/products/m-41i_CPCWorkbook.pdf

            I reread your prior post to me above. I see how careful you were to never write that AA recommends other methods when the 12 steps are not working. All you wrote was that AA seeks medical professionals and that the CPC explains AA’s policy.

            Instead of agreeing with me the AA does not seek other methods you write say “of course AA is going to share there way of recovery”. The you bring out the big guns: “We, by our Traditions cannot be allied with any outside institution or group, whether it is religious, medical, scientific, or otherwise”

            (Wait a second didn’t you just write and din’t I read in the CPC that AA does ally itself with the medical profession?)

            Bruce – in some way – I understand completely were you are coming from. If I went to Home Depot looking for a Hammer and they did not have the hammer I needed, I would not expect them to say “Go to Lowes they might have it.”

            I have an issue with treating addictions in the same manner.

            Thank You for your concern – I have not had alcohol (been sober) for over 20 years.

          • Susan Jones

            He answered you honestly and fairly. When the majority of the literature was written, what alternatives were there beyond professional help?

  • Dave G.

    A thoughtful and fascinating discussion on a very controversial topic. If people are curious about the drug mentioned to treat some problem drinkers (Naltrexone), and what Dr. Sinclair has to say about his treatment protocol using Naltrexone, the People’s Pharmacy public radio program did an hour long interview with him on just this topic back in 2010, and you can still hear the full interview here:

    http://www.peoplespharmacy.com/2010/01/02/753-overcoming-alcohol-dependence/

    • Dave G.

      A correction, it’s Dr. Roy Eskapa, who uses Dr. Sinclair’s methods and Naltrexone to treat people who want to reduce their alcohol consumption. It’s my understanding it blocks the reward pathways in the brain linked to alcohol use in some people who have a problem with overconsumption. It won’t keep them from becoming intoxicated, but will make them enjoy it less, and slowly undo those conditioned reward pathways in the brain associated with alcohol consumption.

    • Susan Jones

      Why don’t people seemto know that it isn’t a stand alone therapy? Naltrxone is to be used in conjunction with therapy or “support”. I know many people in AA that use it.

  • firefly

    The characterization of “alcoholism” as a disease has always had some flaws, but conjuring up a picture of asthmatics “forced” to sit in a room and identify as asthmatic does your argument harm and doesn’t communicate the problems with the disease model. Alcoholism is more parallel to diabetes, where the disease exists and the actions of the person, in most cases, determine how badly the disease ravages the body and affects the person’s life.

    The fundamental problem with the disease model for alcoholism is the lack of one solid definition, course, and outcome. Yes, there is a wide range of drinking behaviors and affects on the drinkers and their lives. And while the 12-step intervention model has worked for a great many people, it’s not suitable for everyone who wants to change, as you state. Some people do better with total abstinence, because that grey area of moderation and management is much more difficult. But for much of the rest of regular drinkers, alcohol over-use is a self-feeding loop and simply managing intake will not work. It can be a start, but you fail to acknowledge the huge emotional component of alcohol abuse. It’s a drug that helps people temporarily forget and deny their difficulties. And denying that their drinking is a difficulty can be front and center. The person has to be willing to do the work of facing their difficulties and managing them another way, otherwise a drinking schedule will eventually fall apart. The two have to be done hand-in-hand, becoming mindful of one’s drinking and facing one’s inner pain and struggles. Perhaps you might still choose to drink tonight in order to numb out, but tomorrow you will see your therapist or talk to your support group and work on that reason you wanted to be numb.

  • hadenuf

    if a person needs to “control” their drinking, there’s a problem! limiting oneself to 3 or 4 drinks may work on occasion. a couple of drinks is typically all it takes to impair judgement and good decision making. one other point, it was mentioned that anabstinence program had failed for one who made an attempt. Abstinence cannot fail if one actually abstains! Glaser sounded ill-informed and naive. I got the impression she was selling drugs or simply wanted to be heard. Danger!

    • ccrow

      “limiting oneself to 3 or 4 drinks may work on occasion”
      Well, my occasion has been going on for several years now. Why is it a sign of a problem if someone ‘controls’ their drinking? Do you think someone who has never had more than two drinks at a time *isn’t* controlling their drinking? What about someone who ‘controls’ their weight? There is no good reason for thinking that someone who gets control of their weight is doing a good and sustainable thing, but someone who gets control of their alcohol use is deluded and doomed to failure.

    • Bruce Allen Woodward

      Glaser suggested that the drinker abstain from drinking for 30 days. Wow, that is abstinence! What a concept!

      • Susan Jones

        To be fair, when the BB was written, longterm sobriety was a mere three years. I think most people can stay away from booze for 30 days. I know I could and did – often. The BB suggests a year. I know alot of people that read that and plan to blow out on that first year anniversary because, since they made it, that must mean something, right? But they discovered sobriety worked for them and worked on…

  • John Palmer Smith

    I am fine with 4-5 drinks over a 4-5 hour period and can stop easily but I seem to have a problem after that where If I continue I can’t stop until I fall asleep or pass out.

    • Susan Jones

      That was mine, too. I didn’t always drink to access. The point is that I couldn’t pretermine that I would have three drinks and then go home. And then it came to a point where I was continuing to drink to access most of the times I drank. I tried the stuff in the Moderation Management and HAMS Reuction. There isn’t anything in those books that hasn’t been covered for years in other publications. In fact, I read most of them as a young woman reading Glamour and Cosmo… Many are even in the Big Book. Another point is that the founder of MM couldn’t practice her own pogram and eventually killed two people in a drunk driving accident.

  • Melissa

    I’d like to hear much more discussion of the environmental influences on drinking. Many women drink to cope with unaddressed experiences of trauma, whether it’s unresolved PTSD, living in an abusive relationship, or some other source of severe strain and suffering. We can’t expect women in these situations to stop or reduce their drinking unless we help them to escape and heal from what the alcohol is helping them to cope with. It absolutely must be a wholistic approach if we are not to set people up for failure, or for seeking out other coping strategies that are just as harmful, or even more so.

    • AL

      For women and men, the underlying causes and/or conditions need to be addressed for recovery (from alcohol abuse) to be possible.
      While it is possible to stop drinking without addressing these issues, what eventually follows is relapse or switching to another addiction (food, shopping, sex, gambling).

  • D

    Could lack of good sex in a woman’s life contribute to their alcohol abuse?

  • Anonymous

    What a dangerous book. Why is it important for someone with an alcohol use disorder to drink alcohol? Basic cost benefit analysis demonstrates that the risk outweighs the reward. This book is just a plug for the sale of pharmaceuticals and for self-justification for unhealthy living.

  • Ellie

    Thank you for this piece. My husband has a drinking problem and we recently struggled with the decision about whether to go to rehab or to try another method of recovery. He is European and both him and his family scoffed at the American style of rehab and AA in which our only option for alcoholism or drug abuse is to take them out of a familiar environment and ship them off to be dealt with by someone else. I would have really appreciated learning more about the philosophy of reduction as a viable and successful option for some people. He stopped drinking for several weeks and is working on self-moderation right now but it is a difficult road, however, cold turkey would have never worked for him and now I have some ammunition as to why.

    • Susan Jones

      It can also help save your family, just as could many of the alternatives.

      • PapaBehr

        Well AA is tearing mine apart. I can only speak about my own experience

        • Susan Jones

          I am sorry, Papa. I would have to know more before commenting much more. I have seen families both repair due to AA and I have seen them succumb as the result of too much damage from drugs and drinking even if people achieve d sobriety. But these are not limited to AA.

          • PapaBehr

            Nice try Susan. How about abandoning the family in favor of AA? No it wasn’t because of too much damage to drugs.

            The way you twist things is amazing. Instead of saying you have seen how sometimes AA unifies and other times AA divides families you make another reason which places the blame on the alcoholic. How dare anyone anything wrong with the program?

            Susan I see that your spouse is also in AA – Do you think you could be in a relationship with someone who was not in AA?

          • Susan Jones

            What strikes me as interesting is that I haven’t posted anything about a spouse at all on this site, but yes I would have a relationship with a non AA member. I have many right now. Why is it twisting anything to suggest that perhaps so much damage has been done to a relationship already by the behavior of a drunk that it cannot be repaired? AA has never suggested family abandonment.

          • PapaBehr

            Susan – you are on every website defending AA with your same arguments.

            You did write on thefix: A Moderate Proposal on Moderation the following: “I have been involved with AA for 6 years; my husband 24. We know many people for whom the program has worked. So, yeah, it was the best thing for us”

            Why the dishonesty Susan – I thought AA preaches honestly. (Excuses me if I have the wrong Susan Jones)

            What I was trying to explain is that AA can divide the family. AA does not say – “abandoned your family” – but 90 meetings in 90 days can take its toll on a marriage. I will give you an analogy. Suppose I golfed 90 days in a row – Do you think that might take a toll on the marriage? The Golfing Association did not suggest I abandon my marriage but golfing caused turmoil.

            (Actually the truth is I caused the problem, but my spouse would not be happy about the golfing. Perhaps if golfing was a disease my spouse would pardon me)

            This is my experience not yours – and no the
            behavior of the drunk did not destroying the marriage – it is the meetings.

          • Susan Jones

            While I am glad that I command so much of your attention on so many different venues, where in AA literature is 90 and 90 written? Even if it were, would one hour a day take that much away from your marriage? You could even go too if you have open meetings in your area. I was also referring to my posts here, which solely relate to my own experiences. I know I didn’t post anything about my family here and I am not familiar with your handle.

          • PapaBehr

            I don’t have a handle and I won’t seek your attention anymore. I find you to be predictable and boorish. Peace!

          • Susan Jones

            If you find me to be boorish, then there really isn’t a reason to focus on me. But I will ask you to consider one thing. If you consider time away from the family to be abandonment then you will find fault with any recovery solution as they all take effort and singular commitment. AA isn’t really the issue.

          • Susan Jones

            Remember too that just because a person is in AA it doesn’t obligate me to respond to something. That is yet another untruth spread by Antis.

  • Patrick

    Wow, way to keep promoting stereotypes. If a woman with a family goes away for a month, “Who will take care of the children? Who will run the home?” How about the children’s father? Despite what ads on TV and NPR tells you, men are indeed more than just drunken sports-addicted buffoons; some of us are actually competent parents, partners, and adults. Indeed, someone living with a partner requiring a month-long institutional rehabilitation program is probably already picking up most of the slack around the home.

    • SC

      Thank you Patrick! Beautifully put. It drives me crazy how easily and unquestioningly people still talk about women taking care of the children and the home. In this case, two professional women were discussing it in an outdated way and never even blinked! Why wasn’t the example that the woman was a renowned heart surgeon at MGH and she would need to take a month off from her very important work in addition to leaving her family?And, you’re absolutely right – it shortchanges the men / family members who are doing their share and behaving like genuine partners and supporters in difficult times.

    • gmceieio

      Yes Patrick, I was insulted by that one as well. Our next door neighbor is back from her 2nd treatment and her husband cared for the house and their kids.
      Well, guess I’ll scratch my butt and head back to the TV – that was way too much thinking for one day.

  • Joe

    Joe
    I am a alcoholic I went to AA I have not had drink for 13 years.It is dangerous to suggest to an alcoholic that they may have a drink. Alcolholism is a disease that
    Suggests to the alcoholic that they may have a drink. An alcoholic may not have a drink.That is fiirst an the last rule. When every thing else fails do not take that first drink. One is to many A hundred is not enough.

  • Adam

    For those who don’t know, AA are for those who want it. It does not say you have to give up for the rest of your life it’s one day at a time. I believe that if you have to keep track of your drinking there’s a problem. If you take a pill that only last for as long as you take the pill, but if there’s a problem you will stop taking the pill so you can still feel the effects of the drink. AA is designed for people who believe they cannot drink successfully. Everyone has their own bottom some don’t have to lose everything. AA also says that it doesn’t have the market cornered however if you can’t take it or leave it then it’s there for anyone who needs it. I think Gabrielle Glaser needs to do better research before she decides to dive deeper into this subject.

    • massive

      Most people in AA today are coerced there. Some 60%! They are not there because they want to be, and this has altered AA for the worse. You are reciting AA rhetoric which is just not true anymore. AA is also very dangerous because they have been court ordering violent and sex offenders for over 35 years. Did you know that? DUI people are sent not knowing that AA is just a group of knuckleheads with no new info since 1935. If you watch The 13th Step the film trailer you will see what is really going on in AA and its culture. I have ben all over the country. But I also disagree with your argument. AA says take what you like and leave the rest. But then once your in a year or two they tell you if you can’t swallow that your powerless.

      • Bruce Allen Woodward

        Really? Coerced? Someone drives drunk and the judge says that if they want probation that they have to go to a few meetings. A wife pleads with her husband or a husband with his wife to attend? That is not coercion, that’s consequences.

      • Susan Jones

        Just a question, Monica Richardson. Why do you post under so many names? Why have your forgotten to qualify yourself as a subject in Ms. Glaser’s book?

        Take your own history into account. You’ve published it all over the web. You stopped frinking a bottle of gin a day by the age of 18.
        Three weeks later, you met a guy on the beach that told you to check out AA and then followed him in. Depite that your father had been in AA. I think it is a scream that a woman now making a movie about 13 stepping doesn’t see a direct correlation in her own behavior. You follwed a man into AA yet it is AA’s fault you then spent the next 36 years in a fellowship you now feel never needed in the first place. On your radio show, you’ve spoken of your multiple therapies and how you knew everything you could from
        AA about alcoholism within the first two years. Then you went into therapy for rage but stayed in AA as well.

        This is all about choice. No mandates, no rehab suggestion. I would think with the many areas of help you later pursued, you would have been encouraged to leave the fellowship if it wasn’t a help to you or was a perceived problem. Yet AA is the bane of all your problems, why you doesn’t have a degree and feel robbed of your youth, etc. You also doesn’t have a problem publishing all of this
        confusion on websites, personal blogs and a radio show. Anything I have posted about you comes out of your mouth or from your own fingertips.

  • Katie J

    Wow, such an interesting topic. I am a member of AA, and identify as alcoholic during meetings. I stopped drinking totally after a DUI, and subsequent immersion in the AA model during rehab. I also think AA communicates what was accurately labeled by a previous commenter as pseudo-religious sanctimony. AA language/activities can be counterproductive in contending with the depression I was trying to treat through drinking. I like the self-management tools laid out during the radio program for someone moving towards heavy drinking. I want to read more studies on their effect in changing individuals’ self-efficacy in altering their own drinking behaviors. I have come to see AA a useful resource for me to a certain extent, but I disagree that there is only one way to deal with alcohol abuse and problem drinking. We shouldn’t let the dogma that often accompanies AA to prevent further investigation in the best ways to treat this complex problem.

  • Mark

    The 12 Steps of AA talk about being restored to sanity. It is about addressing the “stinking thinking” that accompanies addiction so that one addiction is not merely replaced by another that is more socially acceptable so that we are still spared taking that hard look at ourselves and our effect on those around us. This is the trap of the so called “dry drunk” who says, “I’m sober, therefore, however I am living must be healthy”, when all that has changed is that they are no longer drunk. For many, sobriety and sanity do go hand in hand. For others, I agree that returning to alcohol socially may be possible.

  • gmceieio

    Gabrielle Glaser is (accidently) correct about her assertion that AA won’t work for the moderate drinker.
    During the interview she quoted many of the cliché statements that originate out of treatment centers. The facts that qualify a person as an alcoholic are clearly written on pages 21 and 22 of the Big Book of Alcoholics Anonymous. (its not going to be in the DMS4)
    First the moderate drinker is described then the hard drinker (neither alcoholic).
    “But what about the real alcoholic? He may start off as a moderate drinker; but as some stage of his drinking career he begins to lose all control of his liquor consumption, once he starts to drink.”
    So, to paraphrase, if you have no control over how much you drink or what happens when you do drink, the AA program can help you . It’s not Gabrielle Glaser fault that she doesn’t understand this because there are thousands of people in AA who don’t read the book either.

  • Andy

    For a perspective that seems to resonate with many high-functioning women with alcohol issues, I recommend the book “Drinking, a Love Story” by the late Cambridge-based author Caroline Knapp.

    • winsomeRefusenik

      I wondered if that book is yet another Trojan Horse to indoctrinate people into A.A. I just went to Amazon and a reviewer who gave it fives stars titled their 2002 review, “I was 12-Stepped by this book.” In that review, the reader laments she had just read that Caroline Knapp died of lung cancer at age 42. I don’t know if that’s from the well-documented A.A. habit of smoking heavily, though I have read a study that more “alcoholics” die of lung cancer than causes like cirrhosis (I don’t know how valid that study was).

      • Susan Jones

        Bill Wilson smoked heavily, as did most of the people in my mother’s generation. That isn’t true today. I wonder if you can show some sort of proof that people in AA smoke ore than the population at large. Where is your “well-documented” research that isn’t decades old?

      • TJtruthandjustice

        There is no smoking allowed in AA meetings. Sheesh. What’s the deal w/ all the BS about AA here?

  • MonaLisa1998

    It’s so strange. Even the big book talks about there being different kinds of drinkers–that not everyone who drinks heavily is an “alcoholic”. And in AA circles, there’s always a lot of discussion about whether someone is or is not a “real alcoholic”. But when somebody talks reasonably about the same exact issue–which is basically the fact that not every problem drinker is addicted, suddenly our AA friends try to tell us that the discussion is DANGEROUS? Why is this? Do the needs of the relatively few among us who require abstinence somehow trump the needs of the vast majority of us who don’t? I am one who does require abstinence, but I don’t see how it helps me to silence a legitimate discussion regarding the needs of those who don’t.

    • Susan Jones

      I think what is dangerous is this ongoing thought that if you have the right counselor, read the right book,, take the right pill or have the right set of circumstances, you too can go back to drinking alcohol. I could care less about the terms and I was also taught that they really dn’t matter. If alcohol creates unmanagability your life, then you need to be doing something about it. What I get fro all of these many articles is the notion that these people seem to think that abstinence is a ba thing. What strikes me as odd are the many people that push that notion after decades of sobriety but who are not the first to test their theory. They don’t CHOOSE to drink. Sure. While i think that is true for me NOW, I would never promote that to a person that feels abstaining is the thing for them. It amazes me to read these comments because they really don’t have the person at heart, they just want to have the opportunity to possibly prove that badass AA is wrong.

      • erinmalloy

        You are wrong, Susan. It is that people don’t want to abstain. It’s not that it’s bad. They also work towards a very moderate level of drinking if they choose to drink. I don’t think people really care about AA, they care about finding something that will help them help themselves.

        • Susan Jones

          I care about that, too, but my point is that people that chose to abstain should be permitted that choice without explanation. I have been on several blogs where people are told that you “might not even be an alcoholic just because AA tells you that you are…” The irony is that AA is about self diagnosis. You decide that for yourself. You decide what you want for yourself. AA doesn’t care if a person drinks. In fact, it says hats off to those that can and acknowleges that many people can moderate. But AA is ultimately for those that cannot, choose not to, or otherwise choose to abstain from alcohol.

          • MonaLisa1998

            But you are permitted that choice. No one has ever said otherwise. In fact, it’s pretty much been the ONLY choice for decades now. People with moderation goals–even if those goals were appropriate for them–have been denied a voice and denied basic support because of all this hoo-hah about how the mere discussion of moderation is “dangerous” and how anyone with a moderation goal is “in denial”. I’m not surprised that people have gotten sick of this. It has never made the slightest bit of sense that the abstinence-based folks should take up all the recovery bandwidth.

          • Clarabelle12

            So does everyone else. Aside from Lifering, which was started in 2001, the programs generally promoting moderation are two decades old. Why are these being promoted as new things? What I have found surprising is that people seem to think that being supportive of that seems to mean that people should discard AA because these alternatives can teach you to drink. Everyone in AA I know has tried these techniques and more. I know I did.

            Susan

          • MonaLisa1998

            Lifering, Clarabelle12, is an abstinence based group.

          • Susan Jones

            Thank you. Mona. I would like to know more about it, including how many meetings are available…

    • Bruce Allen Woodward

      I’ve been in the program for many years and have had heart to heart talks with men who have asked me to sponsor them and have told a few that I didn’t believe that they were necessarily alcoholic. What I believed was that they had an instance of drinking too much that affected their judgment and thusly they drove drunk or did some other stupid thing that caused them to be pushed into an AA meeting. Most of these men, after a suitable time in abstinence have returned to their lives and have been able to drink normally. In my opinion they weren’t addicted but did need to grow up a bit.

      • PapaBehr

        Bruce – that sounds very noble of you – maybe you have but I think that is rare.

        I,have heard sponsors say – “maybe you are not addicted to alcohol but you do have an addictive personality.” Overheard sponsors say “you think like an alcoholic”. I have heard or said repeatedly the phrase “you are in denial”

        When there is a 12 step program for almost anything – made up diseases – I question AA. Is it about stopping the problem due to drinking alcohol or is adherence to the 12 step a program which is a AA priority

        • Susan Jones

          Could it be a bit of both? I used the steps for life repair from problem drinking.

          • PapaBehr

            I don’t understand you previous comment.

            Yes it could be both – and many times it is. What it is not is this idea that that the only requirement for membership is a desire to stop drinking – it becomes much more than that.

            That is fine – but let’s be honest about what it is about.

          • Bruce Allen Woodward

            Yes, the steps ARE the meat of the program. The desire to stop drinking IS the only requirement for joining AA. However, if you care to progress in your life’s lessons the steps will help you with that. And, working the steps are what I’ve found will help keep me sober, both from alcohol or drugs and emotionally as well.

        • Susan Jones

          Papa, I’m not sure. I know any number of people that will talk to people about their drinking and try to figure out if there is a fit for sponsorship. Most AAs understand that some people just get into a scrape while others have long-term drinking histories. I took exception to an earlier post where tactics were referred to as “cold” where AA members could decide if a person was ready for our solution. It was as if the only people that can reject AA are people coming into it whereas a person cannot elect to not work with someone who is just not ready or whose motives are suspect.

  • AndrewTatarsky

    As was previously stated, the field of alcohol misuse is moving from a categorical model, “either you have the disease or you don’t”, to one that recognizes that drinkers vary along a broad spectrum of severity from non-problematc to severely problematic and that people develop problematic drinking habits for a variety of different reasons often with multiple interacting biopsychosocial determinants. No wonder it is hard to change these patterns and many people find it easier to stop. But just as there are many paths to problematic alcohol use, there are many paths to recovery. US government studies, and others, find that many severely problematic drinkers do moderate, with and without treatment or self-help support. Many less problematic drinkers choose to stop. While more severely problematic drinkers with longer drinking histories are less likely to achieve moderation, many do. We don’t have the exact science to predict who can and who can’t. And we should not therefore presume to know the answer for another. This question must be answered by each drinker for themselves. Moderation Management and moderation-friendly harm reduction therapies don’t promise moderation. They offer safe, supportive environments that aim to help people discover what goal is realistic for them and what positive change approach is best suited to them. Many people go through these programs and achieve stable moderation that lasts. Many find that with good information, skills, strategies and support, moderation is not a realistic goal and embrace abstinence. In fact, there is a growing group of Moderation Management members who are choosing abstinence. I also run a harm reduction psychotherapy treatment program in which people sit in groups together who are pursuing a variety of goals; safer use, moderation and abstinence. We honor their diversity and find that when people are supported in finding what is true and right for them, they generally find their way to their ideal outcome. This compassionate, empowering approach that respects the uniqueness of each person works well for many.

    Andrew Tatarsky, PhD
    Board Member, Moderation management network, Inc.
    President, Division on Addiction, New York State Psychological Association
    Director, Center for Optimal Living NYC

  • Yan

    Imagine how much more difficult and costly the problem would be with drug legalization

  • TJtruthandjustice

    The only requirement to be a member of AA is to have the desire to quit drinking alcohol. If you don’t want to quit, don’t join. It’s as simple as that. The bottom for some people who join AA is homelessness or jail. The bottom for others is the realization that alcohol has become a coping mechanism due to an inability to deal with life on life’s terms. The great thing about AA is it only costs a dollar a meeting, so you have very little to lose by trying it.

  • Steve Flower

    I find it strange that so many people assume that the feelings of AA and its supporters are, “It’s our way or the highway.” Nothing could be further from the truth. In fact, the AA text has always talked specifically about “moderate drinkers,” “hard drinkers,” and “alcoholics.” That same text has been saying since 1939 that if a person “thinks he can do the job in some other way, or prefers some other spiritual approach, encourage him to follow his own conscience … we merely have an approach that worked with us.” I know a number of AA folks who would encourage “moderate drinkers” or “problem drinkers” to try almost anything else before going to 12-step groups. Those same folks would especially like courts and treatment centers *not* to see AA as the recovery industry’s default no-cost treatment-follow-up program.

    • OrangePapers

      Denying the standard A.A. slogan of “It’s our way or the highway.” is a good example of the way that A.A. talks out of both sides of its mouth on so many issues. It’s a bait-and-switch trick, or rather, two of the many that A.A. does:

      First, they will tell you that you can do it your way. Then they will tell you that you must do it their way.

      First, they will tell you that you can “Take what you want, and leave the rest.” Then they will tell you that you must follow the formula exactly, or else it won’t work.

      Likewise, first they will tell you that you have a free choice in how to work the program, and then they tell you that you have no choice, and must do it their way, or else your fate will be “Jails, Institutions, or Death”.

      First, they will tell you that you can “Take what you want, and leave the rest”, but soon that will morph into: “You aren’t qualified to judge what you should take — your brain is messed up from alcohol, “Your Best Thinking Got You Here”, and it’s too early in your recovery for you to start being creative — so you should just do what your sponsor says, and Keep Coming Back!

      Then another old-timer will grumble, “Take what you want, and leave the rest? When did this place become a cafeteria?”

      And then another A.A. oldtimer will sagely tell a story about trying to make a chocolate cake from his aunt’s recipe, except that he decided to do it his own way and only use some of the ingredients — and the result was a terrible cake. The moral is that you must work all of the Steps, all of the time, and do the entire A.A. program, just like how the oldtimers supposedly did.
      (They didn’t, really. Half of the original A.A. members totally rejected Bill Wilson’s cult religion practices, and never “worked the Steps”.)

      More relevant A.A. slogans are:
      It’s Bill’s way or the you’ll get killed way.
      It’s Our Way or the Die Way.
      It’s our way or the highway.
      Work the Steps, Or Die!
      Do The Steps or Die.
      Share Or Die.
      Talk Or Die.
      Change Or Die.

      Finally, Bill Wilson wrote:

      “Unless each A.A. member follows to the best of his ability our suggested [Bill Wilson's required] Twelve Steps to recovery, he almost certainly signs his own death warrant. His drunkenness and dissolution are not penalties inflicted by people in authority; they result from his personal disobedience to spiritual principles [Bill Wilson's cult religion practices].
      “Twelve Steps and Twelve Traditions”, William G. Wilson, page 174.

      • Susan Jones

        This is a lot of stuff, most of it pretty distorted or from rehab or a combination of other 12 step programs. You can’t really win for trying bu I will give it a go.

        I didn’t hear most of the slogans you attribute to AA. I aligned myself with a bunch of people with longterm sobriety who had tried everything they could find and found that the program of AA and its fellowship is what gave them sustained sobriety and support. I could try that and give it a go. I did and I recovered my life quite nicely. Jails, insitutions or death? Well, I was a habitual drunk driver, so that wasn’t such an unrealistic possibility. It was not a threat, either. It would seem more of a natural progression. Let your past be your guide. Mine included several DUIs and there would come a time when even the best legal mind wouldn’t be able to keep me out of jail if I kept it up. Then the laws themselves cuaght up with Bill’s notion and you can be sentencd to rehab. You can also kill yourself with drunk driving, although statistically it would appear that we kill others… Am I the only one this makes some sense to? Even if it is, that’s okay because I was th one perping the behavior and all because of alcohol. But I had free choice. I could still make the choice to find a way to get a fix on alcohol.

        As for Bill’s “cold instuctions”, it seems that the Antis can be the only ones to reject the program of AA or that of anything at all. They want to point out the problem aspects of AA, whcih can certainly include people whose motives are not simply to get well from a common problem of alcoholet the AA him/herself cannot do it.

      • TJtruthandjustice

        I’ve been in the program for years and haven’t heard of any of the nonsense that you claim are “A.A slogans”. Enough with the disinformation. If you don’t like the program, that’s cool. But there is no need to make things up about it.

      • I’ll Be FREE Or Die

        Thank you Orange! Your blast of HONESTY is definitely needed here and since as a rule I avoid responding directly to non-sequitur, fallacious statements. Any(honest)one who has been a member of AA can well recall the many slogans and most assuredly: “It’s our way or the highway.” Really, why lie? It’s better to say nothing than to lie.

        (To state that AA meetings are superior to alternatives based on its meetings being in existence longer than current alternative programs is tantamount to saying that landline phones are superior to cell phones based on the same ludicrosity. I won’t even bother; let those with the ability to THINK…do so.)

        Here is my experience:
        When I entered AA I wanted to stop drinking and that AA could help
        me to achieve that goal. I had no desire to enter into any form of a religious sect. I did not wish to be controlled and told what to do by uneducated, unqualified, ill-equipped, self-admitted addicts/alcoholics; but that is what I got. Still,I unwittingly tried to “get with the program” and I fastidiously read and studied the “literature” despite its origin. Where did the steps originate? In AA Comes of Age, (p.39), Bill wrote:

        “Early AA got it’s ideas of self-examination, acknowledgement of character defects, restitution for harm done, and working with others straight from the Oxford Groups (Religion) and directly from Sam Shoemaker, their former leader in America, and nowhere else.” (1)

        Okay.

        The entire concept of “powerlessness” for a woman like
        myself who is also the survivor of childhood molestation and rape was harmful for my psyche to put it lightly. Exposure to AA has this kind of effect on many people who will never again be found at any AA table to report their experience…naturally. They leave or as some AA members might have it; they die. My grand sponsor
        loved to proudly quote what she said was a favorite old AA saying: “Some of us must DIE so that others may live!” (She always smiled when she said that knowing that I was a teenage suicide attempt survivor. She also enjoyed telling me that I had the ‘Look of DEATH upon me…’) And I guess I must’ve while amongst them.

        Cutting to the nasty chase; exposure to AA took me to a
        place and a potentially deadly relationship with alcohol that I had not
        previously experienced. The more I tried to “work it” the more it worked me. (It has reportedly had this effect on many a sensitive soul for anyone who is sincerely interested in knowing rather than
        denying and discounting the experiences of others.) I am fortunate to have escaped AA with my life and my mind…with which I am free again to THINK without guilt as the Creator of my Mind intended me to do despite my ex sponsor’s protestations and admonitions.

        I have been gratefully free of AA and any contact with its
        disciples for a little over a year now. I am not dead. I am not imprisoned. I am not institutionalized. I am not drinking out of control. I experienced dangerous binges due to small “slips” or relapses while in AA; not now. I have not binged, blacked out or awakened in vomit since leaving AA. I was abstinent in
        SMART for 60 days without the trauma and drama of AA. I then decided to try moderation. It works for me. Life is better and promising for me as an autonomous adult who takes full responsibility for my drinking, my thinking and my actions. I do not need Alcoholics Anonymous in my life at all.

        I have learned that I am not an alcoholic. I am one who has
        been mistakenly prone to over drink and/or drink in order to manage anxiety and stress. I now know how detrimental that habit is to me and I avoid it. I am not perfect now. I was not perfect while in AA. I was not perfect prior to AA; but I like myself and my life much more OUT of AA than I did while IN AA. I will never go back. I would sincerely rather DIE (as my sponsors predict I will–but won’t we all?) than to ever go back to AA.

        I have read the BB and the 12 & 12 over and over; NEVER AGAIN. I find much more merit in books such as Her Best Kept Secret by Gabrielle Glaser. It is well written, well-researched, honest and clear…and surprisingly funny at times. Since so many people, especially women are survivors of sexual abuse,
        molestation and rape and must contend with the resultant anxiety, stress and/or PTSD that often result, they would greatly benefit from reading this book and learning about alternative programs. I that
        know Her Best Kept Secret and books like it will help many people. If I had read it before or during my AA ordeal, I would have been spared a life-threatening experience that I or no one already hurting and seeking help deserve.

        I would suggest that anyone who is sincerely looking to learn more about Alcoholics Anonymous, its origins and effects on some people; especially women, pick it up and read it. But no one is going to force anyone to read such a book or find out about current research or alternatives. Many commenting here have quite obviously not even read the book…(of course they are not really allowed to though).
        Really though, if someone just “LOVES” AA and it is working for
        them, I suggest they continue to read “approved literature”, visit approved sites, speak to people in “the fellowship” do service work, get offline and into a meeting.

        For the rest of us; this is America. People are free to speak and share ideas. We can write books and be interviewed. We can do documentaries and comment on web sites. These are facts over which AA disciples must simply claim their infamous and proverbial “powerlessness”. They must accept it. .. now or later as they cannot control the fact that intelligent, empowered people are now
        looking for valid answers to Substance/Alcohol Use Disorder. . . Thank God!
        Honestly, people could control their drinking quicker than they could ever control other people sharing ideas, information, empowerment and support.

        • Susan Jones

          Good for you. You can moderate. There are n any people that know and accept that they cannot. What they choose to do about it us their business. In fact, Orange is one of them that doesn’t believe in approaching that slippery slope. You are one of the lucky few that could find one of the 190 SMART meetings a person could find outside of jail or that isn’t client based. I would love to see what they offer… even if it turns out to be a gateway to one of Tom’s rehab clinics. I am sorry that your sponsor used that “some must die” B’S tgat I can’t find in the AA literature anywhere. I was told that relapse doesn’t gave to be a part of recovery. No one has to die at all.

        • I’ll Be FREE Or Die

          Does someone need a meeting? WOW… I do not even read full comments from such. I see the source, nothing’s said and move on. Do the same…

          Yawn…

          I have shared my experience.

          Ms. Glaser has written her book.

          Next.

          • Susan Jones

            Wow is right. Your anger is palpable. Yes…a meeting would do you well. I would not want to hang onto that.

          • Susan Jones

            Inter.esting how antis are just exercising their 1st Amendment rights while others are fixated… You be well, too

      • I’ll Be FREE Or Die

        Tradition 10 – Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.” Please follow orders from the Interchurch Center if you are an AA member and don’t comment.

        • Susan Jones

          AA is not commenting here but it’s interesting that you would say such a thing since I have read on other blogs that Alcoholics Anonymous members are not even permitted to vote because it’s an outside issue. I wonder why anyone would promote the idea that simply because a person joins Alcoholics Anonymous that they leave their rights at the door.

          • TJtruthandjustice

            AA members not able to vote? Are you you serious? That has to be the most absurd thing I’ve read all day! Thanks for the laugh!

          • Susan Jones

            Oh yes. The fear mongering stretches into everything including that attorneys cannot practice in good conscience because they have agreed to cease fighting anything or anyone, that if you get a DUI you should ask the cop or a judge if they are AA because “rigorous honesty” means they must answer you…. it is amazing the length s they go to in manufacturing garbage or incomplete info. Glaser isn’t the only one.

          • TJtruthandjustice

            AA doesn’t have any PR. I understand why, but these days disinformation spreads so quickly there is a downside to it.

        • Bruce Allen Woodward

          I’ve never seen locked doors at an AA meeting. I’ve never had anyone ask for or even suggest that AA should charge for its meetings or for membership. Anyone is free to come or go. There is nothing holding anyone in a room or meeting of AA. If someone thinks it is not for them they are free to leave. I’ve stayed because it works for me and is so far in my life the only thing that did and does work for me. But, my experience may not be your experience and if you need to go elsewhere for your healing I wish you well. I would hope you would feel the same toward me and my AA friends and our way of healing.

      • Bruce Allen Woodward

        OK. You don’t like the solution that has worked for millions of people all around the world. That’s fine. So what’s your solution? And, why aren’t there millions of people doing it your way?

        • OrangePapers

          Sorry, but A.A. has not “worked for millions.” That is just another old slogan. The truth is that A.A. does not even have 2 million members in the whole world, and most of them are not sober. And they drop out constantly. The recovery rate of A.A. members is just the same as people who quit alone, on their own, which means that A.A. is just taking the credit for those people who would have quit anyway. That is, A.A. is stealing the credit for normal spontaneous remission.

          Barely 1% of the A.A. newcomers get 10 years of sobriety. So no way can A.A. have worked for millions. Its mathematically impossible.

          • Bruce Allen Woodward

            I cant say with perfect authority that AA has worked for so many millions but neither can you say that it hasnt, my friend. I can tell you that it has worked for me and for countless others. It has been working since 1935 and that is a hell of a lot longer than any other recovery program. I’m sorry that you have such a strong resentment toward AA. I’d love to take you to a few of my meetings and let you see what I see.

          • TJtruthandjustice

            You are pulling these opinions out of your … thin air. If you don’t like AA, great! Don’t go! No need to spread disinformation about a program that has in fact helped countless people, scores of whom I have known personally.

          • Bruce Allen Woodward

            Just checked on the number of estimated AA members.
            In the US and Canada 2,131,549 (as of January 2013)
            Just a bit over 4 million worldwide.

  • winsomeRefusenik

    I wonder how addiction treatment programs are handling the recent controversial DSM 5 update which recognizes a spectrum of alcohol and other substance use disorders rather than the false dichotomy between “substance abuse” vs. “chemical dependence.” It’s most likely that they will just misuse this revision as a more expansive dragnet to force people into 12-Step programs, just like they did with earlier versions of the DSM.

    In the case of Rechsteiner vs. Hazelden, Hazelden had the audacity to submit an affidavit claiming that they applied the same intensive inpatient program for both substance abusers and the chemically dependent, despite a witness for the plaintiff stating that they were not aware of such intensive programs being applied to mere substance abusers (in contrast to the chemically dependent). Powerful 12-Step treatment providers like Hazelden can pretty much do whatever they want with virtual impunity.

    In Hazelden’s book “The Way Home,” (1997, ISBN 1-56838-159-X), a client who complains about the lack of one-on-one access to his case manager and that he had already been in 12-Step programs was punished, errrr, issued a “treatment plan” from that counselor:
    [start quote] “First, because Andy was having such trouble recognizing his own powerlessness, he was to read in the Big Book about the limits of self-knowledge, and discuss his thoughts about it with three of his peers. He was also to complete a twelve-page Step One assessment; watch the video Cunning, Baffling, and Powerful; and ask others about how they pray. Andy was instructed to ask someone to watch him pray in his room. Andy wasn’t to go for a walk without inviting someone else along. “From now on,” Steve said, “I want you with someone else. Don’t even think of walking by yourself to lecture hall or sitting alone. And I want you to ask God, a Higher Power, or the spirit of nature to come along with you.” Steve wasn’t trying to make him religious, but Andy did need to rely on others and a Higher Power for support and direction.” [end quote pp 80-81]

    I don’t think I’m alone in believing that this kind of religious brainwashing (just because they say it’s “spiritual, not religious” doesn’t change what it is) and deprivation of privacy and personhood is sick, unethical, and illegal. I, for one, would much prefer taking a pill like Naltrexone, even in enema form, rather than swallow such 12-Step dogma. In fact, I’d probably rather swallow a bowl of hemlock than spend much time at Hazelden.

    Medication-assisted treatment [MAT] has been shown to help some people with serious substance use problems for years, but Hazelden has only recently started offering it. I’ve heard of some new laws (if I’m not mistaken) which actually require that certain medications be made available in addiction treatment programs. Now, 12-Step programs like Hazelden are making 12-Step participation a pre-requisite for receiving such medication in their programs. Yet 12-Step has been determined to constitute religious activity, including proselytizing (e.g. Hazle v. Crofoot, Inouye v. Kemna, etc.). What other medication requires the patient to surrender their life and will over to God to get a prescription?

    Maybe someone in public media can expose this abuse. Maybe a whistle-blower like Bill Moyers can expose the conflicts of interest, fraud, and unethical practices typical in the addiction treatment industry. Oh, wait, he produced a PBS series in conjunction with Hazelden around the time they hired his son, William Cope Moyers. Quid pro quo? Jim Ramstad joined Hazelden shortly after pushing for the Wellstone-Domenici Parity Act while he was in Congress. Quid pro quo? Does NPR have permission from their major sponsor, the Robert Wood Johnson Foundation, to report on this issue?

    It’s funny how so many A.A. members accuse Glaser of just trying to sell her book, when Hazelden and A.A. itself earn gajillions selling their propaganda to people, often while they’re being coerced by courts, employers, or family to consume their services.

    • TJtruthandjustice

      AA isn’t affiliated with Hazelden or any other group. AA costs a buck a meeting (if you happen to have the cash). Your claim that AA “earns gajillions” suggests to me that you don’t really know what you are talking about.

    • Hymie

      Please cite your sources for your claim that AA earns ” gajillions selling their propaganda to people, often while they’re being coerced by courts, employers, or family to consume their services.” Or perhaps that’s just YOUR propaganda. Have you looked at the GSB tax return. If you want to disparage an organization, bring some facts to the table. Oh, and don’t try to confuse the issue by talking about Hazledon, NPR or PBS, this is about AA – not those guys.

    • Bruce Allen Woodward

      Nice quotes. Now go and actually see an AA meeting and talk to some of it’s members. There are “Open Meetings” that you could attend. We regularly get students in medicine, health, etc. that come to try and understand what we are about. It’s apparent that you don’t have a clue.

  • Monica Richardson

    Great Show! Thank you for having Gabrielle Glaser on your show. What a refreshing show! I have read her book and have interviewed her for my upcoming film The 13th Step.

  • Daily Drinker

    Here’s an online version of the alcohol use disorder identification test:

    http://www.markjayalcoholdetox.co.uk/wiki/audit.php

    It’s helpful to see the spectrum in a little bit more detail. For instance, I personally have a drink most nights, but rarely more than 1 or 2 and scored a “7″ on the test, just under the threshold of “8″ for sensible drinking.

  • Susan Flowers

    Alcoholics Anonymous literature also addresses the “high bottom” alcoholic in the Twelve Steps and Twelve Traditions. So, Gabrielle, you might want to do a little more research before you make these categorical statements.

  • Hymie

    Ms. Glaser, I can’t imagine that you would speak so knowledgably about alcohol dependence (alcoholism) without having read the ‘Big Book”, but I’m not sure you have an adequate understanding of what it actually says. The real alcoholic is the person who cannot moderate, and cannot stop.

  • WMK

    To Whom It May Concern,

    In response to your radio show (Jan 20, 12:00pm broadcast on MPB FM 89.9) concerning women and alcohol, I take issue with one remark made by your guest concerning AA and abstinence-only therapy.

    In particular, it’s a bad analogy for her to state that AA advocates “hitting rock bottom” before treatment can work is akin to “getting a heart attack from eating lots of cheeseburgers” before abstaining from them.

    “Hitting rock bottom” according to AA is synonimous with “the gift of desperation:” i.e. the person suffering from the condition reaches a point in which s/he FREELY DECIDES s/he has had enough and needs help. In other words, “rock bottom” is highly subjective. AA’s 12 Steps appeal both to the autonomy of the addict and the interdependence of group support.

    Anyone in AA can tell you that there is no magic bullet to combat the deadly and destructive phenomenon of addiction: But “hitting bottom” vis-a’-vis “the gift of desperation” is a necessary precondition for sincerity on the part of the addict yearning for help. If the addict cannot take Step One, which is precipitated by this gift of desperation, then s/he is just “going through the motions” and manipulating (something addicts are very good at) the spiritual gifts of the 12 Steps as well as the potential support the group can offer, and thus, gains nothing.

    Please contact me if you have any questions.

    Regards,

    -William M. Kallfelz
    (listener in Starkville, MS)

  • http://www.recoveringfromrecovery.com/ Lovinglife52

    It is great so see people looking at the problem many face in modern times with a fresh approach. I am sure advertising has had a huge effect on the way people drink and social attitudes have changed since the the time AA was formed. I found the powerless side of AA was counterproductive and that it was a useless faith based solution. I achieved sobriety without it.

    • Susan Jones

      There are many people that DO find sobriety without AA or any of the alternatives. What do you mean by “modern”? Some of these alternatives have been around for decades. And there is very little that is new is many of them. In fact, much of Moderation Management is in the Big Book under as methods we have tried. AA too address the spectrum of drinking in the BB, and it even allowed that science one day might make a great number of changes in how we view the drink issue and how little was known about it at the time the BB was written.

      Without question, AA is the largest self-help opportunity available and it
      has helped many, many people over the decades. But it isn’t for everyone nor does it claim to be. It was a good thing that I found everything I needed in the program and its fellowship as all of the alternatives the Glasers of the
      world promoted were not available at the beach 6 years ago. Sadly, they still aren’t. These alternatives are decades old, some as much as 30 years, and the issue isn’t that they don’t work or that they too lack any real science to back them up (as is most of them, they simply have surverys of people using them), it is that these alternatives are not available to the average person. The biggest venue for SMART in America are the prisons, and this is also true of SOS. There are not Women for Sobriety meetings in my state.

  • John

    I’d tried AA & it wasn’t for me. SMART Recovery works for me. SMART Recovery is a sceince-based program to help people abstain from any substance or activity addiction.

    • Susan Jones

      The problem with SMART and its “science based” program is that even SMART doesn’t claim that it works. The biggest problem is simple availability. 190 meetings in the US where you don’t have to be a client or a prison inmate to attend and it has been around for cose to 30 years. Since anyone can be a SMART facilitator and teach the course, I wonder why those that have benefitted don’t move it forward so that the opportunity can be offered to more people. That is how AA grew to thousands of meetings all over the world.

  • perihelion22

    No form of obsessive, compulsive, addictive, behavior can ever be repeated in safety (not even binge eating). AA in the only method of stopping drinking that works for most people. If you have some “problem” with AA…like the higher power or whatever…get over it. AA welcomes everyone and every opinion. AA’s “Big Book” offers a stunning insight into the mind and motivations of the drinker. Try reading the first 2-1/2 pages of Chapter 3. (FREE online).

    For those who want to try some other method, good luck. AA will be here if you need it.

  • Conscientious B

    Thank you to Robin & team members of ‘Here & Now’ for bringing to light an issue that is all too familiar to a great number of individuals in our culture. I’d like to see journalists, such as the guest on this show, research deeper into the reasons why women take the larger percentage of individuals with alcohol disorders. My first thought was that women are traditionally more ‘open’ to discuss their struggles than men. But perhaps it is more complicated than that… Could one reason be that the modern women of our age, regardless of social and financial status, are leaning on alcohol to aid them in coping with the stress of the never ending, all-consuming, multi-tasking of career/work, education, family, caring for relatives, raising children, illness, etc., etc.? And I won’t even go into PTSD and domestic abuse (another person touched this issue already).
    Another point that I’d love to hear more about is the spectrum of this disorder , which must be as varied as there are individuals suffering from it. My grandfather was a heavy drinker, on the weekends ONLY. During the week he would not drink AT ALL but come Friday he would drink around the clock until Sunday evening. Never missed a day of work in 30 years. One day he declared himself an alcoholic and never drank again. It’s been 20 years since that day. Which category would he fall into, dependent or suffering from disorder?
    My husband and I decided to abstain from alcohol entirely, for 10 years. Once the economy collapsed in 2008 life got extremely difficult financially, we almost lost our home, twice. It was during that time that we allowed ourselves to drink again, to help us relax I must say. We drink now more than we did when we “resumed”drinking, yet we do it only in the evenings, when there is no more driving to do and we are in for the night. We may have one or a few drinks every evening. According to the guest on the show, we would have a dependency because we are exceeding 4 nights a week. Would we be considered dependents?
    Lastly there is the obvious difference in the drink itself. Four drinks can be four beers or four margaritas…the difference in alcohol intake can vary significantly from drink to drink. It is irresponsible not to clarify that when presenting the results of a study.
    All in all, great show. We’ll stay tuned for more!

  • Susan Jones

    Nope. “Alcoholism” has been in use since before the Civil War. I think the word use started in Sweden in 1848. AA didn’t coin the phrase.

  • I’ll Be FREE Or Die

    We really need and deserve more intelligent, thoughtful, professional people; journalists like Gabrielle Glaser to investigate, debate, research and report their findings. It’s called Free Speech in America and I see no valid reason why it should be repressed for the sake of the AA doctrine. THINKING is actually not a sin or
    character flaw after all; really now. If disciples are truly following program
    directives they are not really supposed to be engaging in these outside
    discussions anyway…or even reading anything other than “approved
    literature” based on the sacred, god-inspired BB text from 1939, right? If
    free thought and discussion among adults is so upsetting why not just stick to
    the good ol Big Book and AA sanctioned and approved 12 & 12?

    As for me, I look forward to further investigation, research, and interviews with esteemed journalists like Ms. Glaser and documentaries such as the upcoming 13th Step Film and I look forward to watching it and discussing it with intelligent, empowered adults whose minds are open to continuing research and developments regarding this vitally important topic.

    People are not “powerless” unless and until they choose to give over their power to another person, system or program of indoctrination. We all have the right to choose…one way or another.

    • Susan Jones

      Esteemed? She got so much wrong in such a short amount of time, it makes me wonder what she did in the three years she “studied.” I am absolutely thrilled with addiction topics and the film, The Anonymous People by Greg Williams is an excellent piece on the positivity of 12 step programs. While I have no issue with alternatives, the fact that they lag so far behind in terms of availability so as to be virtually useless is the biggest issue. Whatever AA is or isn’t doesn’t matter when its nearest equal is over 25 years old and has 190 meetings.

    • Ben

      Actually some people are powerless. If you’d ever lived with a real alcoholic you’d understand. They cannot stop drinking. Powerlessness over alcohol and domination by an outside person/entity are two different issues. It’s ignorance that claims one loses control to alcohol (or another substance) because of lack of willpower or weakness of character. It’s an illness. While one might have the ‘right’ to choose, one might also be too debilitated to exercise that right.

  • Jim D

    Yet another method to learn “controlled” drinking. There have been many in the past and there will be others in the future.
    It might be more difficult to count than just quit, but you will have to find out for yourself.
    But if it is unimaginable to accept not drinking. Try this:
    After drinking more than your daily allowance, pledge to start over tomorrow daily.
    Or you could limit yourself to two drinks, mix your own straight and use 10 to 12 oz glasses.
    Perhaps just switch to an alcohol drink you don’t like so well for a while.
    Lots of methods, denial and rationalizations are available.
    Try all the tricks and good luck. (They have all been tried) You can always quit if you have to, right?

  • Ben

    From Gabrielle Glaser’s website: “While Alcoholics Anonymous is endorsed by many doctors, our judicial system, and is used in more than 90 percent of U.S. treatment facilities, study after study shows that it doesn’t work well for women.”

    What studies Ms. Glaser?

    Ms. Glaser obviously has a bias… and it appears to be toward men. She claims that AA’s message is for men only, and since (the Big Book was) written by men, couldn’t possibly be applicable to women. I don’t relish to be the one to have to inform you of this Ms. Glaser, but there is a common element to humanity that transcends sex. Powerlessness over alcohol in alcoholics is one example of that commonality. It affects women and men alike. The virtue of humility (ego suppression) is another. I detect a personal agenda here. Please don’t say AA doesn’t work for women – I’ve seen far too many examples to the contrary.

    • Susan Jones

      It has worked for this woman. I know many women in AA and women’s meetings can be astounding those ladies saved my life. I have no idea why she feels there has to be a gender difference.

  • Rhianna

    I thoroughly enjoyed reading this article and all the comments. Very thought provoking and I empathize with those who have been indoctrinated with certain 12-step groups. I find myself in a conundrum of thoughts about my own sobriety and programs I’ve been involved with. From my experience, I already know that moderation is not going to work with me however, I do think it is applicable to those who are not deep set into the dependence of alcohol. In any case, I’m willing to believe that there are other options out there for dependent people than just AA or NA and if those of you have found them and leading wonderfully happy lives, that’s awesome. I hope that others find “a” solution that works for them. :) I live my life with the intent to better myself and spirit. Anything that contributes to that is a stepping stone to my personal enlightenment. Thanks!

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  • Miss Understood

    I’d like to put this article on the literature table at our weekly AA meeting. Many in attendance go just because there’s no where else to go, but really don’t want to be there nor belong there. The AA program only works for alcoholics who can see their own hopelessness and are willing to take drastic action immediately. Moderate drinkers & heavy drinkers do not qualify as alcoholics and should not join AA. Most people think heavy drinkers and alcoholics are the same thing; they are NOT. Heavy drinkers could stop if they would. Alcoholics would stop if they could. Many women I’ve worked with are absolutely gone beyond recall by the time I get to work with them. They’re so beaten by the guilt, shame & remorse that a beating from their husband is relief. Now take a girl like this; try to have one of these moderate drinkers or heavy drinkers try to ‘sponsor’ them. Which turns into screwing their husbands & sons, going shopping & having lunch instead of taking the life-saving drastic action a real alcoholic woman needs to get God. This is why so many actual real alcoholic women die.

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