When I started out with my Alcoholics Anonymous (AA) series, Outside The Rooms, in February of this year, my intention was to have a real conversation about AA and share my own experience inside and outside of the rooms. The impetus was to share my story exactly as it was so that individuals who come to this site can get a full perspective on the belief system that feeds Hip Sobriety, and to be a voice for those who had come to similar conclusions that I had, or a voice for those who needed to come to their own conclusions minus the debate and rhetoric that typically accompanies such conversations (see the comments section of my recent post on xoJane).
I walked in to this series with a grand vision and most of it written out. But as I sat on vacation in Hawaii in late February, some three pieces published and three more in queue, I started to question if perhaps I had missed the mark. I couldn't put my finger on it, but the story I was building seemed oversimplified and somewhat incomplete. I spent the better part of that week on Oahu cooped up in a condo, my skin getting whiter by the day, as I seemingly wrote and re-wrote the same sentence over and over again. I called Laura 100 times. "Does this sound offensive? What am I missing?"
And then as I was driving along the coast, my mind and body finally removed from the vacation home that had become Satan's writing cave, it became obviously clear why I was so stuck in being able to say the words I wanted to say. I was looking at AA only as a treatment modality. And AA is not just a treatment modality.
Far from it. Alcoholics Anonymous is the basis upon which we understand alcohol addiction as a society, period. A philosophy so inextricably woven into the fabric of not only the lives of those who suffer addiction, but every other single human being in this society, that to just discuss what was right and wrong in its effectiveness in treating addiction would be akin to saying AIDS is just a virus.
Because of the influence of AA and its philosophy amidst a culture that loves its alcohol and defends its right to drink (and a billion-dollar industry that tells us we need it to be and do anything worth being and doing), we are led to believe, and wholly embrace, a set of truths that keep us each individually stuck in our own behavior.
…that there are only two types of drinkers - normies who can handle alcohol with ease, and alcoholics who cannot.
…that those alcoholics are genetically predetermined to become such, or are allergic to alcohol - naturally powerless to it.
…that it is normal to be able to ingest a toxic chemical (ethanol), and abnormal to not be able to.
…that we only seek help for alcohol or stop drinking if we are alcoholics. That the rest of us are okay if we don't cross some invisible subjective line or don't affirmatively answer more than 7 of the 26 questions on the NCADD self diagnostic.
…that those who are alcoholics will suffer indefinitely from an incurable disease, their only choice to surrender to the fellowship of AA, work the 12 steps, and "keep coming back".
…that if the treatment doesn't work, it is the failing of the human for not trying hard enough. Not the failing of the treatment.
…that to be "cured" is to be able to drink normally.
This is not me being dramatic. Most of this is written into the fundamental literature, and is the foundational belief system accepted by the recovery system, the healthcare system (most doctors attend 12-step meetings as part of their training - few are trained in addiction medicine), the legal system, and society in general.
In other words, the tenets and beliefs developed by Alcoholics Anonymous is what informs our generally accepted idea of alcohol addiction and addiction treatment in America today - and has for the past 80 years.
Before we even drink, before we develop relationships with alcohol, after we drink and develop relationships with alcohol, as our relationship with alcohol changes, as some of us develop drinking problems, as some of us struggle to maintain levels of tolerance, as those around us struggle to maintain levels of tolerance, as we raise our children and share first beers, as we toast our life milestones with champagne, as we cocktail party and wine club, as we influence and teach, as our lives evolve and mature and so too does our relationship with alcohol, as those fall down around us, as our children develop their own relationships with alcohol, as the world turns…AA is and remains the basis upon which our ideas about addiction, abuse, and drinking in general are built and maintained.
Before I stopped drinking - before I even started for that matter - I didn't have to step foot into an AA meeting to understand that admitting a drinking problem meant alcoholism, and alcoholism meant a lifetime sentence. I didn't have to crack open the Big Book to believe that there are only two types of drinkers and that no one wants to be an alcoholic. I didn't need to search the web to know that only alcoholics seek treatment. I only had to live in America to know these things. Because here in America, we look at and measure our relationship with alcohol through AA colored glasses.
You don't need to know my story to understand how this affected me or affects anyone else that drinks in our culture. Drinking is a rite of passage - one that nearly everyone is expected to walk through, and one that most do. From there we are given a set of mixed messages of what is good, bad, normal, unacceptable, and worrysome. There is no magic number of drinks per day or perfect delineation of what an alcoholic is or what alcoholism looks like. There are qualifiers and lines, and it's best understood that it happens when our lives become intolerable, our existence parallels Nick Cage's in Leaving Las Vegas, and that it will only happen to a small percentage of us.
So we mind that one qualifier - whether or not we are alcoholics - as the threshold for whether we need to do something about it.
Currently, about 171 million US citizens consume alcohol - close to 70% of adults aged 18 and over. Of those 171 million, some 30% abuse (engage in high-risk alcohol consumption), or close to 51 million Americans. Of those 171 million who drink, 10% meet the criteria for alcoholism (clinically addicted according to the DSM V), or some 17 million Americans. (Source, 1). Less than 10% of those 17 million Americans clinically addicted actively seek treatment, or 1.4 million (Source, 2).
Put another way - while currently over 50 million American's have an unhealthy relationship with alcohol, less than 3% of them will seek and receive help. The implications for this as a country are magnificent - 88,000 or 1 in 10 Americans aged 18 - 65 will die from an alcohol related disease this year - it is the 3rd preventable death behind obesity and smoking. And it costs us some $225 BILLION annually as a country.
But forget that for a moment. Because those are just numbers and facts and stats. Consider what this means in real life terms.
I have a niece. I think of her. I think, do we send her out into the world with this same idea? Do we wait and see whether or not she'll become addicted to alcohol? Do we drink in front of her and make it seem totally fine to deal with a bad day at work with a chardonnay because we ourselves aren't alcoholics and that's just what we do? Do we tell her it's okay to get drunk at a barbeque, as long as she doesn't drink at home alone or do a handful of other behaviors that qualify her as an alcoholic? Do we tell her that if she has trouble controlling a substance that millions of us secretly have trouble controlling, that there is something wrong with her and she's not normal? Do we wait with baited breath to see whether or not she'll be one of the 50 million that abuse it and just fucking hope she doesn't become one of the 17 million, while we hang on to our right to party, to unwind, to socially lubricate, to toast, to swill, to pair…?
While I do believe that there is much to be said about AA and the 12-steps as a treatment modality for addiction - both good and bad - I think the more important thing we need to discuss are the attitudes we have come to develop towards alcohol consumption, alcohol abuse, and alcohol addiction as a society based on the tenets of Alcoholics Anonymous and whether those beliefs are serving us. That perhaps instead of arguing whether or not AA is effective, we should argue whether what we've come to accept about alcohol addiction as a society - as fed to us through the AA model - might be flawed.
Source 2, NIH Alcohol Use Disorder.
This is the sixth installment of a 9 part series. You can use this link to find the entire series if you want to follow along.
Outside The Rooms. Hip Sobriety & Alcoholics Anonymous: A 9 Part Series.
1. Hip Sobriety & Alcoholics Anonymous: A 9 Part Series, Introduction. // February 18 //
2. My AA Story, Part 1. // February 19 //
3. My AA Story, Part 2. // February 20 //
4. 10 Ways To Evolve Alcoholics Anonymous. // March 26 //
5. Guest Post by Laura McKowen, Why AA Works For Me. // March 30 //
6. Outside The Rooms. Through AA Colored Glasses: How We As A Society See Addiction. // July 10 //
7. The Real Cause of Addiction + Why The AA Debate Is Useless. // TBD //
8. How To Navigate Recovery In an AA Dominated Culture. // TBD //
9. Dear America: Here Is How We Fix Addiction. // TBD //