Yeah, you want them to deal with the problem, not sit you down and say, “it’s okay, none of this is your fault, don’t blame yourself.”
And that’s just it. A broken wrist is also not a “disease,” it’s a problem that needs a solution. Solving the problem “at hand” is more important than determining if it happened while riding an ATV or rescuing a bunch of nuns from a burning building.
And that is an extremely good point that extends to all kinds of problems people face, not just alcoholism.
A broken wrist is a problem to solve once you know that’s what the patient has. That’s the trick, you see. Doctors don’t get to begin knowing it’s a broken wrist. So they ask your medical history.
ATV accidents can include other, related injuries — muscle strain and sprain, possible fracture or dislocation of clavicle or shoulder, possible fracture of distal tibia and fibula, possible concussion, that a wise doctor might check for; rescuing nuns from a burning building might come with burns, smoke inhalation, exposure to toxic burning fumes or asbestos, lower back strain, and so on.
Bolded text mine.
That’s the thing. AA only works if you’re willing to work it the way it’s supposed to be done. There is a great deal of flexibility in the program, but if you don’t follow it and really believe it, I highly doubt it’s going to work for you, because the drug or alcohol is still going to be more important to you than what you’re trying to get clean of. As someone mentioned earlier in this thread, the problem with getting clean through a 12-step-program is that addicts and alcoholics have an astounding ability to lie to themselves; I have never met a group better at mental masturbation.
I am of many thoughts about AA. AA, NA, and other 12-step programs WORK for some people, and I say, if it works for them, let them do it.
“Take what you like, and leave the rest,” was never meant to be directed towards the 12 steps, as far as I can tell from the Big Book. You have to do the steps to make it work. I believe the phrase was meant to be used about the opinions and speakings of your fellow alcoholics.
As ineffective as AA can be, I would love to see the success rates of non-12-step recovery group programs. It seems to me that it’s the best we’ve got right now, until we can develop chemicals to make our bodies not addicted to things (I wonder if such a chemical could exist?). Methadone clinics and things like that don’t really help - they just substitute one addiction for another. I doubt anything similar would, either.
~Tasha
Hijack — not from the questions posed by the OP but from the current trajectory of the debate, which is pretty focused on 12-step programs — what is a “disease”?
Me, my health sciences perspex come out of mid-20th century descendants of the original “germ theory of disease”. A disease, as far as I’m concerned, is
a) An illness caused by a bacterial infection; or
b) An illness caused by a viral infection; or
c) On rare occasions, an illness caused by other microbial infections (e.g, amoebas); or
d) By extension, when research shows that something previously thought to be a disease in one of the above senses turns out to be not due to an infectious microorganism, but rather a physical malformation or insufficiency, those may also be called “diseases”, but should fall into a category within a known and finite set of categories that have been accepted as such, lest everything that ever has the capacity to ail humankind get dubbed a “disease”. Generally accepted categories:
d[sub]1[/sub] Congenital diseases, in which one was born with damaged or insufficient physical organ structures which manifest as an illness; e.g., mitral valve insufficiency in the heart (born that way)
d[sub]2[/sub] Tissue-damage & organ-failure diseases, in which structures of the body cease to perform their proper functions long prior to normal onset of “old age” failures, and not as a consequence of traumatic injury, and those failures then manifest as a disease; e.g., diabetes
d[sub]3[/sub] Somatic misbehaviors, in which normal bodily functions or biological processes within the body veer from normative healthy patterns and engage in activities destructive to the otherwise healthy body, which in turn manifests as a disease; e.g., cancer
Now, that’s all a rosily science-brightened & confidently analytical take on medical practice (let alone social-cultural labeling, which I haven’t even gotten to). In practice, as I found out as I aged, ordinary medical doctors tend to slap scientific-sounding latin-derived labels on human ailments that make it sound like they know that what’s got you feeling miserable is in one of those categories and that, furthermore, they know which one, and in probably considerably more detail than that.
Then you learn a little Latin and get disillusioned. “I had a painful cough and I’ve been running a fever, so I went to the doctor and you know what I’m sick with? I’ve got bronchitis!” That’s an almost meaningless sentence. Or at least it sure doesn’t convey the kind of thing my nice systematic optimistic mid-century health sciences theories had led me to think it meant. “Bronchitis” means “a condition of the bronchial tubes”. Not specific as to what condition. Doesn’t mean there’s a specific microorganism, known to the medical profession and recognized as such by your doctor, a specific microorganism which causes bronchitis. Nope, your doctor essentially listened, poked, asked some questions, and then said “Hmm, something’s bothering your upper lungs, you got a cough and a fever, definitely something going on there”.
Doctor probably thinks its viral, if only because it’s more common, less serious, and spreads more often, but gives you some antibiotics anyhow (to kill off the bacteria that you may or may not have), recommends broth and tea and tylenol and get some rest.
So, given that the real state of day-to-day medical diagnostics in the clinic are a lot closer to broad general common-sense that’s enhanced by medical science knowledge than to highly explicit analytical determination of exactly what is causing exactly what damages by exactly what processes, does it make sense for blowhards like me to hold on so tightly to a rigid definition of “disease”? Why not just say “anything that makes you feel awful or disables you in any way is a disease”?
We can have mental diseases, emotional diseases, behavioral diseases, social diseases, spiritual diseases, why not? We may not know what causes them, we may not know what they actually consist of as opposed to the symptoms that lead us to diagnose them, we may not know what kind of package-deal connections they may have to other aspects of a person’s feelings & behaviors & overall health, and given all that we may not have any idea what, if anything, to do about these diseases, or whether what we do is an improvement over doing something else or nothing at all, but by Jove and by Golly we’ve given it a name.
And the cool thing about giving it a name is that if any portion of its manifestations are troubling and unsettling to me or you, we can say that that manifestation is caused by the name we just gave it. It has an explanation! It has a reason!
People who have a tendency to have all their skin fall off overnight and wake up screaming in excruciating pain? It’s because they have Skinfalloffitis! People who suddenly start stabbing other folks with stainless steel forks do that because they suffer from Forkustabbia! The person who chronically lies for no apparent reason, well, you know, it’s because of the Pantsonfirosis!
“Treatment outcome research thus far confirms that there exists a large variety of treatment methods that appear to work in the short run (weeks or months) . . . only one method of treatment appears to be effective and to consistently work in the long run (years to lifetimes), namely abstinence based treatment when combined with regular, continuous and indefinite attendance at Alcoholics Anonymous meetings (Narcotics Anonymous is probably as effective, but sufficient data are not yet available).”
- Miller NS (ed): Treatment of the Addictions: Applications of Outcome Research. New York, Haworth Press, 1995
I work at a large research university, and trust me, TONS of research has been done. TONS. So far, nothing else has been found to work as well long term as AA and the 12 Steps. The research includes studies that have followed alcoholics for as long as 50 years.
It’s true that’s there’s nothing out there that has anything approaching what you would call a good success rate, and I think that just points to how complex addictions are. They’re physical, mental and emotional; people who have them often arrange their entire lives around them, which means if they want to stop and stay that way, they have to completely reformulate their lives. They can’t maintain contact with people who enable them. They can’t go places or do things that would tempt them to relapse. Sometimes that means cutting off relationships with friends, relatives and spouses, or changing jobs, or moving to a new location. They have to form completely new behaviors and change the way they respond and react to the world around them. Often, addicts have other problems like depression, schizoprenia or bipolar disorder and they use their substance of choice as a means of self-medicating, so they not only have the addiction to deal with, but other problems that need to be addressed.
Needless to say, all this incredibly difficult to do and it’s no surprise at all to me that so many people fail regardless of what outside treatment may be available.
You might want to check out this book, The Natural History of Alcoholism Revisited, by George E. Vaillant. It’s a landmark study of alcoholism and may answer a lot of the questions you have.
Aha! Now we’re getting somewhere. Thanks for your valuable information.
You’re in Ann Arbor. There’s a medical school there. There’s a massive library there. There’s entire journals dedicated to research studies of addiction. Take a look. You can learn everything you want to know right there, and more if you like.
I still don’t see why you think that calling it a disease removes the responsibility from the individual for treating it. Any other disease somebody might have, do they typically say, “Oh, so I have Condition X! Thanks a lot, that’s all I need!”? If a patient refuses to pursue any kind of treatment, that’s their fault as an individual, not that of the person who made the diagnosis–it is the fault of the diagnoser if they tell the patient they don’t need to do anything, but that has no bearing on whether or not the condition is a disease.
Well, yes. That’s how I came to my original conclusion. Because everything I turned up said AA doesn’t work. The information you have provided is the first I have ever encountered that refutes the research I based my opinions on.
Where did you look? On the Internet? Or in peer-reviewed journals?
Both. My university has an online repository of peer-reviewed journal articles.
Mine too. It’s not hard to find stuff just like what I posted above. I am quite surprised you haven’t run across it already. The author of the Internet link you posted has a rather obvious agenda; it’s not something I’d use as a cite for anything.
If it is the first you have ever encountered then I can only surmise you have never been to an AA meeting. Judging by the slice of humble pie you have had in this thread, I think a trip to an open meeting to see how wonderful people can feel when the program works would be in order. 
Good luck, I sincerely hope you go and see for your own self, you will be amazed at the folks you encounter… We have a saying - “from Yale or from Jail” you’ll find all sorts
Actually, not drinking fixes only part of the problem. Also, moral deficiencies certainly play a part in drinking for many alcoholics, it is called guilt.
There are two parts of alcoholism as far as I can tell. The physcial and the mental. Physically, there are many studies out there that show alcoholism is genetic, it runs in families*. There are studies showing that brain chemestry might be a large factor in alcoholism. Here is another study suggesting a direct link between specific neurochemical mechanisms and alcoholism.
The second problem, and I know this from first hand experience, is that moral deficencies do add siginifcantly to the problem of alcoholism. AA directly addresses these issues. The problem is that drunks do stupid shit. Really, really stupid shit to people they care about. For me, and many of the alcoholics I know, this is a core problem that needs to be addressed. A large part of why I drank was to bury the guilt I had over dumbass stuff I did, usually while drunk**. I’d hurt the people I cared most about. Instead of dealing with the guilt in a healthy way I drank to kill it. Obviously this does not work. Following the steps in A.A allowed me to deal with the guilt in a healthy way. I looked at myself and my past behaviour, identified whom I wronged and made amends to those people when possible. When I could not, for whatever reason, make direct amends I worked out the issues with my sponser. Doing this removed a large reason for my drinking. In my case it wasn’t the only reason, but it was the biggest. A.A. also gave me the tools to ensure that I did not end up doing the same things all over again. Are there other ways to get the same result? Yeah, probably. The thing is that people in A.A. have been there, done that and understand in a way that I do not believe a non-alcoholic/addict can.
Slee
*After I came out, as it were, as an alcoholic and finally admitted I had a problem to my family I learned that I wasn’t the only one in the family with the issue. I was rather shocked to learn that a whole bunch of people on my mothers side of the family were alcoholics going back quite a long time.
**It was a nasty little circle. Get drunk, do something stupid, feel guilt, drink to bury guilt, do something even more stupid, proceed to step 1.
I don’t think she’s had a slice of humble pie at all. She came in with a POV that is not unreasonable and has been both open and civil in listening to others, even to the point of conceding her original OP was too harsh and rephrasing it. I think it’s been a very interesting discussion.
Another viewpoint is that once you stop drinking, your normal way of dealing with people returns. There is nothing directly linking moral deficiencies to alcohol that won’t clear up once the alcohol is removed from the equation.
I agree. And Phlosphr sounds like he’s recruiting. She didn’t ask for help, did she?
I agree, and I certainly didn’t mean it to be mean at all. I hope she understands that, we are all expressing points of view and I think it took a certain amount of courage on her part to reiterate a new OP up thread. Very decent indeed.
I love this editing your own posts…
I’m not recruiting Kalhoun, you should know that! 
The reality is that every meeting is different. The rules are so loose as to be nonexistent, and everyone is doing their own thing. Kind of like quitting on your own. 