Alcohol and You: Part 3--what to do?

[Don S]

What do I do about my problem?

You can consider a recovery group.
If you are drinking daily, or get drunk intentionally every so often, or if drinking is interfering with your life in any way, you may decide that you have a problem with alcohol and want to seek help. All of the alcohol recovery groups believe that you should abstain from drinking, but they take different approaches to how and why you should do so.

The disease concept of alcohol use was combined with a strongly spiritual approach to treatment in Alcoholics Anonymous.
AA is the oldest, largest and best-known recovery organization, and despite the spiritual/religious basis it is heavily used in our legal system (this is periodically challenged as a violation of church and state). A DUI is likely to result in a sentence that includes mandatory AA meetings, and people aren't likely to challenge that when jail time is the alternative.

AA is the original and best-known “12 Step” program. Interestingly, the disease concept was not an original part of AA, mentioned only in passing in the ‘Big Book’ that is their basic text. It is a program of rigorous spiritual change, and AA members usually define alcoholism as a ‘spiritual disease’. Much of the quasi-medical disease stuff has been added on by modern recovery programs, which involve intervention, rehab, lots of meetings. This is often reinforced by repetition of the dire consequences of continuing to drink or do drugs. Hazelden is one of the older 12 Step programs of this sort.

12 Step principles are that alcohol abuse is a disease that is invariably fatal, that abstinence is the only cure, that you admit that you are powerless over alcohol, you call upon a higher power for help in achieving abstinence, and that you regularly attend meetings to get the support you need. One big advantage: AA meetings are available just about everywhere.

Newer recovery organizations reject the disease concept of alcohol use.
In the 1970’s, the limitations of 12 Step programs were becoming apparent to many people. Although there have always been women in AA, as a group it was heavily male—particularly the founders and the early members. In 1976 Women for Sobriety was formed to provide a different approach which focuses more on self-affirmation and emotional development.

There are two secular (nonreligious) groups based on cognitive behavioral science. Rational Recovery uses a technique where you learn to argue with your own ‘addictive voice’ and persuade yourself not to drink. SMART Recovery uses techniques where you learn better ways of coping with upsetting emotions, and learn to dispute your thinking patterns that lead to drinking. SMART, in particular, uses principles from Cognitive Behavioral Therapy (CBT) and Rational Emotional Behavioral Therapy (REBT).

Both of these groups use a more scientific approach than AA. They work by helping you choose not to use drugs by identifying the reasons and avoiding the triggers to drinking/using. A big difference is that you--not a higher power, not a group--are responsible for your own recovery. Both programs have online information, and SMART Recovery has an extensive schedule of online meetings.

Many people like the group meetings and peer support that AA provides, but don’t like the religious aspects. In spite of what AA members may say, it comes across as a religious group: many meetings open and close with Christian prayers, and there are lots of references to god. So two groups were formed primarily to have secular (non-religious) meetings: SOS and LifeRing.

Which programs work?
Information on the effectiveness of the different groups is hard to come by. Any recovery group can be effective for people who have acknowledged that they have a problem, are motivated to quit, and can accept the basic principles of the organization. Anyone can benefit from the support provided by other members of a group.

You can try quitting on your own.
It is an interesting fact that the majority of people who quit abusing alcohol do so on their own, perhaps demonstrating that it really is a matter of personal motivation and choice. They may seek support from family and friends, but don't join any particular organization--they decide to quit and "simply" stop drinking.

People who belong to recovery groups will often find it hard to believe that people can quit without a specific support group. They don’t believe they can quit on their own, and may not believe anybody can. The fact is, we vary in where we find the power for change. Some people like groups, others value their individualism. There’s a simple quiz you can take to determine where your ‘locus of control’ is—that is, whether you are more likely to find the power for change from within (internal locus) or from another source such as god, church, a group, etc. (external locus). Here is one link to the quiz:
http://www.psych.uncc.edu/pagoolka/L...rol-intro.html

It is not better or worse to have an external or internal locus! It just might be a good predictor of how likely you are to find peer support or an organized group’s recovery structure useful.

Your choices and your future.

The habits you take on in your late teen years become deeply engrained by the time you are in your 20's. Seeking a high can become an end in itself, and can crowd out other activities and interests.
Do you know people like that? Friends who are choosing to use drugs and alcohol regularly, and who may also be making poor life decisions -- about relationships, who they hang out with, about their futures?

You can still like those people and care about them, but you probably can't help them change the directions they are taking. You can certainly be there with facts and support if they talk about it.

But it may be necessary to avoid drinking/drugging friends when you quit, at least for a while, and they may not like that. It’s hard to stop being a drinker or stoner when you’re surrounded by that mentality. Successful sobriety involves making some lifestyle changes, and changing who you hang out with may be one of those changes.

Planning for those situations – what you’re going to say and do – is really crucial. Peer pressure is very real and can be difficult to deal with. So think about doing what actors do: they have scripts and they memorize their lines. Know what you’re going to say when someone urges you do drink or do drugs. It’s amazing how often people get stoned or drunk ‘without meaning to’ because they weren’t ready for the situation.

How you’re going to spend your time is really important. Drinking and getting stoned are pretty passive activities, and we tend to have a lot of nervous energy when we quit. Fill your time. Identify the times you used to use, and make plans for what you’re going to be doing.

If you choose to use alcohol or drugs again, it isn’t a moral failing or the start of a progressive disease. It's just an unhealthy choice. Is there someone who you trust that you can talk to about why you made that choice? It might be useful to talk about what beliefs and emotions your decision was based on, and how you plan to deal with it next time. Peer support can be incredibly useful, and that support is available online. A habit can be hard to break, but it can be done. Your past does not have to predict your future.

Think back a year or two. Where were you emotionally?
What can you do now to be more content and happier a month, six months, a year from now?
Are there people in your life who you think are models for comfortable, well-adjusted behavior? What do they do that you can apply to your own life?

Let’s say you’ve quit drinking and using drugs. It was uncomfortable at first, but not intolerable. Now think ahead a year or more. If sometime in the future you are plagued by doubt, depression, or anxiety, and things seem hopeless, you can look back on this time in your life when you pulled yourself up, took care of yourself, and developed confidence, poise, and peace of mind. There may even be others you can help. It really is easier to deal with life with a clear mind. I’m not saying sobriety will make you happy. It’ll just make it easier to make and achieve your goals.

Further reading:

About recovery groups:
Alcoholics Anonymous: AA says that their organization welcomes atheists and agnostics. Decide for yourself! Read the 12 steps of AA here: http://www.recovery.org/aa/misc/12steps.html

Rational Recovery: "RR was founded in 1986 by Jack and Lois Trimpey in response to the lack of choice in the field of addictions. At the time, there was no choice other than the 12-step, spiritual healing program of Alcoholics Anonymous. Lack of choice in recovery styles is still a serious national problem, but RR has become well-known as a viable and widely available alternative to addiction." http://www.rational.org/

SMART Recovery: teaches self-reliance rather than reliance on a higher power Views addiction as a complex maladaptive behavior rather than as a disease. Encourages you to recover and move on with your life. Does not use the labels "alcoholic" or "addict." Does not have a "sponsor" Holds meetings which are actual discussions rather than a series of monologues. Evolves as scientific knowledge evolves. http://www.smartrecovery.org/

The importance of your language: http://www.skysite.org/primer/exchange.html gives examples of absolute words and their alternatives.

Links for more information about various recovery groups:

The groups:
• SMART Recovery http://www.smartrecovery.org
• LifeRing Secular Recovery http://www.unhooked.com
• SOS - Secular Organisations for Sobriety http://www.secularsobriety.org
• Women for Sobriety http://womenforsobriety.org/
• Rational Recovery http://www.rational.org


Information and analysis about addiction treatment, social policy, and harm reduction: http://www.peele.net/

Alcoholics Anonymous and some variations on 12 Step programs:
Big Book Search Engine, useful as a reference: http://www.healingresource.org/book.cgi?Display_Welcome
Agnostics AA: http://agnosticaa.org/
Pagan approach to 12 steps: http://members.aol.com/JehanaS/recovery.html
Christian recovery sites:
http://www.celebraterecovery.com/message.asp
Alcoholics Victorious: http://www.alcoholicsvictorious.org/12-steps.html
Interpretation of the 12 Steps from a Jewish perspective:
http://www.a-1associates.com/AA/jacs_journal_2.htm
Buddhist version of the 12 steps: http://www.geocities.com/b12steps/index.html