The Sober Truth

by Lance Dodes

  Lance would also like to thank the people he has seen in treatment over the years who have shared their experiences with addictions and the inner stories of their lives.

  NOTES

  CHAPTER ONE

  1. Benedict Carey, “Drug Rehabilitation or Revolving Door?,” New York Times, December 22, 2008.

  2. L. Amato Ferri and M. Davoli: “Although it is the most common, AA is not the only 12-step intervention available. There are other 12-step approaches (labeled Twelve Step Facilitation (TSF). . . . No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems” (“Alcoholics Anonymous and Other 12-Step Programmes for Alcohol Dependence,” Cochrane Database Systems Review 3 [July 2006]: CD005032).

  3. Alcoholics Anonymous, 3rd ed. (New York: AA World Services, 1976), 58–60.

  4. Ibid., 77.

  5. Paul Pringle, “The Trouble with Rehab, Malibu-Style,” Los Angeles Times, October 9, 2007.

  CHAPTER TWO

  1. W. White, Slaying the Dragon: The History of Addiction Treatment and Recovery in America (Bloomington, IL: Chestnut Health Systems, 1998).

  2. Selected Papers of William L. White website, “Significant Events in the History of Addiction Treatment and Recovery in America,” http://www.williamwhitepapers.com/.

  3. Cynthia Crossen, “If Dr. Keeley Could See You Now,” Wall Street Journal, December 31, 2007.

  4. Ibid.

  5. M. Keller, “The Old and the New in the Treatment of Alcoholism,” in Alcohol Interventions: Historical and Sociocultural Approaches (supplement to Alcoholism Treatment Quarterly), ed. B. Carruth et al. (New York: Routledge, 1986).

  6. M. S. Gold, MD, and Christine Adamec, The Encyclopedia of Alcoholism and Alcohol Abuse (New York: Facts on File, 2010).

  7. Selected Papers of William L. White, “Significant Events in the History of Addiction Treatment and Recovery.”

  8. B. Weiner and W. White, “The Journal of Inebriety (1876–1914): History, Topical Analysis, and Photographic Images,” Addiction 102, no. 1 (January 2007): 15–23.

  9. Francis Hartigan, Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson (New York: St. Martin’s Griffin, 2001). Unless otherwise indicated, in this chapter, quotes from and anecdotes about Bill Wilson are taken from this book.

  10. William James, The Varieties of Religious Experience (CreateSpace Independent Publishing Platform, March 11, 2013).

  11. “Pass It On”: The Story of Bill Wilson and How the A. A. Message Reached the World, 1st ed. (New York: AA World Services, December 1984); also “Bill W.,” Wikipedia, http://en.wikipedia.org/wiki/Bill_W.#cite_note-19.

  12. B. Pittman, AA: The Way It Began (Seattle: Glen Abbey Books, 1988).

  13. “Pass It On.”

  14. Susan Cheever, My Name Is Bill: Bill Wilson—His Life and the Creation of Alcoholics Anonymous (New York: Washington Square Press, 2005).

  15. “Pass It On.”

  16. “Problem Drinkers,” March of Time, 1946, http://www.aamuncie.org/March_of_Time_1946.html.

  17. E. Kurtz, Not-God: A History of Alcoholics Anonymous (Center City, MN: Hazelden Educational Services, 1979), 92.

  18. E. M. Jellinek, “Phases in the Drinking History of Alcoholics: Analysis of a Survey Conducted by the Official Organ of Alcoholics Anonymous,” Quarterly Journal of Studies on Alcohol 7 (1946): 1–88.

  19. T. J. Falcone, Alcoholism: A Disease of Speculation (Amsterdam, NY: Baldwin Research Institute, 2003), http://www.baldwinresearch.com/alcoholism.cfm.

  20. Ad for Alcoholics Anonymous, http://www.barefootsworld.net/aa-medicine.html.

  21. A. Tom Horvath, PhD, ABPP, “Court-Ordered 12-Step Attendance Is Illegal,” Practical Recovery, http://practicalrecovery.com/readings/non-12-step-2/court-ordered.

  22. The Public Papers of the Presidents of the United States, http://quod.lib.umich.edu/p/ppotpus/4731549.1966.001.

  23. Federation of State Physician Health Programs website, http://www.fsphp.org/.

  24. R. L. DuPont et al., “Setting the Standard for Recovery: Physicians’ Health Programs,” Journal of Substance Abuse Treatment 36 (2009): 159–71.

  25. E. M. Gallas, “Endorsing Religion: Drug Courts and the 12-Step Recovery Support Program,” American University Law Review 53, no. 5 (June 2004), http://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?article=1110&context=aulr.

  CHAPTER THREE

  1. Jason Koebler, “Diet Soda Linked to Depression in NIH Study,” US News & World Report, http://www.usnews.com/.

  2. G. Taubes, “Do We Really Know What Makes Us Healthy?” New York Times Magazine, September 16, 2007.

  3. Ibid.

  4. Ibid.

  5. Deborah Dawson, PhD, “Recovery from Alcohol Dependence: Response to Commentaries,” Addiction 100, no. 3 (March 2005): 296–98.

  6. A. H. Thurstin et al., “The Efficacy of AA Attendance for Aftercare of Inpatient Alcoholics: Some Follow-up Data,” International Journal of the Addictions 22 (1987): 1083–90.

  7. Alcoholics Anonymous, 3rd ed. (New York: AA World Services, 1976), 58–60.

  8. J. M. Brandsma et al., Outpatient Treatment of Alcoholism: A Review and Comparative Study (Baltimore: University Park Press, 1980).

  9. C. D. Emrick, “Alcoholics Anonymous: Membership Characteristics and Effectiveness as Treatment,” Recent Developments in Alcoholism 7 (1989): 37–53.

  10. D. C. Walsh et al., “A Randomized Trial of Treatment Options for Alcohol-Abusing Workers,” New England Journal of Medicine 325, no. 11 (September 12, 1991): 775–82. The paper explains:

  The average length of stay at the 10 hospitals (of which 2 accounted for 86 percent of the hospital assignments) was 23 days. . . . The participating hospitals described their programs in similar terms . . . held AA meetings at the hospital, and cited abstinence as the goal of treatment. . . . The third treatment option—referred to as “choice”—was one that involved the subjects in the planning of their treatment. . . . The subjects randomly assigned to a choice of treatments were not required to join AA or enter a hospital, although the staff of the employee-assistance program sometimes encouraged them to do one or the other, and were free to elect no treatment. . . . Of the 71 subjects in the choice group, 29 elected hospitalization in a total of five hospitals (average length of stay, 24.5 days), 33 went directly to AA, 3 chose outpatient psychotherapy (with a social worker, a psychiatrist, or a marriage counselor), and 6 opted for no organized help at all.

  11. D. Sacket, Canadian Medical Association Journal 167, no. 4 (2002): 363–64, http://www.cmaj.ca/content/167/4/363.full.

  12. Cochrane Database Systems Review 3 (July 2006): CD005032.

  13. Citations from ibid.: Brown 2002; Cloud 2004; Davis 2002; Kahler 2004; MATCH 1998; McCrady 1996; Walsh 1991; Zemore 2004.

  14. R. Fiorentine, “After Drug Treatment: Are 12-Step Programs Effective in Maintaining Abstinence?” American Journal of Drug and Alcohol Abuse 25, no. 1 (February 25, 1999): 93–116.

  15. B. S. McCrady et al., “Issues in the Implementation of a Randomized Clinical Trial That Includes Alcoholics Anonymous: Studying AA-Related Behaviors During Treatment,” Journal of Studies on Alcohol and Drugs 57 (1996): 604–12.

  16. Quoted in Taubes, “Do We Really Know What Makes Us Healthy?”

  17. Ibid.

  18. R. H. Moos and B. S. Moos, “Paths of Entry into Alcoholics Anonymous: Consequences for Participation and Remission,” Alcoholism: Clinical and Experimental Research 29, no. 10 (2005): 1858–68; R. H. Moos and B. S. Moos, “Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals,” Journal of Clinical Psychology 62 (2006): 735–50.

  19. Moos and Moos, “Participation in Treatment and Alcoholics Anonymous.”

  20. Ibid.

  21. Ibid.

  22. J. McKellar et al., “Predictors of Changes in Alcohol-Related Self-Efficacy over 16 Years,” Journal of Substance Abuse Treatment 35, no. 2 (Septe
mber 2008): 148–55.

  23. C. Timko et al., “Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-ups,” Journal of Studies on Alcohol and Drugs 72, no. 2 (March 2011): 173–84.

  24. John-Kåre Vederhus and Øistein Kristensen, “High Effectiveness of Self-Help Programs after Drug Addiction Therapy,” BMC Psychiatry 6, no. 35 (2006).

  25. Jane Witbrodt et al., “Do 12-Step Meeting Attendance Trajectories over 9 Years Predict Abstinence?” Journal of Substance Abuse Treatment 43, no. 1 (July 2012): 30–43.

  26. J. McKellar et al., “Alcoholics Anonymous Involvement and Positive Alcohol-Related Outcomes: Cause, Consequence, or Just a Correlate? A Prospective 2-Year Study of 2,319 Alcohol-Dependent Men,” Journal of Consulting and Clinical Psychology 71, no. 2 (2003): 302–8.

  27. E-mail to the author.

  28. McKellar et al., “Alcoholics Anonymous Involvement.”

  29. L. Kaskutas et al., “Alcoholics Anonymous Effectiveness: Faith Meets Science,” Journal of Addictive Diseases 28, no. 2 (2009): 145–57.

  30. R. D. Weiss et al., “The Effect of 12-Step Self-Help Group Attendance and Participation on Drug Use Outcomes among Cocaine-Dependent Patients,” Drug and Alcohol Dependence 77, no. 2 (2005):177–84.

  31. John Majer et al., “12-Step Involvement among a U.S. National Sample of Oxford House Residents,” Journal of Substance Abuse Treatment 41 (2011): 37–44.

  32. M. Ferri et al., “Alcoholics Anonymous and Other 12-Step Programmes for Alcohol Dependence,” Cochrane Database Systems Review 3 (July 2006): CD005032.

  33. Comments on A.A. Triennial Surveys (New York: AA World Services, December 1990).

  34. H. Fingarette, Heavy Drinking: The Myth of Alcoholism as a Disease (Berkeley: University of California Press, 1988).

  35. J. Harris et al., “Prior Alcoholics Anonymous (AA) Affiliation and the Acceptability of the Twelve Steps to Patients Entering UK Statutory Addiction Treatment,” Journal of Studies on Alcohol 64, no. 2 (2003): 257–61.

  36. Fingarette, Heavy Drinking.

  37. Fiorentine, “After Drug Treatment.”

  38. R. Shammas et al., “Remission in Rheumatoid Arthritis,” Current Rheumatology Reports 12, no. 5 (October 2010): 355–62.

  39. R. G. Smart, “Spontaneous Recovery in Alcoholics: A Review and Analysis of the Available Research,” Drug and Alcohol Dependence 1 (1975–1976): 284.

  40. Sheldon Zimberg, The Clinical Management of Alcoholism (New York: Brunner-Routledge, 1982).

  41. S. E. Mueller et al., “The Impact of Self-Help Group Attendance on Relapse Rates after Alcohol Detoxification in a Controlled Study,” Alcohol and Alcoholism 42, no. 2 (2007): 108–12.

  42. G. E. Vaillant, The Natural History of Alcoholism (Cambridge, MA: Harvard University Press, 1983), 283.

  43. R. B. Cutler and D. A. Fishbain, “Are Alcoholism Treatments Effective? The Project MATCH Data,” BMC Public Health 14, no 5 (2005): 75.

  44. D. Dawson et al., “Recovery from DSM-IV Alcohol Dependence: United States, 2001–2002,” Addiction 100, no. 3 (2005): 281–92. Dawson and colleagues’ methodology is as follows: “This analysis is based on data from the 2001–02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which data were collected in personal interviews conducted with one randomly selected adult in each sample household. A subset of the NESARC sample (total n = 43 093), consisting of 4422 US adults 18 years of age and over classified with PPY DSM-IV alcohol dependence, were evaluated with respect to their past-year recovery status: past-year dependence, partial remission, full remission, asymptomatic risk drinking, abstinent recovery (AR) and non-abstinent recovery (NR).”

  45. Brendan I. Koerner, “Secret of AA: After 75 Years, We Don’t Know How It Works,” Wired, June 23, 2010, http://www.wired.com/magazine/2010/06/ff_alcoholics_anonymous/.

  CHAPTER FOUR

  1. Hazelden website admissions page, http://www.hazelden.org/web/public/admissions.page.

  2. Betty Ford Center website, http://www.bettyfordcenter.org.

  3. Sierra Tucson website, http://www.sierratucson.com.

  4. Flyer in author’s collection.

  5. Promises Treatment Centers website, http://www.promises.com.

  6. Saint Jude Retreats website, http://www.soberforever.net.

  7. Sheila Marikar, “Promises Kept, Promises Broken: Inside Hollywood’s Preeminent Rehab Center,” ABCNews.com, March 4, 2011, http://abcnews.go.com/entertainment/charlie-sheen-shines-light-promises-rehab-center-stars/story?id =13048850.

  8. Lance Dodes, MD, “Why There Is Lunacy, Literally, In 28-Day Rehabs,” The Heart of Addiction blog, Psychology Today, April 22, 2012, http://www.psychologytoday.com.

  9. Paul Pringle, “The Trouble with Rehab, Malibu-Style,” Los Angeles Times, October 9, 2007.

  10. R. F. Forman and W. G. Bovasso, “Staff Beliefs about Addiction Treatment,” Journal of Substance Abuse Treatment 21, no. 1 (July 2001): 1–9.

  11. C. Russell et al., “Predictors of Addiction Treatment Providers’ Beliefs in the Disease and Choice Models of Addiction,” Journal of Substance Abuse Treatment 40, no. 2 (March 2011): 150–64.

  12. Pringle, “The Trouble with Rehab.”

  13. Benedict Carey, “Drug Rehabilitation or Revolving Door?” New York Times, December 22, 2008.

  14. “Outcomes of Alcohol/Other Drug Dependency Treatment,” Butler Center for Research, February 2011, Hazelden website, http://www.hazelden.org/web/public/researchupdates.

  15. R. Stitchfield and P. Owen, “Hazelden’s Model of Treatment and Its Outcome,” Journal of Addictive Behaviors 23, no. 5 (1998): 669–83.

  16. Ibid.

  17. Marikar, “Promises Kept, Promises Broken.”

  18. Dana-Farber Cancer Institute website, http://www.dana-farber.org; Austen Riggs Center website, http://www.austenriggs.org.

  19. 1913 ad for Battle Creek Sanitarium, Google Images, www.google.com.

  20. Ad for Dansville Sanitarium, Google Images, www.google.com.

  21. Ad for Moore’s Brook Sanitarium, Google Images, www.google.com.

  CHAPTER FIVE

  1. L. Robins et al., “Narcotic Use in Southeast Asia and Afterward,” Archives of General Psychiatry 32 (1975): 955–61.

  2. According to the US Centers for Disease Control and Prevention, the US adult population of smokers dropped by 40 percent between 1965 and 1990 (“Smoking Prevalence Among U.S. Adults, 1955–2010,” Infoplease, 2012, http://www.infoplease.com/ipa/A0762370.html).

  3. E. Khantzian, “The Self-Medication Hypothesis of Addictive Disorders: Focus on Heroin and Cocaine Dependence,” American Journal of Psychiatry 142 (1985): 1259–64.

  4. J. E. Grant et al., “Pathological Gambling and Alcohol Use Disorder,” Alcohol Research and Health 26, no. 2 (2002): 143–50, pubs.niaaa.nih.gov/publications/arh26–2/143–150.pdf?.

  5. E. Nestler, “From Neurobiology to Treatment: Progress against Addiction,” Nature Neuroscience 5 (2002): 1076–79; http://www.ncbi.nlm.nih.gov/pubmed/12403990; P. Kalivas and N. Volkow, “The Neural Basis of Addiction: A Pathology of Motivation and Choice,” American Journal of Psychiatry 152 (2005): 1303–13; N. Volkow et al., “Dopamine in Drug Abuse and Addiction,” Archives of Neurology 64 (2007): 1475–79.

  6. John E. Helzer, MD, “Significance of the Robins et al. Vietnam Veterans Study,” American Journal on Addictions 19 (2010): 218–21.

  7. Lance Dodes, MD, The Heart of Addiction (New York: HarperCollins, 2002).

  8. K. Merikangas, “The Genetic Epidemiology of Alcoholism,” Psychological Medicine 20 (1990): 11–22.

  9. L. M. Dodes, “Compulsion and Addiction,” Journal of the American Psychoanalytic Association 44 (1996): 815–35.

  10. This is the mission of all psychotherapy: bringing factors to awareness and working them out to understand and eventually master the lingering issues in our emotional lives.

  11. For those who would like to read more about these ideas and see many
real-life examples of how they apply, please see The Heart of Addiction (n. 7) and my book Breaking Addiction: A 7-Step Handbook to Ending Any Addiction (New York: HarperCollins, 2011).

  12. Indeed, the hiker Aron Ralston was widely hailed for cutting off his own arm to escape a boulder in 2003; the 2010 movie 127 Hours chronicles and celebrates his bravery.

  13. Dodes, Breaking Addiction.

  CHAPTER SIX

  1. Here’s the full text of the post:

  I recently completed a review of the scientific literature about the effectiveness of 12-step programs, including regular AA meetings and AA-based rehab treatments. What I found is provocative: Although many people do well in 12-step programs and the famous rehabs around the country, most do not. I’m writing a wide-release book about these issues, to be published next year.

  What’s missing from the project are the firsthand accounts of how people with addictions feel about their own experiences in 12-step recovery. That’s where I hope to have help from readers of this blog: If you would like to describe your honest and open account of personal experiences in AA and/or rehab, I’d like to hear it. Please note that both positive and negative experiences are welcome. If you don’t have a story to tell but know someone who might want to share, I would appreciate if you could pass this request along to them. If I receive enough accounts, I intend to publish many of them verbatim in the forthcoming book.

  No identifying information will be published, including any information about individual counselors, treaters or sponsors. (I.e., it’s fine to say “I was treated at Betty Ford Treatment Center” but not “I was treated by John Smith, a counselor at Betty Ford.”)

  If you’d like to participate in this project, please contact me directly at 12stepbook@gmail.com. Let me know in the email how you’d like to be contacted, and whether you would prefer to conduct a phone interview or simply send your written thoughts. Thank you, and I look forward to hearing from you.

  CHAPTER SEVEN

  1. R. Bond et al., “A 61-Million-Person Experiment in Social Influence and Political Mobilization,” Nature 489 (2012): 295–98.