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“God
will constantly disclose more to you and to us.” (Big Book page 164) “Most
of us have been unwilling to admit we were real alcoholics.
No person likes to think he is bodily and mentally different from his
fellows ... We learned that we had to concede to our innermost selves that we
were alcoholics. This is the first
step in recovery. The delusion that
we are like other people, or presently may be, has to be smashed.”
(Big Book page 30) “...an
allergy which differentiates
these people, and sets them apart as
a distinct
entity.”
(Big Book - “The Doctor’s
Opinion” page xxviii) The
following material is designed to elaborate on the disease concept of alcoholism
as put forth by Dr. Silkworth in “The Doctor’s Opinion.” When
the Big Book was first published in
1939, the suggestion that alcoholism is a disease was so radical that Dr.
Silkworth declined the use of his name. It
is amazing to note, that in the subsequent decades, our ever-widening knowledge
base has not been able to contradict or erode the doctor’s original premise.
On the contrary, it has provided an even greater opportunity to
understand the essential differences between us and non-alcoholics.
We have come to believe through experience that without a thorough
understanding of the ‘exact nature of the malady’
or THE PROBLEM - there is little hope we
will dare to take the action necessary to experience THE SOLUTION. “In
our belief, any picture of the alcoholic which leaves out this physical factor
is incomplete.” (AA’s view in
“The Doctor’s Opinion” page xxiv) We
are confident that with a deeper awareness of what is REALLY meant with “We
admitted we were powerless over alcohol” we will be more likely to come to
terms with the unmanageability of our lives, described so well on page 52 of the
Big Book. “We were having
trouble with personal relationships, we couldn’t control our emotional
natures, we were prey to misery and depression, we couldn’t make a living, we
had a feeling of uselessness, we were full of fear, we were unhappy, we couldn’t
seem to be of real help to other people.” We add “We were not comfortable
with our sex life,” and think of these as the “criteria” for untreated
alcoholism. The
first part of Step 1 helps us ‘buy into’ Sobriety. The
second part of Step 1 helps us ‘buy into’ Recovery. Approached
with a ‘beginner’s mind’, we have found this material indispensable in
showing “other alcoholics precisely
how we have recovered from a seemingly hopeless state of mind and body.” The
following information comes from an article written by Dr. David L. Ohlms,
entitled “The Disease Concept of Alcoholism.” Dr. Ohlms has developed a
national reputation in the field of alcoholism, taking off from Dr. Silkworth’s
“theory.” We offer it here in
the spirit of the Big Book (page 31)
“Science may one day accomplish this...” “There is good news about one of
mankind’s oldest diseases - alcoholism. Not
too many years ago nearly everybody thought it was hopeless.
We don’t think so any more. “The story begins in the late
1930’s when people who were suffering and dying from alcoholism got tired of
going to professionals because the professionals couldn’t seem to help them -
the alcoholics just kept on dying. Or
wound up in lunatic asylums or jails. So
alcoholics banded together and formed an organization to help themselves -
Alcoholics Anonymous - and lo and behold, they did discover a way to stop dying
and make themselves better. “AA members not only stopped
dying and got healthier, they discovered a method that let them give up drinking
and lead as normal a life as anyone else. That’s the second part of the good news.
But in order to help fellow alcoholics, AA first had to decide that
alcoholism was a treatable disease. Let’s
go back to that half of the good news now. “You have to remember that early
AA members weren’t research scientists - they were businessmen, salesmen,
carpenters, waitresses - and they were all seemingly hopeless drunks who only
recently had been able to stop drinking. But
the AA program was so successful that finally after several decades, medical
science felt forced to take a good look at it.
Why did it work? Why was it that these ordinary people, doing what they did,
were able to get well, while we professionals, treating medically and
psychiatrically, seemed to make them sicker rather than better? “The first thing we noticed was
that AA people were saying that alcoholism is a primary disease.
It is its own disease. It
causes its own symptoms - it is not itself a symptom of some other disease - and
AA treated it this way. And medical
science finally had to admit that AA was right!
In 1956 the American Medical Association officially recognized alcoholism
as a true disease - an entity of and by itself, that created its own problems,
its own symptoms, that had its own treatment - and the AMA published this view
in a major paper. “Now in order to go on with our
story, we need to say something here about disease. I think we need to define it, and that’s not easy to do.
Here’s one I like out of a 99 cent pocket dictionary:
"A disease is anything that interferes with the ability of the human
being to function normally". Whatever
it is, however you caught it, a disease prevents you from living your life as
efficiently as you ordinarily would. “The definition I like to use
for alcoholism is: a chronic,
progressive, incurable disease characterized by loss of control over alcohol and
other sedatives. Let’s take a
look at what this really means. CHRONIC
is self-explanatory. It lasts a
long time. PROGRESSIVE is
fascinating. It’s one of the
unique features of the illness, and one of the reasons why most people in the
helping professions - medicine, counseling, etc. - don’t like alcoholics. It goes on and on and on.
And it demoralizes everyone involved.
It tends to make them say “What’s the use?” almost from the
beginning. So while the disease
gets worse as the alcoholic continues to drink, what about the fellow who
resumes his drinking after even a prolonged period of sobriety?
Within a short period of time, the symptoms that the alcoholic will show
are the same symptoms showed when drinking was stopped 10, 15 or 25 years
before. And usually worse.
It’s as if those years meant absolutely nothing.
I know this is shocking - it has almost a hint of the supernatural - but
later I think I can give you a scientific explanation as to why it is a medical
fact. “INCURABLE disease simply means
that an alcoholic cannot be taught to handle controlled social drinking.
Science has so far given us no cure for alcoholism.
LOSS OF CONTROL is what makes this disease different from other chronic,
incurable diseases such as diabetes. Loss
of control does not mean that when an alcoholic takes a drink - every time he
takes a drink - he’s going to drink to excess and get drunk.
Loss of control means that once an alcoholic takes that first drink, he
can’t predict with any reliability whether he’s going to have a normal or
abnormal drinking episode. He’s
lost the ability to predict his drinking behavior.
He no longer controls alcohol, as most of us do; it controls him. “The alcoholic has lost control
over not just the drug alcohol - for alcohol is basically nothing more than a
widely-available, socially acceptable, non-prescription and inexpensive
sedative. He’s lost control over
all other sedative drugs as well. Most
alcoholics, in my experience, run back and forth from alcohol to some form of
tranquilizer. It is a vicious cycle
and a significant number of alcoholics will eventually have their minds
destroyed by the disease. About 34
out of 36 will be killed by it in one way or another.
One out of 36 will get treatment, will recover and get well.
That’s a tragic statistic. It’s
tragic because it’s unnecessary. For
middle-stage alcoholics, recovery rates are as high as 80%.
Late-stage recovery rates run from 25% to 35%.
By “recovery”, I mean people regaining their health and going back to
normal, functioning, working lives. There
are very few chronic, progressive, incurable illnesses where 25% to 80% of those
who have found treatment can get well again. “The cause for alcoholism, like
many other diseases, has yet to be proven.
However, heredity studies, done all over the world, clearly show that
genetics is far more significant in determining whether or not you’ll be an
alcoholic than any combination of social or environmental factors combined.
Now I’m not saying a person is born an alcoholic.
No. I’ve never met an
alcoholic who didn’t drink. But I
think it’s conclusive that some people are indeed predisposed to alcoholism
because of their heredity; and if they ever start drinking, they run an
unbelievably high risk of developing the disease. “Of course, in medicine we have
a lot of diseases that work that way. Diabetes
has a high family predisposition, for example.
When science notices a family predisposition toward a disease, it will
look for some abnormality in body chemistry.
What about the body chemistry of the alcoholic?
They key discovery came by complete accident.
A medical scientist named Virginia Davis was doing cancer research in
Houston, Texas. For her studies,
she needed fresh human brains – which are not widely available.
So she’d ride out with the Houston police in the early morning and
collect the bodies of winos who had died on Skid Row the night before.
The warm bodies were rushed back to the hospital, where the brains were
removed. “One day Virginia was talking to
some doctors in the hospital cafeteria. She
was telling them about some finding of her laboratory studies, and she said:
“You know, I never realized that all those winos used heroin as well as
booze.” The doctors laughed. “
Come on, Virginia,” they told her. “These
guys don’t use heroin. They can
barely afford a bottle of cheap muscatel.”
She had discovered in the brains of those chronic alcoholics a substance
that is, in fact, closely related to heroin.
This substance, long known to scientists is called Tetrahydrolsoquinoline
- or (fortunately) THIQ for short. When
a person shoots heroin into his body, some of it breaks down and turns into this
THIQ. But then these people hadn’t
been using heroin; they had just been simple alcoholics.
So how did the THIQ get there? “When the normal adult drinker
takes in alcohol, it’s very rapidly eliminated at the rate of about one ounce
per hour. The body first converts
the alcohol into something called acetaldehyde.
This is very toxic stuff, and if it were to build up inside us, we would
get violently sick; and indeed we could die.
But Mother Nature helps us to get rid of acetaldehyde very quickly.
She efficiently changes it into acetic acid, which we will know as
vinegar, and then changes it a couple of more times - into carbon dioxide and
water - which is happily eliminated through the kidneys and lungs.
That’s what happens to normal drinkers.
It also happens with alcoholic drinkers, BUT they get what we might call
a P.S. “What Virginia discovered in
Houston, which has been extensively confirmed since, is that something
additional happens in the alcoholic. In
them, a very small amount of poisonous acetaldehyde is NOT eliminated; instead
it goes to the brain where, through a very complicated biochemical process, it
winds up as this THIQ. THIQ is
manufactured right in the brain, and it only occurs in the brain of the
alcoholic drinker; it does NOT happen in the brain of the normal social drinker
of alcohol. THIQ has been found to
be highly addictive. It was tried
in experimental use with animals during W.W.II, when we were looking for a pain
killer less addicting than morphine. THIQ
was a pretty good pain killer, all right, but it turned out to be much more
addicting than morphine. There are,
as you might know, certain kinds of rats that cannot be made to drink alcohol.
Put them in a cage with a very weak solution of vodka and water; they
will literally thirst to death before they agree to drink it.
But if you take the same rat and put an unbelievably minute quantity of
THIQ in its brain - the animal will immediately develop a preference for alcohol
over water. In fact he’ll be
happier if you mix his drink with less and less water.
So we’ve taken a teetotaling rat and turned him into an alcoholic rat.
All we needed was smidgen of THIQ. “Other studies have been done
with monkeys, our close animal relatives in medical terms.
We’ve learned that once THIQ is injected into a monkey’s brain, it
stays there. You can keep a THIQ’ed
monkey dry, off alcohol, for as long as 7 years; then when you study his brain,
that weird stuff is still there.
This takes us back to the progressiveness of the disease.
Remember that person who’s been sober for 10 or 25 years, and then
suddenly starts drinking again? The
alcoholic will immediately show the same symptoms displayed years before! - and
it’s no wonder. The human
alcoholic is still carrying THIQ like those man-made, alcoholic monkeys and
rats. “Now alcoholics don’t intend
to make THIQ when they start drinking. They
don’t mean for their brains to manufacture something stronger than morphine.
Most normal folks take a drink now and then, and the young
alcoholics-to-be want to be normal. So
they take a drink now and then, too. But
they don’t know about the predisposition toward THIQ-making their brain
chemistry has inherited. In their
drinking careers, as THIQ piles up, the alcoholic will cross over a shadowy line
into a whole new way of life. Some
predisposed people cross the line while they’re teenagers - or earlier!
It won’t occur in others until they’re 30 or 40 or maybe even
retired. But once it does happen,
the alcoholic will be as hooked on alcohol as he would have been hooked on
heroin if he’d been shooting that instead - and for very similar chemical
reasons. “Alcoholism is a disease - and that’s good news.
Alcoholism is not the alcoholic’s fault - and that’s good news too.
The alcoholic patients I see are usually hugely relieved to hear that it’s
not their fault, because they’ve been carrying tons of guilt along with the
alcoholism - and that guilt was often worse that useless.
Now instead of guilt, the alcoholic person knows the facts, he or she
can, with treatment, learn how to live like normal, healthy grown-ups again.
That’s good news for all of us. That’s
the best news any human being can ever expect.”
Food for thought: Most
alcoholics reach out or arrive at our doorstep with three things intact:”
(A) the illness of ALCOHOLISM, (b) ignorance and misinformation as to the
EXACT NATURE of the malady, and (c) a BAG FULL of SECRETS. There
is a widely held misconception that taking a new person to a few AA meetings or
giving them a Big Book will “plant
the seed,” and really “screw up their drinking.” Our own experience has proven THIS IS NOT SO. In
our basic text, we will find the following statement: “But the ex-problem
drinker who has found this solution, who
is properly armed with the facts about himself,
can generally win the confidence of another alcoholic in a few hours.” (
Big Book page 18 italics
- underline added) It
is interesting to note that in the
“original manuscript” this
read: “...who is properly armed with CERTAIN
MEDICAL INFORMATION...”
(caps and
underlining added) We
find validation of this in Twelve Steps
and Twelve Traditions: “It was then discovered that when one alcoholic
had planted in the mind of another the true nature of
his malady, that person could never
be the same again.” (Page 23) “IN
A FEW HOURS” we can address two of the three items mentioned above!
We can then, and only then, move on to discussions and sharing of the
Spiritual Solution which will take care of the illness AND the “bag of
secrets.” When
this material is in place, and we are confidant that it is understood, we dare
to go so far as to explain to the new person that though they may be held
ACCOUNTABLE for their past actions, they are not RESPONSIBLE. The other side of the coin is, now that they DO understand the “Disease Concept of Alcoholism” and that there is a “Spiritual Solution,” they are 100% ACCOUNTABLE and 100% RESPONSIBLE.
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