The Committee on
Alcoholism and Drug Dependence of the American Medical Association defines
alcoholism as "an illness in which there is preoccupation with
alcohol and loss of control over its consumption, as a type of drug
dependence that can harm a person's health and interface with his ability
to work and get along with other people."*
How A.A. views alcoholism
Alcoholism, in A.A.'s
opinion, is a progressive illness-spiritual and emotional (or mental),
as well as physical. The alcoholics we know seem to have lost the power
to control drinking.
The medical profession
has long been an ally and resource of Alcoholics Anonymous. A.A. shares
with physicians a concern for the health and well-being of those who
still suffer from the disease of alcoholism.
The rate of growth
in A.A. shows that an increasing number of alcoholics are recovering
from this disease. There are over 73,000 A.A. groups, in 114 countries.
Women today constitute one-third of the Fellowship, and young people
(30 years and under) about 20% of A.A. members sober more than a year
have a very high likelihood of continuing their successful process of
resistance to help can be frustrating
Since denial of
the problem is symptomatic of alcoholism, alcoholic patients rend to
be evasive when questioned about their drinking; and some physicians
may not recognize that alcoholism may be contributing to their symptoms.
Patients may resist any suggestion that alcoholism is involved and may
be equally resistant to the suggestion of Alcoholics Anonymous as a
Few doctors have
had the experience of having their diagnosis rejected. Few have been
told, "I certainly am not a diabetic." Yet when the doctor
makes a diagnosis of alcoholism, an alcoholic will often respond, "I
don't drink that much," or will offer excuses for his or her drinking.
Physicians can expect and anticipate this.
and denial are part of the alcoholic's illness. Initial rejection of
A.A. is part of the denial mechanism.
A.A. members, having
broken through their denial and faced the harm in their drinking, are
particularly suited to helping others break through their denial.
What some members
of the medical profession have learned; how they apply that knowledge.
Many doctors have
found effective ways to refer their patients to A.A.
In the words of
Stanley Gitlow, M.D., a clinical professor of medicine, Mt. Sinai School
of Medicine in New York, and chairperson of the Committee on Alcoholism
of the Medical Society of the State of New York:
of your patients suffers more than the alcoholic. When you once touch
the life of an alcoholic and help him or her to recover, when you
observe this incredible change from a suffering, helpless, sick (and
dying) person to one who is alive, vital, functioning, and happy,
you will be part of a rich, rewarding, and profound experience. A.A.
is the most effective means of teaching an alcoholic how to stop drinking
that I know of."
In an address to
the Third Annual Department of Defense Alcohol and Drug Abuse Conference,
William E. Mayer, M.D., director of the Alcohol, Drug Abuse and Mental
Health Administration (ADAMHA), referred to the "explosive growth "
of A.A. in the last decade and said:
"A.A. by and large
works better than anything we have been able to devise with all our
science and all our money and all our efforts.
"If you are ignoring
the utilization of A.A. groups-interaction with them, referral to
them-then you are ignoring a critical, crucial part of the important
kinds of care people with this disorder deserve and must have.
" A.A. has shown
the way and presented us with a model of long term care that is really
not care. It is participatory self-management. It is an assertion
of the autonomy of the individual. Instead of his thinking of himself
as a victim, a helpless person,
. . . A.A. gives
a person the kind of sense of self-worth and along with it the kind
of humility and reality-testing that are absolutely essential in the
management of alcohol problems."
Ann Geller, M.D.,
director of Smithers Alcoholism Treatment and Training Center, St. Luke's-Roosevelt
Hospital in New York, suggests obtaining a number of copies of A.A.
meeting lists from the local intergroup or central office of A.A. (listed
in your local telephone directory ) to give to patients.
Dr. Geller also
thinks physicians should attend open A.A. meetings, as it is extremely
difficult to feel confident in referring a patient to an organization
about which the doctor has little information. Dr. Geller, like many
physicians, finds it helpful to have a list of A.A. contacts available
to take people to their first meeting. She suggests specific inquiries
as to which meetings have been attended, how frequently, and whether
the patient has obtained an A.A. sponsor.
Whether the alcoholic
patient is suffering from a diseased liver or an emotional depression,
getting him or her sober is the first step toward recovery, according
to Dr. Geller. She adds that wherever the patient lives, there is sure
to be an A.A. meeting nearby for help in maintaining sobriety.
As Dr. Geller's
comments indicate, A.A. is listed in most telephone directories, and
a phone call is all that is needed for help. Some doctors dial the local
A.A. number while the patient is still in the office, and then present
the patient with the immediate opportunity to reach out for help. Some
simply write a prescription to attend Alcoholics Anonymous meetings.
The local A.A. office
can provide the physician with information about the types of A.A. meetings
in the area -e.g., professional, women's, young people's, gays', blacks',
Hispanic, etc. Such information may help patients to identify with their
peers more readily.
Dr. Saul Cohen,
a Canadian physician, emphasizes the need to focus on stopping the drinking
itself in the "here and now ," and he urges A.A. attendance as a way
of dealing with that problem. He further encourages the family to become
involved in Al-Anon and Alateen.* This combined approach, along with
the doctor's continued encouragement, increases the support that the
alcoholic so desperately needs in the early days of recovery.
Dr. Cohen also points
and management of alcoholism, one of the most untreated, treatable
illnesses, is when within the scope of any physician who is willing
to test his diagnostic acumen on a widespread, multiple-system disease
which masquerades in many disguises. Paraphrasing Osler's remark,
one may say that 'to know alcoholism is to know all medicine.'
who works closely with Alcoholics Anonymous in his community is in
a key position to provide leadership, education, and support in an
area which will pay great dividends in the quality of care and rates
of recovery of those still suffering alcoholics."
recommend A.A. to their patients, the physicians should not base their
opinion of the effectiveness of A.A. on one or two meetings attended
by the patient, but give A.A. a fair trial. Having a patient attend
the first A.A. meeting with a member is desirable, although not a must.
Most newcomers have many questions. The older member can answer these
and reassure the newcomer that others have experienced the same reluctance
and fear in taking a first step toward recovery. Sharing experience
as peers is the unique service Alcoholics Anonymous offers. In most
instances, doctors find A.A. members not only willing but eager to introduce
newcomers to the A.A. program.
may object to going to A.A., saying:
"It's too religious."
A.A. is not a religious program, but a spiritual fellowship. It refers
to a "Higher Power" and "God as we understand Him," but no belief
in God is necessary; atheists and agnostics find plenty of company
"I don't want to stand up and bare my soul in front of a lot of
Only those who wish to do so speak at A.A. meetings.
"I don't want to meet with a lot of losers. It's too depressing."
A.A. more accurately represents across section of "winners,"
in the sense that they have survived the disease. A.A. rnembers are
an interesting representation of society at large. If patients go
to enough meetings, they are sure to find people with whom to identify.
"I can't go there. An those people are sober and I'm not. I'd be
The only requirement for rnembership is a desire to stop drinking.
Members who are still drinking are encouraged to "keep coming back."
Sober alcoholics are not going to sit in judgment on someone who cannot
stop drinking, since not being able to stop drinking is what brought
them to A.A.
"I don't want everyone to know about my drinking." Anonymity
is and always has been the basis of the A.A. program. Traditionally,
A.A.'s never disclose their association with the movement in print,
on the air, or through any other public medium. And no one has the
right to break the anonymity of another member anywhere.
welcome at open A.A. meetings. (Closed meetings are for alcoholics only.)
We invite doctors to visit and see what A.A. offers the alcoholic.
have found the following pamphlets helpful in introducing patients to
This Is A.A.
Is A.A. for You?
Young People and A.A.
A.A. for the Woman
Too Young? (for teenagers)
A Newcomer Asks
Time to Start Living (for alcoholics over 60)
A Member's-Eye View of A.A.
Do You Think You're Different?
and complete order forms are available from Box 459,Grand Central Station,
New York, NY 10163.
Medical Society on Alcoholism Resolution on Self-Help Groups, October
is a complex disease affecting the body, mind, family, occupational
and social life of the person afflicted;
WHEREAS, the treatment
of the disease alcoholism requires a cooperative effort involving many
disciplines in addition to physicians;
groups, particularly Alcoholics Anonymous, have been a tremendous help
in recovery to many thousands of alcoholics, their friends and families;
THEREFORE, be it
resolved that the American Medical Society on Alcoholism encourages
all physicians and the alcoholism treatment agencies with which they
work to develop relationships of maximum cooperation with the self-help
groups, such as Alcoholics Anonymous.