Wellness Total

Alcoholics Anonymous (and its offshoots) is the great success story in the treatment of addictions. On any given day, more people go to AA groups around the world than attend any other form of therapy. The message of AA is compelling and translates very well across different drugs, social classes, and cultures. AA groups are so numerous and so varied that almost anyone can find a congenial one that is readily available, conveniently located, and probably meeting that night. AA provides hope, a philosophy of life, a spiritual reawakening, an emotional experience, concrete support, a sound­ing board, great advice, and help for family members. It is all the more remarkable that it does all this with virtually no bureaucracy or budget.

The goal of treatment must be complete abstinence from the substance for life. Almost always, people with substance problems resist this goal, hoping instead to return to a state of “controlled” substance use. Although there is an occasional person with Substance Dependence who can eventually go back to social use, this goal is totally unrealistic for the vast majority of users. Becoming dependent seems to reflect a fundamental inability— mediated at the brain level—to just have a little bit, without need­ing more. You may have periods in which you control your drug intake by setting up stern self-imposed limits (“I’m only going to have one joint tonight.”,  “As long as I don’t drink alone, it’s okay.” , “No drugs after 10 P.M.”). Invariably, and before very long, there are seemingly endless and irresistible reasons to bend a rule slightly (“I’m under a tremendous amount of stress.” “I’m celebrating a promotion.” “All work and no play make Jack a dull boy.”