Addiction: “Lefty” Hooligan, “What’s Left?”, March 2022

All sin tends to be addictive, and the terminal point of addiction is what is called damnation.
W.H. Auden

I got nasty habits / I take tea at three / Yes, and the meat I eat for dinner / It must be hung up for a week
Mick Jagger & Keith Richards, “Live with Me,” Let It Bleed

I was newly sober thanks to Kaiser’s Chemical Dependency Recovery Program. It was 2012 and I wasn’t doing Alcoholics Anonymous. Instead I was sitting zazen at the Page Street Zen Center every Monday night for the Meditation in Recovery meeting which melded soto zen with AA. I’d started putting out cushions for that meeting on a regular basis, but suddenly it was determined I needed to be vetted for such an innocuous volunteer task. So I went out for a cup of coffee with Tom to discuss the state of my recovery. He prefaced our talk by saying that, while the AA 12-steps fit hand-in-glove with Buddhist meditation, AA is absolutely necessary whereas Zen is not. Then he proceeded to quiz me about whether I’ve committed to a higher power yet and how far I’d gotten in my fourth step to “make a searching and fearless moral inventory” of myself.

“In my experience,” Tom said. “Most relapse happens due to a failure to make a thorough moral inventory.”

Now, I wasn’t in line to become Tom’s sponsee, so I didn’t understand the need for him to grill me on how well I’d been doing in my sobriety just to put out some pillows. The AA rigamarole seemed decidedly evangelical (“Have I taken Jesus as my savior?” and “Have I confessed all my sins?”) and even cultish. I decided not to hold back.

“A Harvard Medical School study reported that alcoholism has an annual spontaneous remission rate of around 5%,” I said. “When figures are reported at all, AA can claim only a 5% to 10% annual success rates, at best double the annual spontaneous remission rate. This is an extremely low bar for recovery.”

Tom seemed startled as much about the facts I’d presented as about my audacity to criticize AA at all. He delivered his clincher:

“AA’s anonymity, the Steps, its structure, the whole program works to prevent relapse. Criticizing AA threatens not just your recovery, but everybody’s sobriety.”

“Treating alcoholism with AA is like treating cancer with a sugar pill.” I got angry. “Now you say criticizing a bogus cure like AA endangers lives?”

We sparred a bit more, but it was clear he wasn’t prepared to debate me on his blind adherence to AA. Nor was he willing to block my volunteer service work based on his dubious grasp of the efficacy of recovery options. I was disturbed he hadn’t done the research to ferret out the facts about AA’s dismal success rate. Our discussion ultimately devolved into the old dodge he eventually voiced that “well, it works for me.” Yet I stayed with the Zen Center’s “Meditation in Recovery” meetings until the pandemic ended them in person. In their zen rewrite of the 12-Steps, those meetings were nowhere near as obnoxious as regular AA meetings. Yet folks like Tom give it a hardline dogmatic feel that’s zealous and off putting.

If you read the anti-AA “Orange Papers” online it’s hard NOT to consider Alcoholics Anonymous a cult. AA had its genesis in the First Century Christian Fellowship/Oxford Group/Moral Re-Armament organization, whose leader Frank Buchman admired Adolf Hitler and the National Socialist German Workers’ Party. Leaving that aside, AA’s founders William “Bill W.” Wilson and Robert “Dr. Bob” Smith crafted a crypto-religious, quasi-Christian recovery movement centered on their undisputed leadership. AA includes a bible (the “Big Book”), private confessionals (“a searching, fearless moral inventory”), complete surrender to an anthropomorphic god (phrased as a “higher power”), a “build ‘em up, break ‘em down” process that encourages conformity and discourages independent thinking and autonomous identity, and anonymous group processes that often shield predatory power dynamics. Because AA is decentralized, individual groups sometimes modify the organization’s core precepts and there are now explicitly atheist or anti-authoritarian AA groups. Yet it is hard to avoid the cultic stench of AA’s origins and early years.

I went on to discover and partake in Noah Levine’s Refuge Recovery community that developed a coherent Buddhist-based sobriety program. Levine is an unrepentant sexual harasser who refuses to demonstrate compassion or take responsibility in the Buddhist sense of those words. But Refuge Recovery is a promising addiction recovery option that avoids some of the pitfalls of AA and its 12 Steps/12 Traditions.

So what exactly is a cult? Aside from charismatic, unquestioned leadership (either living or dead), reliance on scripture, an emphasis on blind obedience, and often hierarchical power structures, there are a few more points to emphasize. Leaders micro-manage the lives of their followers, mind-molding techniques are practiced, the group is elitist and has an us-versus-them mentality, all means justify the group’s ends, guilt and shame are used to cow the membership and have them cut ties with family and friends, a preoccupation with recruiting new members and making money, and defining a core of “true believers” who have no life outside their group. Depending how many of these are checked will determine how far along the group in question is toward being a cult. I have encountered numerous cults in my life—Children of God, Krishna Consciousness, Scientology, pretty much anything related to Lyndon LaRouche, Communist Party USA (Provisional), and scores more. AA is only a quasi-cult, the more traditional the version the more cultish.

AA’s cultishness aside, there is the problem of how AA defines alcoholism. The American rugged individualist ethos values self-control and being the master of one’s fate. This runs counter to the notion that drug addiction is a disease that cannot be controlled or cured by will power. AA’s first step asserts that “we admitted we were powerless over alcohol—that our lives had become unmanageable.” While AA is an explicitly “spiritual,” often faith-based program that doesn’t endorse the idea that alcoholism is a disease in the medical sense, quite a few AA members openly advocate it. The disease model for drug addiction seems to be the preponderant thinking in the medical community, with stitched statements like “drug and alcohol addiction is a disease, not a crime … not a moral failing … addiction is a chronic medical disease like diabetes, hypertension, heart disease, lupus and cancer.” And the medical disease model makes some sense. The initial drug experience (the “high”) provides the excitement and pleasure, whereas the prolonged use of any drug causes physiological changes to the individual’s body and brain that alters the chemical and physical functioning of both. The desire for the “high” becomes the need to simply maintain. Aside from potentially damaging an individual’s body and brain, the altered physiology almost inevitably produces withdrawal symptoms when the drug in question is removed.

I spent the first three months of 2010 in Kaiser’s CDRP program viscerally tracking the 30-60-90 day changes to my body’s organ systems, individual organs, cells, and biomolecules as I went through withdrawal from alcohol. I attended different group meetings (trad AA, harm reduction, LifeRing, etc.) twice a week and had access to counselors, therapists and psychiatrists who had the authority to prescribe medications. I became severely, clinically depressed in the course of my withdrawal, so I spent another nine months working group cognitive behavioral therapy to finally feel comfortable with my sobriety. Round this out with weekly meetings and meditation at the Zen Center and I never relapsed. I haven’t had a drink for twenty-two years, yet clearly this was not “going cold turkey.” It wasn’t me exercising my individual will power to stop drinking, but involved combining several collective processes to finally become and stay sober. Instead of accepting AA’s second step (“came to believe that a Power greater than ourselves could restore us to sanity”) I realized that the simple act of surrender, of realizing how powerless I was over my drinking, allowed me to maintain my sobriety.

The medical model has its limits. Experiencing a disease that happens to you (getting cancer, say, from asbestos exposure) cannot be equated to a disease caused by something you’ve done to yourself because of an addiction (the physical and mental decline produced by decades-long alcohol abuse you could not control). And while being tossed into jail or institutionalized can halt the progress of the disease of addiction, the same can’t be said for a disease like cancer. For these reasons I’ve been leery to call drug addiction a disease. To the addict’s inability to exercise will power and self-control to “cure” one’s drug addiction must be added the crucial need for collective organizing, action, and support in confronting and overcoming one’s drug addiction. AA’s not the most effective way to deal with drug addiction in my estimation, even ignoring it’s cult-like aspects. But a communitarian response to individual substance abuse is absolutely key.

Personal recollections
“The Cybernetics of ‘Self’: A Theory of Alcoholism” by Gregory Bateson (Steps to an Ecology of Mind, 1972)
Handbook of Alcoholism Treatment Approaches edited by William Richard Miller and Reid K. Hester
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Lance Dodes
Inside Rehab by Anne Fletcher
Refuge Recovery by Noah Levine
“The Irrationality of Alcoholics Anonymous” by Gabrielle Glaser (The Atlantic, 4-2015)
“Addiction is not a disease: How AA and 12-step programs erect barriers while attempting to relieve suffering” by Marc Lewis (Salon, 7-11-2015)
“Deprogramming From AA—When a Fellowship Resembles a Cult” by April Wilson Smith (Filter Magazine, 5-2-2019)
Orange Papers:

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