2010
*
The church will be closed tomorrow, and the drunks are freaking out. An
elderly lady in a prim white blouse has just delivered the bad news, with
deep apologies: A major blizzard is scheduled to wallop Manhattan tonight,
and up to a foot of snow will cover the ground by dawn. The church, located
on the Upper West Side, can't ask its staff to risk a dangerous commute.
Unfortunately, that means it must cancel the Alcoholics Anonymous meeting
held daily in the basement.
A worried murmur ripples through the room. "Wha. what are we supposed to
do?" asks a woman in her mid-twenties with smudged black eyeliner. She's in
rough shape, having emerged from a multiday alcohol-and-cocaine bender that
morning. "The snow, it's going to close everything," she says, her
cigarette-addled voice tinged with panic. "Everything!" She's on the verge
of tears.
A mustachioed man in skintight jeans stands and reads off the number for a
hotline that provides up-to-the-minute meeting schedules. He assures his
fellow alcoholics that some groups will still convene tomorrow despite the
weather. Anyone who needs an AA fix will be able to get one, though it may
require an icy trek across the city.
That won't be a problem for a thickset man in a baggy beige sweat suit.
"Doesn't matter how much snow we get-a foot, 10 feet piled up in front of
the door," he says. "I will leave my apartment tomorrow and go find a
meeting."
He clasps his hands together and draws them to his heart: "You understand
me? I need this." Daily meetings, the man says, are all that prevent him
from winding up dead in the gutter, shoes gone because he sold them for
booze or crack. And he hasn't had a drink in more than a decade.
The resolve is striking, though not entirely surprising. AA has been
inspiring this sort of ardent devotion for 75 years
. It was in June 1935, amid
the gloom of the Great Depression, that a failed stockbroker and reformed
lush named Bill Wilson founded the
organization after meeting God in a hospital room. He codified his method in
the 12 steps, the rules at the heart of AA. Entirely lacking in medical
training, Wilson created the steps by cribbing ideas from religion and
philosophy, then massaging them into a pithy list
with a structure
inspired by the Bible.
The 200-word instruction set has since become the cornerstone of addiction
treatment in this country, where an estimated 23 million people grapple with
severe alcohol or drug abuse-more than twice the number of Americans
afflicted with cancer. Some 1.2 million people belong to one of AA's 55,000
meeting groups in the US, while countless others embark on the steps at one
of the nation's 11,000 professional treatment centers. Anyone who seeks help
in curbing a drug or alcohol problem is bound to encounter Wilson's system
on the road to recovery.
It's all quite an achievement for a onetime broken-down drunk. And Wilson's
success is even more impressive when you consider that AA and its steps have
become ubiquitous despite the fact that no one is quite sure how-or, for
that matter, how well-they work. The organization is notoriously difficult
to study, thanks to its insistence on anonymity and its fluid membership.
And AA's method, which requires "surrender" to a vaguely defined "higher
power," involves the kind of spiritual revelations that neuroscientists have
only begun to explore.
What we do know, however, is that despite all we've learned over the past
few decades about psychology, neurology, and human behavior, contemporary
medicine has yet to devise anything that works markedly better. "In my 20
years of treating addicts, I've never seen anything else that comes close to
the 12 steps," says Drew Pinsky, the addiction-medicine specialist who hosts
VH1's Celebrity
> Rehab. "In my world, if someone says they don't want to do the 12 steps, I
know they aren't going to get better."
Wilson may have operated on intuition, but somehow he managed to tap into
mechanisms that counter the complex psychological and neurological processes
through which addiction wreaks havoc. And while AA's ability to accomplish
this remarkable feat is not yet understood, modern research into behavior
dynamics and neuroscience is beginning to provide some tantalizing clues.
One thing is certain, though: AA doesn't work for everybody. In fact, it
doesn't work for the vast majority of people who try it. And understanding
more about who it does help, and why, is likely our best shot at finally
developing a system that improves on Wilson's amateur scheme for living
without the bottle.
AA originated on the worst night of Bill Wilson's life. It was December 14,
1934, and Wilson was drying out at Towns Hospital, a ritzy Manhattan detox
center. He'd been there three times before, but he'd always returned to
drinking soon after he was released. The 39-year-old had spent his entire
adult life chasing the ecstasy he had felt upon tasting his first cocktail
some 17 years earlier. That quest destroyed his career, landed him deeply in
debt, and convinced doctors that he was destined for institutionalization.
Wilson had been quite a mess when he checked in the day before, so the
attending physician, William Silkworth, subjected him to a detox regimen
known as the Belladonna
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