All in the Family

Mental Illness and Caregiving Across the Generations

The Most Important Homework Assignment

Attending an AA meeting might save someone’s life

Last week my son, a high school senior, completed what might be the most important homework assignment of his life. Not his senior essay. Not his bridge made of newspaper made to withstand the weight of a brick. Not his AP Physics lab report on centripetal force.   

He attended a one-hour Alcoholics Anonymous (AA) meeting required for graduation.

Founded in 1935 by Bill Wilson and Dr. Bob Smith, AA is an international mutual aid fellowship whose primary purpose is to stay sober and help other alcoholics achieve sobriety.  The 12-step program of spiritual and character development developed by AA’s founders is credited with helping many alcoholics achieve and maintain sobriety. In 2013, AA had 2,131,534 members worldwide.The AA model has been adapted by a wide range of substance abuse and dependency problems, including Narcotics Anonymous, Gamblers Anonymous, Overeaters Anonymous, Sexual Compulsives Anonymous, Clutterers Anonymous, and Workaholics Anonymous.

The original twelve steps as published by Alcoholics Anonymous2 are:

  1. We admit we were powerless over alcohol—that our lives have become unmanageable.
  2. We believe that a greater power than ourselves can restore us to sanity.
  3. We made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. We made a searching and fearless moral inventory of ourselves.
  5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. We were entirely ready to have God remove all these defects of character.
  7. We humbly asked Him to remove our shortcomings.
  8. We made a list of all persons we had harmed, and became willing to make amends to them all.
  9. We made direct amends to such people wherever possible, except when to do so would injure them or others.

10. We continued to take personal inventory, and when we were wrong, promptly admitted it.

11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

The meeting my son attended included about a dozen women between the ages of 30 and 50. All were dressed in business casual attire. He said they could easily have been the mothers of his friends.  The meeting began with a reading of Step 2. Then several of the women talked about their day. One, a newcomer to the group, said she’d thought about buying a bottle of alcohol just to know it was there, if she wanted it.  Another woman said she’d lost her job because of her drinking problem. Still another feared she’d lose custody of her children if she did not stop drinking.

My son was unusually quiet that evening. I hope he was thinking about what those women had to say.

While many research studies have examined the extent to which participation in AA leads to increased abstinence, results have been inconsistent. A Cochrane Review of eight studies conducted between 1967 and 2005 found that the available experimental studies did not demonstrate the effectiveness of AA or other 12-step approaches in reducing alcohol use or achieving abstinence compared with other treatments.3

A recent special issue of the journal Substance Abuse (January 2013) 4 included articles finding that:

  • People attending AA over a 16-year period had reduced levels of impulsivity.
  • People attending AA meetings over a 9-month period had increased abstinence and reduced drinking intensity.
  • AA involvement was a stronger predictor of drinking outcomes than AA attendance and that AA involvement led to increases in private religious practices, daily spiritual experiences, and forgiveness of others.
  • AA programs are beneficial in maintaining recovery for adolescents with and without psychiatric disorders.
  • Patients suffering from depression have difficulty sustaining involvement with 12-step programs and are more likely than those not suffering from depression to relapse over time.
  • AA meeting attendance reduced use of alcohol.
  • Meeting attendance and having a sponsor predicted abstinence over a 12- month period.

Research about AA programs is very difficult to do. It is virtually impossible to randomize people to AA programs and people are not randomly selected to the population of alcoholics. Furthermore, people choosing to participate in AA meetings may be motivated to stop drinking even before they participate and AA may attract people with the most severe problems.

Next year, my son will be a college student. Virtually all college students experience the effects of college drinking whether they drink or not. According to the National Institute on Alcohol Abuse and Alcoholism, four out of five college students drink alcohol and about half of college students who drink engage in binge drinking.5 Each year, 1,825 college students die from alcohol-related injuries. Another 599,000 college students sustain injuries while under the influence of alcohol.

I hope the opportunity my son had to witness an AA meeting gives him pause when alcohol becomes widely available to him next year. But I also hope that if he, or someone he cares about, develops an alcohol problem, he will know that help is available. 

This homework assignment might just save someone’s life.

 

  1. http://www.aa.org/pdf/products/m-24_aafactfile.pdf
  2. Bill W. (June 2001). "Chapter 5: How It Works" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. ISBN 1-893007-16-2. OCLC 32014950.
  3. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/abstract
  4. Substance Abuse, 2013. Special issue
  5. http://www.niaaa.nih.gov/alcohol-health/special-populations-co-oc...

Rachel Pruchno, Ph.D. is Endowed Chair and Professor of Medicine at Rowan University School of Osteopathic Medicine. Her memoir Surrounded by Madness comes out March 2014

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