Wilson, Bill

Bill W. co-founded Alcoholics Anonymous.

At a time when his doctors believed his only viable path to abstinence might be long-term institutionalization, Bill Wilson had an awakening late in 1934.

It spurred him not only into sobriety but ignited a life-long desire to help other alcoholics get sober and stay sober.

Religious influences

The folks who helped Bill were members of the Oxford Group, a Christian group seeking personal growth through their faith. He tested his religious options, particularly in the early portion of his sobriety, but the long-term religious theme for his life was agnosticism.

Dr. Bob

Five months into his sobriety, after disappointing attempts to help other alcoholics, Bill met Dr. Bob. A physician whose practice was failing due to his years of alcoholism, Bill was instrumental in bringing a fresh approach to sobriety into Bob’s life.

They joined forces in expanding the Oxford Group’s outreach to help other alcoholics.

Founding of AA

Ultimately, the Oxford Group and its alcoholic contingent parted ways, and Bill and Dr. Bob’s voices grew clearer and more determined. Although not named as such until a couple of years afterward, the start of Bob’s long-term abstinence in June 1935 has been marked as the founding of Alcoholics Anonymous.

Author of the 12 Steps and the Big Book

Bill was the initial drafter of the 12 steps as part of his authorship of the first 11 chapters of the Big Book, published in 1939.

He visualized AA as a movement which would help alcoholics everywhere with the concepts he molded, and yet with an organizational structure driven by principles, not personalities, requiring him to lead by consensus-building.

Gentle, human giant

Respected by his peers in AA as a gentle giant, Bill was known as a man who welcomed all and liked nothing better than talking things out one-on-one with an alcoholic in need.

Succeeding in recovery still left him human and challenged, as recounted by Francis Hartigan on page 2 of Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson:

Even after he quit drinking, Wilson had a number of personal problems, and he regarded as moral failings his inability to deal with them successfully. His financial situation never truly righted itself, his womanizing continued, and no matter how severely it affected his health, he could never manage to quit smoking. There was also the fact that he could not find any effective means of dealing with his cripping depression.

Bill’s lesser-known thoughts

Although skeptical about moderate drinking as a long-term solution, Bill encouraged folks who didn’t find their lives to be unmanageable to work on controlled drinking. In the description of the first step in 12 Steps and 12 Traditions, he noted that some of the folks trying out AA were “scarcely more than potential alcoholics”, and:

To the doubters we could say, “Perhaps you’re not an alcoholic after all. Why don’t you try some more controlled drinking, bearing in mind meanwhile what we have told you about alcoholism?” This attitude brought immediate and practical results. It was then discovered that when one alcoholic had planted in the mind of another the true nature of his malady, that person could never be the same again. Following every spree, he would say to himself, “Maybe those A.A.’s were right…”

He was painfully aware of, and frustrated by, the large numbers who had not been reached or helped by AA. From the Afterward of his autobiography Bill W: My First 40 years, p. 167:

While the overall AA program moved toward stability and maturity, Bill still seemed obsessed with those who somehow weren’t able to make AA work for them. Warning of the dangers of pride and complacency, he challenged AA members at AA’s thirtieth anniversary meeting [in 1965] with a question: “What happened to the 600,000 who approached AA and left?”

That concern was tied to the friends who had been instrumental in Bill’s path to sobriety, yet unable to sustain it themselves. One of them was Ebby Thacher, who had led Bill to the Oxford Group, but relapsed a couple of years later and many more times before his death by emphysema in 1966. As recounted in the Hartigan bio:

Whenever a grateful AA member asked Bill if there was anything he could do for him, Bill invariably replied, “Well, I just wish there was something we could do to help Ebby.”

Blip

From Dictionary.com:

blip, n.

• A spot of light on a radar or sonar screen indicating the position of a detected object, such as an aircraft or a submarine
• A temporary or insignificant phenomenon, especially a brief departure from the normal.

My definition:

A break in a drinking pattern, such as drinking during a period intended to be abstinent. Worth examining and learning from, but not necessarily a setback or helpful to interpret as a failure.

Some blips turn out to be anomalies, like false echoes on a radar screen, or inconsequential. Sometimes a blip is the first sign of a threat, needing to be addressed proactively.

The keys to reading a blip are consciousness and context: How does it fit with our typical or recent patterns?

The 12 Steps

The Twelve Steps of Alcoholics Anonymous, from the AA.org page titled The Recovery Program:

1. We admitted we were powerless over alcohol — that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. 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.

Additional info from the same page:

Newcomers are not asked to accept or follow these Twelve Steps in their entirety if they feel unwilling or unable to do so.

They will usually be asked to keep an open mind, to attend meetings at which recovered alcoholics describe their personal experiences in achieving sobriety, and to read A.A. literature describing and interpreting the A.A. program.

A.A. members will usually emphasize to newcomers that only problem drinkers themselves, individually, can determine whether or not they are in fact alcoholics.

At the same time, it will be pointed out that all available medical testimony indicates that alcoholism is a progressive illness, that it cannot be cured in the ordinary sense of the term, but that it can be arrested through total abstinence from alcohol in any form.

AA: Alcoholics Anonymous

Alcoholics Anonymous, co-founded by Bill W. and Dr. Bob Smith, in 1935, pioneered the use of peer support to help alcoholics.

It synthesized the personal experiences of its founders and early members with the science of its day to offer help through the 12 steps and, beginning in 1939, the Big Book.

Its official website is AA.org, where the Recovery Program page begins:

The relative success of the A.A. program seems to be due to the fact that an alcoholic who no longer drinks has an exceptional faculty for “reaching” and helping an uncontrolled drinker.

In simplest form, the A.A. program operates when a recovered alcoholic passes along the story of his or her own problem drinking, describes the sobriety he or she has found in A.A., and invites the newcomer to join the informal Fellowship.

The group identifies itself as a Fellowship using this definition:

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.

The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy; neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

Copyright © by the A.A. Grapevine, Inc.

Alcoholics Anonymous can also be defined as an informal society of more than 2,000,000 recovered alcoholics in the United States, Canada, and other countries. These men and women meet in local groups, which range in size from a handful in some localities to many hundreds in larger communities.

Worth noting, also, is that A.A. does not consider its work to include treatment or education:

A.A. is concerned solely with the personal recovery and continued sobriety of individual alcoholics who turn to the Fellowship for help. Alcoholics Anonymous does not engage in the fields of alcoholism research, medical or psychiatric treatment, education, or propaganda in any form, although members may participate in such activities as individuals.

The Fellowship has adopted a policy of “cooperation but not affiliation” with other organizations concerned with the problem of alcoholism.

Traditionally, Alcoholics Anonymous does not accept or seek financial support from outside sources, and members preserve personal anonymity in print and broadcast media and otherwise at the public level.

Naltrexone

Naltrexone is a pharmaceutical drug,

also referred to by its brand name, ReVia, or abbreviated as Nal, which was approved by the FDA in 1995:

Naltrexone offers new hope for preventing relapse in many of the more than 1 million Americans treated each year for the disease. Of treated patients, approximately 50 percent relapse within the first few months of treatment.

“While not a ‘magic bullet,’ naltrexone promises to help many patients in their struggle against a chronic relapsing disease. Identification of this pharmacologic treatment builds momentum to elucidate the myriad, complex brain mechanisms of alcohol addiction,” said NIAAA Director Enoch Gordis, M.D.

Separate NIAAA-supported, 3-month trials conducted by Joseph Volpicelli, M.D., Ph.D., and colleagues at the University of Pennsylvania and Stephanie O’Malley, Ph.D., and colleagues at Yale reported in 1992 that naltrexone helped to prevent early return to heavy drinking in a significant proportion of treated patients. In addition, patients who received naltrexone reported less alcohol craving and fewer drinking days than patients given a placebo.

Both NIAAA-supported studies were conducted in conjunction with psychosocial treatments.

Medline Plus offers basic info:

Naltrexone is used to help people who have a narcotic or alcohol addiction stay drug free. Naltrexone is used after the patient has stopped taking drugs or alcohol. It works by blocking the effects of narcotics or by decreasing the craving for alcohol.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Dr. Alex DeLuca points to evidence that it may support problem drinkers as well:

[T]here is a body of research on the use of naltrexone specifically as an aid to controlled drinking. Instead of taking the medication every day, this research suggests that people carry Nal with them at all times, and take a pill before entering into a drinking situation, or whenever craving for alcohol occurs. This ends up being a lot cheaper, as you are not taking it every day.

Dr. DeLuca’s site includes a Naltrexone FAQ page with links to background information and evidence.

Researchers are studying the effectiveness of injectable forms of Naltrexone. One study, which tested a product branded Vivitrex, has reported promising results, but in men only, with an injection which lasts 30 days:

A study of 600 men and women found that [Vivitrex] reduced heavy drinking among men by nearly 50 percent compared to a placebo.

But the Naltrexone injection had no effect on women. Researchers are conducting a larger study to determine why.

Intro to Evidence

Getting to the bottom of issues related to alcohol requires us to look at the facts.

In the U.S., taxpayers support over $400 million in alcohol-related research each year through the NIAAA. Research is also funded by pharmaceutical companies and private sources.

Solid evidence is crucial to understanding how we relate to alcohol. We need to understand how it affects us physiologically, and how genetic and other factors affect us.

The evidence isn’t limited to neurological and other factors beyond our control, though. The evidence points to behavioral, cultural, and personal factors over which we can assert personal control.

And, the evidence doesn’t stand on its own. Studies which suggest correlations — wine drinking correlated to health, for example — really don’t tell us about cause and effect (i.e., wine drinking may not cause better health, but may be related to socioeconomic well-being and thus access to good health care). So, it’s important that we interpret the evidence critically.

We’ll follow these kinds of issues here in the Evidence category.

Antabuse (disulfiram)

From Medline Plus:

Disulfiram is used to treat chronic alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed. These effects include flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety. These effects begin about 10 minutes after alcohol enters the body and last for 1 hour or more. Disulfiram is not a cure for alcoholism, but discourages drinking.

The National Council on Alcoholism and Drug Dependence, on its History and Mission page drawn from White’s Slaying the Dragon, notes that, in 1948:

Disulfram (Antabuse) [was] introduced as an adjunct in the treatment of alcoholism in the U.S. Other drugs used in the treatment of alcoholism during this period include barbiturates, amphetamines (Benzedrine), and LSD.

NIAAA: National Institute on Alcohol Abuse and Alcoholism

The NIAAA is part of the National Institutes of Health (NIH).

It was established in 1970 when Congress passed the “Comprehensive Alcohol Abuse and Alcoholism Prevention Treatment and Rehabilitation Act”. Sponsored by Iowa Senator Harold Hughes, Bill Wilson testified in support of its passage.

(Am I boring you already? Check out the “Why would I care about the NIAAA?” page.)

To put things in a 1970 perspective, consider that:

• Distribution of the Big Book, first published in 1939, crossed the one million mark in the early 70s, making average annual sales over its first three decades under 30,000. (Total distribution would hit 5 million in 1985, 10 million in 1991, and 20 million in the late 1990s.)
• Betty Ford’s journey into recovery was still eight years away.
• The Mary Tyler Moore Show hit the airwaves in 1970, and the booze bottle Lou Grant kept in the bottom drawer of his desk remained a comic fixture throughout the show’s 7-year run.
• The 1964 Grand Rapids Study suggested that BAC levels as low as .04 could impair driving safety, but DUI thresholds remained as high as .15.
• The founding of MADD (Mothers Against Drunk Driving) happened a decade later, in 1980.
• Dedicated alcoholism treatment centers were few. Before the Betty Ford Center center could open in 1982, California statutes had to be changed to permit the first non-hospital-based alcoholism treatment center to operate.

The NIAAA’s history page notes that the National Council on Alcoholism (NCA), formed in 1944 by Marty Mann, the American Medical Association (AMA), World Health Organization (WHO), and the American Psychiatric Association were all devoting some resources to alcohol issues. And yet,

By the 1960’s the National Institute of Mental Health (NIMH) in the U.S. Public Health Service had begun a very small program of grants in the alcohol area, leading to the establishment in 1965 of the National Center for the Prevention and Control of Alcohol Problems. The Center, however, had limited program authority and a limited budget. The situation with research was even more dismal. As asserted by the Cooperative Commission on the Study of Alcoholism in its 1967 report:

“Additional information about the nature and causes of problem drinking is urgently needed. Past research in this area has been uneven and sporadic…. While special attention to alcohol problems is currently required … research in this field cannot be developed in isolation from investigations of a basic science nature and those on other medical and psycho-social problems (Plaut 1967, pp. 50 and 52).”

There was a general feeling among advocates that the only way to sway public opinion and to address comprehensively alcohol abuse and alcoholism was from the national level through a highly placed and therefore highly visible Federal organization.

Today, the budget for the NIAAA is in the $400M range, per its 2005 Budget (908K PDF, page 4):

Its mission statement includes:

NIAAA provides leadership in the national effort to reduce alcohol-related problems by:

• Conducting and supporting research in a wide range of scientific areas including genetics, neuroscience, epidemiology, health risks and benefits of alcohol consumption, prevention, and treatment
• Coordinating and collaborating with other research institutes and Federal Programs on alcohol-related issues
• Collaborating with international, national, state, and local institutions, organizations, agencies, and programs engaged in alcohol-related work
• Translating and disseminating research findings to health care providers, researchers, policymakers, and the public

The NIAAA’s website includes a reasonably robust search function, giving ordinary folks access to evidence, research, and clinical approaches to alcohol issues.

The site includes a database page with links to several online resources for looking up alcohol-related data.

The National Institutes of Health (NIH), founded in 1887:

is the Federal focal point for medical research in the United States. The NIH, comprising 27 separate Institutes and Centers, is one of eight health agencies of the Public Health Service which, in turn, is part of the U.S. Department of Health and Human Services..

Simply described, the goal of NIH research is to acquire new knowledge to help prevent, detect, diagnose, and treat disease and disability, from the rarest genetic disorder to the common cold. The NIH mission is to uncover new knowledge that will lead to better health for everyone. NIH works toward that mission by:

• conducting research in its own laboratories;
• supporting the research of non-Federal scientists in universities, medical schools, hospitals, and research institutions throughout the country and abroad;
• helping in the training of research investigators; and
• fostering communication of medical and health sciences information.

Intervention

From the Hazelden Foundation website’s page titled, What is an ‘intervention’?:

An intervention is a deliberate process by which change is introduced into peoples’ thoughts, feelings and behaviors. The overall objective of an intervention is to confront a person in a non-threatening way and allow them to see their self-destructive behavior, and how it affects themselves, family and friends. It usually involves several people who have prepared themselves to talk to a person who has been engaging in some sort of self-destructive behavior.

JACS: A Jewish Recovery Group

Jewish Alcoholics, Chemically Dependent Persons and Significant Others.

From the group’s About page

JACS, an organization led by volunteers, is dedicated to:

• encourage and assist Jewish alcoholics, chemically dependent persons and their families, friends and associates to explore recovery in a nurturing Jewish environment by conducting retreats and other events that provide support to Jews in recovery;
• promote knowledge and understanding of the disease of alcoholism and chemical dependency as it involves the Jewish Community; and
• act as a resource center and information clearinghouse on the effects of alcoholism and drug dependency on Jewish family life.

Alcoholics Victorious

A Christian recovery group.

From its home page:

Founded in 1948, Alcoholics Victorious support groups offer a safe environment where recovering people who recognize Jesus Christ as their “Higher Power” gather together and share their experience, strength and hope. Both the 12 Steps and the Alcoholics Victorious Creed are used at most AV meetings.

Big Book of AA

The foundational book of AA, titled Alcoholics Anonymous.

The entire book is available online.

Booth, Fr. Leo

An author and trainer in spirituality and recovery.

His self-description at FatherLeo.com includes:

…Father Leo Booth is a priest cut from a very different cloth. He says you don’t have to be religious to be spiritual. He’s as likely to quote from the Beatles, The Velveteen Rabbit, or Oscar Wilde, as he is from the Bible. His passion is to help people discover that God and spirituality are not “out there” somewhere, but are found within ourselves and our world…

Father Leo was born in England and raised in a home divided by religious arguments. Driven and ambitious, he became one of the youngest rectors in England. He also became an alcoholic and a religious addict. After a drunken car crash in 1977 led to his treatment for alcoholism, he subsequently devoted his work to helping addicts and others who suffer from low self-esteem. From his work as both priest and an addictions counselor, he has developed a new spiritual model based on Choice, Action, Responsibility, and Empowerment.

Harm Reduction Psychotherapy

From the Harm Reduction Therapy Center’s (HRTC) home page:

Harm Reduction Psychotherapy is based on the belief that substance abuse develops in each individual from a unique interaction of biological, psychological, and social factors.

Harm Reduction Psychotherapy is a non-judgmental approach to helping substance users reduce the negative impact of drugs and alcohol in their lives. It respects that people use drugs for reasons. It addresses the complex relationship that people develop with drugs and alcohol. Drug and alcohol issues are addressed simultaneously with social and occupational concerns and psychological and emotional issues.

The HRTC’s About page identifies the target audience for Harm Reduction Therapy:

Harm Reduction Therapy is suited for anyone who:

• is questioning whether their use of drugs and alcohol is a problem.
• has tried abstinence-based approaches and found them to be ineffective or undesirable.
• relapses frequently after attempts to be clean and sober.
• also suffers from emotional or psychiatric problems and wants help with these issues simultaneously.
• prefers an alternative way of thinking about their drug use.

Background Image

What’s the splotchy stuff hiding behind the text boxes at Live Sensibly?

Here it is, without anything getting in the way.

It started as the picture of a path through some woods, on the right. I messed with it to create the two-color image in the background.

Here is a larger (115K) copy of the original.

I chose a picture of a path, with twists and turns, sun and shade, because living sensibly with alcohol is a lifelong journey, not a one-time destination.

The original photo came from Pixel Perfect Digital’s free image archive.

Town Square Intro

In this category, I’ll track trends and public policy related to alcohol.

Withdrawal Symptoms

From WebMD:

Withdrawal is an uncomfortable physical or psychological change that occurs when the body is deprived of alcohol or drugs that it is accustomed to getting. Symptoms of withdrawal are caused by decreased amounts of a substance in the blood or tissues of a person who has grown accustomed to prolonged heavy use and who then suddenly stops using or drastically reduces the amount of that substance.

Symptoms of alcohol withdrawal begin from 4 to 12 hours after you cut down or stop drinking or as long as several days after your last drink. The symptoms can last a few days and may include:

• Nausea or vomiting.
• Sweating.
• Shakiness.
• Anxiety.

In severe cases, delirium tremens, or DTs, can bring tremors, hallucinations, and seizures.

Bottom line: It’s a medical condition, can be life-threatening, and requires immediate medical treatment.