On May 8, 1976, 52 prominent people met in Washington, D.C., to announce to the press and the world: "We are recovering alcoholics." Dubbed "Operation Understanding," the media event was sponsored by the National Council on Alcoholism to dispel the myth that alcoholism doesn't happen to "nice" people and to reduce the moral stigma that cripples efforts to successfully treat the disease. "Operation Understanding" also underscored the fact that people can recover from alcoholism and that there are resources and agencies that can help alcoholics resume – or enjoy for the first time – normal, happy, successful lives without alcohol. To find out what resources exist on a local level to help the alcoholic achieve sobriety, we sent a contributing editor into the community of Pasadena, California. Here is his report.
While 500,000 alcoholics in Southern California were making the rounds of the bars, careening in cars on the freeways, or nursing their bottles at home on the evening of August 25, 1976,200 plus happy, grateful, recovered alcoholics were celebrating the 35th anniversary of the South Pasadena — San Marino chapter of Alcoholics Anonymous and their own sobriety. They were a living testimony that alcoholism can be overcome. Alcoholics Anonymous is the most successful modality of treatment for alcoholism in existence today. It began in 1935 when two alcoholics discovered they could strengthen their sobriety by sharing their experiences and helping others suffering from alcoholism. Today AA has grown to 22.000 local chapters in 92 co un tries. An estimated one million people participate in AA — more than found in all other modalities of treatment combined.
AA Steps and Traditions
On the flyleaf of their literature AA describes itself as "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." AA is nonsectarian and nonpolitical. It neither endorses nor opposes any ca uses. The key to the individual alcoholic's success is the "Twelve Steps" of AA, and the key to AA's success as an organization is its "Twelve Traditions." The "Twelve Steps," read at the start of every AA meeting. starts as follows: • We admitted we were powerless over alcohol — that our lives had become unmanageable. • Came to believe that a Power greater than ourselves could restore us to sanity. • Made a decision to turn our will and our lives over to the care of God as we understood Him. • Made a searching and fearless moral inventory of ourselves. The "Twelve Traditions" that govern the fellowship as a whole include such points as: • The only requirement for AA membership is a desire to stop drinking. • An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise. • Every AA group ought to be fully self-supporting. declining outside contributions. • Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers. • Anonymity is the spiritual foundation of our traditions, ever reminding us to place principles before personalities. (In respect of that tradition, only initials or pseudonyms of alcoholics are used in this article.)
The Payoff — Sobriety
The fruits of AA's approach to alcoholism were everywhere in evidence at the 35th anniversary celebration. It was evident in the happy smiles, the warm handshakes, the camaraderie, and the concern that pervaded the room. It was evident from the number of "birthdays" being observed. "Birthdays" in AA are the date of a member's last drink. Each complete year of sobriety is celebrated with a "birthday cake." That evening 13 people observed from 1 to 30 years of complete sobriety. It was evident in the reactions and words of those who came forward to blow out the candles on their cakes. The "babe" of the celebrants, a middle-aged woman, B. G., was marking her first year of sobriety. After hugging her sponsor (the person who helped and encouraged her to attend AA) and blowing out her candle, she turned to the audience and began, "I'm a very grateful alcoholic ..." but could not finish for the tears of joy. A middle-aged man, S. H., celebrating 5 years of sobriety, said with profound emotion, "If I could have written a scenario five years ago. I couldn't have imagined all the good things that have happened to me since I achieved sobriety." The last of the celebrants was a wealthy businessman, T. P., with 30 years of sobriety. A dozen of his children and grandchildren were there for the occasion and applauded with special vigor. He asked, "How can you express what it is like to have 10,959 days of sobriety after experiencing 20 years of alcoholic living death?"
Help That Goes Begging
In the United States, an estimated one out of every ten drinkers is an alcoholic. That ratio adds up to over nine million people of all ages for whom one drink is too many and a thousand is never enough. Pasadena has its share — 14,000 by one estimate. Only a small fraction of them have sobered up, but it has not been for lack of opportunity or help. Pasadena has a wide variety of agencies and programs to help the alcoholic. "There's help running out of the ears." says Jean B. Vandervoot, executive director of the Pasadena Council on Alcoholism. But alcoholism is a disease of denial. Most alcoholics will not admit to themselves, let alone anyone else. that they have a drinking problem. Consequently, it is very difficult to help most alcoholics until they have sunk into their own personal hell. Alcoholics must often suffer broken marriages, lost jobs, jail sentences. auto accidents, cirrhosis of the liver, delirium tremens, and other crises before they run out of alibis and seek help. "Referral and educational services such as ours can help people to avoid going to the bottom," says Jeanne. "People don't have to lose loved ones or jobs. If they're informed and if they get treatment and help in the middle part of their disease, they can save themselves from all that suffering."
The Turn of the Tide
In spite of the readily available help, a certain percentage do hit the bottom of bottoms — the late or chronic phase where obsessive drinking results in physical complications and imminent death. For these people, recovery must begin at one of the two detoxification centers in Pasadena: Pasadena Community Hospital or St. Luke Hospital. On the wall in the corridor of the detoxification ward of Pasadena Community Hospital hangs a poster with a message and metaphor. The message is: "The lowest ebb is the turn of the tide." The metaphor is a turbulent surf crashing on the rocks of a rugged coastline. The poster states a fact and presents a hope for the alcoholic. The fact is his health, his very life, is on the rocks. Alcohol has devastated his personal life and is literally killing him. He has come or been referred to the "delox unit" to "dry out" under medical supervision because it's too dangerous to do so on his own. The hope is that they call bottom out and rebound. Most alcoholics who seek help do recover and go on to lead productive, happy lives. While touring the detox facility at Pasadena Community Hospital, a call came from the front desk: An alcoholic man wanted to be admitted. Staff — counselor Bill Rose went to see him. At the age of 27. Bill is a veteran, an expert on drug abuse, having spent over half his life — 14 years — as an addict-alcoholic, a multiple drug user. Now he's part of the solution instead of the problem. He has been "clean" for a year and started working in the detox unit a couple of months ago. Bill brought back a disheveled. stubble-faced, bleary-eyed, 40-year-old man — the kind of alcoholic stereotyped in jokes and TV comedy skits. But this real — life alcoholic was no laughing matter, but a sick man named Larry. Larry said he had been drinking half a gallon of vodka over the past couple of days. Now he was coming down with wine to avoid delirium tremens. He had them once before several years ago and didn't want to experience the agony again. He had also been hallucinating — he was hearing water dripping out of a tap. The paperwork was begun, and Larry started detoxification and a 21-day rehabilitation program which consists of two vital parts: occupational therapy and group therapy.
Small But Important Steps
Jerrie Williams, occupational therapist in the detox unit, gave me a tour of the occupational therapy room. It is s mall and simply equipped and contains supplies for painting, knitting, and macrame. Jerrie explained that the patients are given relatively simple tasks to occupy their time while in the room. Some wrap bottles with tape and paint them with shoe polish. Others decorate cigar boxes with patterns of macaroni shells and elbows and then spray them with gold paint. Patients also try their hands at macrame, sketching, and painting. In another room there is some exercise equipment for those who want a little more vigorous activity. As plain and simple as the materials and tasks are, they have important therapeutic benefits. The first steps toward recovery must necessarily be small and often undramatic. All alcoholics are losers in some sense, and some are complete losers — people who have never succeeded, never accomplished anything in their life. Learning to perform rudimentary tasks in occupational therapy can provide positive reinforcement that enables them to tackle bigger tasks and problems of everyday living.
The heart and core of every rehabilitation program is group therapy. Here the alcoholic faces the reality of himself — his problems, needs, and aspirations. He also faces the reality of other people who, he often discovers, are cut from the same fragile, imperfect cloth. "We try to improve their self-image. In the deepest part of their being, alcoholics don't like themselves. They feel very inferior." says George Richardson, another staff counselor. "By getting everyone to come out from behind his shield. each alcoholic learns that he isn't any different from anyone else. This helps him to accept others and cope with anger, resentment, and frustration rather than drink." The detox unit at St. Luke Hospital across town is larger and the program somewhat different. But it too is a benign assault on a losing, destructive life-style. While being detoxified at St. Luke Hospital, the alcoholic patient is evaluated for the following 21-day program designed to help him clean up — and dry up — his act and get a new and winning show on the road. As Bob C., a recovered alcoholic, put it. "Sobriety is the tip of the iceberg. What is involved is a brand new life, a new beginning. If I may say so, a rebirth." Sean Hamilton, community services coordinator for St. Luke's detox unit, explained that "we evaluate every aspect of the patient's life physically, psychologically, socially, and even spiritually. Each patient is given a complete physical, not only to diagnose alcohol-related diseases but any other ailments he may have. We have physical therapy for those who need it. If the alcoholic has problems with his job, we bring in the employer. If he is dissatisfied with his job, we interview him for vocational rehabilitation. "Families, friends, employers — anyone connected with the alcoholic — is brought in to help confront the patient with his problem as well as be a pan in his recovery." In addition, St. Luke Hospital has established an outpatient program to help the alcoholic stay dry in a wet world. "But no one can do the entire job alone. "stresses Hank Klein, chief alcoholic therapist at St. Luke Hospital. "We cooperate with other agencies. We tie the alcoholic's recovery into the community-based resources."
The first community resource that alcoholics are exposed to is AA. The second is often the recovery home, the next way station on the road to sustained sobriety for those who are detoxified. Pasadena has three: the Grandview Foundation, the Bishop Gooden Home, and La Casa (for women). The setup and program varies for home to home, but each provides a minimum of three to four weeks of refuge and rehabilitation. The Bishop Gooden Home primarily serves the white-collar worker, the professional man, and the prosperous businessman. In contrast, the Grandview Foundation has a more heterogeneous group including the unskilled, the indigent, and the welfare case. Three or four weeks may not suffice for many of the less fortunate, so a relatively new nonresidential program has been developed to provide needy alcoholics with 10 to 15 months of counsel and help. "We feel that the alcoholic needs to be involved for at least a year in rehab programs — AA, group therapy, etc. — to be able to say he has put his act together. That is the bare minimum necessary to stabilize fairly well his sobriety," states James Panariello, program director for Grandview. But even relapses arc possible. A number of authorities believe it takes three to five years of total sobriety to say an alcoholic is truly stable and recovered. La Casa. established in 1968, is something of a rarity in alcohol rehabilitation — a facility exclusively for women. "If only they had something like this back in New York City, I might have recovered sooner," lamented E. M., a recovered alcoholic. "But they don't because women alcoholics aren't as visible as men alcoholics. I just stayed home all day and drank. Anytime I needed some more, I just got on the phone and said, 'Send over a case.'" And then, without prompting, she gave about by bout account of her drinking career: (Be forewarned! Ask a recovered alcoholic a simple question, and you may get a ten-minute autobiographical sketch. Their candor is amazing — and refreshing.) "It finally got so bad that I was rushed to the hospital vomiting up blood. My temperature was 106°. I needed nine blood transfusions. I stayed in the hospital for two weeks living on jello. "The day I got out, I walked around the corner and bought a bottle. I still had further to go to reach the gutter. "I finally ended up in the psychiatric ward in Bellevue.... In a moment of clarity, I said to myself, 'You're in trouble. Do exactly what they say.' I did and got out. But I never licked my problem until I came west and discovered La Casa."
Carrot and Stick
For the drunken driver, there is a special route to recovery. First-time offenders are referred to four, weekly, 2 1/2-hour educational and rap sessions on alcohol abuse and available recovery programs. First-time offenders are motivated by the carrot of a reduced fine for successfully completing the program or the stick of the full fine for not attending. Multiple offenders are referred to the High Road Program. The High Road Program provides a minimum of 12 months for the education and resocialization of the chronic alcohol and other drug abuser. The goal is the revamping of the drug offender's life-style. "The rate of recovery or life change is phenomenal," reports Robert Dorris, project director of the High Road Program. "We're seeing 80% to 90% of the participants make a basic change. The length of the problem is a big key to its success. We don't claim to have more information — just more time for people to understand and absorb it." Helen Dorris, personnel director for the program, points out another factor that is lacking in most other programs: The carrot and stick motivation provided by the courts gives alcoholics an added incentive to comply with the program. Failure to do so could mean no reduction in charges or legal penalties, and they are much more serious for multiple offenders. "They have certain activities they absolutely have to complete. They have to visit rehabilitation centers, write book reports, do community service and volunteer work. All of these things are geared to changing their lifestyle."
Cooperation and Care
A recent development in Pasadena is the formation of a coalition of agencies and programs dealing with alcoholism in the city. "This had been done before in name, but until now not in fact," states Charles M. "Buz" Hamilton, assistant executive director of the Pasadena Council on Alcoholism. "We strive to assist each other and keep the focus on helping the alcoholics in Pasadena." "Oh there are some internal squabbles," admits Scan Hamilton, "but we're all working for the same goal. We all realize we need cooperation — not competition." This spirit of cooperation is but a manifestation of a factor that all the diverse programs and agencies have in common — that great in tangible called love, care, concern. Those three words cropped up again and again as I talked with recovered alcoholics and those involved in rehabilitation. "You don't have to have a degree to help alcoholics," declared Colleen Cervik, who supervises the Pasadena Community Hospital detox unit. "But it does take care. People who care, who are dedicated to helping others, make all the difference in an alcohol recovery program." Epilogue: After writing the story I called Bill Rose and asked him about Larry. "Funny you should ask," he replies. "I just saw him a while ago. He's up at Grandview. and is attending group therapy and AA. He's coming along fine."
With a Friend Like Alcohol, Who Needs Enemies? by Freddy C.
Freddy C. was a well-known entertainer whose career and family life were nearly destroyed by his addiction to alcohol. Since overcoming the problem, he has recently had a book published entitled The Alcohol Problem Explained.
The year 1954 was, to quote a phrase, a vintage one. I was considered one of the top musicians in Britain. I was married to a wife with whom I was very much in love, and I had two lovely daughters. It seemed nothing could possibly go wrong. My work consisted of accompanying all the big "names" in the world of films, recordings, and TV. I was on first-name terms with all those artists. This was not only good for my bankbook but also my ego. But if I had position, money, and family life, I also had one other thing that just cannot be left out of this little saga — alcohol. And if the truth must be told, I was quite happy with the arrangement. For alcohol is unique. Its properties are remarkable: If you are cold, it will create the feeling of warmth: if you are warm, it will bring the illusion of coolness. If you are tired, it will provide instant energy; if you are tense. it will act as an instant relaxer. Not for nothing has it been called Nature's Anesthetic, and for those who can handle the stuff, it has at times proved a blessing. But I couldn't handle it. And people who can't handle it shouldn't drink it. But when the exacting and demanding work started to bring mental pressures, I found that a glass of Scotch brought not only instant relief but also a confidence that was needed to do a particular job. And so the bottle became as necessary a part of my equipment as was my instrument. A person who drinks for reasons other than social is on a dangerous path, and I was no exception. The price that had to be paid for my booze slowly crept up. Rows, tears, and scenes with my wife and girls were commonplace. The one-time dependable character who used to sit in the orchestra with "nerves of steel" was slowly reduced to a nervous, shaky, pathetic character whose only nerves were those of alcohol. "Try and control your drinking." friends advised. "Use a bit of willpower," they declared. "Pull yourself together." they suggested. I just couldn't get through to them that I WAS trying to control the stuff; I WAS trying to use my willpower. What I did not know is that alcohol, to the alcoholic, is the greatest destroyer of the will; and when the will has gone, so has the control. And when the control has gone, the alcoholic is in no position to pull himself or herself together. Once the first drink has gone down, the mental obsession coupled with the physical compulsion makes the alcoholic a slave to alcohol. And so the job, money, family. and everything else that I had so desperately tried to hold on to started to go. What was I to do? First of al I went to see the family doctor. "How can I help you?" he asked. "It's my nerves." I answered truthfully. After all, they were in a terrible state. So he treated me for nerves, and things got worse. He then sent me to a psychiatrist (I was to visit eight in all), and he, too, asked me the problem. This time I mentioned that I drank a little too much, but only because of the pressure of work, plus the fact that I now suffered from insomnia and amnesia. He treated me for tension, nerves, insomnia, and amnesia, and I continued to drink and continued to suffer from nerves, tension, insomnia, and amnesia. It was as vicious a circle as one could imagine, and I couldn't get out of it. I tried hypnotists, faith healers, and health farms, but the end result was that I woke up in a police cell and then was moved to a locked ward in an alcoholic unit. It was here that they did the impossible: They stopped me from drinking. But I subsequently learned that the alcoholic's main problem is not only to STOP drinking, but also to STAY stopped. After being released from the unit. I began drinking almost immediately. In sheer desperation I phoned Alcoholics Anonymous, and the same night I attended my first meeting. I just could not see how the well-dressed and seemingly happy people there could in any way be identified with the shivering mess that was me. But the minute the speaker opened his mouth, I knew that I was in the right place. He talked my language. One reason AA is so successful is because when a shy, embarrassed alcoholic walks into their meeting, no one laughs, condemns, or ridicules him, because all of them, without exception, were in similar shape when they themselves began attending. It is that personal identification that contributes to the success of AA. All have been in exactly the same boat — or bar — as the newcomer. And as soon as the new member feels THAT kind of identification, they are on the first rung of the ladder back to sobriety and sanity. But just to stop drinking alcohol is not enough in the treatment for the illness of alcoholism; the alcoholic must not only stop drinking alcohol, he must also stop thinking alcohol. The thought precedes the action: If he thinks it, he will drink it. Alcohol is unique, and so is alcoholism. And to combat alcoholism. there has to be something equally unique — the Fellowship of Alcoholics Anonymous. The number of the nearest AA group is in your phone book. Dial now if you need help.
Can an Alcoholic Ever Resume Drinking?
For nearly two decades there has been a smoldering controversy over whether an alcoholic can ever resume "normal drinking." On June 9, 1976, it burst into flames with the release of a report on alcoholism by the Rand Corporation, Santa Monica, California. The report suggested that some alcoholics can, after treatment, resume normal drinking without risking a relapse. The three authors of the report concluded that "relapse rates for normal drinkers are no higher than those for longer-term abstainers." The researchers emphasized in their report that they were not recommending that alcoholics resume drinking. They agreed that there are alcoholics who cannot drink without getting into serious trouble but added that there is no way to tell in advance who they are. The conclusions of the report were controversial enough; unfortunately, the news media exacerbated the issue by giving the story such alarmingly dangerous headlines as "Study Suggests Alcoholic. Treated, Can Drink Safely." despite the cautionary notes given in the report. The result was a firestorm of angry criticism from scores of researchers and paraprofessionals in the field of alcoholism. Many expressed the rear that the report's conclusions and the way the media reported them would endanger the lives of some alcoholics by encouraging them to resume drinking. On July 1, the National Council on Alcoholism sponsored a press conference in Washington, D.C., in which 11 widely respected researchers in the field of alcoholism rebutted the Rand report. Some of the weaknesses in methodology they cited were: (1) All data were based on the clients' self-reports of the quantity of alcohol consumed, with no objective verification, such as blood samples to determine alcohol concentration. (2) The actual number of patients interviewed was too small a percentage of the original number of alcoholics being investigated. Six months after treatment, researchers were able to locate only 20.6% of the 11,500 patients they originally included in the survey. After 18 months they were able to locate only 62% of the 2,161 designated to be surveyed. Combining the 6- and 18- month studies, over 70% of the patients weren't interviewed. Dr. David Pittman has shown the harder an alcoholic is to locate for follow-up interviews, the more severe his problem with alcohol is likely to be. (3) The reporting period of 18 months is too short a time to decide that "normal drinkers" will not relapse. Dr. John Ewing, director of the Center for Alcohol Studies at the University of North Carolina, conducted a study for controlled drinking over a period of over 55 months. He found that "the results looked promising in the first 12 to 18 months. It was only when we did a long-term follow-up ranging from 27 to 55 months since treatment ended that we detected a universal failure to maintain controlled drinking." (4) The maximum amount of alcohol consumption considered by the Rand researchers to be "normal" is considered by others to be excessive. The Rand report is not the first report to suggest that some alcoholics may resume drinking. And a couple of new reports have been released since the Rand report making similar conclusions. But most people working with alcoholics would emphatically agree with Dr. Jokichi Takamine, chairman of the American Medical Association Committee on Alcoholism: "Abstinence must remain the foundation of recovery for the alcoholic."