12 Steps and Addiction

in #healthlast month

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The above image was done using stable diffusion using the prompt 'AA medallion.'

Alcoholics anonymous has saved countless lives. It probably saved mine. Drinking and drug binges caused trouble in my life as a kid and into my early twenties. Then my headache disorder forced me to cut alcohol out completely as it turned out to be a reliable headache trigger.

So I couldn't drink and was discovering what it was like to live with one of the most painful conditions known to medical science. In this situation, giving up alcohol felt almost like an afterthought happening alongside a much more serious struggle. I went to AA meetings, went through the 12 steps again and again, and did the fellowship. As a result, some of my problems became more manageable.

The core problem I needed help with at that time was not that I wanted to drink alcohol. I could've cared less about alcohol by that point. My problem was that I didn't want to live at all because life with cluster headaches was such a nightmare. Working AA's program gave me the tools I needed to begin approaching this problem one day at a time.

The 12 steps themselves offer a powerful pathway for transformation:

  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.

These steps can be generalized to address other addictions and issues. Some people balk at the reference to a higher power but old school AA atheists reframe God as an acronym for Good Orderly Direction. In my situation, I wasn't too worried about defining divinity. I was much more focused on trying to become a good and whole person while dealing with a brutal medical reality.

After going through these steps in a structured way with a sponsor a couple of times, there came a point when step work stopped being linear. Instead, it became sort of perpetual, with the lessons from each step coming up naturally in the circumstances they might benefit. More than anything, these lessons give a person something to reach for in response to any difficulty that may arise. Pop culture often makes fun of this and other AA cliches like the serenity prayer, but these things have helped me to make better decisions in my life countless times.

I went to meetings for years and still do on occasion. And I recommend AA for anyone struggling with addiction of any kind. The program may not work for everyone, but there's really no downside to sitting in a room with people and listening to their stories. There's a special kind of healing that can happen when people share their truths with each other in a supportive environment.

Some addicts in recovery are intensely involved in AA their whole lives. Others find it helpful for a while and then move on. I'm more or less in the second camp, though I didn't move on for no reason. I use cannabis to reduce the frequency and intensity of headache attacks. I've also tried using various psychedelics to treat the disorder, with mixed results. AA has a deep-seated bias against cannabis and psychedelics, which alienated me.

AA's co-founder Bill Wilson used LSD to treat his own alcoholism and promoted the use of the psychedelic medicine as a way to give recovering addicts access to spiritual experiences they might not otherwise be able to find. Other members of the early Alcoholics Anonymous community were "violently opposed" to this idea, and AA culture moved forward with the abstinence absolutism that still dominates the recovery community today.

An alternative to the abstinence-only approach is harm reduction. The idea is to reduce as many of the harms of substance use as possible. In many cases, abstinence turns out to be the only real way to reduce the harm being done by a substance's use. There is no harmless way for me to consume alcohol, for example. But because cannabis reduces the damage that my headache disorder does to my life, if I were to abstain from using cannabis, I'd be harming myself.

Opioid users have a special set of problems. Some kick the habit a hundred times and keep going back. Some find the smallest possible dose that can get them through the day and spend decades maintaining their addiction invisibly. Given the epidemic of opioid addiction in the US, we should be using every measure at our disposal to encourage people to make better choices.

The criminalization of addiction creates many more problems than it solves. Industrial medicine treats addiction like a gold mine. Alcoholics Anonymous, harm reduction, and psychedelic medicine all provide part of the solution. But there is something to be said for social responsibility, too. Why are so many people turning to drink and drugs? They're not all crazy, and it's not for no reason.


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