Is Alcoholism Recovery still a Medical Mystery?

Is Alcoholism Recovery still a Medical Mystery?


It seems that we still know very little about the process of recovering from alcoholism and drug addiction, in spite of medical advances in other areas of knowledge. How is it possible that we still know so little about what it really takes to recover?

If you look at the data today it is not encouraging. Many people who are addicted or alcoholic never seek out help to begin with, which is a huge problem in itself. Last I looked I believe that the data indicated less than half of alcoholics actually seek help. Of those who do seek help, probably only about 1 in 5 or so achieve any sort of meaningful long term sobriety. Of course you can find data that disagrees with this but most of the government data seems to back up those figures. Very few people recover, though of course there is still hope if you are serious about wanting to change.

Understanding alcoholism as a disease of the brain

A lot of research and progress has been made lately in terms of understanding addiction itself. They are closer to having a full understanding of alcoholism and drug addiction as a disease of the brain. They are much better able to track what is going on at a cellular level inside of the brain in terms of drug and alcohol addiction.

This may have future implications in terms of treating addiction in terms of medications and therapies that we develop, but right now it is not really changing the landscape of alcoholism treatments as we know it.

We do have some medications that are being used to control addiction cravings for various substances, and these seem to work with varying degrees of success. It is probably the case that more medications are needed with more studies to confirm their effectiveness. In other words, there is currently no pill that exists that we can point to and say “that is the cure for addiction” or “that is the cure for alcoholism.” No such pill exists and it may never exist at all. We have to be prepared for that possibility by developing other forms of treatment as well.

Implications for people in recovery

If you are abusing chemicals and holding out hope that they will “cure” addiction one day then I think that you have a very poor plan indeed. I do not believe that anyone should be counting on the idea that they will solve the problem of addiction in the future.

Certain solutions exist today for recovery, and anyone who is struggling should embrace one of those solutions.

Here is the thing:

It doesn’t really matter which solution you choose, so long as you dive into it and embrace it fully.

There was once a study done that attempted to compare success rates among three different types of addiction treatment. I believe that those were roughly 12 step based, religious based, and therapy based (one of them may have been cognitive therapy, I don’t remember the exact details). That study essentially concluded that all three forms of treatment were viable options and they gave a slight edge to the 12 step based approach, however it was not statistically significant enough to say that any of them were better or worse than the others.

In other words, there were 3 different forms of treatment and they did a major study comparing them and after it was all said and done they could not declare a clear winner. None of the approaches enjoyed a huge advantage over the others.

To me that gives us two possibilities: One, that recovery is downright challenging and difficult and there is never going to be a sure fire “cure,” and two, that perhaps there is a superior method of treatment out there and we just haven’t developed it yet.

Based on the nature of addiction and recovery I am guessing that it is the former, that we will never have a perfect cure or even a dominant recovery solution. AA and the 12 step model happens to be the most widespread and accepted form of treatment today but that doesn’t necessarily make it more effective than other options, nor is it anywhere near being a “cure.” That is a not so much a criticism of AA though as much as it is a criticism of our overall efforts at treating addiction. We have a long way to go and in historical terms we are only really just getting started.

The solution is still a mystery to some people in recovery even after achieving sobriety

One of the amazing things about 12 step based recovery (and religious based recovery for that matter) is that the people who are successful in it do not always know exactly how it works.

This seems odd to me personally. To be in a program of recovery, to be following certain directions, and to not really understand how it is producing the desired results for you. You know that it is working and that your life is getting better, but you don’t really understand how or why. That to me is amazing.

The fact that this happens so frequently in AA leads me to believe that we have a lot more to learn about the recovery process.

My idea in early recovery was to start making observations of other people, recovering alcoholics who were successful in their sobriety, and to start comparing what they were doing in terms of everyday actions. In other words, what exactly was keeping them sober?

When I started to dive into this sort of investigation in early recovery, people told me to basically knock it off. They suggested that I was barking up the wrong tree. Their advice was to simply work the AA program and stop asking questions about why or how it worked. “It just works, the program keeps you sober, keep coming to these meetings and shut up about it already. Just be grateful that you are sober today!” That was the attitude that I got when I tried to figure out exactly how sobriety was working.

What actually keeps people sober?

Is it the daily AA meetings? Is it the faith that develops from working the 12 steps? Is it the relationship with a higher power? What gives people the strength to say “no” to alcohol? How does it actually work? I wanted to find the answers to these questions.

The reason that I wanted to know this is because I did not want to relapse. If I knew how it all worked then I had a chance to remain sober in the long run. But I had to have an understanding of what was actually going on in terms of recovery.

It was too vague for someone to tell me “Just go to meetings every day and read the book and work the steps.” That was far too vague. No, you have to show me exactly how that will prevent me from drinking. You have to show me why that will work before you can convince me to follow through with it.

This stubborn streak in me led me to create my own path in sobriety. At the time I was watching many of my peers who were taking the traditional path in AA, and I was comparing notes with them (so to speak). They were on a path of personal growth as they worked through the steps with their sponsors. They were on a path of personal growth because they were helping other people in recovery, both at meetings and through sponsorship. Some of my peers relapsed, which on the one hand scared me a great deal, but on the other hand it validated my own choices in terms of personal growth.

I was focusing on personal growth and positive action, just without the structure and backdrop of the 12 step program in my life. I had walked away from the daily meetings even though I was told that this would lead to relapse. I no longer believed that. It was not daily meetings that kept people sober. I watched too many people who attended meetings and still managed to relapse, and too many people (mostly that I met online) who had left the daily meetings and who were living a great life of sobriety. So that solution did not add up for me any longer. The idea of “just go to AA meetings every day and you will be cured” did no longer wash for me. I knew that there was something deeper going on in terms of success in sobriety. Staying sober was about more than just stopping into a meeting each day.

I started to pay very close attention to my own thoughts, cravings, and obsession over drugs and alcohol. I started to monitor this very closely. At one time I noticed that if I stopped going to AA meetings every day then I would have more thoughts of drinking. I did not like that, and it seemed to give support to the idea that daily meetings were a cure. But I knew that something was wrong with that, even though the evidence seemed to indicate that I was headed for trouble.

And this became my starting point. Here I was, drifting away from the daily AA meetings, and trying to figure out what really keeps people sober. Could it be that you simply had to attend AA every day to remain sober? There had to be more to it than that. I could not accept that as a solution. The meetings were too boring, too annoying to me. I know that sounds terrible but I really don’t think this was a bad attitude on my part–AA meetings were just a poor fit for my personality. I help people, I reach out and connect with people, I try to help others in recovery every day, but I simply don’t like the venue of AA meetings for a variety of reasons. Was this going to doom me to relapse? Just because I couldn’t embrace daily AA meetings as some sort of cure for alcoholism?

So I dug deeper. I watched the people who were successful in recovery. What I was trying to do was to deconstruct their methods of sobriety.

In other words, figure out what people were actually doing on a day to day basis that was keeping them sober. Subtract the daily AA meetings and what was left? What actions were they taking? How were they challenging themselves? How were they engaging in personal growth? How did they motivate themselves? What was actually keeping them sober? And so on.

And I started to look at these things for myself. What was keeping me sober? Why did I have cravings for alcohol if I skipped AA meetings for a few days? What actions could I take that would alleviate that problem?

And so I started to take action. I started to push myself to dig deeper, to explore the things that would help me to remain sober. I started to write in a journal every day. I started to participate in an online recovery forum every day. I started to exercise every day and push myself to get into better shape. I experimented with prayer, meditation, and so on. I read books about spirituality. I reached out to other people and tried to help them in various ways. I tried to become a better and healthier version of myself.

My solution was “personal growth.” I tried to become healthier through this growth. Not just physically healthier, but also mentally, emotionally, socially, and spiritually.

I discovered the power of gratitude, and realized that it held the key to my happiness. I started to practice gratitude every day. I started to make gratitude lists every day. I was practicing how to be happy. I was training myself to practice happiness.

In doing these things I started to see my recovery a bit more objectively. Instead of just attending daily meetings with some vague notion that it would help me, I was doing specific actions every day that were leading me to greater health. I was on a path of personal growth and I was starting to see how this was preventing relapse directly. And so eventually I figured out that relapse prevention is personal growth. If you are not on a path of positive change then you are–by default–on a path of negative change. They hint at this in traditional recovery programs when they say “you are either working on recovery or you are working on a relapse.” It is always one or the other. Therefore you should be engaged in a process of personal growth and positive action if you want to stay sober. The alternative is the negative slide towards relapse. There is, unfortunately, nothing in between these two extremes. That seems unfair but it is one of the tough lessons that every alcoholic has to learn in sobriety. You either work like crazy on recovery by taking positive action, or you end up relapsing. There is no third option there. If you try to find a third option then you end up relapsing. It really is that simple. The program and direction that you choose for your recovery is actually just a minor detail. The important thing is the dedication to positive action, the willingness to change, the commitment to your new life in recovery.

Can recovery be objective and well defined some day?

I am not sure that alcoholism recovery will ever be well defined in the sense that there will be a “cure” and that this cure will have a specific set of instructions.

People can argue that the 12 steps of AA constitute this cure but I don’t really believe that is the case. They may work for some people but they are far from being what I would call a “cure.” Just take a look at the data and you would be hard pressed to call the 12 step program a universal solution. Some people who are in AA like to offer the idea that AA is a perfect solution that will work for anyone so long as that person is willing to embrace the solution, but this doesn’t seem very helpful in the real world. Of course the alcoholic has to be willing to take action, but there are plenty of people who voluntarily attend recovery programs, treatment centers, and AA meetings who still end up relapsing in very large numbers. We are far from a cure at this point but we have hope for the future. I have hope for the future.

I like to look at various recovery programs and try to pull out the fundamental principles. For example, surrender seems to be a fundamental concept in recovery. Everyone who gets clean and sober goes through some sort of surrender process, regardless of what recovery program they choose to follow. It is universal.

The same can be said of a concept such as “willingness.” No one who gets sober does so without embracing the concept of willingness. It is essential to the sobriety process. It is fundamental.

If we painstakingly study those people who are successful in sobriety and we continue to pull out these different fundamental principles then I think we can get a good idea of what objective sobriety really looks like.

Do what you have to do in order to recover

The bottom line is that you should do whatever you have to do in order to recover.

Please don’t let me talk you out of AA meetings if that is what works for you or gives you hope. The meetings did not work for me but they did cause me to dig a little bit deeper, to question what was really keeping me sober on a daily basis. So in leaving the meetings I had to look inside of myself and figure out what was really driving me forward, where the motivation was coming from, and how that was affecting my life in recovery. This led me to a mission of personal growth. I wanted to become healthier in every way that I could because I was starting to see how this had a positive impact on my recovery.

In the end I started to live the life that was working well for me, the life that led me to personal growth. I still have close friends and peers who attend AA meetings every and they have an amazing life in recovery was well. It is not about one solution being better than the others, it is about finding your own path to success and sobriety. If that means daily AA meetings then by all means, go to meetings every day. I had to look beyond that and in doing so I found the principles that worked well for me.

What about you, what works well for you in recovery? Have you “solved” the problem of overcoming your addiction? How is that working out for you so far? Let us know in the discussion forums. It only takes a second to register!