How do you stop drinking? Where can you go? What’s the difference between AA and treatment? Which path is right for you?

AA, Treatment, or Cold Turkey

Alcoholics Anonymous began in 1935.  At the time, “treatment” for alcoholism didn’t exist; alcoholism was not considered a disease, and alcoholics were moral or psychological ‘failures.’  “The Cure” consisted of drying out spells, often aided by chemicals such as belladonna (now considered poison).  Alcoholics who had the money spent time in sanatoriums, those who didn’t spent time in jail or public hospitals.

People whose “cure” didn’t seem to take were diagnosed as hopeless cases and occasionally institutionalized.

Of course, some people managed to get sober for good.  The most commonly cited reason was a spiritual awakening.  Bill’s grandfather ‘saw God’ on top of a mountain in Vermont, swore to never drink again, and never did.

The disease model of addiction followed Alcoholic’s Anonymous’ tremendous success.  The medical field came to recognize that alcoholics respond to alcohol – any amount of alcohol – differently than normal drinkers.  Behind medicine came social theories, criminal justice, and the clergy; “treatment” centers didn’t really come into their own until the late 1970s.

Some find AA too religious, too demanding, or too invasive.  With treatment centers, a variety of counseling options, even changing religious choices, there are alternatives.  How to decide?

Outside AA


In and out-patient treatment centers are available anywhere, to anyone, on any pay scale.  They originally followed AA’s “12 step” model quite rigorously, discharging patients after they had completed a 5th step.  Early on, a patient would stay in the program however long that might take.  These days, the crunch on health insurance means stays are usually limited to 21 days.

Treatment offers the immediate benefit of medical attention.  Even people who don’t think they need detox will go through stages of detoxification as their body (and brain) begins to work without alcohol in it.

Treatment – especially inpatient treatment – offers an immediate change and respite to the alcoholic and his family; for a few weeks, the alcoholic is allowed to take a step back from other responsibilities, focus on the alcohol problem, and make significant progress before having to return to ‘real life’.  Many find this time away crucial: the problem is big enough, serious enough, that they can’t seem to stop by attending a meeting or two a week, or an afternoon counseling session. Most alcoholics and alcohol affected families are deep in denial of the problem – it isn’t until they give it the attention and importance of a medical emergency, intense counseling, and weeks spent with other alcoholics and addicts that the severity of their disease hits home.

In treatment the alcoholic and his family are given enormous amounts of information about alcoholism and its medical and psychological effects.  This is information widely available elsewhere, and shared in 12 step circles, but the ‘crash course’ might help break through denial or bring a sudden awakening to alcoholics who aren’t sure.


Most alcoholics look for help with other problems before they try sobriety.  Alcoholism causes marital problems, stress, job problems, mood disorders, and otherwise chaotic lives.  Usually, it’s this chaos that people struggle with; the alcohol doesn’t seem to be the problem.  After all, trouble doesn’t happen every time you drink.

People may also feel more comfortable talking about their issues in the privacy of a counselor’s office, or feel comfortable with their therapist (minister, social worker) in a way they don’t with a room full of strangers.


Like Bill W.’s grandfather, some people find faith their best shot at getting sober.  Religion offers grace and redemption, communion with others, and powerful emotional grounding.

Faith manages to weather all challenges and ends up, for millions of people, being the most solid bedrock there is.

Religion also offers strong spiritual guidance – a direction to g0 – both within the community and within the precepts of the faith.


Active alcoholics usually don’t have an immediate connection to any one of the above choices.  Treatment may seem too severe or too expensive.  Religion, counseling, and AA can be dismissed, intellectually, as being a trade off of one addiction for another, or brain washing, simply a waste of time.  Why, if alcohol is the problem, spend so much time focusing on it?

We are strong people.  Since most alcoholics don’t fit the stereotype of the bum in the gutter, there is reason to think we can make the necessary changes ourselves. 

We also have examples all around us of people who drank excessively at some point, and seem to have ‘grown out of it’.

Finding your way

In truth, most alcoholics stick their toes in every one of the above options in their path to sobriety.  To try to choose the ‘right’ one may be a way of procrastinating, avoidance, or denial.

Here are the numbers.  90% of alcoholics will die actively drinking.  That is a terrifying number; it means that even those addicts and alcoholics who manage to get some sobriety are likely to ‘go back out there’.

The success rate for treatment centers is usually more dismal than even that.  This reflects the fact that many people ‘aren’t ready’ when they go to treatment.  They may have been ordered by a court or pressured by family members or employers.  They may recognize that they’ve been drinking too much recently, but are sure they can bring it back to normal.

Treatment has saved many lives, and its contributions to the understanding of alcoholism and addiction are precious.  It is often the first step of recovery for those that ‘make it’ and they cite treatment as ‘saving their lives’.  But treatment is a temporary solution: its is often possible for us to quit drinking and using for 21 days, six months, even a year.  The information we’ve gained and the knowledge about ourselves pushes us to stay clean and sober. But after leaving treatment, you are on your own.  Most offer some kind of ‘after care’ program, but these are poorly attended and can be more depressing than helpful.

It is common to build strong and emotional friendships with the people in treatment with us. We share our guts, go through it together, and reveal ourselves as vulnerable.  It’s a bonding experience, to say the least.

It’s not uncommon to leave treatment feeling committed to sobriety, and to watch your friends relapse one after the other, or to simply ‘lose touch’.

The counseling, helping professions have also saved the lives of many alcoholics.  However, what most therapists will suggest is participation in a 12 step program.  It’s not uncommon for them to refuse further treatment until the client agrees to that.

Because alcoholism is a disease of denial, and it breeds chaos in every part of our lives, it’s possible to spend a lot of time in counseling focusing on those other issues.  If that is the goal, it works.  It may also be a way of working toward accepting one’s disease and deciding to quit.

But it’s also true that millions of alcoholics seek ‘help’ and aren’t able to find it because they never discuss drinking during the counseling sessions.  Denial is powerful and insanely intelligent; there is no reason a shrink would ‘notice’ alcoholism unless the alcoholic were open about his drinking.

Many alcoholics continue counseling into their recovery, even those who haven’t seen a professional before.  With the experience of sobriety and the realization that we can change, that life can be better, many are motivated to work though other issues in their lives or simply to grow more.

Religion is such a personal matter that it’s relationship to recovery is slippery.  The 12 step programs do identify as a ‘spiritual program’, but insist it isn’t about any god or religion in particular; ‘spiritual’ can simply mean ‘ethical’ or ‘moral’, or refer to the feeling many experience in non-theistic traditions of yoga or buddhism.

Many will find their faith in recovery, and become active members or regular practitioners of their faith.

For those who seek the path of religion without the 12 steps, there is much less optimism.  As with counseling, denial can mean the alcoholic works very hard, the clergy works very hard, and the community works very hard on all sorts of things except the alcoholism. This can work for some people, for a while.

interpretations of religion also tend to label alcoholic behaviors as sinful or wrong; many alcoholics stay sober by focusing on their shame and their desire to repent.

But alcoholism is a medically and scientifically recognized disease.  That doesn’t mean it works against or outside of faith, but it does mean that treating it as a ‘sin’ or denying it altogether doesn’t help.


There are as many paths to recovery as their are addicts.  If there is anything an alcoholic should remember, it’s that recovery is possible.

In truth, following the statistics, and the advice of the helping professions and communities of faith, Alcoholics Anonymous is the most successful route to recovery.

Alcoholism is a disease, and needs to be treated as seriously as a disease.  If you or a loved one think you might have a problem, you should give yourself as much support as possible. Use all available options.  Go to treatment, find your spiritual direction, or get into therapy.  But remember, too, that Alcoholics Anonymous is available anywhere you go in the world, has support any time of the day or night, and has managed to get millions of people sober.  If you’re serious about sobriety, you owe it to yourself to try it for awhile.

Yes, it is strange.  The talk may seem too spiritual or ‘god-like’ to you.  You may not feel you can relate to others there or even like spending your time in meetings.

Go anyway.

There are no rules- no one there will tell you what to do or how to do it.  There aren’t any ‘right ways’, and no one is going to judge you.

I don’t like this.  I don’t like the god crap and higher powers and I don’t like talking about powerlessness and serenity.  I’m sick of the serenity prayer.  I don’t like going over and over again, I don’t like bad coffee or church basements.  I don’t like it, I said.

You’re not supposed to ‘like it’, a friend with 20 sober years said back; ‘you’re supposed to get sober’.

And I did.

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