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An Author Explores 222 Paths to Sobriety

by JANE E. BRODY - Science Times, 4/17/2001. Originally posted 11/16/2001; Revised: 6/17/2004.

The press kit for Anne M. Fletcher's new book, "Sober for Good" (Houghton-Mifflin, $25), states, "Sometimes one book can make a difference." After reading the book, I could not agree more strongly.

In it, Ms. Fletcher, a health and medical writer and a former problem drinker, describes the recoveries of 222 men and women who had seriously abused alcohol. Some had done so for decades but had been sober for five or more years, a point where relapse is highly unlikely, studies suggest. For two-thirds of the group that she calls "masters" over alcohol, sobriety has lasted at least a decade.

But the fact that hundreds of former abusers of alcohol are now sober is not what makes this book special. What sets it apart is her in-depth descriptions of the routes to sobriety taken by those she questioned and the many myths about alcohol recovery that they expose. In this book, there is a path to recovery for virtually everyone, including those who have tried repeatedly to escape the yoke of alcohol and those who believe they can never give up drinking.

If you want to get sober and stay sober, you must join Alcoholics Anonymous and follow its 12-step program.

Although Alcoholics Anonymous has helped millions, more than half the people who completed Ms. Fletcher's seven-page questionnaire about their drinking problems and how they resolved them said they did so without A.A. Many quit on their own. Others sought the help of therapists, especially those who practice cognitive-behavioral therapy, which helps people recognize their self-defeating thoughts and change their behavior. Others who preferred a group approach but found A.A. unsuited to their beliefs joined other groups, like Women for Sobriety and Smart Recovery, in which participants take responsibility for their drinking.

Herb N., 42, an alcohol abuser since age 17 who quit 13 years ago, said: "The 12 steps wanted me to believe in a `higher power' and admit that I was powerless over alcohol and drugs. But I knew that I wasn't. I wanted to learn how to fight my addiction, not give in and pray to a God I didn't believe in to relieve my suffering."

Rosa L., who acknowledged the value of A.A. for the many people it had helped, nonetheless said, "I am also very angry at the recovery community and treatment centers for not allowing space for other programs and for not telling their clients about other approaches." Rosa has been sober for 10 years with the help of Women for Sobriety, which emphasizes competence and strength, not powerlessness over alcohol.

While 97 of those surveyed achieved sobriety through A.A., 56 percent used nontraditional methods, including 25 people who quit on their own. And those who have remained sober for a decade or longer were equally divided between A.A. members and those who used of unconventional approaches, Ms. Fletcher reported.

Nearly 14 million Americans abuse alcohol, but just one in 10 receives treatment. Of those who join A.A., fewer than 10 percent are still members after a year. Offering other roads to recovery is likely to bring more people into treatment and foster lasting sobriety. As Rick N., sober for 21 years, put it, "There are probably as many ways to defeat alcohol problems as there are people who want to recover. The more choices we can offer, the more people can be helped."

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You have to admit to being an alcoholic to recover.

The word "alcoholic" threatens many people and prompts them to avoid seeking help, Ms. Fletcher wrote. Many of the masters conquered their drinking problems without ever seeing themselves as "alcoholics" with a "disease." Their stories also expose another myth: that alcohol abusers must "hit bottom" before they can recover. Many took control of their drinking before reaching desperate straits, for example, while their marriages were threatened but still intact or before they lost their jobs but knew that their performance was seriously suffering.

Ms. Fletcher concluded, "While the amount of alcohol and the regularity of drinking certainly provide important clues that something is amiss, the masters' stories suggest that their awakening had more to do with recognizing what drinking was doing to them and those around them."

As Karen M., sober for 14 years, put it, "It's not so much the frequency of drinking but how it affects your life when you do."

For example, Liz B. typically drank four or five glasses of wine a day, "a far cry from stereotypical `alcoholic' drinking," Ms. Fletcher reported. But Liz said she was "a mean drunk" who was losing the respect of her husband, picking fights over trivial matters, and she feared the effects of her drinking on her young sons.

In another example, Jackie D. said, "I had attributed all my problems in life to other things: trauma, the world's not fair, money. Suddenly it became crystal-clear that if I took alcohol away, I could handle all the other stuff."

Recovery is best handled, as A.A. puts it, "one day at a time."

Many who achieved lasting sobriety, including some members of A.A., said they did so by making a lifetime commitment to changing their relationship with alcohol.

As Richard D., who abused alcohol for eight years, said at age 47 after seven years of sobriety: "I have made a conscious choice that I will remain alcohol-free for the rest of my life." He added that he was aware of the allure of alcohol, but that nothing could touch or compare with living a sober life."

Others Ms. Fletcher questioned made statements like "I told myself I would not drink again," "I put the cork in the bottle," "I accepted that I couldn't handle alcohol," and "I said, `That's it, I quit.' "

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A former alcohol abuser is one drink away from drunk.

While most of the masters say they have chosen total abstinence as their route to lasting sobriety, a few have found that they can drink moderately, and about a dozen have been able to handle small amounts of alcohol in occasional situations, like weddings or with friends who don't abuse alcohol.
"This select group of masters is living proof that at least for some people, one drink does not a drunk make," Ms. Fletcher wrote.

Still, a return to moderate drinking is an option for only a few. Maintaining control of an alcohol problem can be challenging for those who continue to drink even rarely.

Lorraine Collins, a psychologist and addiction specialist in Buffalo, N.Y., explained: "Restrained drinkers have to put a fair amount of effort into controlling their drinking and/or fighting the urge to drink. In contrast, a true social drinker is someone for whom alcohol presents little or no issue. Certain former problem drinkers who choose to drink again achieve a peace with alcohol, and they don't have to worry about it anymore."

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Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D.

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Originally posted:  11/16/2001

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