“I’m in AA – Can I use The Sinclair Method as my Higher Power?”

“Mister Taterhead Higher Power” or “a God of your own conception” – if a rock or a doorknob is valid, then why not medical science?

Time for a new discussion: can The Sinclair Method be reconciled with the 12 steps of Alcoholics Anonymous?

Here’s what I have to say on the subject in a piece I’ve submitted for an upcoming anthology Claudia Christian is putting together…

 

Can a person in Alcoholics Anonymous use SCIENCE – specifically The Sinclair Method – as their very own chosen Higher Power instead of the supernatural (or instead of a doorknob or a rock, for that matter)?

 

‘The only requirement for AA membership is a desire to stop drinking[my emphasis]

William Griffith Wilson, page 139, Tradition Three, Twelve Steps and Twelve Traditions, 1953.

 

‘Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn’t done so yet.’ [again, my emphasis]

William Griffith Wilson, page 31, Chapter 3: More about Alcoholism, Alcoholics Anonymous, 1939

 

‘He [Bill Wilson] suggested that in my future research I should look for an analogue of methadone, a medication that would relieve the alcoholic’s sometimes irresistible craving and enable him to progress in AA toward social and emotional recovery, following the Twelve Steps.’

Dr. Vincent Dole, co-founder of Methadone maintenance treatment (MMT) and recipient of the prestigious Lasker Award for Medicine.[1]

 

 

 

November 2013  

 

‘…Whoooooaaaa, Nelly. Are you trying to blow up the fucking internet?!??  That’s a goddamn nuclear bomb, that is.’

 

Such was my gut reaction. My own ‘contempt prior to investigation’ to the following message which I received in my e-mail inbox one day via my blog:

 

‘I’m also an alcoholic and I have tried AA and it works for me for a moment, then the craving increases. I’m reading “The Cure for Alcoholism”, and I’m very intrigued by the idea that “yes” perhaps there is a cure.


I do subscribe to many of the AA ideas, but I also know that the cravings for alcohol are what keeps me from being successful. I also know that many in AA are not successful, and that the success rate is extremely low (5% – 10%???? can’t know for sure because of the anonymity part of AA) versus what is claimed here.


I just started on my 2nd Month of treatment with “the little pill”, and I’m hoping and praying this will work. I can tell you that I honestly, today, feel like I’m craving it less. Who knows? perhaps even this with the combination of AA will be even more powerful, although studies have shown that it is not necessary.


 Perhaps, I can come back within the next two months and provide yet another success story. I’ve prayed and prayed for help out of this hell, and I honestly wonder if perhaps, this isn’t an answer to prayer? I saw this story on CNN (http://cnnpressroom.blogs.cnn.com/2012/02/23/cnn-in-depth-addiction-dr-gupta-on-new-pill-to-help-stop-drinking-drug-use/) and was even more intrigued. I have to tell you that I’m excited at the prospects, and if a pill can provide the cure, then honestly why not?


Doing otherwise, if there is a cure is analogous to a faith based family that refuses to provide a cure to a child because they believe God will do it in a miraculous manner, when God already provided Doctors and cures via the medical system. I don’t get it.’

 

As I say, I nearly fell out of my chair.

 

In short, I thought that the very suggestion was heretical; an absolute abomination – to both AA and to TSM.

So yes, you could say that I had an immediate Semmelweis Reflex of my own upon reading that and was about to write back to this person with quite a nice and polite (but still firm) message saying that – no – actually, you CANNOT even begin to reconcile a secular, scientific method like pharmacological extinction with a faith-based one like the 12 Step programme of Alcoholics Anonymous; not like she or he was suggesting, anyway.

 

‘Square peg, meet round hole’ was my smug thought.

 

Then I had to stop myself.

 

Because, wouldn’t you know it?  I suddenly found myself having a weird light bulb moment.  Put it down to the persistence of memory, but one of those odd little useless factoids that you collect in your head (much the way how a computer picks up temporary internet files, cookies and other bits of junk) suddenly flashed right onto the computer screen of my mind…

Namely this:

 

‘Ah, of course.  There’s the precedent of Bill Wilson’s advocacy of niacin as a treatment for the physical component of alcoholism, isn’t there?’

 

Okay, time for a little history lesson.  This one is about William Griffith Wilson (A.K.A. ‘Bill W.’), co-founder of Alcoholics Anonymous and the main author of their bible/instruction manual ‘the Big Book’…

 

The following is a letter that Lois Wilson (Bill Wilson’s widow) wrote to three doctors who were interested in researching what they perceived to be ‘the biological component’ of alcoholism not long after Wilson’s death from lung cancer:

 

MRS. WILLIAM G. WILSON

Stepping Stones

Bedford Hills, N. Y. 10507

 

Dear Dave, Ed and Russ,

When the matter of the AA Trustee’s ratio was finally settled, Bill felt that he had finished his job and done all he could to help AA to build a lasting structure.  Then, as rarely happens in life, he was given a second opportunity to aid the sick alcoholic.

Aldous Huxley, a great admirer of AA, introduced Bill to two psychiatrists who were researching the biochemistry of alcoholism as well as schizophrenia.  Bill was convinced of the truth of their findings and realized he could again help his beloved alcoholics by telling them about this probable aid for the physical component of alcoholism.  He recognized that this work must be kept separate and distinct from AA and wrote a letter to the AA Board so stating.

As you know, Bill’s last years were mainly devoted to the spread of this information among alcoholics and other ill persons.  With your help, he wrote and distributed to AA doctors which has twice been enlarged and brought up to date.  Before he passed on, he dictated a letter stating his hopes that you three doctors who were interested in AA and had worked closely with him in the niacin field, would extend your endeavours along the latter lines.

I sincerely believe that you want what is best for the sick alcoholic who, as yet, has not been able to join AA, and that you will continue to place the principles of AA first and researching second.

Bill’s great hope was that continued research would find a means whereby those thousands of alcoholics who want to stop drinking but are too ill to grasp the AA program could be released from their bondage and enabled to join AA.

 

All good wishes,

Affectionately,

Lois

(Mrs. William G. Wilson)

 

Of course, as I say, I had this memory – Bill Wilson and his whacky ideas about niacin stored in my head for some time.  I think that I’d first read about it fleetingly quite some time ago when I was reading on an anti-AA site called The Orange Papers, but didn’t really pay much attention at the time and didn’t make that much of a conscious effort to study it or ponder upon its implications because (if I’m quite honest) back then I was enjoying feeding my hatred far too much to pay attention to an odd but relatively boring detail like that, you see.

I had, after all, only just become recently estranged from AA and was quite chuffed at how perceptive I was for discovering that there were lots of other disgruntled people like me out there who had an axe to grind after having had such a bad experience with the fellowship.

In my own instance any ability that I might have had to view any aspect of the 12 Step movement in a rational, impartial manner was burned away as a result of my ex-sponsor brainwashing my own half-brother (also an AA member) against me.  Not nice, I’ll tell you.  This probably goes a long way towards explaining why, for the longest time, I had such a fierce resentment against alcoholics Anonymous…

Understandably so, I’d say.

Oh that and the fact that it simply didn’t help me.  Even with the peer support and peer encouragement that I got by going to the meetings, the craving – the compulsion – would never quite go away.  As I stated earlier, the longest time I ever managed to remain abstinent in AA was nearly 6 months and it was pure white-knuckle… just wall-to-wall cravings throughout that time.  Like being water-boarded; not nice.

 

But if I had to sum up the one biggest reason why AA was of neither use nor ornament to me personally then I would sum it up in these words:  the 12 Step programme of Alcoholics Anonymous itself was quite simply a religious square peg for my atheistic round hole that, from my viewpoint, didn’t allow any room to manoeuvre.

 

To illustrate what I mean, here are the 12 Steps of the programme of Alcoholics Anonymous:

 

THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS

  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.

 

This is what’s read out at the beginning of every AA meeting around the world.  And, as you can imagine, given the instances of words like ‘God’ it is straight away a bit of a cognitive dissonance headache for people of an atheistic or secular bent, given that it explicitly demands an element of faith in some supernatural force.

 

Sure, it tries to give some wiggle-room with wording like ‘God as we understood Him’… but essentially it demands that the participant use some resource greater than themselves and then, further into the steps, asks them to open some form of communication with said entity in order to recover from their alcoholism.

 

And this is a problem. People who are in AA or who who support AA often try to dodge this by saying something along the lines of:

 

‘Oh your Higher Power or God of your understanding can be whatever you want… it can be the spirit of the universe or it can be gravity or it can be a rock or a doorknob… anything – absolutely anything – you want to put your faith in…’

 

But here’s the thing…. none of those are sentient entities…. none of those are things that you can have anything in the way of a meaningful transaction with, are they?  Neither a doorknob nor a rock are particularly useful deus ex machinas when it comes right down to it, really.

And this is the problem that people have – it really doesn’t leave any room for interpretation.  Which is quite a big issue because how in the hell can you possibly ask a fucking doorknob to ‘restore you to sanity’ (as stated in Step 2)?!??

(Heh. Riiiight. Good luck with that)

 

My ‘Keyser Söze’ moment of realisation

 

But going right back to the original message that I received on my blog from the individual asking whether he/she could use some form of ‘God or Higher Power through doctors’ or ‘the science that God gave us that resulted in the invention of The Sinclair Method’ as their own personal Higher Power…… that’s to say, as a way of starting to reconcile the 12 Steps………. do you know what?

 

This is a big, big, big thought that would send a chill down my spine, but upon recollecting Mr. Wilson’s interest in niacin and his real desire (as his widow put it) to ‘help his beloved alcoholics by telling them about this probable aid for the physical component of alcoholism’, there is indeed a case that could be made for reconciling pharmacological extinction using naltrexone or nalmefene with Alcoholics Anonymous.

 

How?

Well, let’s look at all of it – and I mean really look at it all – through eyes not blinded by either ideology or polemics for once, shall we?

 

(Deep breath)

Here goes.  Here is my thought process on this.  This is the chain of thoughts that I suddenly had.  This is why I was now finding myself having what amounts to something similar to that epiphany moment the Chaz Palminteri character had when he dropped his coffee cup at the end of the The Usual Suspects.

Here was the cascade of thoughts that I suddenly had:

  1. As Lois Wilson’s letter demonstrates, we know for certain (despite what any AA member might choose to tell you) that Bill Wilson was indeed interested in the biological component of alcohol addiction and thought that there could be a way of pharmacologically addressing it. We know Wilson tasked Vincent Dole with creating “a methadone for alcoholism” and we also know that Bill devoted much of his own time and many of his own resources to studying niacin as one possible way of remedying this ‘physical component’.  Hence the three pamphlets that he wrote on “the B3 Therapy” – the first one published in 1965, the second one published in 1968 and the last one posthumously in 1971.  And we also know that before he died Wilson said that he wanted to be remembered not for founding AA, but for the discovery of niacin as a way of treating the physical component of alcoholism.
  2. He thought that it was important enough for him to in fact clash with members of the fellowship that he himself originally founded on this one issue – hence why it never came to fruition and why it’s not really spoken about nowadays.  It’s been swept under the carpet ever since and the party line these days is ‘AA doesn’t support the use of pills of any kind’…which has quite big implications when you really stop and think about it, because here were members of his own fellowship telling their divinely inspired prophet that he was wrong.  Which really is like saying ‘God is wrong’ (hence why it was swept under the carpet).
  3. Why did Bill think that this was so important?  Well, again, you have to look at history.  William Griffith Wilson had, prior to founding the fellowship been someone who had suffered terribly with a serious alcohol addiction and who, if the fact that he died pleading for whiskey is anything to go by, never lost his craving for alcohol.  Yes, he became abstinent… yes, he founded AA and tried to help people conquer their own addiction to booze… but the fact remains that he himself never lost this strange, visceral ‘hunger’.
  4. This leads on to yet another thought.  He had over many tears tried many things to find a solution to solving this riddle.  He’d tried religion and he’d tried science.  Alas, he’d been unsuccessful in ridding himself of his own craving.  Niacin would prove to be a dead end – as evidenced by the fact that he died pleading for whiskey.
  5. But what if…. what if he was actually onto something with pharmacology but just looking in the wrong place?  What if he’d stumbled across naltrexone and The Sinclair Method of pharmacological extinction?  What if TSM had been around back then?  Would he have pursued it – would he have been very interested in it – or would he have blindly refused it as an option?  Now, that’s A BIG QUESTION.

 

And to interject with my own opinion, dear reader (for what it’s worth) I think that he would have been very interested indeed in TSM and would have ultimately likely discarded his research on niacin in favour of that instead.

That is my intuition.

Whilst much has been written about Bill Wilson and his founding of Alcoholics Anonymous over these last eighty-plus years and whilst much has been written about him which has been (justifiably) very critical, I do not believe that he was an unintelligent man; perhaps confused and misguided about a number of different ideas, but not stupid.  He was smart enough to know a good bet when he saw one and he did have the salesman thing about him – so he might well have seen naltrexone and The Sinclair Method as ‘a good punt’ – a good investment.

 

I mean – sure – given what he thought he knew about alcoholism thanks to Dr. William Silkworth’s ideas, I think that he would at first have had real difficulty reconciling the approach of gradual extinction as opposed to abstinence, so he would have been forced to rethink his attitude on that.  It would have caused him some real cognitive dissonance.

But whereas he made a rod for his own back thanks to his other claims about being divinely inspired (‘hoist by his own petard’, so to speak), perhaps there was a loophole here that he could exploit after all if you were to argue that though articles of faith aren’t open to revision, science most definitely is.

 

There’s your loophole right there.

 

You could argue that we’ve moved on a great deal since Silkworth put forward his thoughts on alcoholism being an allergy activated upon consuming that first drink and absolute abstinence being the only way to combat it.

You could certainly argue that that notion is open to revision because it is based solely upon the questionable standards of scientific knowledge in the early 20th century, in which nobody had yet to consider gradual extinction through pharmacological means – so there is wiggle-room here.

Especially when you consider the fact that famous rehab centres like Hazelden (which uses the 12 step model) have recently become increasingly more open to the notion of the concept of what I suppose you could call a form of “gradual sobriety” for heroin addicts using prescription drugs like suboxone[2] – so, given this precedents, why ever not make the case for naltrexone or nalmefene using The Sinclair Method?

 

The only question then would someone begin to adapt the 12 Steps to make it workable.  Well, the thing about the 12 Steps is that they are ‘but suggestions’, so they are malleable and open to reinterpretation.  So with that in mind you could now rework them to this effect:

 

 

 

THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS USING THE SINCLAIR METHOD

  1. We admitted that we had difficulty moderating our alcohol intake—that our lives had become unmanageable due in no small part to this difficulty.
  2.  Came to believe that a rational, compassionate scientific approach could help us to make our lives more manageable.
  3. Made a decision to use The Sinclair Method – a sensible, scientific way to attempt to reduce our alcohol intake.
  4. We took stock of ourselves and examined any previous wrong-doing to others.
  5. Decided which areas of our personalities and which previous wrong-doings we could take measures to correct.  If need be, we approached a trained therapist or other appropriate sympathetic professional to confide with in order to help us. 
  6. Became ready and willing to make positive change to our lives.
  7. Put our faith in science and reason.
  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 research, rational discussion and private contemplation ways to constantly improve our knowledge and become better, ever-evolving human beings.
  12. Having found a new point of view as a result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

 

 

 

Starting a Revolution

 

So these are the arguments that you could make.  There are the facts that you could use to start to begin to bring about a revolution if you decided to become invested in the notion of doing so – your own science/secular driven splinter group of Alcoholics Anonymous.  You don’t have to destroy the old; you just have to build the new.

And, to summarise, in order to defend your right to exist you could do so by:

(a) Citing the ‘B3 historical precedent’ – Bill Wilson’s interest in pharmacology.

(b) Arguing the case that the blind insistence upon abstinence is open to revision because it is based solely upon the opinion of a 1930s medical doctor who had yet to discover the concept of gradual pharmacological extinction – so whilst there is not much of a loophole to allow you to ‘challenge Bill W.’s God’, there is a case for saying that outdated medical opinion (in this case the chapter ‘The Doctor’s Opinion’ that serves as  the foreword The Big Book) is not an irrelevant “outside issue” and can and should be challenged in light of new knowledge – because whilst articles of faith may not be open to revision, science most definitely is.

(And not just that: any medical practitioner who refuses to offer a safe and effective treatment in favour of a much more antiquated and much less effective one is committing malpractice, pure and simple)

You could even, if you chose to passionately argue your case against traditionalists, say that you were fighting to both vindicate your founder’s noble desire to see reform and bring change to the fellowship that he helped create – by not shutting the door on assistance through pharmacological means.

…So you could actually take the moral high ground in that respect.

A new chapter indeed.  Talk about uncharted country. One that would no doubt bring about some level of controversy and conflict with stubborn, intransigent old-timers who can’t bear to accept new ideas or new interpretations.

But in this instance you could perhaps cheekily suggest that maybe – just maybe – they should take another look at the whole niacin thing again because perhaps Mr. Wilson was a visionary after all… someone who could see into the future… but just one who evidently couldn’t spell very well, because he got the fact that it began with an “N” right – but it wasn’t niacin.

….Nope, it was naltrexone.

(Or nalmefene)


 

[1] Extract taken from here: http://drewhorowitzassociates.com/what-is-addiction-recovery-anways/

[2] See: http://healthland.time.com/2012/11/05/hazelden-introduces-antiaddiction-medications-in-recovery-for-first-time/

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