As a physician and educator, I have worked with individuals involved in 12-step recovery for many years. As a pediatrician, I have a particular concern for our youth. When I heard the news of Robert F. Kennedy's granddaughter being lost at 22 years of age, I was not only saddened but gripped more deeply by understanding – understanding that if she did succumb to addiction, it was neither her choice nor her fault.
Why not? As a community, we must embrace the knowledge that addiction is not an eccentric problem pressing into a temperate culture, but a fundamental biological process requiring treatment just as certainly as an individual with diabetes may need insulin.
I wrote a previous article about opioid use disorder which, according to National Institutes of Health data, occurs in 8% to 12% of patients prescribed opioids for pain control. Similarly, published data indicate that approximately 12% of our population is dependent on alcohol and 6% on illicit drugs, with alarming substance abuse rates among our youth.
The night Martin Luther King Jr. was shot in 1968, Robert F. Kennedy was in Indianapolis. He quoted his favorite poet Aeschylus: “Even in our sleep, the pain which cannot forget falls drop by drop upon our heart, until in our own despair, and against our will, comes wisdom, through the awful Grace of God.”
Herein begins the problem. Life has trauma. Trauma requires coping. And the need to cope leads to cravings for dopamine release in the brain. Alcohol and mood-altering drugs provide such euphoria to many people.
Interestingly, NIH has dedicated substantial resources to researching the answer to the question of why some individuals become addicted while others do not. In the meantime, addictionologists often describe the biological reaction that an addict has to drugs (or an alcoholic has to alcohol) as analogous to an allergy. And those who have “the allergy” must abstain from drugs/alcohol and learn to re-program their approach to coping in life. This is where 12-step programs become essential.
The most compelling point I wish to underscore is what to do when experiencing problems with excess alcohol or drug use. Of course it should be discussed with a physician. It may also be helpful for readers to understand the ease of access to nearly 100 local 12-step meetings each week.
Before I learned of 12-step programs, I presumed – as perhaps most do – that attendance at an AA or NA meeting required a dramatic disclosure that “I am an alcoholic” (or addict). It does not. All who desire to end their problem are welcome, and it is OK if the attendee is unsure whether they have “the allergy.”
This is a critical point for people to understand. The worst-case scenario is that meeting attendance will lead to learning something from a group of very honest and real people. The best-case scenario is that it will save your life.
My favorite quote from Bobby Kennedy came from a speech about what drives our economy and the American way of life: “The gross domestic product in America tells us everything about America except why we are proud to be Americans.” He was disturbed by how many harmful products contributed to the GDP: the assassin's gun, excesses of alcohol, etc.
In contrast, there is much pride to be found in the pursuit of sobriety. And better sooner than later. There is no fault and no shame with addiction – all program participants should be celebrated.
The result of 12-step coping is not simply sobriety but a life defined by removing personal faults (which often contribute to poor coping skills). The program teaches participants to cope in salutary ways rather than deleterious ways.
The promise that results is published in the AA literature: “before you are half way through, you will be amazed at how your life has changed” (paraphrasing). It has such a remarkable track record that there are now programs in Fort Wayne (e.g., “Celebrate Recovery”) that seek to apply this program to life even for those who do not struggle with addiction.
Dr. Scott Myers is a Fort Wayne pediatric oncologist and former clinical professor at Georgetown University.