Is a Twelve-Step Program for You or Your Family?

In recent years, there has been a backlash against 12–step programs and a number of books have been published decrying the spiritual aspect of the 12-step programs, the word “God” used in the steps, and/or outlining what they consider the cult-like environment they feel they perceive in AA, Alanon or other 12-step programs.

However, as one privately operated teen treatment center’s website says, “Understanding that many people are reluctant to the idea of “God”, the twelve step program allows individuals to substitute their own concept of a “higher power” – which may range from classic religious figures to something as simple as the individual group meeting they attend. We go one step further and assist individuals in finding a higher power that they are comfortable with and adapting the 12 step method to fit their needs.”

Albert Ellis, the grandfather of Rational Emotive Behavior Therapy – you decide how to feel about each life situation – a form of cognitive therapy, offers the book “When AA Does Not Work for You: Rational Steps to Quitting Alcohol.” Dr. Ellis was a traditional “listening therapist” for many years before developing REBT. Ironically, there are inpatient alcohol and drug cessations programs that combine the 12-steps with REBT.

However, for those who sincerely wish to avoid using a 12-step program, there are alcohol cessation programs that are based on other premises and methodologies.

Some programs you may want to look at that do not rely on a 12-step program or a spiritual basis include Save Our Selves (SOS), SMART Recovery, Life-ring Secular Recovery, Rational Recovery (RR), Pennsylvania Model of Recovery, YES Recovery, Women/Men for Sobriety, 16-Step Empowerment Model, Moderation Management, Sinclair Method, and Harm Reduction Therapy.

In her book, “AA: Not the Only Way--Your One Stop Resource Guide to 12-Step Alternatives,” author Melanie Solomon’s main point is that there are many alternatives to dealing with alcohol and substance abuse besides Alcoholics Anonymous (AA) and its twelve steps yet the alternatives are not widely known. In her own experiences with substance abuse, she was not able to find help or support through AA although her father did use the program successfully.

The thesis of her book is that AA is not as effective for everyone as everyone might think and that other non 12-step programs have much more success. She eventually found a program that worked for her. In short, she advocates the attitude that just as each alcohol abuser is different, so are the successful treatments for that individual.

I can tell you that AA worked for me. What I was taught early on is that it a very personalized form of group therapy. That I needed to take out of it what worked for me and leave the rest behind. As far as a higher power goes, aside from God, I've witnessed everything from the group they belonged to the United States Marines. But like me, they were all able to stay sober one day at time thanks to AA.

Let me share with you something a minister recently said to me.

“Churches have an open door policy -- as do AA and NA meetings. That means that they attract – and accept the attendance – of all kinds of people. That also means that all members need to adhere to the old saying, “Caveat Emptor – Let the buyer beware.”

In AA or NA, although a sense of community seems to be there, it is always wise to remember you are among strangers, and to act on the premise that it takes time to really know another human being, wherever you meet them. Act in ways that will keep you safe.

Support Groups

One of the most powerful tools in the addiction arsenal has long been support groups. Younger alcohol abusers seem to have good results from the traditional 12- step programs where they will have an “older” -- meaning more experienced -- sponsor, a group of youngsters struggling through the same stages of recovery and a guidance counselor.

While Alcoholics Anonymous and Narcotics Anonymous programs are based on the 12 –step format, so are most of the non-profit or for-profit treatment programs now operating. Whether AA, founded by a former alcoholic, or a private treatment center like the grandmother of them all, Hazelden – founded in Minnesota in 1949 – they rely on the power of the following Twelve Steps.

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.

Personal Faith and Alcohol Abuse Prevention

Faith and spirituality can play a beneficial role in the prevention of drug and alcohol misuse. Furthermore, it has long been acknowledged that both can be significant ingredients in programs designed to treat, promote and recover from substance use disorders.

Alcoholics Anonymous, founded by “Bill W”, the most widely known self-help treatment for alcohol and/or drug abusers, is a faith-based 12-step program. By 12 step, it means that each of the members of AA uses those 12 steps to advance their understanding of themselves, the reasons they drink (or use drugs), and explore other avenues that lead the member to be able to handle their cravings for alcohol or drugs, or both. Those 12 steps, used by most treatment centers in the United States, are rooted in faith in a spiritual being – God or another interpretation of ones “higher power.”

Faith communities can actively support prevention initiatives and mobilize their own resources to tackle substance abuse issues. These groups help reinforce strong values that discourage unhealthy temptations. Faith communities often help people guide their lives and resist peer pressure.

Faith communities can discourage alcohol or substance misuse by:

 Providing important information to individuals so they can make healthy decisions.

 Teaching people to identify social influences such as advertising and peer pressure that encourage substance abuse.

 Teaching young people how to develop personal and social skills to resist pressure to use.

 Encouraging and supporting substance-free social activities, environments and relationships in the community.

 Establishing guidelines for safe, healthy and appropriate behavior for members in the community.

 Linking with other agencies, institutions and organizations to design and implement prevention efforts that reflect diversity and address the needs, interests and concerns of the community.

 Supporting community policies that restrict advertising and access to alcohol and tobacco by youth.

 Supporting ongoing community dialog to influence community norms about substance abuse prevention.

Personal faith can also be an important part of a person’s journey from alcohol abuse to recovery. Faith communities regularly help individuals and families who are experiencing substance abuse problems.

For more information about faith-based initiatives in the Substance Abuse and Mental Health Services administration, call 1-800-729-6686

Inpatient treatment,Outpatient treatment & Detoxification

In a “live in” facility, the client is taken from school, unable to leave when they wish (unless they are of legal age, this changes from state to state) and his or her life is pretty much put on hold until their body is alcohol free and they are able to control their craving for alcohol.

This may seem drastic; however, it may be the only way to help the youth learn how to handle his or her alcohol abuse problems -- and learn why it has taken hold of his or her life to such an extent. They are away from the negative influences that helped him learn to drink. The other positive is that ostensibly they don’t get alcohol.

However, some programs are more secure than others. You need to check this assumption; it may not be true. Can a friend sneak in alcohol? Can your child pay someone to bring in alcohol? Is there a consequence if your child receives alcohol in any of these ways? Will you be notified if this occurs? Ask. Get it in writing.

Always visit the program you are considering more than once. Listen to what you are being told on your formal tour; then come back and look around. What is the feeling you get about the space; the patient’s rooms; the public living areas? Even the grounds. Are they attractive, look well cared for, a place that comforts and inspires? You’re looking for a school and solid medical treatment, not a prison.

On the other hand, if the youth’s alcohol use is at the stage where the drinking can be addressed by either behavioral therapy, cognitive therapy, or motivational therapy, a 12 step program can be expected to be effective, outpatient treatment might be a choice. Obviously, it’s urgent that the evaluation of the youth’s desire and ability to work this kind of outpatient treatment be on target. A few questions asked of your child by a professional counselor who is associated with a government anti-alcohol program could help you make this determination.

If, on the other hand, the drinking has advanced to a state where the youth needs detoxification before they can attend any program, you’ll be looking for a medical detoxification program. Some treatment programs are capable of also providing you with a medically supervised detoxification program. Until someone is able to be free of withdrawal symptoms, they can’t respond to any treatment program.

Fortunately, there are now medically prescribed drugs that can help relieve withdrawal symptoms while a client is going through the pangs of detoxification. This is something you can discuss with your physician or pediatrician. It is certainly a drawing card if you ever need to suggest this to your child.

TREATMENT OPTIONS

There is no one way to treat alcohol abuse. Just as each alcohol abuser is different, so are the treatments that may be successful for that individual. That’s one reason why examining several programs before committing to one is an important step.

First and foremost, it’s important to know what alcohol does to the human body, regardless of the drinker’s age. Alcohol is a depressant. What causes all those fatalities on the highway is the impairment of the drinker’s brain, sight, hearing, and coordination. Unfortunately, a drinker is usually unable to know they are driving impaired. And they don’t know when to stop drinking.

That’s when detoxification and addiction treatments enter the scene. Treatment can be offered in a round the clock “live in” facility – like the one my son enrolled in, or as an outpatient where the treatment is delivered in a medical or psychological treatment center, or they might first get detoxification treatment in a medical facility like a hospital prior to addiction treatment.

Each method has its benefits and its drawbacks.

Beer, tobacco and marijuana – gateway drugs

The most shocking thing is that alcohol and tobacco are considered by many to be “gateway” drugs, as are inhalants and marijuana. Simply put, that means that drinking alcohol or smoking tobacco is widely considered a “gateway” to using harder drugs. And yes, alcohol is a drug as is nicotine addiction.

In a recent study released by Columbia University’s Center on Addiction and Substance Abuse (CASA), it was reported that children aged 12 to 17 who use gateway drugs – alcohol, tobacco and marijuana, are up to 266 times more likely to use cocaine than those who don’t use any gateway drugs.

Compared with people who used only one gateway drug, children who used all three are 77 times more likely to use cocaine.

“An increasing number of American children and teens believe there is little risk in chugging a beer or smoking a tobacco or marijuana cigarette,” says Joseph A. Califano, Jr., CASA’s president and former Secretary of Health, Education, and Welfare (HEW).

“This report is a wakeup call to encourage parents to discourage their children from drinking or smoking and for governors and mayors to enforce the laws prohibiting the sale of cigarettes, beer, wine coolers and other alcoholic beverages to minors,” says Mr. Califano.

The popularity of energy drinks mixed with alcohol is based on the drinker’s fallacy that mixing energy drinks with booze makes for an increased ability to party all night, says James Mosher, a Pacific Institute for Research and Evaluation alcohol policy expert.

While the Acting Surgeon General’s Call to Action to help stop kids from drinking fills our papers, alarm is being raised by parents and alcohol experts who claim that some alcohol manufacturers are producing products that will encourage young drinking.

While there are those who might refute the “gateway” drug theory, and I’m sure not all young drinkers gravitate to more dangerous drugs, my experiences in the teen rehab world my son and I inhabited for a while supported the “gateway” theory. Of the over 430 families involved, some with multiple children enrolled, a majority of the young clients said they used drugs after drinking beer and/or smoking tobacco or marijuana.

Why are beer, tobacco and marijuana smoking considered gateways to harder drugs?

Well, it’s pretty simple. First, as children and young adults drink more and more, their levels of tolerance increase. They need more and more alcohol to get the same “high.” Then, seeking even higher “highs”, more oblivion, more self medication, they seek stronger drugs for stronger results. Most teenagers and young adults I knew as a host parent had morphed from alcoholics to drug addicts for that reason. They needed stronger drugs to get the same – or more potent – “highs”.

As for tobacco, it’s considered “cool” to smoke in many schools. It’s cheap, it’s believed to calm the nerves (until your blood sugar takes a dive whereupon you go into withdrawal and hey, help, I need more nicotine!) and it’s, like beer or wine coolers, relatively cheap. Smoking nicotine cigarettes helps the smoker convince himself or herself that there isn’t much difference between smoking tobacco and smoking marijuana. Then the same distorted rationality moves onward and it becomes “easier to get high” on cocaine, “hash” or whatever.

And here’s the shocker, folks. One third of the teens and nearly half of the 17-year olds surveyed in CASA’s National Survey of American Attitudes on Substance Abuse XI: Teens and Parents’ Study reported that they attend house parties where parents are present and there is drinking, smoking marijuana or using cocaine, Ecstacy, or prescription drugs going on at that party.

A Personal Story: A Family Intervention

The boy was 12. He had been drinking heavily since he was 11. He was tall and skinny and what his mom called “cute.” He stood outside liquor stores and paid a dollar to the seediest adult he could find to buy him liquor. How did he get the money? He used his allowance; he sold his clothes to other kids; he stole his grandmother’s silverware and got an adult to help him pawn it. He was 12 when his mom finally caught his hand in her purse and a pint of whisky in his backpack.

She tried taking his allowance away. He started shop lifting and selling the stuff he sold.

She tried checking his backpack. It took her months to find his next stash spot under the back porch.

She tried talking with him. He listened, said all the right things, and then went on drinking himself unconscious with his new friends, all older teens.

When she tried getting even stricter with him, grounding him for weekends, he started running away. Not far but the experiences unnerved and frightened his parents for him.

Finally, his parents woke him one evening and took him -- in his pajamas lest he run away -- to a state where a teen aged rehab center was alerted to expect him.

Finally, he got the message. He was going to have to learn to give up alcohol.

When a young person is addicted to alcohol or drugs, they are not themselves. They can’t make safe and healthy decisions without confrontation and/or intervention. They may say – even shout and curse they don’t need or want you, but they do now more than ever.

Does your child need intervention?

If so, you need to speak to your spouse as soon as possible to decide how and when you will do this, and as quickly as possible. Forget detachment; you wouldn’t stand outside the door while the house was burning down waiting for your child to wake up and run out. So don’t do that now. Interfere all you want. If there is evidence that your child is abusing alcohol, intervene in the most effective way possible to help your child do what they can’t think straight enough to do on their own right now. And yes, Mom and Dad, that sometimes means enrolling your underage child in a treatment program without their permission.

A warning about this. There are treatment programs and there are treatment programs. You are legally entitled to enroll your child in a medical treatment program without his or her consent if they are underage. However, before you do this, I strongly suggest you first ensure that the program you choose adheres to laws that protect the child from any kind of abuse.

If the live in facility is privately owned and operated, you can check the reputation of the program with licensing authorities, any physicians connected with the program with medical licensing and board certification authorities, with local police departments, with former clients and their parents, and by reading every word, no matter how tiny, in their literature and any contract. I would sincerely question any contract that requires large sums (like a year’s costs) upfront and has a contract with a clause that says you forfeit all the money if you withdraw your child before they approve this move. This can lock you into feeling you can’t remove your child.

I would also assure that you will have opportunities to visit with your child ALONE so that if any abuse is taking place, you can be alerted by your child.

You may be feeling desperate at this point, but doing your research is your responsibility to your child and to your role as a parent. Never put your child in a program that seems too good to be true. It may be just that.

However, there are wonderful, successful programs that have been in existence for decades without scandal or any hint of child abuse.

Do you need help cutting down on your drinking?

If you are the abuser, don’t cry “foul” if an intervention team shows up at your home one day – or morning – or even at sunset. And remember one thing always, no matter how tough you may have been having it, it was you who drank enough alcohol to alarm everyone who truly loves you. You may not thank your interventionists the day they strip the horse blinders off your eyes and mind but you will later when all the dreams for your life have become possible.

Love yourself enough to help yourself. Right now, your thinking is pretty off target. If you’ve been drinking heavily or binge drinking, your brain is operating on some strange automatic pilot because it surely isn’t operating on clear head stuff. Don’t try to rationalize why you don’t need treatment. Not if you want to see next year. Just go to an adult and ask for help.

Or pick up the phone and call Alcoholics Anonymous. You won’t be the first youth to show up at their door and thankfully, you won’t be the last. And when you get there, don’t sit there telling yourself that these guys or gals have nothing in common with you. Listen to their life stories. Listen like your life depends on what you learn there because it does.

Alcoholics Anonymous information site and meeting location finder: www.aa.org

You may also find Alcoholics Anonymous listed in your town’s local telephone directory.

Intervention

Intervention simply means addressing the problem of alcohol or drug abuse, whether it’s your problem or someone you love’s alcohol or drug’s abuse problem -- and doing it in a timely manner. This is no time to be indecisive. “Let’s wait and see” does not cut the mustard, as they say.

It’s like when a hurricane is headed your way and you need to decide whether to stay and hope it goes away, or run in the opposite direction like the dickens. If you see the highways heading North right after the evacuation order goes out in South Florida, you’ll know that not many want to trust the “wait and see” concept. Neither should you wait if you or yours have been abusing alcohol or drugs.

For those who are considering an intervention, there are three kinds of intervention. They are:

 The informal kind where you and your spouse quietly and calmly sit down and talk to your child. It’s described above and it’s also called a confrontation

 The formal kind where you round up all the folks who are deeply concerned about the abuser and are intimately involved with him or her. This group intervention is usually done when an analysis and/or treatment seems imperative and the abuser will need a lot of convincing to get his or her cooperation. The group might include family members, a loved one, a best young friend, a family friend who has been an abuser and has had successful treatment, a faith leader or anyone else who might have influence with the alcohol abuser and can help gain his or her cooperation.

 Then there is the professional interventionist. That person may be a medical professional or a faith leader or both. The person may be a professional interventionist. You may consider either the formal, or professional intervention, if the person has refused help in the past and you see the downward spiral in his or her lifestyle.

The goal of an intervention is to convince the drinker or drug user to admit they have a problem that is out of control and to convince them to seek treatment. Any treatment should follow the intervention as quickly as possible.

You have just learned that your child is abusing alcohol.

You have just learned that your child is abusing alcohol. He or she has failed far too many subjects; his or her attitudes are changed radically -- for the worse; or he or she was in an auto accident while he or others were under the influence of alcohol.

You are lucky if your child and possibly also alcohol impaired passenger are both alive and safe; you are also lucky because you now know what you are dealing with and can’t hide behind “Not my child” any longer. However you learn the problem, the important thing is to get help for your child fast.

If you are a parent or parents and you suspect your child is using alcohol (or drugs), you need to know your options for analysis and treatment, if necessary. Your family physician or pediatrician can help you determine if your child is abusing alcohol (or drugs). It may just take a few questions from your child’s medical advisor or it may take a blood test or urine test. Tests are fast, inexpensive -- and can’t be refuted.

As a parent or an adult listener, your main goal is to let the child know you care about him or her; that you are not being judgmental but protective and caring; that it is your job to help educate them about the negative aspects of drinking alcohol and to set guidelines and restrictions on drinking alcohol beverages.

As a parent, you and your spouse first need to agree on the tone and approach you will use when you talk to your child. You need to decide upon the rules and limits and consequences of drinking without your permission. You both need to make it clear that teenage drinking is not only illegal but not allowed in your family. If you have seen signs that make you get that gut feeling that your child is abusing alcohol (or drugs), you may want to arrange for a medical exam at this point.

If you do decide upon the medical approach, you may find it helpful to check for any other problems, like Attention Deficit Disorder, Learning Disabilities, or a medical problem that may be influencing his behavior at the same time as the alcohol is influencing behavior.

If you learn from your medical advisors that your child needs treatment for alcohol abuse, you will need to learn about available treatment programs for youth.

All adults have resources to help them deal with youthful alcohol abuse.

Those resources include:

 School counselors
 Church leaders, or a pastoral counselor
 Employee Assistant Professionals
 School nurses
 Family physicians or pediatricians
 Community health centers
 Alcoholism prevention or treatment professionals
 Local anti-alcohol or drug coalitions
 County health departments

If you are a teenage or young adult drinker

If you are a teenage or young adult drinker, you may want to check yourself out. Take a look at www.checkyourself.org to learn if you have an alcohol or drug problem and what to do about it if you do.

The first thing you need to do is the hardest; you need to tell your parents. You cannot treat yourself. So how do you talk to them? There are lots of guidelines out there and if you check out this chapter’s links I’ve included for your use, you’ll find some helpful tips how to tell them you’ve been drinking too much, are worried and think you need some help to deal with your urge to drink.

IF YOU ARE A ALCOHOL OR DRUG ABUSING YOUTH, YOU ARE VERY LIKELY IN DENIAL OF ITS SEVERITY OR DANGERS AND SO IT MAY BE UP TO THOSE WHO LOVE YOU TO TAKE THE NEXT STEP.

IF, ON THE OTHER HAND, YOU ARE AWARE OF YOUR PROBLEM WITH ALCOHOL OR HARDER DRUGS, TELL YOUR PARENTS. IF YOU NEED TO GET SOMEONE TO HELP YOU TALK TO YOUR PARENTS, START WITH YOUR FAITH LEADER OR A TEACHER, BUT TELL SOMEONE WHO CAN AND WILL HELP YOU. RIGHT NOW. DO NOT WAIT. YOU ARE IN HARM’S WAY.

A Personal Story – the Mysterious Woman in Blue

The young mother had used all her resources to help her 15 year old son get the special education he needed. He was diagnosed as someone with a learning disability -- just a year earlier – and was already feeling the pressure of being transferred from mainstream classes to special education classes. “Dummy, dummy!” his classmates would call out as he passed.

Finally, in desperation, his mother called a hot line for a national organization that focused on helping families with a child suffering with learning disabilities.

Since then, the term “learning disability” has been co-opted by parents with mentally challenged children who prefer to use the term “learning disabled.” Some believe it muddies the waters for the child who has a normal IQ – or higher – but who suffers from having a learning “difference.” In this story, the son had a normal IQ but severe learning “differences.”

Soon after the call, a lovely woman with blue eyes and a matching dress showed up at the frustrated mother’s home. She shared her story.

“My son was learning disabled. He simply couldn’t read. We tried everything. They passed him through grade after grade and he still couldn’t read. We took him to the best diagnosticians. We finally accepted that he would never be able to go to college.

“But he loved to ski so his father and I decided to invest money in his skiing. He took a lot of classes and he did very, very well at it. He zipped up and down the mountains as if he had wings. He was finally happy. He’s working now as a professional ski instructor in Aspen, Colorado and loves it. I think if you could find something your son loves to do and help him excel at that, he could have a happy life.”

She then gathered her things and left.

It seemed that this strategy was too late for this young man. He had already turned to alcohol for self-medication. It took over four years for his parents to detect his alcohol abuse and get him help. It was then and only then that he could concentrate on his skills as a martial artist.

He concentrated on earning a black belt in Tae Kwan Do, then taught children karate to work his way through college. Yes, he managed to go to college. Within two years, he was on the Dean’s list. He also stayed alcohol free and attends AA meetings regularly. His karate life and his college life – a totally unexpected possibility – were too important to him to “screw up,” he says.

The morale of this story? If you know how to do something especially well, you don’t usually become a follower. You often become a leader.