Community Meeting Paper

Substance Abuse and Society

 On Tuesday April 11th I attended a meeting at the Back Bay Steps, a local meeting

group of Alcoholics Anonymous that are held at the Arlington Church in Boston. The meeting was

scheduled for early in the day, 7:30am to 8:25am. There was a total of 20 people present,

including myself and my companion. The group was primarily made up of males, but there were

three females aside from my friend and I. The age of the group members were pretty much middle

age (30s to 50s). Before attending the meeting I was alittle nervous about going, for a couple of

reasons, but I was willing to take in the experience and really learn from them.

The main reason that made me feel nervous was that I did not know what to expect. But

also because I was scared of what I would hear from those who shared. I was unsure of who was

going to be there, if I would know anyone, or if anyone would know me. Initially I had arrived with

a notebook with the intention of taking notes, but I quickly scratched that idea. I felt as though I

was going to be invading the privacy of those in attendance if I sat there and took notes.

Immediately upon arrival I felt uncomfortable for two reasons, the obvious age difference, and the

male to female ratio. The nervousness passed quickly as the members welcomed us in, and

made us feel as if we were a part of the group. I think that part of my initial nervousness was due

to the fact that I did not know what to expect, I was unsure as to what a drunk would look like.

My first thought was that the meeting was going to be somewhat depressing, a bunch of

drunks sitting around telling stories about how alcohol ruined their lives, and feeling sorry for

themselves. But once I met these people and began listening to them I knew I was wrong. I think

that I felt this way because of the negative stereotypes that are attached to being a drunk, and not

what the positive effects of a group such as Alcoholics Anonymous could be. In this small group of
individuals that I’ve never met before, I felt comfortable. I could see that these people cared not

only about themselves, but for each other as well. They all shared an addiction to alcohol, which

brought them together to open up about their life stories. The outlook and attitude of these people

was very optimistic. This surprised me considerably because I had expected the meeting to be full

of negativity and pessimism. The warm welcome that this group showed me how much that they

do care and how willing they are to help others that are suffering from addiction.

Every meeting has a “topic” and then the floor is opened for everyone to speak. Each

person who speaks starts by saying “My name is -------- and I’m an alcoholic. Everyone else then

says “Hi ---------.” I heard stories that were heartbreaking. They were stories of members drinking

themselves into comas, the pain that they put family members through, the pain that they caused

themselves, everything that was lost due to drinking and the long lasting effects, physical and

emotional, of the disease on their lives. A few had been sober for over 30 years, others, for 30

days. Even though the group was diverse, their stories were so similar that it sounded like it came

from a textbook.

One lady spoke about her sobriety for 3 years until unexpectedly being offered a drink;

she thought that she had overcome it, but that one drink led her to another 10 years of addiction,

the power of that first sip was overwhelming. One of the stories that hit home was about this

mother fighting to get her son back. This woman’s alcoholism drove her into a dark path and lots

of trouble with the law. Due to many DUI and trouble with her addiction, she lost custody of her

son. When she said that she was 9 weeks sober it only made me root for her more. Everyone

leaves with hope and renewed faith that they can get through the next 24 hours without taking a
drink or doing their drug of choice. One person said, “I’m 26 yrs old. I have a rap sheet 4 pages

long. When I come here, I can leave that at the door because I’m just like everyone else when I

come into this room.” They all know and understand that everyone in that room faces the same

demons that they do every single day. I heard several people say “I come here and know that I’m

not alone.”

As a society, we tend to have an image of what alcoholics might look like, which is

usually bad dressed, smelly, and drunk. Once I arrived I realized that they do not look any

different than anyone else. Some men and women were dressed in business attire and looked like

any other professional working in the city of Boston. It was then when I realized that addiction can

affect anyone, no matter the social class or financial situation. The main point made about

addiction in "The Roots of Addiction" is that the addiction, especially a substance addiction, has

the power to "control" one's brain. Not only does the addiction totally take over your dopamine

system through identifying cues, but it also impairs your judgment from determining right from

wrong. The TED talk done by Johann Hari, explained how levels of loneliness and happiness

contribute to how one develops an addiction. If someone is lonely and unhappy with their life, they

may use in order to compensate for their lack of fulfillment in life.

A study was done by Professor Bruce Alexander, in which he compared how often the

rats drank the drug filled water bottles if they didn’t have food, friends, and toys. When they were

in the rat park, they didn't like the drug water because these rats had happy and connected lives.

The other group was of lonely rats. The percentage of rats that overdosed compared to the other

rat group was shocking, 100% of the rats chose to not drink the drug water when they were in the
rat park. Now, of course this experiment was done with rats, but just as easily if we were to look

into the lives of the people we know or have heard stories about that are addicted to substances

we will see a pattern. There isn't one factor that explains why a person becomes addicted, but

factors such as social environment, ages, biological factors and brain activity.

The one thing about this group that surprised me the most was how openly some of

them referred to themselves as drunks. I had always thought that it would be an insult or

degrading to a recovering alcoholic to call them a drunk. I realized that I was wrong. Being a

drunk is what each and everyone of these people is, and in order for them to begin the recovery

process they need to first admit to themselves that they are indeed a drunk. One belief that

seemed to be held universally among all of the members of the group was that AA has one

purpose. That purpose is to help alcoholics deal with their addiction to alcohol. An AA meeting is

where you go to discuss the effects of alcohol on you.

According to researcher George Vaillant, there are four factors that are commonly

present in relapse prevention for most addictions. The four factors that prevent relapse are

external supervision, ritual dependency on a competing behaviour, new love relationship and

deepened spirituality. Alcoholics Anonymous addresses these factors through its program and the

12 Steps, which is one possible reason that AA is able to help its members recover and avoid

relapsing (Humphreys 2002). AA provides motivation from within and suggests that the member

return again and again to meetings. The members of AA meetings are encouraged to ‘work the

steps’ and to engage in service. One study says that these activities provide “external

supervision” (Vaillant, 2005). However, the member has a choice in whether to submit to this
supervision, which is why it works. This study also suggests that it is important to find a substitute

dependency or a competing behaviour for the addiction, because you cannot easily give up a

habit without having another outlet to which one can turn to.

Alcoholics Anonymous provides social and service activities in the presence of supportive

and recovering alcoholics. This researcher has also found that “new love relationship,” are

important to recovery, because “it seems important for ex-addicts to bond with people whom they

have not hurt in the past and to whom they are not deeply emotionally in debt.” (Vaillant, 2005).

Through group meetings, AA provides its members with a resource that members can use to form

new friendships with other ex-addicts who can offer the member understanding and empathy

instead of pity. Finally, the fourth common feature in recovery is the discovery or rediscovery of

spirituality. AA strongly emphasizes the importance of spirituality in the recovery process.

Another study has also found that “helping behaviors” within 12 step programs are

critical to sustaining sobriety. Alcoholism has been described as a disease of the ego with

recovery requiring a shift toward thinking of one’s self “as part of something larger rather than the

center” (Humphreys, 2002). In AA, peer helping is “a fundamental” aspect of 12 step oriented

treatment. Alcoholics Anonymous’ emphasis on the importance of helping others is most clearly

expressed in the twelfth step. They emphasis on helping also provides the fuel for AA principles of

sponsorship, lifelong meeting attendance, and volunteering for service positions. Another

researcher proposes two additional theories as to why AA is an effective intervention. First, the

movement from active alcoholism to recovery is a major life transition that is complex and

participation in AA helps. Individuals cope with this difficult, and oftentimes painful, transition
(Streifel, 2006). Second, participation in AA facilitates individual’s working through the loss and

grief issues associated with recovery from alcoholism, including loss of alcohol itself,

relationships, the ability to escape feelings, and assumptions around the world (Streifel, 2006).

The group strongly believed in the 12 steps, focusing heavily on the fourth and fifth steps

as being the bridge to true recovery, saying that the recovery process began once you crossed

the bridge. It seemed as though each person in the group gained a strong sense of who they were

and what was important to them to survive. I was given the impression that they had an idea of

how important they are to themselves and their family and how important alcohol was to them.

One major concept that came up throughout the meeting, was the idea of one day at a time. It

was this idea that helped each of them to become sober and how they hoped to remain sober.

Alcoholism is not like a cold or the flu, it's not gone when you wake up in the morning, it will

always be there.

When alcoholism is looked at on the short term basis, one day at a time, rather than

on the long term, a week, month, or year, it makes sobriety more realistic and more manageable.

Sobriety was not a term that was used a lot throughout the meeting, instead the term “not

drinking” came up quite a bit. I was given the impression that this was because of the pressure

that is implied by the word sober. Both the 12 steps and the 12 traditions are major players in the

lives of those in the group. The meetings and their lives seemed to revolve around them. They

discussed both the step and the tradition at great length, and what each meant on a personal

level. They took the idea of taking inventory on themselves very seriously. It was as though they

felt once they completed this process they were truly on their way to recovery.
 According to Prochaska & DiClemente, there are five stages of change that every

recovering addict goes through, which include pre-contemplation, contemplation, preparation,

actions and maintenance. The Stages of Change starts with pre-contemplation, which is when

there is no intention to change behavior. So the goal is to get patient to consider they have a

problem. That is when the contemplation phase starts because they are becoming aware of the

problem and seriously considering a change, but no commitment to take action. The goal would

be to raise awareness of the problem by observing behavior. Preparation would be the next part

and that is when the patient intends to change and makes small behavioral changes. The goal is

to encourage these steps and support change process by helping them commit to making change

a top priority. The action phase is finally when a patient decides to take decisive action to change.

This is when we need to make action plan suggestions, reinforce changes, provide support and

guidance. Most importantly, maintenance is to work to prevent relapse and consolidate gains. The

goal is to support continued change and help patients with relapse prevention.

The goal of MI interventions is to motivate an individual to want to accomplish a positive

goal that involves a change in their behavior. Alcoholics Anonymous provides motivation from

within and hopes that the member return again and again to meetings. Through practicing the

steps and principles of the AA program, individuals take on new roles or re-establish old ones,

form new relationships with others in recovery, and undergo profound changes in behavior

(Streifel, 2009). Basically, the AA program is aimed at not only helping individuals quit drinking,

but also helping them find and adopt a whole new way of being.
 Alcoholics Anonymous is a non-judgmental program for an alcoholic. It’s not a healing

drug or a bandage to cover the pain. It is a program to get to the root of the problem. It helps

people recognize who they are and what they have done and how to overcome that. At the

beginning of the meeting the leader asks, “Is there anyone coming back today?” I did not

understand this question until someone explained it to me at the end of the meeting. It is asking

“Did anyone go out drinking last night and came back to the meeting today?” If anyone raised

their hand, they stick to steps 1 - 3 for that meeting. Why? Because bringing that person back is

worth it. They are all worth it.

Although I only attended this one meeting with this small group of people, they taught me

a great deal about helping myself. They let me know that to get through it you need to be brutally

honest with yourself. They showed me that alcoholics are ordinary people just like you and me,

and what they need most of all is support and understanding. I found this group extremely

informative and helpful and I would highly recommend any type of self help organization to

anyone who feels they need help dealing with the problems in their everyday lives. I believe that a

group such as Back Bay Steps, would be extremely beneficial to those who had a problem with

alcohol. Their positive attitude and outlook that they posses makes the road to recovery

achievable.
References:

Hari, Johann. "Everything You Think You Know about Addiction Is Wrong." ​Johann Hari:

Everything You Think You Know about Addiction Is Wrong | TED Talk | TED.com​. TED Talk, 1

June 2015.

Jaffe, Adi. "Addiction, Connection and the Rat Park Study." ​Psychology Today.​ Sussex

Publishers, 14 Aug. 2015.

George Vaillant. Alcoholics Anonymous: cult or cure? 39 Australian and New Zealand

Journal of Psychiatry 431 (2005)

Cathy Streifel , et al. Alcoholics Anonymous: Novel Applications of Two Theories. 24

Alcoholism Treatment Quarterly 71, 72 (2006).

Cathy Streifel. Recovering from Alcohol and Other Drug Dependency: Loss and Spirituality

in a 12-Step Context. 27 Alcoholism Treatment Quarterly 184, 195 (2009).

Keith Humpreys. Alcoholics Anonymous and 12-Step Alcoholism Treatment Programs. 25

Recent Developments in Alcoholism 711(2002).