Types of Drinkers
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Of the many drinking types described in the
Big Book (by no means comprehensively), the Big Book suggests its 12 Step
spiritual program of action will work for only one. The one with willingness.
The one “with a desire to stop drinking.”
A Desire to Stop Drinking is the only
Requirement for AA Membership. -3rd Tradition of AA.
“For those who are unable to drink moderately
the question is how to stop altogether. We are assuming, of
course, that the reader desires to stop. Whether such a person
can quit upon a nonspiritual basis depends upon the extent to which he has
already lost the power to choose whether he will drink or not.” Pg 34
Original AA members documented their
experience in the Big Book. These members realized a 72% success rate from
1934-1938 (died sober) using this spiritual program of action.
Types of Drinkers from the Big Book:
1.
Alcoholic Addiction - xxv or (xxvii 1st edition) The Doctor's Opinion (Dr. Silkworth)
2.
Chronic Alcoholics - Pg xxv, xxvi, xxviii, xxix, 27 The Doctor's Opinion
3.
The Average Temperate Drinker - Pg xxvi
4.
The Ex-Problem Drinker - xiv, 18, 20 There Is a Solution
5.
The Moderate Drinker - Pg 20 There Is a Solution
6.
The Hard Drinker - Pg 20-21 There Is a Solution
7.
The Real Alcoholic - Pg 21-22 There Is a Solution
8.
The True Alcoholic - Pg 21-22 There Is a Solution
9.
Abnormal Drinker - Pg 30 More About Alcoholism
10.
Normal Drinker - Pg 31 More About Alcoholism
11.
Young People (drinkers) - Pg 33 More About Alcoholism
12.
Potential Female Alcoholic - Pg 33 More About Alcoholism
13.
Serious Drinker - Pg 34 More About Alcoholism
14.
The Actual or Potential Alcoholic - Pg 38-39 More About Alcoholism
15.
“nonalcoholic people who, though drinking foolishly and
heavily” can moderate. Pg 39 More About Alcoholism
16.
Alcoholic of the Hopeless Variety Pg 44 We Agnostics
18.
The Bad Intentioned Exception - Pg 108 To Wives
19.
Type One: Heavy Drinker - Pg 108 To Wives
20.
Type Two: Showing lack of Control - Pg 109 To Wives
21.
Type Three: Lost Control and Knows it - Pg 109-110 To Wives
22.
Type Four: Complete Despair - Pg 110 To Wives
23.
Problem Drinker - Pg 115 To Wives
24.
Teetotaler - Pg 139 To Employers
25.
Habitual or Whoopee Drinker - Pg 149 To Employers
26.
Unhappy Drinkers - Pg 151 A Vision For You
"...for those who are unable to drink moderately..."
AA Does not say That ALL Problem
Drinking is a Progressive Illness
What is says on Pg 30:3, after describing many
other types of drinkers (many of whom can stop or moderate), is in regards to
“real alcoholics”, who have lost control.
“We are convinced that alcoholics of our
type [real alcoholics] are in the grip of a progressive
illness. Over any considerable period we get worse, never better.” More About
Alcoholism
This paragraph is talking about “real
alcoholics” who have lost control over their drinking. Not all
drinkers. The AA book is clear that there are many other types of drinkers
(many are listed above), some of whom may be able to stop or moderate their
drinking. But in the experience of those drinkers who lost control,
their illness always progressively got worse.
The Vicious Cycle: This loss of control
increased as long as the first drink was taken and without the first drink
the alcoholic suffered (irritable, restless, discontent) until the first
drink alleviated the suffering, setting into motion the phenomenon of craving
and more out of control drinking.
Abstinence and the spiritual program of action
was the most successful remedy that was known to arrest this vicious cycle as
of 1938-39. However, it was not the only way and people got sober through
medical, therapeutic and religious methods, including The Oxford Group.
If he thinks he can do the
job in some other way, or prefers some other spiritual approach, encourage
him to follow his own conscience. We have no monopoly on God; we merely have
an approach that worked with us. But point out that we alcoholics have much
in common and that you would like, in any case, to be friendly. Let it go at
that. -pg 95
The spiritual program of action outlined in AA
promises a "spiritual awakening" at the 12th step. They
promise this will be the result of working the previous steps. If the
program of action is followed a "daily reprieve" from drinking will
occur. This is still the "Gold" standard, the "Highest Way"
of recovery, since it involves deep characterological development and
spiritual development. Of course, it is not an easy way and not for everyone.
Current
Studies and Data
For those interested in rehabs, scientific approaches and current studies plenty of information has been discovered since 1938. At this point, time has proven that the authors of the Big Book were right on target. The bigger issue society faces is that AA is not a rehab or a cure. It is only for those "with a desire to stop drinking" and are willing to do so using a spiritual approach. With so many dying of addiction everyday it is sad to say that very few are willing to take the actions toward "ego deflation at depth" that AA suggests.
72% with Alcohol Dependence stop on their own
after one 3-4 year episode.
28% have persistent disorder.
1.12% could be statistically calculated as
“Real Alcoholics” out of US Population as of 2012, using NESARC data.
These have severe recurrent or chronic dependence (Hasin et al. 2007).)
Recovery From DSM–IV Alcohol Dependence:
United States, 2001–2002
This was the first study of
the prevalence and correlates of recovery from DSM–IV alcohol dependence in
the U.S.
general population that distinguished asymptomatic risk drinkers from
low-risk drinkers and recent from stable recovery. This study examined people
who met the criteria for DSM–IV alcohol dependence prior to the year
immediately preceding the NESARC interview. Only 25.5 percent of these people
had ever received treatment. The analysis found that:
·
25.0 percent of these people were still
classified as dependent in the year before the NESARC interview.
·
27.3 percent were classified as being in
partial remission.
·
11.8 percent were asymptomatic risk
drinkers who demonstrated a pattern of drinking that put them at risk of
relapse.
·
17.7 percent were low-risk drinkers.
·
18.2 percent were abstainers.
Factors associated with
recovery included age, gender, marital status, education, interval since
onset, severity, age at onset of dependence, tobacco and other drug use, and
personality disorder. The analysis revealed that there are substantial levels
of recovery from alcohol dependence. Information on factors associated with
recovery should be used to improve the prospects for treatment.
Illness not Disease
AA Calls Alcoholism an “Illness” not a
“Disease”. As of 2015, medical science still does not know exactly what
causes alcohol addiction. As of 2015, “Mental Disorder” or Mental
Illness is currently more accurate than “Disease” terminology which is not an
AA term and is outdated and for the most part irrelevant to current addiction
treatment. It does come from an interesting history and is worth learning
more about. Disease theory of
alcoholism and Alcoholism: A
Disease.
Thomas Sasz had some interesting thoughts on the “disease” terminology. There
is an intro to him in this article.
There is some great science coming forward on
the HPA AXIS and neurosteroid treatments for imbalances in the neuroendocrine
system. There are a number of Mental Disorders that are known to be caused by
disruption of the HPA AXIS and neuroendocrine system. As advances are made
perhaps science will discover a physiological solution to mental disorders
such as addiction. If this occurs it may one day be known as a disease of the
brain, endocrine, or other part of the body. Until then it is still mostly
called a “disorder” or illness and treated as such.
The DSM V Currently Sets the Criteria to Obtain the Medical Codes Required by Insurance Companies. (This allows clinicians to get paid.)
THE AMERICAN PSYCHIATRIC ASSOCIATION - Diagnostic
and Statistical Manual of Mental Disorders (DSM) is the
standard classification of mental disorders used by mental health
professionals in the United States
and contains a listing of diagnostic criteria for every psychiatric disorder
recognized by the U.S.
healthcare system. About DSM
Alcohol Abuse
Alcohol Dependence
ALCOHOL USE DISORDER (AUD) is Classified
here as a “Mental Disorder” (not disease).
Severity based on how many of the 11 Criteria
are met:
MILD (2-3)
MODERATE (4-5)
SEVERE (6 or more)
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