Do I need AA after all?

Hi, Andrew.

Few people have long-term success achieving and maintaining sobriety on their own, because, according to the most recent research, it is not an issue of willpower or desire, but one of biochemistry, specifically the way your dopamine and endorphin systems were formed early in life.

This doesn't mean that the problem is unsolvable, but the means of solving it require basically a long-term restructuring of those pathways, and that takes time and persistent effort. And that's where AA comes in.

The means to maintaining sobriety are in making long-term changes to behavioral patterns that eventually change the neural pathways. And to do that requires help and support and encouragement.

Having someone to be accountable to, being around others who are working on the same things you are, and having constant reminders that the impulses, desires, and motivations are something coming out of the old patterns is the best way we currently having of making change in the long term.

I would recommend starting with just attending a local AA meeting. It can be hard just to walk in the door the first time, but it is a very supportive and accepting community, and in many areas, there are gay AA meetings as well. The fellowship is set up to welcome and encourage newcomers and you should be able to find someone who will sponsor you and help you maintain your sobriety, and that's a big part of what increases the success of the program.

Also, remember that much of what drives addictive behavior is not only the neural pathways, but feelings and emotions that underlie the behaviors. In other words, for most people, addictive behaviors, whether alcohol, drugs, eating, porn, masturbation, sex, exercise, or anything else, are ways of numbing. So ultimately, to solve the problems, we must work with the issues that we're numbing.

It may seem overwhelming at first but it isn't. You take it one step at a time, one day at a time, and you work on it. There are a lot of people here at EC that are overcoming addictions, so you're far from alone.

 

Well... 30 years ago we didn't really have solid evidence, but today we know, pretty much without question, that it *is* a disease, a dysfunction of dopamine and endorphin pathways, and really isn't in the control of the addict.

Alcoholism is a disease that really isn't any different from any other chronic disease such as diabetes, heart disease, or arthritis. Just as with the others, it isn't something you cure, but if effectively treated, on an ongoing basis, it can have minimal impact in your life. But left untreated, it (for most people, anyway) *does* have huge power over one's life for most people, as the untreated condition makes it difficult to make good decisions, because it directly impacts reason and reward centers in the brain.

A lot of people don't like the religious overtones of many AA groups, but AA itself actually doesn't require or endorse any religious belief; they talk about "God" and then in the next breath say "whomever we perceive him to be." And there are a number of non-religious AA people who replace "God" with "The Truth" or see God as "Great Opportunity Daily."

Certainly 12 step isn't for everyone, but based on the newest research about causal factors, the social influence of AA appears to do more to rewire the brain chemistry damaged early in life than pretty much any other intervention we have out there. Inpatient rehab can definitely help, but without the followup and social influence provided by AA or something similar, it's hard to achieve permanent rewiring of the brain functions that give rise to the disease.

 

It's certainly your choice to call it what you want. I'm just telling you how the medical profession and those who are doing the research view it. It's probably closer to something like chronic depression or schizophrenia or Huntington's disease than it is to cancer, because it is a chronic condition requiring long-term treatment rather than something that can be treated and cured in the short term. Some people are lucky enough to be able to get sober and stay sober with no further difficulties, but many others struggle over very long periods of time.