The History of AA and the 12-Step Program

It seems like every week, we hear in the news that some celebrity has checked into a rehab facility for treatment of substance abuse. Some of them actually manage to stay more than a few days and remain sober later. These days, the methods of Alcoholics Anonymous and its Twelve-Step program are so familiar that it seems like this organization has always been around. Actually, AA is less than 100 years old

Alcohol abuse is a problem as old as man, and “being taken with strong drink” is mentioned in the Bible. The United States attempted to solve the problem of widespread alcoholism among its citizens by passing the Volstead Act in 1919, leading to a decade of Prohibition. Alas, this did not stop the abuse of alcohol, instead leading to the rise of organized crime and numerous deaths from illegal alcohol.

After the U.S. repealed its failed experiment of Prohibition in 1933, those suffering from alcohol addiction could again indulge their habit legally, but couldn’t count on much help from the medical community if they wanted to get sober. The well-off could seek help from private doctors, while the poor were likely to be locked up in state mental institutions. Back then, most doctors considered alcoholism to be a moral failing rather than an illness, a condition that was incurable and ultimately lethal.

Early efforts

One of the earliest pioneers in helping alcoholics was Dr. Franklin Nathanial Daniel Buchman, a Lutheran minister who in 1921 founded a movement called A First History Christian Fellowship, later changed to The Oxford Group. Dr. Buchman took a new approach to alcohol addiction with the group’s philosophy: “All people are sinners. All sinners can be changed. Confession is a prerequisite to change. The change can access God directly. Miracles are again possible. The change must change others.”

The practices of The Oxford Group hinged on what they called the Five Cs: Confidence, Confession, Conviction, Conversion and Continuance. The Group’s standard of morality was based on the Sermon on the Mount and included its Four Absolutes: Absolute Honesty, Absolute Purity, Absolute Unselfishness and Absolute Love.

Enter Bill W.

It was from The Oxford Group that Bill Wilson, one of the co-founders of Alcoholics Anonymous, sought relief from his own drinking addiction. Although he split with the organization, Wilson later credited The Oxford Group with saving his life.

Wilson was a sad example of someone who had ruined a promising life with drinking. After losing his marriage and his Wall Street career to alcoholism, Wilson was hospitalized under the care of a Dr. William Silkworth, who took an unusual approach to treating the condition. Unlike other doctors who treated alcoholism as a moral weakness, Silkworth saw it as an illness caused by the combination of an allergy to alcohol and a mental obsession that drove the patient to drink. His prescription was total abstinence from alcohol.

Wilson tried several times to kick his habit, managing to stay sober for a period of time, then falling off the wagon and winding up back at the hospital or the local rescue mission. During his periods of temporary sobriety, Wilson tried to help other alcoholics get sober, but none managed to stay that way for very long. When tempted to drink again, Wilson realized he really needed another alcoholic to talk to. A minister introduced him to Dr. Bob Smith.

AA founded in 1935

Like Wilson, Dr. Smith had been fighting his own demons for years, putting his practice as well as his family life into turmoil. He agreed to meet with Wilson for 15 minutes, but was so impressed with how much they had in common that the meeting stretched out to six hours. In 1935, the two founded Alcoholics Anonymous after finding sobriety and vowing to help others.

By 1937, after helping 40 alcoholics in the Akron, Ohio, and New York areas get sober, the pair decided to take their work nationwide. This led to the publication of the book Alcoholics Anonymous, also known as The Big Book. The main message of the book is that the alcoholic must yield to a power greater than himself if he is to achieve sobriety. Sales were slow at first, but positive articles in the media propelled the success of the book and the Alcoholics Anonymous program.

Although the founders of AA had originally planned to seek financial backing for opening treatment centers, they were later convinced that the future of the program lay in person-to-person contact, of one alcoholic achieving sobriety, then reaching out to help another.

The message spreads

In 1949, Hazelden Farm in Minneapolis was founded by a group of AA members and is considered to be the first alcohol treatment facility. The “Minnesota Model” of treatment resulted from the partnership of Hazelden, Pioneer House and Willmar State Hospital. New drugs were introduced into the treatment of alcohol abuse during this period including Disulfram (Antabuse), amphetamines, barbiturates and LSD.

The Al-Anon Family Groups for the loved ones of alcoholics were opened in 1951.
In 1953, Narcotics Anonymous was founded, using the same 12-step program created by AA. NA is now the second largest organization using this program. In 1958, the Association of Halfway House Alcoholism Programs of North America was founded.

Changing perceptions

The success of AA led the medical community to take a different look at the problem of alcoholism. In 1956, the American Medical Association first recognized alcoholics as legitimate patients but stopped short of declaring the affliction a disease. In 1963, the American Public Health Association adopted an official statement declaring alcoholism to be a treatable illness. In 1967, the AMA finally passed a resolution identifying alcoholism as a “complex” disease “that merits the serious concerns of all members of the health professions.”

In the 1960s and 1970s, insurance companies began to cover the costs of alcohol abuse treatment, paving the way for a major expansion in both private and hospital-based inpatient treatment programs. In 1982, former First Lady Betty Ford lent her name to a California treatment center for alcohol and other addictions.

In 1992, the Center for Substance Abuse Treatment was created to improve the quality and availability of treatment for addiction.

None of the opportunities for treatment now available would have been possible without the pioneering efforts of those who laid the foundations for today’s 12-Step programs.

What has been your experience with AA or other 12-Step programs?

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