12 Steps Alanon=12 Steps AA

When it comes to the problem of drink,

I want to know what you think

The road to get well

Starts with steps 12

But it helps if you see your own brink.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa.  In 2010 I danced back from the brink of burnout, and, honoring a 1-year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand.  After 3 Community Health years, I took temporary gigs in Iowa, Pennsylvania, Nebraska, Canada, and Alaska.  Since the pandemic, I did telemedicine, staffed a COVID-19 clinic in Iowa, worked at the Veterans Administration in South Dakota, held part-time positions close to home, worked 10 weeks in western Pennsylvania, had a 5-month assignment in Northern Iowa, then several months of telemedicine.  I am now in Texas, a big place with a lot of Spanish speakers. 

If people followed the doctor’s advice, we wouldn’t have nearly as much work as we do. 

Tobacco and alcohol guarantee me full employment for as long as I care to work.  The effects of alcoholism ripple through the generations. 

Alcoholics rarely spring from functional, sober families.  A person drinking 1.75 liters of rum per week, or putting away a 12-pack of 24-ounce cans of beer three times a week, generally doesn’t want to hear the diagnosis of alcoholism. 

Today I cared for 14 patients.  Four times I said, “Tell me the best three things about alcohol,” and after careful listening and active repeating, I said, “Tell me three bad things that have happened to you because of alcohol.”  And then, each time, I had to reach for the box of tissues. 

By the time someone comes to the attention of the medical community, alcohol-related problems have already smashed them between the eyes several times.  People deal with loss of jobs, licenses, and romantic relationships.  People get into bitter fights and make bad decisions.  Cars crash and bones break and STDs go bouncing around the party.  The most macho of men will break into tears. 

I don’t have to add to the sufferer’s regrets or guilt.  I don’t have to “educate,” and all too often “education” becomes synonymous with judging.

Still, even when the patient agrees out loud with the diagnosis of alcoholism. I have trouble getting them to Alcoholics Anonymous.

Many say they’ll cut down.  I ask if they’ve tried it before, even though I know the answer is yes.  Then I ask how it’s working for them. 

If they answer that it’s working just fine, I have to resist the urge to prove them wrong, and I don’t always succeed.  Sometimes I give the 5-second blank stare, and I move on.  People who aren’t ready really aren’t ready.  From my perspective, coming to recovery on their own brings more lasting change than recovery forced. 

Almost all come from addictive, chaotic homes, and almost all have mates with similar backgrounds.  People are more receptive to the idea of Alanon, the group therapy organization for families of alcoholics, then they are to the idea of Alcoholics Anonymous, even though it has the highest success rate. 

Yet both programs use the exact same 12 steps, prayers, and rhetoric.  A person can access both on the internet easily at any time of day.  Almost every municipality has a group in recovery. 

Tags: 12 steps, addictive and chaotic homes, Alanon, Alcoholics Anonymous, alcoholism, motivational interview