AA and Harm Reduction

Hi all–I am posting this paper which I had to write for my addictions counseling class at The New School:


On Monday, October 27, 2008 I attended AA at St. John’s Episcopal Church, 139 St Johns Place, Park Slope, Brooklyn. I chose this particular venue because I have been employed as sexton by St John’s for the past two years and hence it is a physically comfortable space for me. I also knew that this was a rather large (50 to 100 people) open meeting which has a reputation for being somewhat laid back. This was actually two meetings for the price of one, the first was a “Beginners Meeting” which started at 6:30 and this was followed at 8:00 by a “Topic Meeting” which it turned out was an anniversary meeting.


One man came up to speak to me between the two meetings and I explained that I was there as an observer to fulfill a requirement for my CASAC. This man asked what populations I was interested in working with me and I explained that my primary interest was in harm reduction. He replied that this was a good thing since not all people were open to total abstinence. It was a welcome change for me to hear this since on many occasions I have been attacked by AA members for my work in harm reduction.


What I really learned from attending AA as an observer is that an observer cannot really comprehend what it is like to attend AA/NA as a person seeking help for a problem with alcohol or drugs. Hence I must speak a bit about my personal experience.


I was raised in the Evangelical Free Church of America which is essentially a religious cult–what Chaz Bufe has referred to as “cult lite”. This was an organization which ruled through fear in an attempt to suppress all normal human pleasure. From my earliest memories I remember being bombarded by the threat of eternal damnation and burning in hell forever. And what were the things that would lead one to burn in hell forever and ever? Drinking, dancing, playing cards, going to movies, smoking or believing in evolution. Not to mention extramarital sex or sexuality or the worst sin of all–a failure to believe–even though there was an absence of evidence. And of course all the Episcopalians and Catholics would go to hell because they worshiped idols (i. e. had religious statuary) and used demon alcohol in communion. By age 13 I had read Darwin and was an atheist and later read Spinoza and became a pantheist. I escaped that cult.


Later in life I was suffering from depression and loneliness and was drinking too much in response to this. I did not like the way in which I was drinking and sought help to change it. I encountered AA.


AA is in my experience another incidence of “cult lite”. AA has almost exactly the same cultish features as the cult which I had escaped as a child. AA rules its members through fear, but rather than the fear of hellfire it is a fear of a horribly alcoholic death. In point of fact people coming to AA are threatened with a horrible alcoholic death unless they come to believe in God. To quote the chapter “We Agnostics” from the AA “Big Book”, “To be doomed to an alcoholic death or to live on a spiritual basis are not always easy alternatives to face… after a while we had to face the fact that we must find a spiritual basis of life—or else.”


For me personally attending AA had an extremely negative effect. I went from having a moderate drinking problem to having a severe drinking problem. I found myself having to drink every time I left and AA meeting and finally after leaving one meeting I went on a bender so bad that five days later I came out of it with severe and life threatening withdrawal. I had to check into Ramsey County detox in St Paul to get some valium in my system before I died of a stroke or a heart attack. And it was at this point that I realized that I had to leave AA or die.


I found some support and friends in alternative groups and I began to get better. I used art therapy and online support to deprogram myself from AA. And once I had thoroughly rejected their path I began to find myself in control of my drinking. And with the help of CBT and Stoic Philosophy I began to feel happy and in good mental health. Volunteering in needle exchange during this period also taught me the essentials of harm reduction.


I have met many, many people whose drinking became worse while they were attending AA and who were only able to achieve successful moderation or successful abstinence after leaving AA.


However, certain other experiences of mine have convinced me that AA may perhaps not be a bad match for everyone; some people may actually find it valuable. When I founded HAMS Harm Reduction for Alcohol one of the people I invited to join our advisory board was Rae Eden Frank who was my former boss at Access Works, the Minneapolis syringe exchange. When we invited Rae to be our guest speaker in our online support group we were surprised to find that she was a member of NA. However, she explained to us that for her harm reduction and the 12 steps were entirely compatible. Harm reduction keeps people alive when the 12 steps can do nothing for them. If and when people decide to abstain the 12 steps are one possible option which they can follow.


Ultimately what I learned from this experience of attending an AA meeting is that the time has come for an end to the hostility between AA and other approaches. AA’s “Big Book” says, “Upon therapy for the alcoholic himself, we surely have no monopoly.” It is unfortunate that far too many people working in the chemical dependency treatment industry feel a need to use everything from lies to coercion to torture to attempt to force clients to succumb to the 12 steps.


I feel that it is time for all of us to realize that different people need different approaches. It will be good for people from 12 step programs and people from other approaches to join hands and to try to offer each individual a choice of what treatment approach will best benefit that individual. If we all work together some of the abuses of the 12 step system can reform themselves from within.


Copyright © 2008, The HAMS Harm Reduction Network


About Kenneth Anderson

Kenneth Anderson is the author of the book How to Change Your Drinking: a Harm Reduction Guide to Alcohol. He is also the founder and CEO of The HAMS Harm Reduction Network.
This entry was posted in 12 steps, Alcohol, alcohol harm reduction, alcoholics anonymous, hams harm reduction network, harm reduction and tagged , , , . Bookmark the permalink.

2 Responses to AA and Harm Reduction

  1. Are you aware of the City of Toronto’s Seaton House (men’s honeless shelter) Annex Harm Reduction Program for alcoholics? 1 drink every hour starting at 8am to 11pm. If you don’t have your own booze to check in with, the nurse will provide a glass of wine or a beer. Tax payer funded. Excellent program.

  2. janetlandis says:

    Thank you so much for sharing this information. I realized that I was mis-using alcohol to cope with overwhelming stress, and AA was the only option I knew of. However, AA meetings left me feeling depressed and demoralized. It reinforced (for me) the “victim” mentality of being powerless, which was a key component of my problem in coping with the stress in my life. The problem I face now is loved ones who will not allow me to practice harm reduction in relation to alcohol. Your blog gives me hope that as a 50-year-old woman I have choices, that I can be empowered rather than powerless, and that using a rational approach is not an “easier, softer way.” In my area, it is common for AA meetings to end with the group holding hands and reciting the Lord’s Prayer, which felt uncomfortable to me in that setting.
    Again, thanks for sharing this.

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