Dear Patti:

Alcoholics Anonymous has saved the lives of untold numbers of people addicted to alcohol. It spawned the 12-Step model that has saved the lives of many others with different kinds of addictions. All this is to be respected.

But...

AA and the 12-Step model, in general, is not necessarily consistent with the Catholic worldview for many reasons. One is the disease model, which is the most commonly accepted thought about alcoholism, even in the medical community.

However, the founders of AA never asserted that alcoholism was a disease. Rather, they found the disease concept a useful tool in their efforts to bring sobriety to alcoholics.

The closest the AA Big Book comes to a definition of alcoholism appears on page 44, at the conclusion of the first paragraph of the “We Agnostics” chapter, where we are told that alcoholism “is an illness which only a spiritual experience will conquer.”

Disease is not conquered by spiritual experience except on the rare occasions of miraculous healings. Prayer and devotion may facilitate healing in general, but a disease is rarely conquered by spirit alone without the aid of medicine (if we are truly talking about physical or psychiatric disease).

In 1938, while preparing the manuscript of the A.A. Big Book, Bill Wilson asked Dr. Bob Smith (a proctologist) about the accuracy of referring to alcoholism as disease or one of its synonyms. Bob’s reply, scribbled in a large hand on a small sheet of his letterhead, read: “Have to use disease -- sick -- only way to get across hopelessness,” the final word doubly underlined and written in even larger letters (Smith [Akron] to Wilson, 15 June 1938).

This is the key to the non-Christian approach to addiction proposed by AA — an admission of powerlessness over alcohol and the surrender to hopelessness that cannot be retractable. The "cannot be retractable" is the problem notion. The disease model serves to accomplish this unBiblical notion since it makes us powerless and helpless over an incurable disease. AA teaches that alcoholics are hopelessly incurable and can never find healing, only varying degrees of "recovering."

Big Book’s page 86 cautions: “We are not cured of alcoholism. What we really have is a daily reprieve contingent on the maintenance of our spiritual condition.”

Michael Liimatta, a Protestant who wrote the book, "A Guide to Effective Rescue Mission Recovery Programs," has a remarkably Catholic view of this issue. He talks about addiction at its core level as a personal choice. Our brains do not doom us, he says, to a life of addiction. What can create a life of addiction is consistently bad choices. No program or meeting or expert can help an alcoholic unless he can find more meaning in his life than what is in a bottle.

Generally this is what happens to alcoholics. Some bottom-hitting event takes place in their lives when they are finally knocked into the realization that there is more meaning in life than alcohol and they begin to want to pursue that meaning.

From a Biblical point-of-view, which means from God's point-of-view, Liimatta asserts that we must reject an extreme application of the "medical model."

He states that this hopeless model of the incurable disease that alcoholics "catch" implies a lack of responsibility for the choices the person makes that lead to his current condition.

Re-establishing a relationship with God (not a higher power) requires contrition and repentance. If we remove personal responsibility from the equation and blame a "disease" then we remove the person from responsibility for his own choices and actions.

Liimatta makes the correct point about choice. All addiction begins with sin. In the case of alcoholics, it begins with the sin of drunkenness. This is a choice they make. Even if there is a genetic pre-disposition, that predisposition will not be triggered without the personal choices the person makes to drink and to get drunk.

God tells is in the Bible that choosing habitual sin results in slavery or bondage. A predisposition may establish this bondage more rapidly, but it is personal choice that begins that process.

Liimatta explains that the Greek word "bondage" (douleia) that implies a condition that begins in personal choice and ends in a person's ability to choice being impaired to such a degree that he cannot break free of his bondage on his own.

God can and does deliver addicts from the bondage of their addictions and even from the emotional, psychological, social, spiritual, and physical consequences of an alcoholic lifestyle.

Liimatta correctly point out that all this is not to say that alcoholism is a mere habit.  Alcoholism goes far beyond mere habit into physical damage, perhaps permanent damage to body organ systems, including the brain. There are consequences to our actions, and consequences to addiction that may remain long after the person is delivered from the bondage the addiction brings. There are many psychological and biophysical factors that serve to make an a recovering addict, or a cured addict, fall back into their addictive behavior or transfer their addictive behavior to some other compulsion.

I agree with Liimatta that thoughtfully combining insights from the secular research into these dynamics with scriptural principles can equip us to effectively help addicts and their families.

We must understand and affirm as believers in the All Powerful and merciful God that recovery (cure) is possible. In 2 Timothy 2:26 we find the Greek word,  "ananepho", translated as "recover" in the Douay-Rheims, actually means to "return to a state of soberness, as from a state of delirium or drunkenness."

Recovery, that is "a cure", is possible. AA says it is impossible thereby contradicting Scripture and stepping on the Sovereignty of God.

Although the medical community has pretty much run lock-step in the notion of the disease model, not every scientist is so convinced.

For example, Paul Kenyon, Ph.D., a evolutionary scientist retired from the University of Plymouth in England, and expert in psychopharmacology, psychoteratology and physiological psychology, remarked, "One problem with the disease model is that it not clear how one catches this disease. The presence of withdrawal symptoms led to the idea that the avoidance of withdrawal symptoms was the reason people continued to self-administer drugs. This is the essence of the physical dependency model."

The physical dependency model and/or the Positive Reinforcement model are much more plausible explanations of alcoholism, and for any addiction, than is the disease model.

Quoting from Dr. Kenyon:

Addictive drugs are positive reinforcers (Carlson, 2001). As you know positive reinforcement can lead to learning a new response, and the maintenance of existing behaviours. It follows that the behaviours associated with taking an addictive drug (i.e. injecting or smoking it) will increase in probability. One way of testing this claim is to examine the reinforcing properties of drugs in animals. We already know that conventional reinforcers support bar-pressing in animals, therefore if a drug maintains a response such as bar-pressing in an animal, it is a reinforcing stimulus.

Regardless of the science, the idea of addiction as an incurable disease in which we must face a permanent hopelessness and powerlessness is inconsistent with God's Revelation.

Roman 8:37 states that, "No, in all these things we are more than conquerors through him who loved us."

One person from AA told me, "I have always loved the theory often mentioned in 12 step programs that "Once a cucumber becomes a pickle it will never return to a cucumber".

Well, the Bible says that a when a cucumber becomes a pickle, through the power of God, it can be renewed and be a cucumber again.

Romans 12:1-2: "I appeal to you therefore, brethren, by the mercies of God, to present your bodies as a living sacrifice, holy and acceptable to God, which is your spiritual worship.  Do not be conformed to this world but be transformed by the renewal of your mind, that you may prove what is the will of God, what is good and acceptable and perfect.

And especially:

Ephesian 4:17-24: "Now this I affirm and testify in the Lord, that you must no longer live as the Gentiles do, in the futility of their minds; they are darkened in their understanding, alienated from the life of God because of the ignorance that is in them, due to their hardness of heart; they have become callous and have given themselves up to licentiousness, greedy to practice every kind of uncleanness. You did not so learn Christ!-- assuming that you have heard about him and were taught in him, as the truth is in Jesus.  Put off your old nature which belongs to your former manner of life and is corrupt through deceitful lusts, and be renewed in the spirit of your minds, and put on the new nature, created after the likeness of God in true righteousness and holiness.

I am afraid AA does not come from this point-of-view.

We can certainly borrow the good parts from AA and 12-Step programs, and from science, but all that must be submitted to the Revelation of a God who is all knowing about how human beings work.

God Bless,
Bro. Ignatius Mary