A Pill for Sobriety?

I recently read and re-posted this very interesting critique of AA on two counts: first, the author points out that there is very little science to back AA, or evidence of its effectiveness. Fair enough. The pluralists among us can acknowledge the lack of scientific evidence but still recognize that AA and its variants do a lot of good work for a lot of people.

The “lack of science” bit can give us more pause when it comes to public policy and its funding consequences, and this is the second and I think central thrust of author Glasser’s discussion. In short, AA orthodoxy pumps tons of money in to residential treatment programs that aren’t accountable to anyone for their outcomes. And AA seems to crowd out other ways of thinking about addictions and treatments.

A really interesting alternative discussed in depth is Naltrexone, which seems to quite magically interrupt that craving for the *next* drink that sucks us all in. (The next, and the next, and the next…). The Finnish doctor interviewed in the article offers lots of caveats, and highlights the complex relationship between taking the drug and engaging in therapy and behavioural changes, including abstinence. In other words, Naltrexone is not a panacea.

  • As in the case of AA, I’m agnostic on the drugs thing. If they help, great. If there is promise, let’s raise awareness and make combinations of drugs and behavioural interventions part of the “toolkit.” But as I approach my 100th day of sobriety (for realz!) I’m reflecting a lot on all the things I would *not* have experienced if I’d just popped a pill:
  • I would not have thought so hard and so much about my loneliness, and the difficulty I have reaching out to other people.
  • I would not sought out the stories and experiences of other people with addictions; and as a result,
  • I would not have strengthened my conviction that compassion and humility are values worth building your life around.
  • I would not have given myself a chance to structure my life differently, try new things, or meet new people.
  • I would not have rethought my relationship to exercise, and softened back to a place of loving it instead of using it as punishment for drinking.
  • I would not have felt fearful, vulnerable, or self-questioning in ways I haven’t had the courage to in many years.

When I think, “should I drink again,” or wonder if a pill would let me drink again as a social drinker, I realize that ultimately this isn’t a very important question. The question is what is still available to me to learn? After going it alone for most of this three months of sobriety, I’m dipping my toe in the water of a “sober community,” and feel I have so much to gain from the wisdom of others, and so many possibilities for experiences and changed perspectives that have not yet unfolded for me.

I would never judge someone for taking Naltrexone. I just know that for me, it would have been a shortcut that may have left me sober but still “stuck” in ways I wouldn’t even have understood. This “old school” sobriety trek is scarier. And harder. But I think it’s more rewarding.

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