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Mar122010

« In Which We Look Out For That Next Step »

The Urge to Rehab

by ALEX CARNEVALE

In 1929 Congress appropriated the first funds that allowed for federal treatment of addicts. The U.S. Public Health Service Hospitals in Lexington, Kentucky and Fort Worth, Texas began treating addicts in the late thirties, although they were essentially prison hospitals from the first. When we compare the ball-licking treatment Tiger Woods receives for his sex addiction to the treatment the first national addicts faced, the difference is rather jarring. Tiger has a dedicated testicle-moistener who operates twice daily (even on weekends!); addicts of the 1930s had to milk cows, or work at the local cannery to justify the cost of incarceration. Back then, there wasn't really such thing as a free ride.

Addicts were routinely hassled by the government; there was no legitimate way to recover from the problems of drug addiction. By 1939, the Christian movement The Oxford Group had given rise to Alcoholics Anonymous, and the organization published The Big Book, the foundational text of AA. The rise of AA was a huge inspiration for the eventual formation of Narcotics Anonymous.

jimmy kinnon's notebook and other materials

A recovering alcoholic named Houston S received a job transfer to Kentucky in 1947. He had helped a man get sober who found himself unable to kick a concurrent morphine habit, and had seen the face of addiction to narcotics firsthand. Once in Kentucky, Houston suggested the AA model could work for addicts as well. The Narco Group began at the Federal Narcotics Farm in Lexington Kentucky around this time. One of the patients in that program, Danny Carlsen, would spread the first iteration of NA to the New York prison in the late forties.

Writing something down where it can be seen by others and verified (or not) has always been a critical part of recovery lore. The addict can't deny what his habit has wrought once he sees it in print. The initial thirteenth step of NA pleaded, "God help me."

Narcotics Anonymous would evolve beyond being a social service organization for victims of drug addiction once it was born-again in southern California over the next decade. The Brown Booklet was the first real piece of NA literature, and it reads wonderfully well even today, with none of the officiousness or preaching that addicts would come to expect from those attempting to change their lives. The organization struggled through the fifties before entering a real renaissance in the 1960s. Jimmy Kinnon, who arrived at Ellis Island from Scotland in 1923, was responsible for much of both the early NA writing, the NA logo, and the formation of the society as we now know it.

Because it has been extraordinarily successful, the basic outline and information provided by Narcotics Anonymous and Alcoholics Anonymous has changed little over the years. Even the pamphlets look largely the same. There was an episode of Seinfeld where George convinced his girlfriend that toilet paper hadn't changed in 500 years; this is roughly true of addiction literature, which exists as a cipher through which the addict himself must find a place.

jimmy k's origination text for what would become NAYet the literature itself remains a weird reshaping of codes of behavior. Each of us, unless we were dropped on our head as a child, has a basic moral code we live by. It is impossible to know, Venn-diagram style, where this intersects with the morality of others, so NA literature explains the basic principles of life for addicts. It is a little shocking to see the world spelled out this way, but this is usually necessary for people prone to abusing themselves and/or others.

drug victims (probably)The presence of God - moreso in Alcoholics Anonymous, which also features deep sociological and psychological underpinnings - never leaves the literature or the people who preach it. There is no way to recover from anything without believing someone is watching you, whether it be some omnipotent being or your family and friends. Otherwise, you are accountable to no one, and the use of drugs retains its otherwordly flair. This is another interesting idea that on its face seems immoral to me, since it is based on a lie.

NA tries to go a bit easier on God than its hard-drinking brother-in-law. For those who have difficulty accepting their savior Jesus Christ, members are allowed to substitute the term "higher power" or read God as an acronym for "Good Orderly Direction." Members are not permitted to roll their eyes or make jokes about this aspect of their recovery.

Unlike AA, there is something unprepossessing about Narcotics Anonymous. It is probably related to the disease being recovered from. For those addicted to alcohol, there is always a happy return to use, and the poison itself is available on every street and every corner. Eternal temptation is eternal viligance. Harder drugs rarely offer a happy return, or a positive ending, beyond the thrill of the initial high. As such, addicts usually need to be very real with themselves in order to confront their disease.

What is most amazing about these programs is that they are effective at all. Tiger Woods' experience, and Steve Philips' experience, indicate there is a future full of things we can be addicted to, and treated for. We now view alcoholism as a disease; there is ample proof that it is, but the most striking reason is that we seem to believe it wholeheartedly, and it is best for us to feel this way.

In the old days, it was not easy to become addicted to sex. The overstimulation of the internet celebrates our best senses, elaborates on our finest indiscretions. People are addicted to the internet and they will probably not require recovery. The internet is the solution more than the problem, but it is still a fairly big problem. I don't really know how rehabilitation works - I usually believe it doesn't work, and that's why these organizations that profess eternal viligance are so popular and effective. How did Michael Vick stop believing that betting on staged dogfights wasn't a fun activity on a Saturday afternoon? About the same time he received the Ed Block Courage Award?

There is also something distinctly American about recovery, and to separate it from a Christian impulse would be to sever the head at the neck. There are worse countries to live in than a Christian one. Whether is it good to become a compassionate country, as George W. Bush basically put it, or whether it is better to tolerate less capriciousness from our fellow man is an open question. The degrading conditions of the first American addicts make a strong argument we are improving as a society. I don't know if it's sad or what that this is as good as we've ever been.

Alex Carnevale is the editor of This Recording. He twitters here and tumbls here.

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Reader Comments (4)

Thanks for that. I really enjoyed the article. Oh, but as a member I can tell you that the "spiritual" aspect of things (God, Higher Power, Good Orderly Direction) is joked about all the time (at least among us younger members). There are atheists, agnostics, and other "non-believers" that stay clean in AA and NA both (I'm one of them). I roll my eyes occasionally and go about my business.

March 12, 2010 | Unregistered CommenterJRAC

thought Mike Skinner was Will Hubbard

March 12, 2010 | Unregistered CommenterMolly

I worked in a rehab clinic for half a year and one patient told me, "Steps? Books? I just go to the meetings." Clearly he hadn't worked through any steps but making it to meetings is an unwritten step in these programs. Also, how would you explain a heroin addict like William Burroughs?

March 13, 2010 | Unregistered CommenterHugh

Interesting article, Alex. I'm in AA and rehab right now and the hardest part for me is dealing with the religious underpinnings of the whole thing. AA meetings are so much sexier in movies. Here I was, thinking I was about to relive a scene from Fight Club/meet my own H. B. Carter... not so much. I'm also in the south eastern US, so every AA meeting begins with the 'Serenity Prayer' and ends with 'The Lord's Prayer'... not sure if this is the same everywhere. I won't say I'm completely opposed to it since I'm more of a spiritual person, but it does make me uncomfortable and somewhat less enthusiastic about participating.

March 15, 2010 | Unregistered CommenterN

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