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My Turn
Other Views from Those in the Know
Chelsea Carmona
West Coast Regional Manager, the Op-Ed Project
More Flexibility at AA Might Better Help Today's Addicts

I was 20 when I attended my first Alcoholics Anonymous meeting.

"Hi, I'm Chelsea, and I'm an addict," I said, introducing myself to a group of mostly middle-aged men and women.

The room fell silent.

"No!" a discouraging voice bellowed from the back of the room. "This is a meeting for alcoholics!"

I didn't understand. The staff at my inpatient treatment program had told me that newcomers were always welcome in AA. In fact, they said that if I wanted to get well, AA was the best place to go. I wouldn't find the kind of sobriety in Narcotics Anonymous, the 12-step program for drug addicts, that I would in AA.

"I'm so sorry," I mumbled to the group. "I didn't mean to offend anyone."

I started again: "I'm Chelsea, and I'm an alcoholic."

Admitting you have a problem is the first step to recovery, but perpetually admitting you have a problem that you don't actually have can make recovery difficult. Accordingly to AA's literature, approximately 10 percent of members are under age 30. Many of these younger folks are only beginning to struggle with addiction to drugs or alcohol. The recovery community requires them to fully take on the addict and alcoholic identity as a part of the acceptance process. But, from what I've seen, by defining these members as addicts or alcoholics, 12-step programs can unintentionally encourage their members to develop self-fulfilling prophecies.

Adolescents and young adults are deeply affected by the labels thrust upon them. Once labeled "troublemakers" or "difficult" by parents or teachers, they find it hard to overcome such a persona. In my experience, many of those who acquired the addict/alcoholic designation, even if they didn't deserve it at first, began to behave accordingly.

When I labeled myself an alcoholic that day, I hadn't picked up a drink in almost three years, and I'd never been a heavy drinker. My troubles began when I was introduced to Adderall during finals week my first year in college. As a high-achiever who was struggling with the freshman 15, stimulants seemed like the solution to my problems. I could sit in class all day, study all night and skip meals without the slightest hint of exhaustion. Most important, I could compete with the other students who were also abusing such drugs.

After a few months, I was starting to fall asleep in class but couldn't seem to sleep at night. So I started taking opiate painkillers to help come down from the Adderall. It wasn't long before I was waking up with opiate withdrawal symptoms — cold sweats, seizure-like shakes and awful mood swings. I realized I needed help, so I approached my mom and checked into a rehab facility.

A few days into my treatment, as I embraced my new identity as an alcoholic, my mom was in a meeting for addicts' loved ones. She refused to introduce herself as the mother of an alcoholic, instead saying she was the mother of a "young woman struggling with an addiction." She received more than a few eye rolls. Mom preferred to concentrate on my identity as an honors student and council representative.

Introducing oneself as an alcoholic is much less difficult for those who have a history of alcohol and drug abuse. As Penny Lee, an addiction counselor at Recovery Solutions in Santa Ana, Calif., explains: "It helps the newcomer to be able to admit defeat. It was difficult for me, but once I did it, I knew I was in the right place: with other alcoholics."

In my case, labeling myself an alcoholic paved the way for me to take on the "addict" persona, and I got much worse before I got better. After treatment, I traded in my college friends for the criminal ones I met in recovery, and in turn, I gained access to a variety of hard drugs.

That is perhaps the most disheartening aspect of 12-step recovery and inpatient care: Because most of their AA colleagues are older, the adolescents I met in treatment found more drug connections, party buddies and rehab romances than they did mentors, counselors and long-term sober friends.

During the fourth week of my stay, family week, our parents and spouses were told to cut us loose at the first sign of relapse. These principles were taken from the 12-step program of co-dependency that our loved ones were directed to follow, called Al-Anon. Relapse is part of recovery for most addicts, and that certainly was the case for me. I couldn't bring myself to tell my supportive family about my struggles because I thought I would lose their support if I did so.

My addicted peers and I may have entered treatment to leave deceit behind, but after family week, we were so terrified of losing our loved ones that we conspired to cover for one another's lies.

The lying played out during AA meetings on a regular basis. I'll never forget when a friend stumbled up to the front of the room, his sponsor beaming with pride, to take his chip for being sober for 30 days. He was high as a kite, but no one said anything because we didn't want to risk alienating him from his support system. AA's Old-Timers, older alcoholics with long-term sobriety, and our treatment center's counselors would have surely told his parents that their son needed some serious tough love. They would have recommended kicking him out of the house and taking his car, preventing him from attending work or school. What little he had left in his life would be gone.

This is not to say that young people can't get sober, and that AA can't help them. But, in my experience, some of the techniques that work for adults are much more challenging for the 46 percent of patients at substance abuse treatment centers who are age 18 to 24. When these facilities label teenagers, who are just beginning to struggle with drugs, as addicts and call their parents "co-dependent enablers," the safe environment can quickly become hostile.

AA originated in 1935, when a hopeless alcoholic faced financial trouble. The mutual aid movement was founded by and designed for middle-aged men who had been battling the bottle for years, and had decades of job and family wreckage behind them.

If you hang around AA long enough, you will inevitably have to talk about your "bottom," or lowest point. The teenagers I met in recovery, many of whom were suburban kids who had only recently started to abuse drugs and alcohol, were laughed at when they revealed their bottom was getting a D in calculus, a fight with their parents or maybe a time they got caught sneaking out of the house. Eventually, these teenagers compared their lowest moments to those of more seasoned patients who had been separated from their children or had multiple drunken-driving offenses, and questioned the severity of their own drug and alcohol problems.

"Someone once told me that the AA program won't work unless you're desperate," says Lisa Neumann, founder of an AA alternative and author of the book "Sober Identity." "But why is this the way? You don't need to go so far down before you can say, 'Can you help me?' "

For young people, there aren't a lot of alternatives to AA. Those who choose not to follow the rigid 12-step structure are almost always viewed as in denial or on the verge of relapse. Although many addicted teenagers are in denial, those who genuinely wish to find sobriety are forced into a "with us or against us" environment in which addiction can thrive.

"AA isn't for everybody — nor should it be," Neumann says. "It's more about the discipline to stick with something, not necessarily AA. ... There are many paths, and that's OK."

One of AA's numerous slogans asserts that each addict is unique, but it offers only one path to sobriety. In reality, people sober up doing all sorts of things that don't involve 12 steps. Many people find sobriety by going to church, changing their friends or ending a bad relationship. Some studies show that young people tend to "mature out" of their drug and alcohol addictions.

Genuine sobriety came when my mentor told me that we did not have to adhere to the conventional 12 steps. Once I was able to free myself from the AA traditions that kept me from being sober, such as chip-collecting, making amends and daily prayer, the process was simple. Unfortunately, many AA members shunned me for working outside the AA model.

AA may not help many young addicts get sober, but it can do wonders to help them stay that way. The program stresses honesty, service work and gratitude — which are vital to helping alcoholics and addicts sustain sobriety.

AA groups continue to work to be youth-friendly, but they have a long way to go. They might start by learning a thing or two from other 12-step programs, such as Narcotics Anonymous. NA holds bowling nights and family picnics, Lee says, adding: "AA is geared toward adults, but what about the kids? Where's the AA picnic?"

Fellowship is the most beloved and successful aspect of AA. After all, Neumann reminds me that "we don't heal alone."

AA leaders need to revise the program to accommodate the experiences unique to the next generation. That may start with allowing members to admit they have a problem without having to take on a label. AA should embrace, not alienate, young drug users and alcoholics. We're there to benefit from the group's most productive tradition: long-term sobriety.

Chelsea Carmona is the West Coast regional manager of the Op-Ed Project, which works to bring underrepresented voices into opinion writing. 

This piece first was published in The Washington Post. Republished with permission.

by Dr. Radut.