Editor's note: Anonymity is the spiritual foundation of all of the traditions of Alcoholics Anonymous, according to the organization's literature. For that reason, we have chosen to identify by first name only the AA members quoted in this story.
ATLANTA — On May 16, 2004, Bob awoke at 2 a.m. in the driver's seat of his car with a bottle of vodka in his lap. He was in the parking lot of a convenience store, but he had no idea where the store was.
"I had developed a tendency to get angry and drink and drive and be gone for a couple of days," Bob says. "This was one of those crazy excursions. I could have been in Arkansas or Minnesota. I figured it would seem stupid to stagger into the store and ask where I was, so I drove around until I figured it out."
He shakes his head. "Great logic."
Luckily, he was near Atlanta.
"When I got home, my heart was pounding, I was sweating and the room was spinning, like a thousand times before. But I'd scared myself so much that the fear of continuing to live like that overcame my fear and reluctance of turning my life and will over to God."
Bob was willing to admit that he was powerless over alcohol and prayed to God to take the burden from him.
"It sounds stupid, but I felt the presence of something in the room," he says. "I could feel it, and then it felt like an elephant had been sitting on my chest, and it got up and walked away. Something big and good had happened."
Bob hasn't had a drink since, and attributes his abstinence to the five Alcoholics Anonymous (AA) meetings he attends every week.
"Every time I go, I'm reminded that I'm an alcoholic and I have a problem," he says. "But it can be overcome, and I am overcoming."
It's been 73 years since AA began, and the 12-step concept it fathered is more popular than ever. Twelve-step programs now treat millions around the world for everything from drug addiction, gambling and overeating to clutter, sexual compulsion and workaholism.
"Twelve-step programs are very helpful for a lot of people, especially when it comes to substance abuse issues," says Dr. Tommie Richardson, a staff member of the Ridgeview Institute. "They are the most successful modality we know of right now. The fact that they've been around so long and continue to thrive tells you that."
"It's a brilliant program," says Tere Tyner Canzoneri, a minister and pastoral counselor at The Emmanuel Center for Pastoral Counseling in Atlanta. "There's not a person on the planet who couldn't benefit from working the steps."
Robby Carroll, a minister at Shallowford Presbyterian Church and a marriage and family therapist, regularly refers clients to 12-step programs because "they're the only programs that understand the challenge of addiction."
Addiction has resisted the best efforts of science, medicine, psychiatry, social workers and social pressure before and since the providential meeting in 1935 of Bill Wilson, a New York stockbroker, and Dr. Bob Smith, an Akron, Ohio, surgeon.
Both were alcoholics, but Wilson used spiritual principles and the insight that alcoholism was a disease to get sober. After he persuaded Smith to follow suit, they began working with other alcoholics and started the first AA group that same year.
Favorable publicity and the publication in 1939 of Wilson's book "Alcoholics Anonymous" anchored the program's status and popularity.
Today AA is the largest of the 12-step programs (followed by Narcotics Anonymous and Al-Anon) with an estimated worldwide membership of 2 million. Experts, citing the difficulty of estimating anonymous fellowships, believe the numbers are much higher.
There are more than 400 groups and 1,100 AA meetings a week in the Atlanta area alone. Dr. Steven Lee, medical director of Summit Ridge Hospital and director of Addiction Services in Gwinnett County, estimates addictions affect 15 to 20 percent of the population in Gwinnett alone.
"We're just touching the tip of the iceberg that needs treatment," he says.
The 12 steps are a rigorous program of spirituality, self-examination and self-renewal that Smith, affectionately remembered as "Dr. Bob" by 12-steppers, summarized as "Trust God, clean house and help others."
Trusting God doesn't come easily, however. Many participants either don't believe in God or blame Him for their difficulties, which is why the steps refer to "a Power greater than ourselves" and "God as we understood him." Mention of religion during meetings is forbidden, and rigorously enforced.
Nevertheless, therapists say that some find spirituality of any stripe objectionable and don't return. Nor do 12-step programs always work with those in the early stages of addiction.
"I see folks who have gotten into treatment after a DUI or who think it's an aberration," says Bob Fredrick, a clinical social worker and therapist in Atlanta. "They say 'I just don't connect there' or 'I'm not as bad as them.' There's a lot of denial with addiction."
Lee says there is an organization for physicians that relies on conventional therapy and medication rather than meetings. "I disagree," he says, "but they're not the core of the recovery community. It's hard for them to admit they're powerless."
There are other recovery groups, says Scott Maddox, an addiction counselor and executive director of Alpha Recovery in Atlanta and Brunswick, "but all the evidence shows that the 12-step approach is the most successful."
And while individual therapy gets to core issues faster, he says, 12-step programs are superior because, "You have people who have common problems and experience with solutions to those problems. They provide a support network for ongoing recovery that therapy doesn't provide."
"They're one of the few places that folks really feel understood," AA member Frederick says. "Folks ready to deal with addictions find kindred spirits who understand that they're dealing with a disease, and it's not a willpower or moral issue."
Bob says he thinks the steps are pure genius.
"When they started to take hold," he says, "I realized it wasn't about stopping drinking, it was really about living sober."
The program, he says, offers a systematic formula for living life.
"It's a toolbox," he says, "to get me through life. Before, I had one tool, and that was a bottle opener."
This story was published in The Atlanta Journal-Constitution.