The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
THE GENERAL SERVICE BOARD OF
ALCOHOLICS ANONYMOUS AUSTRALIA
A.C.N:001 417 125
ABN: 77 001 417 125
POSTAL ADDRESS: 48 Firth Street, Arncliffe, NSW 2205
TELEPHONE: (02) 9599 8866 FACSIMILE: (02) 9599 8844
e-mail [email protected]
Web Site address: www.aa.org.au
AA HELPLINE 1300 22 22 22
The Committee Secretary
Standing Committee on Indigenous Affairs
PO Box 6021
Parliament House
Canberra ACT 2600
[email protected]
Dear Mr Banson
Thank you for your committee’s invitation to Alcoholics Anonymous Australia to make a
submission to the Inquiry into the harmful use of alcohol in Aboriginal and Torres
Strait Islander communities.
The General Service Board would like the Inquiry to be aware of the enclosed
information about Alcoholics Anonymous (AA).
The dot points from your list of foci that best fit our experience, strength and hope,
and that we will address in our submission, are:
•
Best practice treatments and support for minimising alcohol misuse and
alcohol-related harm and
•
Best practice strategies to minimise alcohol misuse and alcohol-related
harm.
Alcoholics Anonymous Australia welcomes the opportunity to provide accurate
information about our structure, objectives and function. We can be contacted through
the General Service Office on 02 9599 8866 as above.
We would also recommend exploring our public electronic gateway at www.aa.org.au
for an understanding of how a newcomer or a professional might go about gathering
information or making contact.
A hard copy of this submission will be posted for your records.
Kind regards
Dr Vanda Rounsefell
Trustee Emeritus, General Service Board of AA Australia
14 April 2014
The Logo in the top left hand corner and the words ”Alcoholics Anonymous” are the registered Trademarks of the
General Service Board of Alcoholics Anonymous, Australia
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
THE GENERAL SERVICE BOARD OF
ALCOHOLICS ANONYMOUS AUSTRALIA
ACN: 001 417 125
ABN: 77 001 417 12
POSTAL ADDRESS: 48 Firth Street, Arncliffe, NSW 2205
TELEPHONE: (02) 9599 8866 FACSIMILE: (02) 9599 8844
e-mail [email protected]
Website address: www.aa.org.au
National Helpline 1300 22 22 22
April 16 2014
To: The House of Representatives Standing Committee on Indigenous Affairs
Re: Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander
communities
Thank you for inviting Alcoholics Australia to participate in this Inquiry.
The following paper is offered on the understanding that Alcoholics Anonymous (AA) does not
claim to have expert knowledge of outside matters, but feels that the strategies that have
served its own members well, including indigenous people and communities, are worth
consideration for the purpose of the Inquiry.
We will not be relying on scientific data, notwithstanding that we may point in the direction of
others who have sought scientific explanations of what we do. AA’s strategies are born out of
long-term experience of trial and error of what has worked and what does not – for chronic
alcoholics themselves. This has crystallised into the long-standing, world-recognised and much
emulated AA 12-Step Program of Recovery, now 74 years old, 64 in Australia.
AA has a tradition of sharing its own experience, strength and hope to all who ask for assistance
with seeking a long-term and resilient sobriety. We do not identify a social problem then move
to ‘fix’ it. Nor can we say how many indigenous alcoholics there are. In our experience, quality
sobriety is only achieved without coercion and in full willingness of the participant. Everything in
AA is by invitation, consciousness raising, suggestion and modelling and voluntarily adopting
observed wanted behaviours, not force. Each individual is fully, personally responsible, but
there is also a great deal of patient help and the first-hand experience of ‘wounded healers’ –
not that AA members refer to themselves as such: Sponsoring, mutual, friendly, understanding
support in meetings, tolerance of the person but not the bad behaviour, processes for assuaging
guilt and harm, time structuring from meetings and Service that replaces time spent drinking.
The AA ‘Responsibility Statement’ or ‘Pledge’, (1965) says:
I am responsible. When anyone, anywhere, reaches out for help, I want the hand of AA always to
be there. And for that: I am responsible.
Alcoholics Anonymous Australia invites anybody who feels that AA could be of assistance to any
indigenous (or other) individual or community in the manner described in this paper or our
formal literature, please to contact us as above to explore opportunities for co-operation.
I commend this paper to the Standing Committee.
Vanda Rounsefell PhD MB,BS CTA,ITAA FACNEM
Trustee Emeritus (former non-alcoholic Trustee & Chair General Service Board)
Alcoholics Anonymous Australia
Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
EXECUTIVE SUMMARY
This paper introduces the Fellowship of Alcoholics Anonymous (AA) and provides a brief
orientation to its nature and characteristics, with special reference to indigenous populations
and AA’s current and potential work in that arena.
A working knowledge of AA is provided, including its origin, how it operates, and key factors for
the success of members who closely follow the program of recovery.
Some core AA concepts mentioned through the paper are the goal of permanent sobriety, the
disease model of alcoholism, singleness of purpose, the ‘higher power’ concept, individual selfresponsibility, and the unique global support network of sober alcoholics.
AA’s current indigenous literature resources are reviewed, and internal and past external
activities relevant to indigenous communities are identified.
Of the dot points in the letter of invitation, the two most relevant to AA are addressed:
• Best practice treatments and support for minimising alcohol misuse and alcohol-related
harm and
• Best practice strategies to minimise alcohol misuse and alcohol-related harm.
Of the first, we suggest that the Alcoholics Anonymous program has been inspirationally
successful in the past for indigenous communities (example Alkali Lake, British Columbia,
Canada), that it has been successful for many indigenous alcoholics in our country and has
potential to be very helpful in the future.
We explain the prerequisites for setting up AA meetings and offer assistance for this.
Of the second, we suggest a number of existing AA strategies and structures that could be of
great service if more systematically sought, especially by professionals dealing with indigenous
and other alcoholics – strategies available to indigenous communities, organisations and
individuals on request.
These include development of local relationships with courts, prisons, hospitals, rehabilitation
centres, general practitioners, businesses and schools, to name a few.
Further information about AA explains several aspects on which we are frequently questioned,
including our independence from relationship outside entities, including other 12 Step
Fellowships, our Sponsorship system, ‘God as we understand him’ and AA in a world context.
The paper provides a short list of annotated sources for reading further information about
Alcoholics Anonymous, including several AA Conference-approved items. Any research mentioned
here, internal or external, is in the spirit of the search for understanding about best practice
strategies required for this project, and is not endorsed by the AA General Service Conference
process, as AA has no opinions on external matters and is not concerned with reasons. The
Vaillant paper (abstract only provided here), is a bridge that spans the scientific approach and a
deep internal knowledge of AA’s workings, that inter alia explain the mechanisms of action and
effectiveness of AA. Key concept: relapse prevention.
We conclude by warning that in our experience, nothing works long-term with alcoholics that is
imposed by authority. AA is always ready to co-operate with alcoholics and professionals alike,
but only the willing will receive the full benefits: AA is not for everyone. The opportunity to
attend AA meetings can be a powerful facilitator of insight and motivation through the
‘identification’ process. Full participation in AA meetings and Service can be a powerful driver
of personal growth over time.
Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
TABLE OF CONTENTS
TABLE OF CONTENTS
5
INTRODUCTION
7
OVERVIEW OF AA
7
What is Alcoholics Anonymous?
7
The Service Structures – General (national) and Central (local)
7
Central Principles of the AA Program
8
Key Factors Underlying AA’s Long-Term Success with Sobriety
9
Contacting AA
10
CURRENT ACTIVITIES OF AA RELATED TO INDIGENOUS AFFAIRS
10
Committees at many levels
New Remote Communities Committees
Dedicated Literature
Support for Indigenous Activities
AA in rehabilitation centres
Indigenous people in AA
Where might we meet?
10
10
10
11
11
11
11
BEST-PRACTICE TREATMENTS AND SUPPORT FOR MINIMISING ALCOHOL MISUSE &
ALCOHOL-RELATED HARM IN INDIGENOUS COMMUNITIES
12
The short answer
12
Work in Corrections
12
The Alkali Lake example
12
BEST-PRACTICE STRATEGIES TO MINIMISE ALCOHOL MISUSE & ALCOHOL-RELATED
HARM IN INDIGENOUS COMMUNITIES
13
Key Learnings from outreach to geographically remote communities
13
First Steps
13
Other kinds of meetings
13
Other means of support
14
Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
Suggested opportunities, some happening now at small scale
14
OTHER ASPECTS OF ALCOHOLICS ANONYMOUS
15
Co-operation with the professional community
15
Outside entities and other 12 Step programs
15
The Sponsorship program
16
AA traditions and ‘God’
16
AA meetings: general information
16
Reaching out to the world
17
Further Information about AA
AA Literature
The Twelve Steps
The Twelve Traditions (short form)
The ‘St Francis Prayer’
The ‘Serenity Prayer’
17
17
18
18
19
19
CONCLUSION
20
APPENDIX: RESEARCH INTO ALCOHOLICS ANONYMOUS
21
Research Abstract: the George Vaillant Paper
Abstract: ‘Alcoholics Anonymous: Cult or Cure?’
21
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The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
Introduction
Alcoholics Anonymous (AA) is a large and lively, voluntary network of recovering alcoholics from
every social stratum, who help each other find and maintain sobriety and enhance well-being.
The subject of AA and indigenous affairs is dealt with below. This paper seeks first to share a
working knowledge of AA and how it operates, and then to look at AA’s current internal and cooperative indigenous affairs activities, and finally, to suggest strategies available to indigenous
communities and individuals that could potentially be facilitated through the AA membership
and Service structures.
AA understands that the problems of alcohol include intrapersonal, interpersonal, family, social,
cultural and spiritual issues. We believe the simple strategies used by AA can deal with all these
in a non-professional but effective way. We may be complemented in this by the existence of AlAnon Family Groups, for the families and friends affected by alcoholics (see below).
The AA program of recovery has been associated with long-term success at community and
individual level in indigenous people, as long as sobriety is the goal and the individual
alcoholic is prepared to follow the program.
… Historians may one day recognise Alcoholics Anonymous to have been a great venture in social
pioneering which forged a new instrument for social action: a new therapy based on the kinship of
common suffering: one having a vast potential for the myriad other ills of mankind.
Citation from The Lasker Award of the American Public Health Association, 1951.
Overview of AA
What is Alcoholics Anonymous?
AA was formed by two former end-stage drunks, a stockbroker and a doctor, on 10 June 1935 in
Akron, Ohio, USA. It was first established in Australia in 1945. Currently, it has some 2 million
members in over 150 countries internationally.
AA’s founders, known today as ‘Bill W’ and ‘Dr Bob’, collaboratively worked out the details of
the recommended recovery program over a lengthy period of trial, error and fine-tuning to the
realities of the alcoholic condition.
The Service Structures – General (national) and Central (local)
For co-ordination purposes, AA arranges itself into the geographical scales of nation, Region
(mostly corresponding to States) and Area. Below Area, Districts may be a geographical or
functional association of Groups. Groups run the recovery and maintenance meetings.
AA Australia’s ‘bottom up’ hierarchy of what authority these is, flows down from the Groups
through Districts and Areas to the annual national General Service Conference, which is
attended by Area Delegates, the Board and some others with specialist service duties. The Board
looks after national finances and carries out Conference’s decisions.
The Trustees employ 3 staff in the General Service Office in Sydney. They implement the wishes
of Conference through GSO and take legal responsibility for the non-profit company, Alcoholics
Anonymous Australia and its Trademarks, and also publishes and distributes AA literature.
Throughout Australia there is a local 12 Step support structure system mediated through Central
Service Offices, run by and on behalf of local Groups.
Alcoholics Anonymous Australia
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Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
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The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
The whole AA structure is self-funding from individual donations, literature sales and internal
fund raising. AA traditionally does not accept external funding from any government or other
entity.
Every 12th Step call, every prison visit, every public or professional outreach meeting is
completely AA-funded and is done voluntarily.
Central Principles of the AA Program
One of the key recognitions from AA’s iterative establishment process, was that a disease model
for the understanding of alcoholism was far more effective than a blaming or moralistic one. At
the same time, taking individual responsibility, identifying hurtful personal behaviours and
making amends are core elements of the program.
AA partly attributes its longevity to its insistence on maintaining its singleness of purpose: to
help the suffering alcoholic to stop drinking and to stay sober, ie, it does not deal with other
types of addiction as such, but recommends that alcoholics with dual or multiple addictions also
attend other relevant 12-Step Fellowships.
Again, long experience has shown that people whose drinking is persistently or recurrently out of
control, are not in a physical, mental or spiritual position to return to social drinking in the
longer term.
AA therefore works only to assist sufferers achieve total abstinence. Recent research validates
the contention that people may have a genetic disposition toward the development of
alcoholism.
The implication of the disease model stance is that recovery does not imply an ability to
return to social drinking. Most alcoholics coming to AA have been through multiple such
attempts, resulting in failure with increasingly serious consequences.
Experience has shown that permanent sobriety is the most reliable basis for attaining long-term
quality of life. AA members therefore refer to themselves as ‘recovering’ rather than
‘recovered’. ‘Picking up that first drink’ for an alcoholic is more than likely to constitute the
first step to a new cycle of loss of control. The number one warning for relapse prevention is
therefore “Don’t pick up that first drink”, or “Call me (sponsor) or get to a meeting or read the
Big Book if you feel like picking up. Do whatever it takes but don’t pick up”.
AA’s claim is that those who (voluntarily) undertake the suggested program in a thoroughgoing
manner, can expect success in gaining and retaining sobriety.
AA does not see itself as being in competition with other approaches to the alcohol addiction,
nor as the only solution, however it does have long experience of compatibility and co-operation
with these, to mutual benefit.
On-going meetings and Group members offer confidential support and 24/7 understanding and
‘AA friendship’ for suffering newcomers. The time-tested program of personal action is
facilitated by a unique social structure for those needing support, and the opportunity to
develop new interpersonal and many other skills.
AA’s philosophy is concisely summed up in its ‘Preamble’, which is read out at the start of every
AA meeting:
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and
hope with each other that they may solve their common problem and help others to recover from
alcoholism.
The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA
membership; we are self-supporting through our own contributions.
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Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
AA is not allied with any sect, denomination, politics, organisation or institution; does not wish to
engage in any controversy; neither endorses nor opposes any causes.
Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
© The AA Grapevine Inc. Reprinted with permission.
The Alcoholics Anonymous Fellowship logo is a triangle, representing our Three Legacies:
‘Recovery’ (The 12 Steps), ‘Unity’ (the 12 Traditions) and ‘Service’ (The 12 Concepts). These
form the fundamental structure of the program.
Key Factors Underlying AA’s Long-Term Success with Sobriety
Strong assistance is provided at meetings by having recovering alcoholics present as trusted
mentors, role models and friends. The comfort and understanding an alcoholic finds at an AA
meeting is often associated with a reversal of denial (inability to accept the problem). ‘One
alcoholic talking to another’ has proved to be a powerful tool for recovery, coupled with a
supporting and reliable ongoing friendship network.
Key success factors cited in an informal internal survey of alcoholics who are AA members
include inter alia:
•
The sponsorship system
•
The abstinence model
•
Identification at meetings: “I heard that person’s story, and it was my story. I couldn’t
avoid seeing myself there. But I could also see hope, because this person was sober and
had a good life”.
•
Availability of 24-hour support
•
12-Step visits or phone calls
•
Anonymity
•
Full acceptance of the person, not the ‘isms’
•
Time structure (“something good to do instead of sitting there wanting a drink”).
•
Hope and relief from guilt in discovering that one is sick, not bad
•
Understanding how sick a drinking alcoholic may be (“I was too sick in the head to get
anything out of therapy for two whole years. Most hospitals and doctors I went to tried to
help me too soon”).
•
The slogans: helpful sayings such as ‘one day at a time’, ‘pick up the phone before you
pick up a drink’, ‘easy does in’, ‘let go and let God’, ‘how important is it?’, ‘first things
first’….
•
One alcoholic to another. “Takes one to know one” (Deep first hand understanding and
caring together with unlikeliness that other alcoholics will be hoodwinked by a member’s
self deception – put bluntly by one alcoholic: “once sober, we have great ‘bullshit
detectors” – “I hated this but it saved me – coming from another alcoholic, it got
through”).
•
No fees or charges (“It only cost the effort to get there. Later I wanted to give back in
service and gratitude”). (Note: even donations from members and bequests are strictly
limited in size to avoid conflicts of interest and power plays).
•
“It’s spiritual, not religious. They told me I was free to believe in anything I liked and I
should work out a ‘Higher Power’ that suited me. As long as it was greater than me,
because ‘me’ had failed at everything I had tried.”
Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
9
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
•
The service structure (service outside the group): “I was headhunted into Service at first
– had no idea of the amazing benefits of giving without expecting a reward or working
with others for special outcomes for the fellowship or reaching out to others – it’s
awesome how good it feels”.
Contacting AA
AA’s strategy is to respond to expressed need, and the levels and types of need vary greatly
from place to place, as do the AA responses to those requests.
AA now has a 24-hour National Helpline 1300 22 22 22, which connects alcoholics to another
alcoholic at a service office or on an associated roster system, as close as possible to the caller’s
location. The national website aa.org.au/ also has a list of all official Helplines in Australia.
Our co-operative and outreach efforts are case-by-case, voluntary and self-funded, and are
normally at local level. Approaches by organisations and individuals may be made through
Central Service Offices or through General Service Office (GSO) in Sydney (contacts above); if a
matter is clearly of national scale, GSO should be contacted first.
Current Activities of AA Related to Indigenous Affairs
Committees at many levels
AA does not have any special arrangements for indigenous people as such. However we do have a
number of committees at Board and Conference levels, and many also at local levels, whose
briefs are very relevant to indigenous individuals suffering from alcoholism. The presence of an
Aboriginal AA Board member a few years ago made the Board aware of a many of the issues and
current external solutions and concerns.
There is an overlap here with some of our international sponsorship work in developing countries
and with our work at all scales with treatment and correctional facilities, where, as is common
knowledge, indigenous people are represented ‘above their weight’ in terms of population.
New Remote Communities Committees
In the last two years we have instituted new Remote Communities committees at Board and
Conference levels whose brief is to deal with rural and geographically remote communities as
well as communities and people isolated from mainstream by reason of culture, language or
disability. This was in recognition that significant gaps exist and that such communities need
extra help. We have established special internal funding systems for this ‘12th Step work’. Since
having dedicated committees, there has been an increase in rural and geographically remote AA
activities. There is no reason why indigenous alcoholics could not participate in this, or ask for
assistance to set up more of their own meetings.
Dedicated Literature
AA has published two pamphlets and a booklet for indigenous prisoners, with stories designed
with the help of and for the Aboriginal community. These will be generalised to an ‘indigenous’
audience at the next printing. There is other video material available from overseas, much of it
outdated. We have received requests for literature for low education alcoholics and the Steps in
pictorial form. We will be focussing more on these types of materials in the future once
members make specific requests via Conference.
Not all indigenous people are low education of course, and many just participate in the
mainstream, using our ordinary literature.
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Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
Support for Indigenous Activities
AA has supported two very successful indigenous AA Conventions held in recent years. The first,
at Ballina NSW, included Andy and Phyllis Chelsea from Alkali Lake Reservation, British
Columbia, sponsored by the AA General Service Board. See
http://imap.ammsa.com/publications/windspeaker/alkali-lake-story-victory for their story.
AA in rehabilitation centres
From the bottom up, AA is active in the Aboriginal community in some areas of Australia, often
associated with rehabilitation centres. There are others that are patterned on AA but not part of
our system, and others that have no contact or leaning towards AA at all.
Indigenous people in AA
From time to time inspiring leaders emerge and drive a lot of indigenous activity in AA. We
welcome and support such people when aligning themselves with AA. Without succession plans,
however, such people may move on, die or pick up a drink, so AA’s Tradition 12 ‘principles over
personalities’ provides wisdom. Currently there are only a handful of known dedicated
Aboriginal AA meetings around the country. There are also many, especially urban, indigenous
folk who are members of ordinary AA Groups.
Some meetings are ‘12 Step’ but not ‘12 Traditions’, in that they are financially supported by
government or other organisations, so are less individually responsible for their expenses than an
AA group would be. GROW groups are in this category and some Aboriginal Sobriety groups.
Where might we meet?
AA Groups usually seek out low cost but publically available premises, for which they pay
(amongst other things such as food and literature) by taking a voluntary personal collection at
the end of each meeting. This is all part of encouraging members to take personal responsibility
for all aspects of their lives.
If a venue is available for any community meeting, then by Tradition 7, AA may also use a ‘free’
venue from a non-AA source. If offered because it is for AA as such, then we may not accept it.
We have noted the differences between urban and remote, poverty-stricken communities’
ability to raise funds amongst themselves, and contribution may also be non-financial. The fact
remains, however, that drinking is funded by many dollars, when a few cents in the basket might
be a symbol of self-support. These arrangements are the business of the Group. In AA we make
suggestions, sometimes strong ones, but end up saying (about suggestions made) ‘take what you
need and leave the rest’.
There can be a lot of flexibility in where meetings are held. In the early days, AA meetings were
often started in people’s homes. This is not the best arrangement but can make the difference
between having a meeting and not.
Meetings can also be held in the open air and ad hoc meetings may be held anywhere. Some
members for example, go for long motorbike rides and hold meetings in parks or on beaches.
We also have people from time to time doing ‘Tag-Along’ meetings, some four per year in
different States (outback) - where a long remote area route is announced and locals join
whoever is leading for part of the journey, holding meetings and shared activities along the way.
These are very enjoyable events, bringing AA to those who normally don’t have one-to-one
access; anyone can join in the meetings and/or the journey. Indigenous people could well
participate if aware they were on.
Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
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The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
Best-Practice Treatments and Support for Minimising Alcohol Misuse & AlcoholRelated Harm in Indigenous Communities
The short answer
AA is a major community resource that is freely available to all who seek help with a drinking
problem – as well as to all those in the professional community who deal or come into contact,
with the addiction or have to finance action.
It is also regarded by many researchers as a best practice resource. But we reiterate, with
alcoholics especially, our experience is that coercion never works. We have learned that
suffering alcoholics must be attracted into considering recovery by seeing first hand what
success looks like.
For AA, the short answer to this is to understand that Alcoholics Anonymous is not some
outmoded approach that was replaced with ‘modern’ methods. Sobriety and AA can complement
a modern, wholistic approach to alcohol misuse and harm, and the fact of the persistent human
beneath the disastrous modern behavioural and cultural overlays means that a system developed
by trial and error to address the real human and tuned to success through the first person
understanding of alcoholics themselves, might just be in a position to provide real help.
The strong sense of family and of spirituality commonly seen in indigenous people can fit well
with the idea of AA as a kind of family and a spiritually-based one that does not compete with
any individual religion or absence of it, even though highly compatible with Christianity, which
also suits many indigenous people.
Work in Corrections
Alcohol-related crime is itself in the background of the majority of prison sentences. There are a
number of AA meetings in and related to such facilities, and AA members also do presentations
about AA from time to time. In 2011 AA established a correspondence service for prisoners
managed by GSO.
Being dried out be a long prison term is a great opportunity for bridge-building in anticipation of
release, as the AA network outside is a ready-made family that can make a big difference to
resilience at this vulnerable time.
While not supporting coercion, in some situations a little push may be appropriate: a choice
between attending AA meetings and going to prison may just end up facilitating a crack through
the curtain of denial that surrounds the drinking alcoholic. The opportunity to attend AA
meetings can be a powerful facilitator of insight and motivation through the ‘identification’
process. Full participation in AA meetings and Service can be a powerful driver of personal
growth over time.
The Alkali Lake example
This was a well-known Canadian indigenous project mentioned above, that took a whole
community of seriously ill people from utter alcoholic depravity to sobriety, sanity and
productivity. It was driven by two fire-souls who had been drinkers all their lives. They used AA
as the basis for their first moves into their own sobriety, followed eventually by the entire
community. The detailed story is elsewhere, but this story has been shown to be very
meaningful to indigenous Australian alcoholics, and is likely to contain ideas that the Standing
Committee would find useful.
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Alcoholics Anonymous Australia
Submission to Standing Committee on Indigenous Affairs
Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
The harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Submission 64
Best-Practice Strategies to Minimise Alcohol Misuse & Alcohol-Related Harm in
Indigenous Communities
Key Learnings from outreach to geographically remote communities
In recent years we have sent members to assist liaison with local members and professionals on
Thursday Island and with establishment of new AA Groups in the Solomons (international
program). Both have provided important learnings of relevance to our Remote Communities
activities.
Experience has taught us not to expect immediate results, the need to do considerable
preliminary one-on-one exploration of the usually complex cultural and inter-cultural context
and correctional and helping community resources, making and following up personal contact
with local professionals and listening to their concerns.
These visits demonstrate the absolute need to have a personal entry point, and well as a strong
commitment to be available long term so trust can be built.
Follow-up is critical after making such contacts or running Public Information events, and there
needs to be a local group of longer-term stayers who champion the cause, within AA or in the
helping and corrections areas.
Locals tend to be uniformly and justifiably cynical about external experts who blow in, promise
much then vanish. This is understandable, but trust is already a big issue even before contact
and even when invited in. Al-Anon independently carries out outreach work in remote areas, and
is sometimes the route through which local alcoholics may be accessed through observing
positive change in a partner. As may women’s centres. Potentials exist for more co-ordinated
approaches through AA and Al-Anon together.
Our main learning from the Solomon Islands was patience: expect a long, slow process, probably
years long, possibly with false starts, but the sine qua non is persistence. The first contact was
highly successful, then lapsed, then picked up again and is now much better established and
confidence is growing, which in turn is becoming a magnet for more Australian members to visit
and offer support. We have found that it is absolutely critical to have local champion(s) of the
process. This one began with a request for help from a church. These learnings are well known
to aid workers, NGOs, CBOs and such, but they bear repeating.
First Steps
The First Step of Alcoholics Anonymous starts with the admission of loss of control of drinking
and the resultant mess one’s life has become. All (not to minimise the difficulty of just this) that
is required is a willingness to act, and the best outcomes arise from having a powerful
experience of situational clarity, followed by a determination to do whatever it takes to
recover. Some fortunate people suddenly drop their denial and become sober from their first
meeting.
For remote alcoholics especially, two things greatly enhance the chances of relapse prevention:
one is mutual on-going support from other sober alcoholics, the other is some form of local
‘champion’ such as a church, a social worker, a hospital superintendent, a gaol governor … or a
supportive community centre or family. All too many indigenous alcoholics have successfully
dried out in a distant rehab or prison, only to return home to zero support and rapid relapse.
For this reason we suggest that home communities request the assistance of AA but also Al-Anon
for the families and friends. And professionals could with permission, put newly sober people in
touch with each other for mutual support, perhaps via a new AA Home Group.
Other kinds of meetings
In remote areas AA meetings are few and far between. People may rely on ‘Loners
Internationalists’, a letter-writing or email ‘meeting in print’. Sometimes Skype meetings are
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held. The NBN may facilitate large scale video conferencing in the future, and better support
face-to-face meetings on the Internet for geographically remote alcoholics.
To start an AA Group, only three people are needed. If they contact GSO or the local CSO they
will be provided with information, a package of start-up materials and assistance with
implementation.
Sometimes established Groups elsewhere may be willing to Sponsor new ones to get them going.
It is also recommended where possible, for individuals to attend as many established meetings
as possible, as the different meetings vary a lot in character – to learn how to run them and how
they work in practice. For example a party of indigenous people could organise a city visit that
took in a new meeting every day.
Other means of support
From time to time it is suggested that an AA bus might visit remote communities, but the
distances, costs and inability to make regular trips make it impractical. On the other hand, if
any sort of long-term support structure is present or can be built, intermittent visits can
strengthen the local resilience, as in our experience in the Solomons.
The Tag-alongs mobile meetings in the outback mentioned elsewhere often cover thousands of
kilometres, stopping at remote towns and communities, visiting local authorities and
institutions, health, medical, education, rehab and corrections people, courts and police,
supporting local members if any, running meetings, leaving information pamphlets and other
resources. There are usually a dozen or so cars, caravans, tents, and numbers vary for different
parts of the journey, sometimes linking up across State borders. Those participating may come
from far and wide, some are grey nomads, some townspeople from along the route or from big
towns or cities.
Suggested opportunities, some happening now at small scale
• Encourage modern professionals to consider AA as a best practice organisation for sobriety
and encourage referrals and co-operative projects.
• Encourage acceptance of the reality that sobriety is critical to most chronic alcoholics.
• Bridging work, establishing meetings and consciousness raising in staff and inmates before
and after discharge from prisons and rehabs.
• Liaison with courts and corrections more, so that more selected, suitable people can attend
AA meetings within or instead of prison or as a parole condition.
• Ensure indigenous people are aware of AA and the Alkali Lake story.
• Invite both AA and Al-Anon to help remote communities together. Families often become
very unstable when the alcoholic stops drinking, hence the founding of Al-Anon by the wife
of AA’s co-founder.
• Support indigenous communities in making a long-term recovery plan for themselves.
• Support natural leaders in indigenous communities, not too large scale, and not global
scale, ‘one size fits all’. While insisting on autonomy, remember that autonomous people
are not necessarily skilled. As long as literate, AA members gain a lot of secondary benefit
from participating in organising all scales of AA events, presentations, social gatherings etc.
We have many long-pondered guidelines on how to do these things, which are an indirect
way of offering training.
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Other aspects of Alcoholics Anonymous
Co-operation with the professional community
AA relies for new members upon word of mouth, media strategies and referral from the
spectrum of health and corrections system professionals and community gatekeepers in the
professions and the media – by public awareness raising and ‘attraction rather than promotion’.
Local AA groups may approach professionals to make them aware of AA’s presence and to ask if
a need exists and how AA may help. A large range of literature is available, which is funded
internally by member donation and literature sales. There is no overall strategy, rather, locals
respond to local expressed needs.
From time to time Groups may initiate community awareness seminars attended by such as
general practitioners and other health professionals, teachers, police, magistrates, social
workers, managers, hospitality, armed services, business and industry personnel.
AA members are available where geographically possible to visit or bring literature to patients in
hospitals and clinics, to discuss how AA might be able to support them overcome their alcohol
problem. We do not initiate such meetings, but are available if asked. These are referred to as
‘12th Step calls’.
Some AA Groups will maintain direct liaison or arrange to hold AA meetings in institutions such
as treatment facilities or gaols.
The national Helpline 1300 22 22 22 22 or local Central Service Office is the usual first point of
contact, or GSO can triage such requests.
All this is more difficult in rural and regional areas. However there is a small but growing band
of dedicated alcoholic volunteers who work the outer reaches of our society. In AA’s experience,
local professionals in remote areas are often desperate to learn what else they could do to help
alcoholics in their care. Professionals and suffering alcoholics alike, tend to get a lot of insight
by attending one or two AA meetings.
Attendance at AA meetings may be prescribed by magistrates by agreement with the prisoner in
lieu of imprisonment, and by treatment and rehab centres as part of an inpatient régime. This is
less common than formerly.
When other issues exist, such as mental or drug problems, AA focuses on the alcohol problem.
We support members by not interfering with other treatments, including prescribed
medications. It is normal to suggest that individuals attend other 12-Step programmes – eg,
Narcotics Anonymous, Marijuana Anonymous, Overeaters Anonymous or Gamblers Anonymous –
to deal with other addictions.
AA places a strong emphasis on personal responsibility however. We do not provide reports on
individuals or their progress. It has been agreed that attendance cards may be signed by the
chair of an AA meeting.
Outside entities and other 12 Step programs
From its inception, the Fellowship of AA has worked in co-operation with many other
organisations and programs, including in the areas of treatment and corrections, but is always
careful not to be formally aligned with, nor have opinions on or accept money from, external
entities.
Even AA’s ‘sister fellowships’, Al-Anon and Alateen, while from closely-related origins, are still
regarded as stand-alone and similarly independent. Al-Anon was started by the wife of AA cofounder Bill W. It supports the families and friends of alcoholics, and also hosts Alateen for the
teenage children of alcoholics. These Fellowships approach alcoholism by doing the AA program
themselves and declining to participate in the problematic relationship disturbances alcoholics
and their families are prone to. We refer on many people who call AA about a family member in
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such distress. A number of 12 Step programs have similar arrangements (eg Nar-Anon, GamAnon, OA-Anon).
Due to the success of AA’s approach, some hundreds of other ’12 Step’ programs have emerged
globally, emulating some or all of the original principles. Well-known examples are Narcotics
Anonymous, Gamblers Anonymous, Overeaters Anonymous and GROW Groups. These are likewise
regarded as separate entities with their own specific objectives and unique adaptations.
The Sponsorship program
Many alcoholics discover they can stop drinking by attending AA meetings regularly, personally
acknowledging their addiction, taking one day at a time by not ‘picking up the first drink’,
especially in the early days.
The more difficult tasks of maintaining sobriety and ongoing personal development are achieved
by ‘working the Steps’, which include maintenance Steps, and by applying AA’s Twelve
Traditions in one’s personal life. In addition, a voluntary arrangement called ‘sponsorship’
commonly takes place by asking for the support of an older sober member who then volunteers
to takes on the role.
This is a highly personal relationship that can greatly improve the stability and quality of
sobriety. A key function of the Sponsor is to support the new member to work through the
personal application of the Twelve Steps. It is a kind of mentoring, coaching or apprenticeship
system but not a therapeutic relationship, and does not involve money. The sponsor does not
give advice or demand goals or deadlines, but simply remains available for contact and, when
asked, relates his or her own experiences. The newcomer is free to listen or not, and to take on
what fits best. In AA, the individual is always personally responsible for his or her own progress
in sobriety.
Once stable sobriety is established, longer-term options include undertaking service both within
and beyond the AA Group. Members are encouraged to seek ‘Service Sponsorship’ to support
these activities.
AA traditions and ‘God’
Alcoholics Anonymous is non-religious but does understand itself as ‘spiritual’. It welcomes
atheists and all religions and denominations.
There is substantial AA literature written by the founders and others who followed them that
may remind one of religious ritual – Step 3 of the 12 Steps advocates transcendence of self by
handing over one’s will and life to any trusted higher power, real or abstract.
While the principles behind the 12 Steps of Recovery did emerge from a Christian background,
early AAs soon and wisely realised that aligning with any particular religion would inevitably
bring fatal disharmony, especially because at least half the early members were atheists or
agnostics.
The reference to a ‘Higher Power’ (which can be the power of experience of the Group, Nature,
the great unknown or functionally, anything that is greater than the person), or ‘the God of your
understanding’ means that AA is compatible with any of the Great Religions, and indeed has
members across all cultures, including Christian, Hindu, Buddhist, Moslem and various
indigenous, sectarian and atheist traditions. The ‘God of your understanding’ is a key but strictly
personal entity within the program.
AA meetings: general information
There are just under 2000 established meetings throughout Australia and approximately 17,000
to 20,000 members across every State and Territory. Most Groups hold several meetings each
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week. It is common for members to attend many meetings in addition to those of their ‘Home
Group’.
A noticeable, comparatively recent change is the number of younger people attending meetings.
Membership cuts right across every stratum of society.
Meetings vary in style to suit particular needs. Thus, in addition to general meetings, there are
women’s groups, business people’s groups, community-based groups, prison, hospital and rehab
groups and so on. In addition to open meetings there are closed meetings when particular
confidentiality or anonymity is needed.
Anyone is free and welcome to attend an open AA meeting as an observer, should they wish to
have first-hand experience of what happens at a meeting. Visitors should introduce themselves
to the chairperson or any member on arrival, or call the contact person in advance if known.
The best way to locate a meeting is to consult the meeting finder on the national website
aa.org.au/.
AA holds a national convention each Easter, rotated through the States. In addition, young
people’s conventions are held in most State capitals and there is an extensive nationwide
network of forums and other convivial get-togethers. Australia also supports the Asia-Oceania
Service Meeting and will host the next one.
Reaching out to the world
AA is present in over 150 countries worldwide, and AA literature is available in over 50
languages. In Australia the National Office can usually provide literature and assistance for nonEnglish speaking people.
Alcoholics Anonymous is a worldwide fellowship and Australia was a founding member of the
first World Service Meeting in 1969 and currently has two World Service Delegates. We also
participate in the biennial Asia Oceania Service Meeting, and often sponsor delegates from
developing countries such as Cambodia, Indonesia and India to attend the AOSM or our own
National Conventions, and regularly provide literature and other support. We have a special
(internal) collection to fund these activities on Founders’ Day every year.
In 2013 at the invitation of AA India, some 90 self-funded sober alcoholic women, most from
Australia, some from New Zealand and elsewhere, travelled to five major Indian cities, visiting
and participating in information and sharing sessions at hospitals, medical, police and judicial
training institutions, rehab centres, media centres and many other local meetings and events.
The main objective was to carry the message of AA recovery and quality of life to female
alcoholics. At the time there were 16 female members and 30,000 male members of AA India.
Further Information about AA
AA Literature
A list of available literature is available on the national website aa.org.au/. It is available from
our national General Service Office or local Central Service Offices. Literature is extensive, and
includes pamphlets, booklets, books, posters, digital media and other Conference Approved
service items.
The basic text of AA that describes the program in detail and its basis, is the book ‘Alcoholics
Anonymous’, fondly known by members as ‘the Big Book’. A preliminary section is entitled “The
Doctor’s Opinion” by William D Silkworth, who was instrumental to AA’s early development.
Short appendices address AA’s guidelines for internal unity and public relations for the
Fellowship (‘The Twelve Traditions’), spiritual aspects, and the medical and religious views of
the time. Each edition contains numerous stories of the journey to recovery of real alcoholics, in
the format ‘what it was like, what happened, what it is like now’. The Second Australian edition
of ‘Alcoholics Anonymous’ is soon to be published.
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Detail of the establishment story of AA can be read in the book ‘Pass It On’.
‘AA Comes of Age’ covers the early development of the fellowship and the rationale for the
institution of the highly democratic General Service Conference system which eventually took
the place of the founders as the core guardian of the traditions, and the driver of internal and
external service and accommodation to change.
‘The Next Frontier: Emotional Sobriety’ is a collection of stories and articles from the AA
Grapevine (North America). It includes a chapter from ‘Language of the Heart’ by Bill W that
describes the nature of living from the spiritual platform of the ‘St Francis Prayer’ (see below),
his resolution of deep and recurrent depression by this means and his prediction that this could
be the next frontier for the future development of AA.
The Twelve Steps
Step One: We admitted we were powerless over alcohol, that our lives had become unmanageable.
Step Two: Came to believe that a power greater than ourselves could restore us to sanity.
Step Three: Made a decision to turn our will and our lives over to the care of God, as we
understood Him.
Step Four: Made a searching and fearless moral inventory of ourselves.
Step Five: Admitted to God [as we understood Him], to ourselves and to another human being the
exact nature of our wrongs.
Step Six: Were entirely ready to have God remove all these defects of character.
Step Seven: Humbly asked Him to remove our shortcomings.
Step Eight: Made a list of all persons we had harmed and became willing to make amends to them
all.
Step Nine: Made direct amends to such people wherever possible, except when to do so would
injure them or others.
Step Ten: Continued to take personal inventory and when we were wrong promptly admitted it.
Step Eleven: Sought through prayer and meditation to improve our conscious contact with God as
we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Step Twelve: Having had a spiritual awakening as the result of these Steps, we tried to carry this
message to alcoholics and to practice these principles in all our affairs.
Reprinted with permission of AA World Services Inc.
The Twelve Traditions (short form)
Tradition One: Our common welfare should come first; personal recovery depends upon AA unity.
Tradition Two: For our group purpose there is but one ultimate authority—a loving God [as we
understand him] as He may express Himself in our group conscience. Our leaders are but trusted
servants; they do not govern.
Tradition Three: The only requirement for AA membership is a desire to stop drinking.
Tradition Four: Each group should be autonomous except in matters affecting other groups or AA as
a whole.
Tradition Five: Each group has but one primary purpose—to carry its message to the alcoholic who
still suffers.
Tradition Six: An AA group ought never endorse, finance, or lend the AA name to any related
facility or outside enterprise, lest problems of money, property, and prestige divert us from our
primary purpose.
Tradition Seven: Every AA group ought to be fully self-supporting, declining outside contributions.
Tradition Eight: Alcoholics Anonymous should remain forever non-professional, but our service
centres may employ special workers.
Tradition Nine: AA as such, ought never be organised; but we may create service boards or
committees directly responsible to those they serve.
Tradition Ten: Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought
never be drawn into public controversy.
Tradition Eleven: Our public relations policy is based on attraction rather than promotion; we need
always maintain personal anonymity at the level of press, radio, and films.
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Tradition Twelve: Anonymity is the spiritual foundation of all our traditions, ever reminding us to
place principles before personalities.
Reprinted with permission of AA World Services Inc.
The ‘St Francis Prayer’
This widely used prayer, attributed to but not actually written by Saint Francis of Assisi, has also
been an integral part of the AA repertoire, and was used particularly by Bill W and later Prof
George Vaillant to help explain the nature of the ‘spiritual life’ espoused by AA as distinct from
the ‘religious life’, as part of ongoing self-maintenance after the achievement of stable
sobriety. The common version used in AA is known as the ‘Eleventh Step Prayer’, and the
recommendation is that it be used bit by bit for deep meditative reflection and used as a guide
and inspiration for application to daily life:
Prayer of Saint Francis of Assisi
(from page 99; 12 Steps & 12 Traditions)
Lord, make me a channel of thy peace!
That where there is hatred, I may bring love.
That where there is wrong, I may bring the spirit of forgiveness.
That where there is discord, I may bring harmony.
That where there is error, I may bring truth.
That where there is doubt, I may bring faith.
That where there is despair, I may bring hope.
That where there are shadows, I may bring light.
That where there is sadness, I may bring joy.
Lord, grant that I may seek rather to comfort, than to be comforted.
To understand, than to be understood.
To love, than to be loved.
For it is by self-forgetting that one finds.
It is by forgiving that one is forgiven.
It is by dying that one awakens to Eternal Life.
Copyright © Alcoholics Anonymous World Services, Inc. Reprinted with permission
The ‘Serenity Prayer’
Used at the beginning and/or end of most AA meetings, including Service meetings, where
it assists in maintaining good working relationships.
God grant me the Serenity
To accept the things I can not change
Courage to change the things I can an
Wisdom to know the difference.
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Conclusion
We would like to re-iterate: our experience shows that alcoholics of any stripe do not take well
to coercion: nothing works long-term with alcoholics that is imposed by authority. One size does
not fit all.
We have found by experience that the only viable decisions to be made about alcoholics must be
made with a high level of democracy and substantial unanimity. For this reason our Fellowship
has adopted a very thoroughly argued approach to Service to others that was put together when
our founders were about to retire and die respectively. Their role was taken over by the annual
General Service Conference.
For an understanding of the Twelve Concept for World Service, which has potential application
to the governance of any bottom-up organisation, we suggest reading the book ‘AA Comes of
Age” and reading the long, detailed discussions that accompany the short statements of the
Concepts. The latter are to be found in the “Australian AA General Service Manual”, and no
doubt many other places.
AA is always ready to co-operate with alcoholic individuals and professionals alike, and would
welcome approaches from many more indigenous people and communities, especially now that
we have set up new ‘Isolated Communities’ committees.
AA is not for everyone, certainly, but we see the miracle of recovery in the willing, every day in
the rooms of AA, and sharing how that can happen is an important part of sobriety maintenance.
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APPENDIX: Research into Alcoholics Anonymous
Apart from occasional internal surveys, AA itself does not conduct or endorse research, including
the article mentioned below, however this does provide information that helps explain the
nature and effectiveness of AA to a professional audience, and is included in that spirit.
Research Abstract: the George Vaillant Paper
The Medline abstract for this is included for scientific interest below, but not endorsed by AA.
The 2005 article in the Australian & New Zealand Journal of Psychiatry by George Vaillant
“Alcoholics Anonymous – Cult or Cure?” is a modern research paper by a Harvard Professor of
Psychiatry and former non-alcoholic Trustee of AA in North America who amongst other
achievements, directed for 30 years a generational study of adult development that lasted 5
decades in all.
It gives a description of the psychiatric and spiritual aspects of AA, the author’s literature
review and a detailed appraisal of the mechanisms of action and long-term effectiveness of AA’s
approach, plus an understanding of its demonstrated and potential complementarity with
current professional approaches.
Aust N Z J Psychiatry. 2005 Jun;39(6):431-6.
Abstract: ‘Alcoholics Anonymous: Cult or Cure?’
Vaillant GE.
Abstract
OBJECTIVE:
To discuss the mechanism of action, the efficacy and the safety of Alcoholics Anonymous (AA) in
the treatment of alcoholism.
METHOD:
The published works on effective treatments for alcoholism is briefly reviewed and a prospective
multidisciplinary follow-up of recovery from alcoholism in two community cohorts of adolescent
males followed from 1940 until the present day is reviewed.
CONCLUSIONS:
The suggested mechanism of action of AA is that it employs four factors widely shown to be
effective in relapse prevention in addictions: external supervision, substitute dependency, new
caring relationships and increased spirituality. In addition, AA serendipitously follows the principles
of cognitive behaviour therapy in relapse prevention. Alcoholics Anonymous appears equal to or
superior to conventional treatments for alcoholism, and the skepticism of some professionals
regarding AA as a first rank treatment for alcoholism would appear to be unwarranted. Alcoholics
Anonymous is probably without serious side-effects.
PMID: 15943643 [PubMed - indexed for MEDLINE]
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