In 2000, a woman named Audrey Kishline, founder of a movement called "Moderation Management," had a blackout and, while driving drunk, killed two people. She is currently in prison. When this happened, the national Alcoholics Anonymous organization issued a statement condemning the drinking moderation movement and re-iterating its century-old assertion that only lifelong and total abstinence was appropriate for anyone with any sort of drinking problem.
Those of us who have known diehard AA members for most of our lives immediately grew suspicious. We dug deeper, and found out something that AA, to this day, has yet to acknowledge: Several months before her accident, Kishline resigned from the board of Moderation Management, renounced moderation, and began regularly attending meetings of Alcoholics Anonymous.
She was a 12-stepper in good standing when she killed those people.
Ask anyone with more than 10 years of sobriety within AA, and they will tell you stories of fellow members they knew who were sober for many years within AA, only to suddenly fall off the wagon and destroy their own lives, completely without warning.
Given this, why would AA choose to deny its own failure in regards to Kishline, and instead choose to attack another organization that is dedicated to helping people overcome their problems?
In any case, despite the black eye that MM (and AA) received from Kishline's tragedy, Moderation Management remains a national organization that claims to have helped countless people overcome their dependence on alcohol. It takes the common-sense position that if you think you have a drinking problem, you probably do, and offers positive suggestions and goals for getting drinking under control.
MM takes the position that about 30% of problem drinkers--roughly a third--probably require lifelong abstinence. They seek to support those people, and openly state that their program may well be a stepping stone toward programs such as AA, RR, SMART, WFS, SOS, and similar total-abstinence programs.
Still, MM takes the position that a majoritiy of people can moderate if they really want to, so long as they take it seriously, and are genuinely committed to changing toward a healthier, more positive, and more safe lifestyle.
How does their approach work? First and foremost, MM stresses that the goal is good health and firm control. Anyone wishing to take the MM approach seriously must first commit to a significant period of total abstinence. The minimum requirement is 30 days (referred to as "doing a 30"), although longer is encouraged. This allows the drinker to prove to himself that he is capable of abstinence, and gives him a substantial period to think hard about his use of alcohol, carefully considering why it's become a problem for him and finding ways to enjoy himself without drinking.
If the drinker decides to return to drinking, he is expected to follow a rather rigorous program of moderation. Goals must be set: what is the maximum you will allow yourself to drink in any 24 hour period, and what is the maximum you will allow yourself to drink in any 7 day period?
The MM suggestion is a maximum of 4 servings of any alcoholic beverage in any 24 hour period, with a maximum of 14 servings in any one week. Within any 24 hour period, it is further suggested that you allow yourself no more than one serving per hour. Drinking more than two days in a row is also generally discouraged.
The program also stresses that these are maximums. Drinking less is encouraged. The real goal is to get the drinker to develop the discipline, to "build the muscles," that will allow him to reach a point where he can casually have a drink or two without allowing himself to become truly intoxicated, and to avoid becoming dependent upon drinking to relax, have fun, or fall sleep.
When first returning to drinking, the person faithfully following the MM program is required to keep a "drinking journal." Any time he wishes to indulge in an alcoholic beverage, he is required to write down what he is about to drink, why he is going to drink it, what he believes the effect will be, what the cost is, what the negative consequences might be, and whether he intends to have another. If after the first drink he decides to have a second, he is expected to repeat that exercise: Why am I going to drink this? What will the effect be? Willl there be any negative consequences, any risks? If so, what are they? Do I intend to have still another one after this?
If he exceeds his daily or weekly limits, he is expected, upon arising the next day, to write a journal entry explaining what happened, and why, and to carefully and honestly contemplate what it might mean.
The MM approach also strongly encourages the person with a goal of moderate drinking to either attend group meetings, or to use "online meetings" to discuss all these issues with others who have the same goals: getting problem drinking under control, without beating themselves or each other up.
Interestingly, among regulars to MM meetings are people who, after a period of experimentation, have decided that they cannot effectively moderate, and who choose to more or less permanently abstain. Yet, while MM openly encourages such people to seek out total-abstention support groups, they are also welcome to stay within MM as members who abstain. Some do so, because they find value in the companionship of others who are committed to lives not controlled or dominated by alcohol, and are happy to support those who eventually decide that moderation won't work for them.
The question many who look at MM have is, "If you think you have a problem, why would you drink at all?" The answers to that question vary with each individual, but they are usually a variation on one of the following:
* I don't like the idea that I am "helpless" and can't control myself. I'd rather learn control.Critics of MM say that if you have a problem with something, you should cut it out of your life forever. They also say that just by suggesting, by even hinting, that total abstinence may not be necessary, they are encouraging alcoholics to "stay in denial" and not help themselves.
* Moderate drinking, if it stays moderate, is healthy and can be a part of a balanced life.
* It's pleasurable to have a beer, or a glass of wine with dinner, once in a while.
* I hate being fearful of a beverage.
* Complete abstinence forever makes me feel like I'm denying myself and makes me want to drink more.
* Alcoholic beverages are as old as civilization itself; Why deny myself one of life's simple pleasures if I can return to healthy control instead?
The response from MM advocates is that people are responsible for their own behavior, and that MM has always advocated total abstinence for some people. But they also point to a large body of research which shows that total-abstinence programs fail far more often than they succeed.
Moderation Management is the only the only national alcohol support organization that does not mandate total, lifelong abstinence. The Moderation Management web site contains more information, including where you can find support meetings, where you can sign up for online support if meetings are not available in your area, FAQs, and links to other resources for people seeking to get drinking problems under control.
For those of you who are curious, I have not decided at this time to follow the MM approach. I am still abstinent and may well stay that way the rest of my life. But I do respect the Moderation Management organization and its goals. If you think you have a drinking problem but do not feel ready to jump into a program of lifelong sobriety, you might want to investigate MM. I have corresponded with many people who report good results with the MM program, including more than a few who found AA intolerable but have been successful for several years now with MM.
If nothing else, exploring what MM has to offer is likely to be a learning experience for anyone wrestling with alcohol issues.
Once again, the Moderation Management web site is right here, and has lots of material worth exploring.
* Update * It has been pointed out by two commenters that the Alcoholics Anonymous organization has a long standing policy of not commenting on other sobriety programs at all, and that AA never issued a condemnation of MM. I therefore retract the above comment. What I should have said was that prominent individuals who advocate for 12-step programs, and organizations that advocate the AA approach, and countless AA members I've met, hae so condemned MM. The AA organization itself, so far as I know, never issued a statement, and I'm sorry I said otherwise.I continue to point out, however, that I've heard Kishline's story told over and over again by AA advocates, virtually all of them failing to acknowledge that Kishline had quit MM and as a 12-stepper in good standing when she killed those people. I also re-iterate that, while I know for a fact that AA has saved lives that seemed otherwise hopeless, it's inappropriate for AA advocates to point to the failures of other programs without acknowledging AA's own shortcomings. The question is not "how do we get people into AA," it's "how do we get people healthy and back in control of their lives?" Dissing other programs is not the way to do that.
I don't think anyone would argue with that, would they?
Just to head a few folks off at the pass:
You are all very welcome to discuss or debate the merits or demerits of the MM approach. I'm happy to provide a forum for anyone who wants to do that. So long as you remain civil, you're welcome to say whatever you want here.
Furthermore, I deeply appreciate the support and counsel of others who are struggling with these issues. But let's try to keep in mind that this is not an AA meeting, and not an invitation to psychoanalyze Dean.
Besides, while I am a boozehound, I have to say that any silly-ass fellow boozehound who falls off the wagon just because I posted information on a drinking moderation program gets what he deserves. I am not responsible for anyone else's recovery, nor do I have any power whatsoever to make anyone pick up a drink.
Thanks in advance for your thoughtful comments on the Moderation Management program, its merits and its down sides--and thank you again for your support. ;-)
No amateur psychologizing and unsolicited pushy advice? What fun is that? I think I'd rather give up drinking.
The key issue here is discernment. There is a difference between alcoholism, heavy drinking, and doing something stupid while drunk. Anyone questioning their drinking needs to understand the difference. (There is also a difference between immaturity and alcoholism, between not having been raised properly and alcoholism, between ordinary human stupidity and alcoholism ... things of this nature.)
Discerning alcoholism from other problems is not an easy process -- too many alcoholics actually are in denial about their alcoholism, and at the same time, too many folks in the rehab industry are pushing folks into AA. The individual drinker needs to make his or her own decision. Anyone who has a question, especially young folks, may want to try MM. Give it a shot. If bringing awareness to your drinking helps, more power to you. If that works over the long term, great. But for others, the only answer may be total abstinence. I know for me, I couldn't be in a group (in the beginning at least) where some folks could occasionally drink ... I'd get too resentful.
I don't believe, for a second, that an alcoholic could possibly learn to control drinking -- but I define an alcoholic as someone who can't do that, so there's really no counterargument. MM seems to agree: Some folks need to quit.
Remember, alcoholism and heavy drinking are just terms we use to describe behavior. Alcoholism is the state (call it a disease if you like) where you simply can't control your drinking. One reason I finally chose AA was I no longer wanted to try to control it. It was too painful ... it was ultimately easier for me to quit altogether, ymmv.
If MM works for someone, then you probably just needed some skills and support to help you deal with alcohol. If it doesn't, the person knows to move to the next group.
The official web site for Alcoholics Anonymous is http://www.aa.org, not the link you listed in your post. And I don't see the statment that condemns MM in the article that it DOES link to.
Just for the record, the usual (Hawaiian) AA response to someone who wants to quit or reduce their drinking is to "try 90 and 90". Ninety days without a drink and ninety meetings. Thirty days is pretty marginal considering how screwed up we can get behind drinking. Three months without a drink allows some clarity to return. Aloha, Hunt
90 days sounds quite reasonable to me. 30 does seem too short.
Meetings I can't do. They have always made me uncomfortable--Alanon, public AA meetings, private AA meetings, really any kind of group meeting for almost any purpose. I'm always uncomfortable in them. I'm just not a social animal in that way.
Come to think of it, I also hate sitting in classrooms full of people. And at work, there's nothing I hate more than sitting in meetings.
Hmm. Think there's a pattern? :-)
Where is this "AA statement." I have never known AA World Service Office to make ANY statement, of ANY kind, regarding other methods of recovery.
Certainly most AA members regard MM methods ludicrous for alcoholics, although they may help non-alcoholic problem drinkers cut down. The difference being of course, that AA terms an alcoholic ONLY one who cannot control his drinking after many attepts to do so, which makes MM inappropriate by definition. AA's also generally view the continuous search for such "cut-back" methods by alcoholics at once understandable and pathetic.
But AA WSO has a 70-year-old practice of not endorsing or opposing other methods.
Link, please.
Kevin: Don't have a link for you, so I'll have to update the article. I recall very well when Kishline had her accident, how countless prominent 12-step advocates and AA members condemned her, but I don't recall AA itself releasing anything official.
As you might notice, however, the link I gave goes to a major 12-step advocacy web site. This is common, and was quite common when Kishline killed those people: countless prominent individuals and groups who believe in the 12 steps used it as an excuse to attack MM. But I'm prepared to believe that the AA organization itself never officially took a position. That seems consistent with their record.
Mind you, it would certainly be nice if the official AA web site would issue a statement clearly saying that it doesn't endorse the views of those AA members and advocates who condemn Moderation Management. But they arent't required to do that, and shouldn't be accused of saying things they didn't.
I will repeat my observation, however, that the attacks on MM were vociferous when Kishline had her accident, and 12-step advocates still bring up her story as if it's proof that MM is a worthless program. To me, they appear to lack the ability to take an honest inventory and ask themselves if they're being fair. Certainly, if they really cared to learn the truth, they'd know that Kishline was an AA member and following the 12 steps when she killed those people.
By the way, our friend Timmer, above, recently sent me a nastygram telling me he would never read my site again, accusing me of not being serious about recovering, and casting dark aspersions at all the prominent groups that question the universal applicabilitiy of AA principles, suggesting that they all have a secret, hidden monetary agenda. Mind you, he gave no proof of that whatever, but told me if I just "did some research" then I would learn the truth.
I hope folks like Timmer know that every time they act like that, they make me more certain than ever that I've made the right choice.
To me, they appear to lack the ability to take an honest inventory and ask themselves if they're being fair. Certainly, if they really cared to learn the truth, they'd know that Kishline was an AA member and following the 12 steps when she killed those people.
Hmm...it seems to me that Audrey Kishline was not an AA 12-stepper in good standing. It's not a club you join like a country club and they just need to check the files and declare, "Oh yes, your paperwork is in order. What time would you like to tee off?"
You are a member of AA if you have a desire to stop drinking and want AA's help following through. If you no longer have both those qualities, you're not in AA.
Ms. Kishline tragically ignored Step One and people died. Surely you see the irony that the founder of MM had a tragic drunken driving accident. You are correct to point out she had already left the MM program, which mitigates some of the irony.
What you are missing is she left the AA program when she picked up her first drink. She was not following the steps, specifically step one, the part about not drinking. So there is no reason to fix blame on either program. When folks drink, we call that, "Going out." That means they left.
Ms. Kishline is a reminder to all of us what happens when alcoholics drink. Tragedies can happen. It nearly happened to me. I woke up in the holding tank in Las Vegas County Jail one morning in early 1988 from a blackout. The only parts of the night I remembered were squealing brakes, flashing lights, a crashing sound, and some details about getting arrested.
After I was awake in the tank about an hour the TV news came on. There was a story about a family that was killed by a drunk driver the previous night. In Las Vegas. Now, I don't want to make this too dramatic ... I was halfway sure it wasn't me, but only halfway. The police wouldn't tell me anything. Even then I recognized something: There was no difference between the drunk that killed those people and me. Not one bit of difference but luck.
Later, I found out that the crashing sound I recalled occurred was a fender bender in a parking lot. The lights and brakes squealing occurred a few minutes later. It turns out I bumped a car in the parking lot, and then a minute later ran a red light and nearly caused a head-on collision. Fortunately, it occurred right in front of a cop. He arrested me. Probably saved lives.
Guess what? Even after that wake-up call, I drove drunk. Several times.
To me at least, what we're dealing with is lives. Not this program or that program or this way of getting sober or that way of getting sober. I wasn't in AA at the time I pulled my stunt in Las Vegas. I was just a garden-variety alcoholic. A few months after Vegas, when I realized that I was not going to stop drinking to excess and not going to stop driving while drunk, I made my decision.
In sobriety, for me, the stakes are high: If I drink, I may lose control. If I lose control, I may drive. If I drive, I may kill innocent people. And that doesn't have a damned thing to do with the 12 steps or AA or MM. It has to do with my duty to stay sober to keep drunk Bill off the road.
Oh, I grant all of that. I merely note that 12-step advocates--such as the folks who run the 12-step advocacy web site I linked to--have frequently tried to use Kishline's actions as an attack on alternate programs. This is simply not appropriate.
I suppose you're right that she wasn't a 12-stepper "in good standing" if she was drinking. Then again, she admitted she had a problem and she was powerless, and that is step one, and she was attending meetings and trying to abstain completely.
You know, whatever. It made national news and a LOT of advocates for AA and other 12-step program advocates used it as a club to beat the drinking moderation movement. It thus seems appropriate to point out where Kishline REALLY was in her life when this happened.
I consider it tragic and irrelevant to either organization. I merely object to double-standards; if we're going to point to people who fail on this or that program, we have to be willing to people who fail on any program. Hell, I have a neighbor who used to go to AA meetings and then after meetings every day would go get drunk with his sponsor. The phrase "unclear on the concept" comes to mind. %-)
That's pretty funny about the sponsor.
Actually, Step One is really about stopping drinking....yes, you admit you're powerless. Clearly if you start drinking, you're not admitting powerlessness*. It's counter-intuitive thinking, so I've interpreted it more simply. Step One: Don't drink. Works for me.
I ain't trying to give you too hard a time. If you still have any sense of humor at all around this point, you're doing very well.
* I'm ignoring here the person who drinks because they declare their powerlessness ... that's just self-pity wrapped up in a suicide fantasy and regression to childish narcissism (See Leaving Las Vegas, where mommy nurses drunk to the grave). Totally different story from an admission of powerlessness while still affirming life (See Caroline Knapp's A Drinking Life).
I think you mean "Drinking: A Love Story" by Caroline Knapp, which I understand was somewhat inspired by Pete Hamill's "A Drinking Life."
Knapp's book is on my Wish List. For some reason the Hamill book doesn't attract my interest although I've heard raves about it.
Oops. Knapp's book is good, though, or it seemed so the day I read it. Hamill's book I picked up but didn't want to read, not sure why. Kinda like you.
On your wish list? OK, done. Enjoy the read :)
Ummm...
"The only requirement for membership is an honest desire to stop drinking."
- Alcoholics Anonymous
Ah, c'mon, let's not get too cute here. By that logic, I suppose you can say that AA has a 100% success rate, as once anyone fails, he has already left, by definition. That logic could prove all sorts of wacky things, e.g., terrorism violates certain tenets of Islam, therefore, there are no Islamic terrorists. A less cute, but more accurate statement is that Kishline tried two approaches to dealing with her own drinking problem, and neither of them worked for her.
Personally, I see AA and MM as a case of apples and oranges. AA's total abstinence model is appropriate for the hard core addicts who should not consume any booze, ever, but offers nothing for those who can drink responsibly, and simply don't.
Not drinking responsibly when one can seems like a bit of an oxymoron. I remember back in the days when I was just a "heavy drinker" that I found tables that indicated that as long as I only had one drink an hour, my blood alcohol level would remain legal. I could do that easily, therefore I wasn't an alcoholic.
The fact that I was constantly slightly toasted didn't seem to slow down things like flying, surfing and driving and even seemed to help keep my creative juices flowing - hey that sounds like responsible drinking to me.
That actually seemed to work for a while, but alcoholism is a progressive "condition" you know. Aloha, Hunt
Sounds like you were a responsible drinker who eventually decided he just plain needed to quit, Hunt.
Interestingly, my grandfather was a pretty heavy drinker until he hit his late 30s. Had a mild heart attack and realized it was also interfering with his professional and family life. Had one last beer, put it down firmly, and never had another drink until the day he died, nearly 40 years later.
No groups. No psychologists. No drugs. No treatment programs. Just, "I don't drink anymore," and never did.
He didn't manage to give up the cigarettes for another 20 years, but the funny thing was, he one day had breathing trouble, almost passed out. Didn't go to a hospital, but when he finally got back under control, he walked into the house, took his last pack of cigarettes, threw it so violently and hard into the trash can that it made a loud "BOOM!" and hurt his shoulder--and he never smoked another cigarette as long as he lived.
Hell of a guy, my grandfather. I still miss him bad.
"Not drinking responsibly when one can seems like a bit of an oxymoron."
I disagree. People do irresponsible things all the time. Sometimes they act out of compulsion, sometimes out of lack of personal discipline. I don't think all problem drinkers fall into one camp or the other.
Xrlq - But perhaps you would agree that they all have a problem?
Dean - In my own case I don't think I was responsible so much as very talented and damn lucky.
Hey Dean...
Good coverage of MM. I connected with it almost four years ago, and it's worked out great for me.
It's not easy to compare MM and AA in large part because it's a self-directed process based on guidelines, not a fixed-in-stone program. The core concept is to get folks thinking and talking about how they want to live healthy, balanced lives (not just whether or not to drink).
In round numbers, 30% of the folks who try MM find that it doesn't work for them, and they move on to long-term abstinence. A lot of those who take that route, though, report that MM helped them make peace with the idea that abstinence would be the best fit.
I'm launching a website next week on the topic of living sensibly with alcohol... click on my name below to take a sneak peek!