‘Charlie Sheen and the art of beating addictions’

My piece on alternatives to AA, from today’s Independent:

Addicts are increasingly questioning the 12-step message of sobriety from Alcoholics Anonymous. Are they on to something?

My name is Catherine, and I’m a Charlie Sheen addict. Since the madness started, I’ve seen almost every moment of Sheenmania. I watched him pop up in a web episode of Sheen’s Korner, looking like the corpse in Weekend at Bernie’s after a couple of days in the sun, ranting about trolls ruining phone service.

I’ve seen the poolside interviews with his “goddess” porn star and former nanny, and the outbursts in which he blasted his bosses at CBS over the loss of his show Two and a Half Men.

But some of his angriest rants were reserved for what he referred to as the “troll hole” of Alcoholics Anonymous (AA). In one interview, he tore up the pages of the AA handbook, which he’s called “a silly book written by a broken-down fool who is a plagiarist”.

According to Charlie, alcoholism isn’t a disease.

“I have a disease?” he’s said. “Bull****. I cured it right now with my mind.”

He may have referred to himself as a “rock star from Mars”, but saying that an addict is NOT helpless in the face of his brain chemistry is probably the most lucid thing he’s said in weeks.

Now I feel like I’m the crazy one, because Charlie Sheen is starting to make sense. Because contrary to what the talking-head television therapists have been saying, addiction doesn’t have to end in rehab or death. In fact, some figures show that most drug addicts stop doing drugs without help.

According to America’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), 75 per cent of drinkers quit on their own, and many heavy drinkers do not have alcohol dependence. An NIAAA official made the statement that alcoholism “isn’t usually” a “chronic, relapsing disease”.

On the surface, Sheen’s porn-star-and-juice detox seems dubious. But Pax Prentiss, co-founder of the Passages Addiction Cure Centre in Malibu, California, says: “He did pee clean. He may have stopped and he may stay stopped. But if you take Charlie out of the picture, there are people who just stop using. In those cases, what happened to the disease?”

Prentiss and his father have been called the “Holocaust deniers of the addiction-recovery movement”, because they believe that alcoholism and drug addiction can be cured.

As Charlie Sheen’s soundbites sound more like Charlie Manson’s, it’s obvious that he needs some type of help. If AA defines insanity as doing the same thing over and over again – and Sheen has been going to rehab for more than two decades – it may be time to try another tactic. But anything other than admitting that you are powerless over your addiction is referred to in AA-speak as being “in denial”.

Celebrity meltdowns are supposed to follow a pattern. First comes the breakdown, and then the celebrity’s publicist suggests that it would be better for everyone if they go to rehab.

The 12-step philosophy has been so ingrained in our cultural philosophy that it’s been parroted on shows such as Intervention and Celebrity Rehab, which is like Celebrity Big Brother with methadone. We’ve seen it all before: the family members tearfully reading letters about how their loved one’s behaviour is affecting everyone, the threatening to stop enabling, and, eventually, tears and hugs.

But Charlie isn’t hugging it out. Instead, he’s waving a machete from a rooftop, becoming a Twitter star and pitching a talk show. P Diddy, never one to miss a promotional opportunity, has even created a Tiger Blood cocktail – a mixture of red berry Ciroc and cranberry juice, in case you were wondering.

Maybe people are fascinated with Sheen because he’s putting two fingers up to a touchy-feely therapeutic industry that says that in order to kick drugs, we have to surrender to a higher power and be humble. “In America, we look at things in very black-and-white, religious terms. So people look at Charlie Sheen with the porn stars and the drugs and they are having a moralistic reaction,” says Stanton Peele, an addiction specialist and author of 7 Tools to Beat Addiction.

“He may be an a**hole, but can he get off the drugs? Those are two separate issues.” Peele writes about the importance of choice and alternatives to AA, including motivation enhancement and Zen Buddhist techniques. “Can you imagine if the government put up billboards that said, ‘Many people quit on their own. Why don’t you try?'”

While I have never been part of Alcoholics Anonymous, I have a long history with the programme. Several of my friends are in it, with varying degrees of success, and I’ve seen it work wonders. It can save lives.

But it’s also not for everyone.

I knew that I couldn’t ever buy the “disease” model the first time I dated a recovering alcoholic. Even after 10 years sober, he went to meetings every day and constantly talked about his brain disease, and the days when he was so messed up that he couldn’t get out of bed to use the loo. He’d even kept the rank bottles he peed in as a reminder of how low he had sunk in his “wild days”.

Maybe it was just me, but he didn’t seem free from addiction at all. In fact, he seemed totally obsessed with alcohol. Of course, being fixated on AA meetings was obviously better than lying in the gutter, but why are 12-step programmes so often publicised as the only alternative?

But this “all or nothing” mentality reflects America’s binge-drinking culture. It’s either about pounding shots, or going cold turkey. While countries in some parts of Europe have experience with harm-reduction therapies, the US doesn’t do temperance.

Martin Sheen tearfully explained that his son’s illness was like cancer. I know that addicts’ brains are wired differently, but they still have the element of choice. So is picking up a beer comparable to getting a malignant melanoma?

“If it was a disease, it’s the only disease that you can quit,” Prentiss says. “I think that it needs to be taken as seriously as cancer because addiction can kill you. You can’t quit cancer, Aids, or hepatitis C.”

Members of AA point out that it never claims to be the only way to recovery. I heard “Take what you need and leave the rest” at several meetings I attended with my then-boyfriend.

Charlie isn’t the only addict who doesn’t buy into the idea that he’s powerless over his addiction. There are more and more alternatives to AA cropping up all over the country. But they don’t get much airtime.

“Alcoholics Anonymous, in my opinion, promotes sickness,” Prentiss says. “People don’t want to say that they are addicts and alcoholics. Once somebody buys into the ‘disease’ concept, it’s a dead-end road that leads nowhere, because once you believe that you have it, you’re stuck with it, and it stops you from looking for the real underlying causes that cause addiction.”

Prentiss believes that fighting alcoholism involves: 1) Giving people their power back, 2) showing them that it’s a choice, and 3) identifying the “underlying causes”, which he labels as trauma, depression, low self-esteem, or chemical imbalances such as bipolar disorder or attention deficit disorder, among others.

Who knows what Charlie’s underlying cause is? Maybe he can’t form meaningful relationships with women that aren’t transactional. All of his relationships either seem to end in divorce settlements, lawsuits, or banknotes on the bedside table. And I definitely believe that Sheen could benefit from a psychiatric evaluation, rather than a talking-head “bipolar” diagnosis from a television therapist. Perhaps someone who is not trying to get him to buy into any higher power other than Charlie Sheen could relate to him before it’s too late. After all, there are lots of sober, egocentric narcissists in Hollywood.

“What they teach in AA is that if you stop going to meetings, you will relapse. If you stop calling your sponsor, you will relapse. That’s a programme that’s not working,” Prentiss says.

AA has remained the mainstay of treatment since the 1930s in the US because it came first. And because it’s free, and easily accessible. This second point was not lost on me as I drove out of Passages’ lush grounds and admired the sparkling Pacific Ocean views. I thought about the steep price tag attached to all that one-on-one therapy (tens of thousands of pounds per month) and could see the benefit of AA, especially in an era of huge health-insurance costs.

But there are cheaper alternatives. Some programmes like Moderation Management offer support for those who want to taper their drinking or seek to quit entirely; other have a goal of total abstinence.

After calling AA “stupid”, Sheen has also said that he hated them “violently”, and added, “they will come at me”.

So is there any truth to my AA friends’ joke that the group is “the sober mafia”? I have coffee with a friend, an entertainment-industry executive in his forties, who says he kicked cocaine and alcohol 15 years ago with a programme that emphasised cognitive behavioural therapy and small group meetings, to find out.

“I walked into the first AA meeting and immediately knew I couldn’t do it,” he says. “Being told that I had a disease, and would have it for the rest of my life made me feel totally deflated, and I thought, ‘What’s the point?’ Having said that, a lot of my friends are in the programme [AA] and it works for them. But you’re either ‘in with the group’, or you’re not. I definitely think that some of them either are jealous of me because I can have a glass of wine with dinner, or think I’m ‘in denial’ because I’m not working the steps. It’s like my sobriety isn’t as ‘pure’ as theirs. But I ignore that, because I haven’t done drugs for 15 years. And that was my goal.”

“It goes back to our preamble, which says that we’re not allied with any sect or denomination and we don’t seek any controversy,” says the public information co-ordinator at Alcoholics Anonymous World Services in New York. “Our primary purpose is to help people get sober, and we sail a very neutral path. We recognise that there are a number of paths out there, and we have absolutely no opinion on them.”

Officially, it is neutral. According to my friend, the pressure to stay sober and work the steps can be intense.

“They say that you are powerless over drugs and alcohol. I say it’s a choice, and I can prove it right now,” Prentiss says. “If I had somebody in here who was dependent on alcohol and a member of AA who said, ‘He’s powerless to stop,’ I’ll put a glass of alcohol in front of him and I say, ‘OK, I’m going to put a gun to your head, and if you drink it, I’m gonna shoot you. What do you think he’d do?’ If he says ‘No’, that’s not powerless. That’s totally capable of stopping at any moment.”

Hopefully, Sheen will seek help before the media circus spirals any more out of control. There are plans for a Charlie Sheen comic book in the works, but if he’s not careful, the story could turn into a Shakespearean tragedy very quickly. AA members would probably say that he has to hit rock-bottom; Sheen says, “Rock-bottom is a fishing term.” So I’m not holding my breath.

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