Specials res in speciDal izatin for aloholic physicians Eleanor LeBourdais In the summer of 1949 Clarence P., a physician living in Cape Vincent, NY, sent a letter to a few colleagues suggesting a discreet meeting in the loft above his garage. The people who responded had one thing in common: they were all recovering alcoholics who were interested in helping themselves and other professionals stay sober. By 1949 Alcoholics Anonymous (AA), the self-help fellowship group for recovering alcoholics, had already been demonstrating for 14 years that by working together, alcoholics could help one another attain and maintain sobriety. In the meantime, Clarence P. had become aware that physicians shared problems and professional concerns that were beyond the Eleanor LeBourdais is a freelance writer in Port Moody, BC.
International Doctors in Alcoholics Anonymous was launched in the loft of a doctor's garage in 1949. Today it has 3800 members living in more than 12 countries, including Canada.
ken of other AA members and difficult to discuss at the average AA meeting. The initial response to his idea suggested that many health care professionals felt they could benefit from mutual support and consultation with their peers; time quickly proved him right. By the summer of 1991, his inaugural meeting of International Doctors
in Alcoholics Anonymous (IDAA) had expanded to a multinational fellowship of 3800 health care professionals living in more than 12 countries. Although most members are physicians, IDAA's membership includes other health care professionals at the doctoral level: nurses, chiropractors, dentists, osteopaths, veterinarians and psy-
chologists, as well as retired professionals and students preparing for doctoral degrees. Many find they have shared problems and difficulties. "There are many problems another doctor may be able to solve if he hears how I solved my problems: talking to my patients about my alcoholism, dealing with my partners or hospital staff, how I handle narcotics in my office, any number of things that people don't normally have access to at a regular AA meeting," explains Harold, a physician and alcoholism counsellor in the southern US. A highlight of IDAA membership is the annual meeting, where members gather, usually in August, to share their experiences, strength and hope, and address common problems and solutions. "Through association with our group, many of us have become better able to solve our common problem, which is alcoholism, and our problems in common," says Harold. Between the annual gatherings, IDAA provides members with a directory of more than 100 weekly doctors-in-recovery meetings in the US and Canada that
There are many problems another doctor may be able to solve if he hears how I solved my problems: talking to my patients about my alcoholism, dealing with my partners or hospital staff, how I handle narcotics in my office." - Dr. Harold anyone can attend. It also provides a listing of regional yearly meetings that often enhance recovery in regular AA. IDAA also helps locate and set up meetings between individual practitioners if all parties involved want that. A
strictly confidential listing of members is held and maintained by the secretary-treasurer. Harold likens IDAA's annual gathering to the "frosting on a cake," a celebration of the work that goes on back in members' home communities. "What keeps people sober is the regular AA meeting they go to with everybody else who is seeking sobriety. I
think we owe our recovery to working the 12-step program of mutual help that people find now in every small hamlet and every large city in the world." Although most IDAA members live and work in the US, Canadians have participated every year since that first meeting in 1949. Toronto played host to the assembly in 1961; Vancouver was host in 1983 and again last year. Membership increases by some 500 professionals each year; a substantial number show up and join during the annual conference. The international nature of IDAA's membership is reflected
RITIS THERAPY THAT OFFERS EFFICACY AND
"If I don't go to meetings I turn into a basket case" As health care providers, physicians are trained to diagnose and treat patients who have alcohol or drug problems. However, medical school curricula and stereotypes of addicts found in television programs and movies often limit physicians' ability to identify their own chemical dependency. "I knew that alcohol was causing some problems," says Louise, a general practitioner in her mid-40s, "but my husband was really the only one who complained about my drinking. I didn't miss time from work, and not really knowing what an alcoholic looked like, I was pretty sure I wasn't one." What Louise did know was that her life had become unbearable. "Even though I had a lot of money and cars in my driveway, I'd reached a state of complete psychological and spiritual bankruptcy. Yet none of that showed; my patients weren't aware of it and my colleagues weren't aware of it."
"I didn't miss time from work, and not really knowing what an alcoholic looked like, I was pretty sure I wasn't one." -
Dr. Louise
In desperation, she finally checked herself into Toronto's Donwood Institute, still unable to see alcohol as the problem. "I was starting to think that if things got any worse, I'd kill myself. I didn't know what else to do." At the Donwood, Louise's perception of alcoholism changed. She began going to
Alcoholics Anonymous (AA) meetings, but as a physician she often felt isolated from other members. "You get emotional support and have a lot of things in common with the other people, but there were certain things I just couldn't share at AA meetings." Unaware at that time that International Doctors in Alcoholics Anonymous existed, Louise managed to locate a few other physicians who also felt a need for peer support, and they set up their own monthly meeting. "We and our spouses met on a Saturday afternoon, driving from all over to reach this central community. I think it was a high point in the recovery process for all of us." Although she has been alcohol-free for 7 years, Louise still feels its influence. "I would say now my alcoholism still impairs me from time to time, not that I ever drink. But if I don't go to meetings, I turn into a bit of a basket case."
m
'U
in members' geographic distribution - annual meeting participants sometimes converge from as far away as Great Britain, Germany, Russia, Spain and South and Central America. Attendance topped 1000 at the 1988, 1989 and 1990 meetings, but dropped to about 600 at last year's meeting in Vancouver. The format of the meeting has changed slightly since 1949 but continues to maintain the essentials of fundamental AA methods, focusing on a range of topics suggested by participants in previous years. Much of the emphasis is on family dynamics and the participation of family members of all ages. Small-group sessions may look at any number of special-interest topics, from communication and dealing with anger to sexuality and other issues of direct interest to doctors in recovery. Also, scientific presentations that provide continuing medical education credits address state-ofthe-art advances in the field of alcoholism and related diseases and help health care professionals keep abreast of current knowledge. Last August's meeting in Vancouver, cosponsored by the College of Family Physicians of Canada, included discussion of
ON
the diagnosis and treatment of the dual-diagnosis patient, and an update on genetics and alcoholism. Like AA, IDAA members pay no dues and there is no fee structure beyond a modest registration fee during the annual meeting; it covers meeting costs, expenses for the year and a contribution to the AA general service office in New York. The sole membership requirement is the desire to belong. Despite the size of IDAA's annual gatherings, Harold says costs have been surprisingly low "for a meeting of this magnitude - the overhead is probably smaller than for any other comparable group." The organization has little difficulty drawing speakers and experts in the addiction field who are willing to donate their time and expertise. "People who appreciate the recovery they enjoy or the camaraderie aren't particularly interested in charging a large fee to come and speak," he says. Harold says the anonymity that is the hallmark of AA has enabled prominent practitioners to feel comfortable in getting involved with IDAA: "We have had some very daring and influential
people in medicine grace our roster, people who have done pioneer work in many fields of medicine." The confidentiality of IDAA's membership is so absolute that even Bill W., one of the cofounders of AA, was denied access to it. Harold tells how Bill W. once tried to get the IDAA membership mailing list from the secretarytreasurer in order to send physicians some information. "He wanted alcoholics to try niacin to help them in their recovery," Harold says. "He was refused access to the membership roster." IDAA's 5-day annual meeting includes a broad range of unstructured social activities that Harold suggests are the essence of alcoholism recovery. "Probably the most influential things happen on boat cruises, around a coffee cup, or up in the hospitality room, when one recovering person shares his story with another. You don't learn it from attending some seminar so much as from experiencing it and doing it. That's really what recovery is all about." Membership information about IDAA is available from Dr. C. Richard McKinley, SecretaryTreasurer, PO Box 199, Augusta, MO, 63332; (314) 781-1317..
CARTILAGE PROTEOGLYCAN SYNTHESIS.
I
International Doctors in Alcoholics Anonymous was launched in the loft of a doctor's garage in 1949. Today it has 3800 members living in more than 12 countries, including Canada.
ken of other AA members and difficult to discuss at the average AA meeting. The initial response to his idea suggested that many health care professionals felt they could benefit from mutual support and consultation with their peers; time quickly proved him right. By the summer of 1991, his inaugural meeting of International Doctors
in Alcoholics Anonymous (IDAA) had expanded to a multinational fellowship of 3800 health care professionals living in more than 12 countries. Although most members are physicians, IDAA's membership includes other health care professionals at the doctoral level: nurses, chiropractors, dentists, osteopaths, veterinarians and psy-
chologists, as well as retired professionals and students preparing for doctoral degrees. Many find they have shared problems and difficulties. "There are many problems another doctor may be able to solve if he hears how I solved my problems: talking to my patients about my alcoholism, dealing with my partners or hospital staff, how I handle narcotics in my office, any number of things that people don't normally have access to at a regular AA meeting," explains Harold, a physician and alcoholism counsellor in the southern US. A highlight of IDAA membership is the annual meeting, where members gather, usually in August, to share their experiences, strength and hope, and address common problems and solutions. "Through association with our group, many of us have become better able to solve our common problem, which is alcoholism, and our problems in common," says Harold. Between the annual gatherings, IDAA provides members with a directory of more than 100 weekly doctors-in-recovery meetings in the US and Canada that
There are many problems another doctor may be able to solve if he hears how I solved my problems: talking to my patients about my alcoholism, dealing with my partners or hospital staff, how I handle narcotics in my office." - Dr. Harold anyone can attend. It also provides a listing of regional yearly meetings that often enhance recovery in regular AA. IDAA also helps locate and set up meetings between individual practitioners if all parties involved want that. A
strictly confidential listing of members is held and maintained by the secretary-treasurer. Harold likens IDAA's annual gathering to the "frosting on a cake," a celebration of the work that goes on back in members' home communities. "What keeps people sober is the regular AA meeting they go to with everybody else who is seeking sobriety. I
think we owe our recovery to working the 12-step program of mutual help that people find now in every small hamlet and every large city in the world." Although most IDAA members live and work in the US, Canadians have participated every year since that first meeting in 1949. Toronto played host to the assembly in 1961; Vancouver was host in 1983 and again last year. Membership increases by some 500 professionals each year; a substantial number show up and join during the annual conference. The international nature of IDAA's membership is reflected
RITIS THERAPY THAT OFFERS EFFICACY AND
"If I don't go to meetings I turn into a basket case" As health care providers, physicians are trained to diagnose and treat patients who have alcohol or drug problems. However, medical school curricula and stereotypes of addicts found in television programs and movies often limit physicians' ability to identify their own chemical dependency. "I knew that alcohol was causing some problems," says Louise, a general practitioner in her mid-40s, "but my husband was really the only one who complained about my drinking. I didn't miss time from work, and not really knowing what an alcoholic looked like, I was pretty sure I wasn't one." What Louise did know was that her life had become unbearable. "Even though I had a lot of money and cars in my driveway, I'd reached a state of complete psychological and spiritual bankruptcy. Yet none of that showed; my patients weren't aware of it and my colleagues weren't aware of it."
"I didn't miss time from work, and not really knowing what an alcoholic looked like, I was pretty sure I wasn't one." -
Dr. Louise
In desperation, she finally checked herself into Toronto's Donwood Institute, still unable to see alcohol as the problem. "I was starting to think that if things got any worse, I'd kill myself. I didn't know what else to do." At the Donwood, Louise's perception of alcoholism changed. She began going to
Alcoholics Anonymous (AA) meetings, but as a physician she often felt isolated from other members. "You get emotional support and have a lot of things in common with the other people, but there were certain things I just couldn't share at AA meetings." Unaware at that time that International Doctors in Alcoholics Anonymous existed, Louise managed to locate a few other physicians who also felt a need for peer support, and they set up their own monthly meeting. "We and our spouses met on a Saturday afternoon, driving from all over to reach this central community. I think it was a high point in the recovery process for all of us." Although she has been alcohol-free for 7 years, Louise still feels its influence. "I would say now my alcoholism still impairs me from time to time, not that I ever drink. But if I don't go to meetings, I turn into a bit of a basket case."
m
'U
in members' geographic distribution - annual meeting participants sometimes converge from as far away as Great Britain, Germany, Russia, Spain and South and Central America. Attendance topped 1000 at the 1988, 1989 and 1990 meetings, but dropped to about 600 at last year's meeting in Vancouver. The format of the meeting has changed slightly since 1949 but continues to maintain the essentials of fundamental AA methods, focusing on a range of topics suggested by participants in previous years. Much of the emphasis is on family dynamics and the participation of family members of all ages. Small-group sessions may look at any number of special-interest topics, from communication and dealing with anger to sexuality and other issues of direct interest to doctors in recovery. Also, scientific presentations that provide continuing medical education credits address state-ofthe-art advances in the field of alcoholism and related diseases and help health care professionals keep abreast of current knowledge. Last August's meeting in Vancouver, cosponsored by the College of Family Physicians of Canada, included discussion of
ON
the diagnosis and treatment of the dual-diagnosis patient, and an update on genetics and alcoholism. Like AA, IDAA members pay no dues and there is no fee structure beyond a modest registration fee during the annual meeting; it covers meeting costs, expenses for the year and a contribution to the AA general service office in New York. The sole membership requirement is the desire to belong. Despite the size of IDAA's annual gatherings, Harold says costs have been surprisingly low "for a meeting of this magnitude - the overhead is probably smaller than for any other comparable group." The organization has little difficulty drawing speakers and experts in the addiction field who are willing to donate their time and expertise. "People who appreciate the recovery they enjoy or the camaraderie aren't particularly interested in charging a large fee to come and speak," he says. Harold says the anonymity that is the hallmark of AA has enabled prominent practitioners to feel comfortable in getting involved with IDAA: "We have had some very daring and influential
people in medicine grace our roster, people who have done pioneer work in many fields of medicine." The confidentiality of IDAA's membership is so absolute that even Bill W., one of the cofounders of AA, was denied access to it. Harold tells how Bill W. once tried to get the IDAA membership mailing list from the secretarytreasurer in order to send physicians some information. "He wanted alcoholics to try niacin to help them in their recovery," Harold says. "He was refused access to the membership roster." IDAA's 5-day annual meeting includes a broad range of unstructured social activities that Harold suggests are the essence of alcoholism recovery. "Probably the most influential things happen on boat cruises, around a coffee cup, or up in the hospitality room, when one recovering person shares his story with another. You don't learn it from attending some seminar so much as from experiencing it and doing it. That's really what recovery is all about." Membership information about IDAA is available from Dr. C. Richard McKinley, SecretaryTreasurer, PO Box 199, Augusta, MO, 63332; (314) 781-1317..
CARTILAGE PROTEOGLYCAN SYNTHESIS.
I
