By Tom Holmes
"Many people will make New Year's resolutions to quit smoking," said Jim [to respect the principle of anonymity, all names in this article have been changed], "and a lot won't keep them. Not if they don't join a support group like Nicotine Anonymous.
"I've quit several times with the help of 12-step programs," he explained, "but six months into recovery, I begin thinking I have it beat, and I drift away from attending meetings. That's when I relapse. One humorous slogan in NA is that you have to 'stay in the herd' if you really want to remain nicotine-free."
The holidays, he said, are especially difficult for people addicted to a substance or a behavior because the season is stressful and can stir up painful memories or loneliness. The temptation is to regress and use smoking or drinking or eating to make you feel better … temporarily.
This week in the Oak Park/River Forest/Forest Park area, 350 12-step meetings have been scheduled — Overeaters, Nicotine, Gamblers, Shopaholics, Narcotics, Families and Alcoholics Anonymous along with Al Anon. There are even two AA meetings specifically for atheists and agnostics.
The large number of meetings is a testimony to the number of people who suffer from one addiction or another. The National Institutes of Health reports that about 7 million Americans could be labeled as alcoholics. The quantity of meetings also bears witness to the fact that 12-step programs work.
Amy began going to OA (Overeaters Anonymous) meetings just recently. "When I got up in the morning," she said, "the first thing I would think of is 'do I have anything sweet in the house?' and I felt anxiety if I did not. I became aware of behaviors like eating sweets in secret. When I weighed myself, it was the most I had ever weighed. I knew immediately that I needed help. Desperation was what pushed me through my resistance to attending my first OA meeting."
Amy's story illustrates the first of the 12 Steps to Recovery: "We admitted that we are powerless over food [or alcohol or drugs or sex or gambling or nicotine or shopping] that our lives had become unmanageable."
Jim's motivation to join NA was similar to Amy's first step into OA. "When I smoke," he said, "I get heart palpitations and my blood pressure goes up. I smoke to relieve stress but because nicotine is a stimulant, it actually makes me more nervous. I have trouble sleeping because I get so hyped up. When I tried to quit on my own, I stopped buying cigarettes, so I wouldn't have a pack with me. But the craving was so strong that I would bum cigarettes from friends. I even found myself looking for butts in the sand in those cigarette disposal containers."
Phil is a sex addict as well as an alcoholic. He recalled a Christmas Eve years ago when he "had to have" some pornography. "I drove to an adult bookstore, and when I found the store closed, I cursed the store. 'Damn you!' I said and then I said to God, 'is this all there is?'"
Phil said the 12-step meeting he attends is 80 percent LGBT. "Being completely honest," he said, "is essential to working a successful program, but honesty is particularly tricky for gay men. Honesty means coming out, first to yourself and then other people. Anonymous sex can no longer be a part of your life. So when I'm finally out of the closet, I want to live an honest, open life, but in this society, how do I do that? For me, having people in a meeting who understand me is very supportive."
Mike, who is an alcoholic, emphasized the importance of honesty and doing the first step to the best of one's ability. "I've hit several bottoms over the last 20 years," he recalled, "because I was not using the program to the best of my ability. With the program, it's all or nothing. Otherwise at the very best you will live the life of a dry drunk. That's what we call people who abstain from alcohol, but their lives are so miserable that they might as well take a drink. You have to look in the mirror and ask if you are doing everything you can to be a better person."
Mike repeated, "With the program, it's all or nothing," then added, "With God, it's all or nothing," a statement that can serve as a segue to the second and third of the 12 steps: "Came to believe that a Power greater than ourselves could restore us to sanity" and "Made a decision to turn our will and our lives over to the care of God as we understood Him."
Amy especially appreciates the "as we understood Him" clause in the third step. "I knew I needed something beyond myself to help me," she said, "but the word God has negative connotations for me. OA uses 'Higher Power.' I get that, but I don't relate to that well either. The term 'Higher Spirit' fits for me, the same Spirit that created nature. That's where I sense something higher than myself anyway. In OA, I think, there's freedom and encouragement to make this personal in a way that fits for you."
Jim, like Amy, has modified standard practice in 12-step meetings to personalize the traditions for himself. "I reworded the Serenity Prayer, used at a lot of meetings," he said. "When I have strong urges to smoke, I pray, 'Dear God, please take away my cravings. When I have them, give me the courage not to pick up a cigarette.' I repeated that like a mantra and it would help a lot." He also attends meetings online at Voices of Nicotine Recovery.
Although Phil admits to still carrying a lot of resentment toward the Catholic Church for its "hostility" toward LGBT people, he freely uses the word "God" in a relatively orthodox way when talking about the second and third steps.
"Reaching my bottom," he declared, "was the most significant spiritual experience in my life. God has come into my life and raised me up from this bottom. What was most important spiritually in my life was putting my knees on the floor on Jan. 29, 1999, and I said to God, 'I can't live this way anymore. Help me.' And it's as if He said, 'OK. Finally you're being honest. I'll help you.' And He did."
Mike often quotes Alcoholics Anonymous — the Big Book or the Alcoholics Bible as many members refer to it — when answering questions about the 12 steps because rigorously following the program outlined in the Big Book is the only way he can live "happy, joyous and free."
When it comes to the Higher Power's place in recovery, the Big Book is paradoxical. On the one hand it asserts, "The first requirement is that we be convinced that any life run on self-will can hardly be a success. But there is One who has all power — that One is God. May you find Him now! Half measures availed us nothing."(pp. 59-60)
On the other hand, it states, "Do not be discouraged. No one among us has been able to maintain anything like perfect adherence to these  principles. We are not saints. The point is, that we are willing to grow along spiritual lines."(p. 60)
These three steps are the foundation, as it were, on which the other nine are built.
With a kind of religious conviction, hundreds of thousands of members of 12-step programs over the years will give anecdotal testimonies to the effectiveness of living by the steps. Recently, however, over 150 studies have been done to test the evidence and found that the 12 steps perform as advertised.
For example, the results of Project MATCH — published in 1998 and supported by the National Institute on Alcohol Abuse and Alcoholism — compared the effectiveness of the 12 steps with Cognitive Behavioral Therapy and Motivational Enhancement Therapy. "Twelve Step Facilitation held its own," the study concluded. "In fact, Twelve Step Facilitation offered a statistically significant advantage when total abstinence was the desired outcome."
Based on her first few months of experience with OA, Amy declared, "I'm really glad I went and I encourage anyone [struggling with addiction] to take that step. It's been really helpful." She added that at the end of every OA meeting, everyone says, "Keep coming back. It works if you work it."