[Transcriptions of correspondence between The Drug and Alcohol Foundation (DAF), Regional Service Office (RSO) (London), The General Service Office of AA (GSO) (Great Britain), and “A Vision for You” AA Group (Eaton Square).
The letters refer to the concerns raised by the DAF with regard to the stance of the Eaton Square group on prescribed medication]
The letters refer to the concerns raised by the DAF with regard to the stance of the Eaton Square group on prescribed medication]
1
DAF (The Drug and Alcohol Foundation)
18 Dartmouth Street, London SW1H 9BL Tel 020 7233 0463 Email: d.a.f@talk21.com
10 October 2000
Alcoholics Anonymous
Regional Service Office
Jacob House
3-5 Cynthia Street
London N1 9JE
Dear Sir/Madam,
Re: Medication
I manage a variety of services for people in recovery from drug and alcohol dependency. Amongst these services we operate a specific service for clients wanting abstinence focused services who also have additional mental health problems, these clients are invariably on various forms of medication to stabilise mental health problems and enable them to enjoy some quality of life.
DAF has a long tradition of supporting clients involvement in twelve step recovery groups, particularly AA and NA. However I have recently been made aware that it has become the practice in some meetings of Alcoholics Anonymous to advise persons to stop taking prescribed medication for mental health problems. In other instances I am informed newcomers have been told that they will be unable to undertake the programme as set out in the twelve steps whilst on medication. Specifically the Vision for You meeting in St. Peters Church Eaton Square has been mentioned to me as such a venue, though I am told it is not unusual for persons to be given such information at other meetings.
Such advice not only goes against the way in which I am given to understand Alcoholics Anonymous is supposed to operate but is reckless, irresponsible and ill-informed. Should a client with some of the more severe and enduring conditions dealt with on the DAF programme act on such advice the consequences could be fatal. I am therefore writing to bring this matter to your attention so that the situation regarding medication for mental health problems and the AA programme can be clarified to all AA office holders. Should this matter not be addressed DAF would sadly no longer be in a position to promote the value of Alcoholic Anonymous to clients.
Yours sincerely
Stan Moorcroft
Clinical Services Manager
Cc: General Service Office
Secretary ‘Chelsea, A vision for you’
ROYAL PATRON: HRH Princess Alexandra, the Hon Lady Ogilvy, GCVO
TRUSTEES: The Lord Mancroft (Chairman), Count Michael Badeni (Treasurer),
Guy Cooper, Bryan Norman, Sally Rees, Christopher Hill
EXECUTIVE DIRECTOR: Daphne Thomas
Registered under the Charities Act of 1960 Registration No 270137
DAF (The Drug and Alcohol Foundation)
18 Dartmouth Street, London SW1H 9BL Tel 020 7233 0463 Email: d.a.f@talk21.com
10 October 2000
Alcoholics Anonymous
Regional Service Office
Jacob House
3-5 Cynthia Street
London N1 9JE
Dear Sir/Madam,
Re: Medication
I manage a variety of services for people in recovery from drug and alcohol dependency. Amongst these services we operate a specific service for clients wanting abstinence focused services who also have additional mental health problems, these clients are invariably on various forms of medication to stabilise mental health problems and enable them to enjoy some quality of life.
DAF has a long tradition of supporting clients involvement in twelve step recovery groups, particularly AA and NA. However I have recently been made aware that it has become the practice in some meetings of Alcoholics Anonymous to advise persons to stop taking prescribed medication for mental health problems. In other instances I am informed newcomers have been told that they will be unable to undertake the programme as set out in the twelve steps whilst on medication. Specifically the Vision for You meeting in St. Peters Church Eaton Square has been mentioned to me as such a venue, though I am told it is not unusual for persons to be given such information at other meetings.
Such advice not only goes against the way in which I am given to understand Alcoholics Anonymous is supposed to operate but is reckless, irresponsible and ill-informed. Should a client with some of the more severe and enduring conditions dealt with on the DAF programme act on such advice the consequences could be fatal. I am therefore writing to bring this matter to your attention so that the situation regarding medication for mental health problems and the AA programme can be clarified to all AA office holders. Should this matter not be addressed DAF would sadly no longer be in a position to promote the value of Alcoholic Anonymous to clients.
Yours sincerely
Stan Moorcroft
Clinical Services Manager
Cc: General Service Office
Secretary ‘Chelsea, A vision for you’
ROYAL PATRON: HRH Princess Alexandra, the Hon Lady Ogilvy, GCVO
TRUSTEES: The Lord Mancroft (Chairman), Count Michael Badeni (Treasurer),
Guy Cooper, Bryan Norman, Sally Rees, Christopher Hill
EXECUTIVE DIRECTOR: Daphne Thomas
Registered under the Charities Act of 1960 Registration No 270137
Alcoholics Anonymous
Regional Service Office (London)
2nd Floor, Jacob House,
3-5 Cynthia Street Tel: (020) 7833 0022
London N1 9JE Fax: (020) 7837 0540
Stan Moorcroft
Clinical Service Manager
The Drug and Alcohol Foundation
18 Dartmouth St
London SW1H 9BL 17 October 2000
Copy: Jim K, General Secretary, GSO
Mark M, A Vision for You, Secretary
John R, Chair, London Region
Dear Stan Moorcroft,
Thank you for your letter dated 10 Oct. which arrived today.
I share your concern and can assure you that Alcoholics Anonymous has not changed its Tradition that the only requirement for membership is a desire to stop drinking.
I have attended the meeting you refer to and can assure you that neither the group guidelines nor the presentation of the weekly meeting at any time mention medication. It may be that individual members of AA sometimes foist their own opinions on newcomers, leading to misunderstandings.
I am copying this letter to AA's General Secretary who will, I feel sure, provide you with confirmation of our national policy. I will also send it to Mark M, Secretary of the A Vision For You Wednesday meeting (along with a copy of your letter, in case it did not filter through to him), in the hope that the group will reassure you.
Finally, I am copying this correspondence to John R, Chair of our London Region, since he will be concerned to do what he can through the structure of AA in London to ensure that none of our 600+ meetings is encouraging or permitting the behaviour reported to you.
Yours sincerely
John H.
RSO Administrator
3
The General Service Office of Alcoholics Anonymous (Great Britain)
PO Box 1, Stonebow House Tel: (01904) 644026
Stonebow, York YO1 7NJ Fax: (01904) 629091
17 October 2000
Mr S Moorcroft
The Drug and Alcohol Foundation
18 Dartmouth Street
London SW1H 9BL
Dear Mr Moorcroft,
Thank you for your letter of 10 October and for raising your concerns with us regarding clients who are attending some of our Groups in London, being advised to stop taking prescribed medication and told they will be unable to undertake the programme of Twelve Steps whilst on medication.
We can only agree with the comments made in the third paragraph of your letter but at the same time would like to assure you that Alcoholics Anonymous does not offer any advice concerning medication or treatments. We are not qualified to offer any such advice to your clients.
The General Service Conference which represents the Group Conscience of our whole Fellowship has on a number of occasions made specific recommendations in respect of members advising on matters of a medical nature; "... recommends that members of AA should not, under any circumstances, meddle in the relationship between doctor and patient, especially in matters of treatment and medication. AA's position is and should always be non-interference in such matters ...' 'Our society therefore will prudently cleave to its single purpose; the carrying of the message to the alcoholic who still suffers.'
We will advise our local Intergroup and members of London Region regarding your letter and the mutual concern we both have in the above matters.
Thank you again for your kindness and your concern for the well being of your clients and indeed the well being of Alcoholics Anonymous.
Yours sincerely
Jim K
General Secretary
Registered Charity No. 226745
4
Mark M
Address (withheld for
reasons of anonymity)
Stan Moorcroft Friday, 3rd November 2000
Clinical Services Manager
The Drug and Alcohol Foundation
18 Dartmouth Street
London
SW1 9BL
On behalf of A Vision For You AA Group, St Peters Church Eaton Square, Wednesday
Dear Mr. Moorcroft,
Thank you for your recent letter. I write further to an acknowledgement sent to you by Nigel, the treasurer of the group. The group was made aware of your letter and as a result the following points were made:
We appreciate your taking the trouble to write to us. We are always anxious to co-operate with those outside AA who are dealing with alcoholism and considered the points you made very seriously.
There is no group policy on any of these issues because it is not possible for any AA group to formulate one. An AA group, as you may well be aware, is a fluid entity with membership changing from week to week. So even if the group tried to create a unified approach, it has no way of knowing, ultimately, what it's members are doing or saying in private and has no power or coercion over it's members anyway. The whole process is entered into voluntarily.
However it is fair to say the Vision for You is a closely knit group, with many of it's core members regularly sharing experience to see how they can best help alcoholics using the AA programme. I can describe to you how those members try to help those who are on prescribed drugs. This does not seem to us to be in contradiction to your approach (though if we are wrong in this assessment, please let us know). I do stress, once more, that we have no way of monitoring how closely this is adhered to throughout the group.
Our approach is taken from a standard AA booklet called living sober, which offers practical suggestions based upon the experience of many members. In the section entitled Avoiding All Chemical Mood-Changers the following paragraph appears, which seems to summarise the relevant approach; "As AA members - not physicians - we are certainly not qualified to recommend any medications. Nor are we qualified to advise anyone not to take a prescribed dosage under proper orders. What we can do responsibly is to offer only our own personal experience".
Nobody at the group, of the members we spoke to, has experience of completing the AA programme of recovery whilst taking prescribed drugs of the type you appear to be referring to. None has experience of successfully guiding ("sponsoring" in common AA parlance) anyone through the programme while taking these drugs. Consequently, the current members say that we don't have the experience to help in these cases (though this may change in the future, of course). We are just one of over 600 groups that meet weekly in Greater London and we feel it is best to admit our limitations and to encourage anyone in this position to go to other groups as well to seek someone within AA who does feel able to sponsor them. We would stress that it is not a requirement of group membership that anyone gets a sponsor. In line with AA custom (we have a set of guidelines called the Traditions), we will always welcome those who have a desire to stop drinking.
The only way in which we would have the confidence to take someone through the programme is if they were to stop taking the drugs. And certainly, we do let the newcomer know this. If the individual wished to try, we would encourage them to go to their doctor and ask "Would it be possible for me to come off the drugs if I went to lots of AA meetings?"
In most cases, the doctors are keen to begin a tapering-off process. Once they have stopped taking any drugs we would then feel able to take them through the programme. This has worked a number of times, in our experience.
If the doctor did not want to stop the programme then we would not contradict any medical opinion and we would not encourage anyone to do so. As a result of your letter we will take particular care to make this clear.
We hope this reassures you. If we can be of further assistance, then please do not hesitate to contact me. We are aware you have been in touch with the offices in London and in York, and so have sent copies of this letter to the London Service Office and also to a trustee of the General Service Board of AA, which meets in York, so they are aware of our response. We would encourage you to contact them also if you feel it is appropriate.
Yours sincerely,
Mark M, group secretary
Cc Regional Service Office, London
William v, General Service Board Trustee
5
The Drug and Alcohol Foundation
18 Dartmouth Street, London SW1H 9BL Tel (020) 7233 0400 Email: daf@charity.xtree.com
07 March 2001
Guy
(rest blanked out)
Dear Guy,
Re: The Dartmouth Street Programme/AA
I am putting into writing the content of my telephone conversation with you this morning.
Firstly however I wish to apologise that I was unable to speak to you before the London Regional Meeting of Alcoholics Anonymous, since had I done so my position would have been clear to you and not be open to potential misrepresentation.
The facts are these. I attended an open meeting of the Vision for You Meeting of Alcoholics Anonymous on Wednesday 21st February 2001. I had been invited to this meeting by Mark M(…) the Group Secretary. I would clarify that I agreed to attend this meeting as a consequence of being invited, however that issues arising out of my original letter of 10th October 2000 needed to be addressed within AA as a whole. It was not my intention to participate in the internal affairs of AA, I had simply brought an issue of concern to the attention of the GSO York. I felt it important to respond to this invitation as a matter of courtesy.
The meeting was of some interest and I certainly did not witness anything that was unduly alarming. Some of the language respecting mental illness left a lot to be desired, with derogatory phrases about “loony bins”, “nut cases” etc being fairly widely used. However this unfortunately mirrors the wider culture and is not a problem exclusive to AA. After the meeting I was approached by a number of individuals who pressed for assurance that all of my concerns had been addressed. I stated that no, I still had considerable concern based upon the letter I received from Mark M(….) on 6th November 2000, but my understanding was that AA was addressing these concerns through its own internal procedures. I was repeatedly pressed as to what my concerns were and why my attendance at the meeting had not allayed them. I clarified that:-
a) In my opinion it was never appropriate to place pressure on anyone to cease taking medication.
b) That clients with a dual diagnosis can be particularly vulnerable to such pressure and can respond inappropriately, e.g. suddenly refrain from taking prescribed medication.
c) That it was not the business of any AA member to make judgements about the nature of any other person’s medication.
It was explained to me that persons were always told to consult a doctor. That it was the widespread experience of the group that people were being “prescribed drugs to deal with alcoholism” [sic]. That it was only in such cases that people were encouraged to come off medication.
As you can understand such erroneous thinking not only did not allay my fears but considerably heightened them. However I did not wish to engage in a lengthy argument and left the meeting at this point.
To characterise myself as being happy with this experience in respect to the issues related to AA and medication is to seriously misrepresent my position
Yours sincerely,
Stan Moorcroft
Clinical Services Manager
6
[Transcript of handwritten letter dated 25.05.01 from a member, Charles N, to Stan Moorcroft, DAF Clinical Services Manager]
London
26.05.01
Dear Stan Moorcroft,
I recently acquired a copy of your letter of 10 October 2000 addressed to the Vision For You Group at St Peters Church, SW1, and coincidentally a member of that group was talking the other day about the very subject you raised in your letter. He did not know I had read your letter and what he said came up, unsolicited, during the course of a normal conversation about AA. It would appear to refute some of what was said to you in the reply you received from Mark M(…..). Their line on medication appears to be, “If you stop taking medication God will look after you and we can “sponsor” you. You will not get sober or complete the 12 Steps of recovery unless you do stop”.
In view of this I think it is time to air a little background information about how the Vision For You group was formed. Over a period of many years I knew well, and was in a position to observe, a now deceased member of AA who undoubtedly devoted a great deal of his time and energy to helping alcoholics achieve sobriety. However, he gradually became dissatisfied with the way in which AA groups were run, and with the quality of sharing within the groups, so he was instrumental in the early 1980’s in the forming of a group which he called “The Joys of Recovery”. I attended this group for several years and for some time it was an extremely upbeat and enjoyable meeting with the accent always on the positive rather than the negative.
My first feelings of disquiet began when I observed the same gentleman becoming dissatisfied even with this group. He began to exert his ever-growing influence, normally through his “sponsees” who became “officers” of the group and procedures and regulations started to appear. Indeed the first 15 or 20 minutes of the meeting were often devoted to procedural matters – anathema to most groups! Eventually the inevitable rift occurred when various long standing members re-acted to his and the group’s ever increasing authoritarianism. Thus he then formed the Vision For You group. He was, in my view, demonstrating classic untreated alcoholism – “Nothing is ever good enough unless it is done exactly as I want it to be done. I know best!”
It saddens me to say that although I continue to attend a great many AA meetings I never saw him or any of his devotees again. I say without any reservation that a kind of sect was formed, which according to some of the women who were a part of it, was also quietly misogynist. A long time sober friend of mine told me that towards the end of this gentleman’s life he became so extremist that on one occasion (that he knows of) he was invited to speak at a meeting outside London which I know well. The whole area has excellent AA groups but at the end of the meeting when invited to lead the group in the Serenity Prayer as is customary, he chose instead to harangue the group, repeating phrases such as, “This is not AA”. My friend who is highly respected for his quality of sobriety eventually had to tell him he would be evicted from the building if he didn’t shut up.
As you know, AA is a worldwide fellowship with many thousands of very diverse groups, all carrying exactly the same message. I travel extensively and all those I attend are a constant source of inspiration and delight. To say that any of these are “not AA” not only demonstrates the kind of arrogance most of us arrive in AA with, but is also a precise description of whomsoever is pointing the finger, as always.
I’m sure you know that AA will continue to do all it can to help your clients, but I have to say I would send them anywhere but to the Vision For You group. I know this will upset some of its members who continue to revere their founder, but I hope they will at least ponder the views of someone who never quite allowed himself to be drawn into his sphere of influence, much as he tried.
Finally I refer you to Tradition Nine, and in particular to pages 176 and 177 of the AA book “Twelve Steps and Twelve Traditions”, photocopies of which are enclosed.
If you require any further information or clarification you can contact me by writing care of: [name and address withheld for reasons of anonymity], as I shall be away for several months.
Yours sincerely,
Charles N.
Cc: Mark M
Jim K
John H
M L
[In the original the pages mentioned above are attached and a section is highlighted as follows: “Who is more unpopular than the old-time AA, full of wisdom, who moves to another area and tries to tell the group there how to run its business? He and all like him who “view with alarm for the good of A.A.” meet the most stubborn resistance or, worse still, laughter.”]
