“These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it…their problems pile up on them and become astonishingly difficult to solve.”
William D. Silkworth, M.D.
The Big Book of AA
This quote is taken from a chapter in the Big Book of Alcoholics Anonymous entitled “The Doctor’s Opinion.” In this chapter Dr. Silkworth describes of the illness of alcoholism and addiction, advises that abstinence should be the ultimate goal for anyone struggling with addiction, and explains how the program detailed in Alcoholics Anonymous can bring about recovery from addiction. That is all well and good but there have been plenty of self-help books written which included a written promotion from an “expert” on the subject matter. What makes this one so different?
Who Is Dr. Silkworth
The book Alcoholics Anonymous describes Dr. Silkworth as “a well-known doctor, chief physician at a nationally prominent hospital specializing in alcoholic and drug addiction.” The doctor describes himself as “Medical Director of one of the oldest hospitals in the country treating alcoholic and drug addiction.” That might not mean much to people in the 21st century when Dr. Silkworth was writing in the 1930s. It might be helpful to compare him to an expert on a subject that many people have heard of.
Dr. Silkworth was a well-known doctor but most people nowadays have most likely never heard of him. But many people have probably heard of Stephen Hawking. Stephen Hawking was a scientist many know about because he had a rare form of ALS that confined him to a wheelchair and later in life caused him to communicate through a computer program. He was most famous for his research and theories about black holes. It is theorized that a black hole happens when a star’s gravity becomes so powerful that it just collapses in on itself and nothing can escape it. Not even light. A lot of what we know about black holes and theoretical cosmology comes from Stephen Hawking and his work.
So Dr. Silkworth was a well-known doctor. Stephen Hawking was a well-known scientist. Dr. Silkworth was the chief physician and Medical Director at the Towns Hospital for Drug and Alcohol Addictions in New York City, which at the time was one of the oldest and most prestigious hospitals treating addiction in the country. Stephen Hawking was the director of research at the Centre for Theoretical Cosmology at the University of Cambridge, which is one of the oldest and most prestigious programs and universities for the field of physics. If one uses Stephen Hawking and his expertise in black holes as a comparison for Dr. Silkworth and his expertise on addiction then “The Doctor’s Opinion” carries a lot of weight. Especially when Dr. Silkworth writes;
“The subject matter presented in this book seems to me to be of paramount importance to those afflicted with alcoholic addiction.
I say this after many years’ experience as Medical Director of one of the oldest hospitals in the country treating alcoholic and drug addiction.
There was, therefore, a sense of real satisfaction when I was asked to contribute a few words on a subject which is covered in such masterly detail in these pages.”
Since the book he was writing about was written by a group of men and women from Akron, Ohio and New York City recovering from drug and alcohol addiction, this is an incredible statement. It’s as if a group of Average Joes from Akron wrote a book about black holes and Stephen Hawking wrote a letter promoting it saying to the effect of, “The subject matter in this book concerning black holes is more important than anything I’ve ever read, said, studied, wrote, lectured, or hypothesized. These people from Akron, Ohio know more about black holes than I could ever hope to know. Because they’ve been there, and have come back to tell us about it.”
Having this mindset when reading the rest of “The Doctor’s Opinion” will give it more weight and urgency. The doctor writes, “We believe…that the action of alcohol on the chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker.” This means that when someone develops an addiction to a substance their body processes that substance differently. The dictionary definition of allergy is “an abnormal reaction of the body”.
According to Dr. Silkworth, when someone who is addicted to something and they ingest that substance, their body has an abnormal reaction to that drug that manifests in a physical craving for more of that substance. This craving will continue, and perhaps even increase, the longer the alcohol or drug is ingested. This is why the doctor states that people who are addicted to drugs or alcohol can never safely use those substances; that abstinence should be the goal of recovery. Because once the substance is ingested the physical craving for more becomes so powerful that they go through what some call a “spree” or “binge” and cannot control how much they take.
According to Dr. Silkworth, abstinence should be the ultimate goal for someone struggling with addiction. How each individual achieves that goal is different for everybody and each treatment plan is customized to fit the individual’s needs.
In order to safely detox from a substance, comfort meds might be prescribed until the individual is stabilized. The withdrawal and detox process can be physically uncomfortable in a best-case scenario, and life-threatening in some extreme cases. That is why at BARC we provide 24 hour medically-monitored intensive inpatient services to ease individuals through the withdrawal management phase and into the active abstinence and recovery. Our medical team will work with each individual to customize and prescribe as necessary a detox medication protocol to safely and comfortably ease the patient through their withdrawal symptoms.
It is hard to overdose when one is practicing abstinence. When one is abstinent, it is less likely that they will go on a binge and lose their job or relationship as a result. Abstinence from alcohol or drugs makes it less likely that one will contract or develop a disease caused or exacerbated by their use. Due to the nature of alcoholism and the physical consequences of use described by Dr. Silkworth, total abstinence from drugs and alcohol is the goal that produces the best outcomes for those suffering from addiction.
Are you ready to abstain? Here at Bay Area Recovery Center we can help you or your loved one achieve that goal.