Sedatives Are they an A.A.problem? An A.A.Publication Published by WORKS PUBLISHING, Inc. P.O. Box 459 (Grand Central Annex) New York 17, N. Y. (Permission A.A. Grapevine,Inc.)

Alcoholics Anonymous has but one purpose: To help the sick alcoholic recover if he wishes. 串***** Alcoholics Anonymous has no opinion on any controversial subject,nor doesit oppose anyone. Copyright 1948 by WORKS PUBLISHING,Ine. Printed in U.S.A. (Price Five Cents)

FOREWORD THE SUBJECT, and often the problem, of “sleeping pil or sedatives is becoming inereasingly interesting to rmembers of Alcoholies Anonymous,according to letters received at both the A.A. General Service Office and The A.A. Grapevine. Although some A.A.s are of the opinion that the problem of sedative addietion or near-addiction is of no concern to alcoholics, many others feel that the widespread use of these drugs in the treatment of active aleoholism, or as a substitute for aleohol, justifies the distribution of information on the subject, The five articles in this pamphlet, written by A.A.s and published in The A.A. Grapevine, are presented for your information. Four of the articles were written by laymen who have either experienced or observed disastrous sedative addiction. One article was written by an A.A. doctor. Opinions expressed in these articles are the opinions of the individual authors and do not necessarily refleet the opinion of Alcoholics Anonymous.

EVIDENCE ON THE SLEEPING PILLMENACE “JOHN DOE was found dead in bed early this morning. Death was attributed to an overdose of sleeping pills.” The words, “overdose of sleeping pill,” have been appearing with inereasing frequeney of late in the daily press.The story behind them is ot always one of intentional suieide. Often it’s the story of an accidental denth and often the victim is an alcoholic. Sleeping pills have also been the subject of urgent warnings to both doctors and laymen in medical journals and popular magazines. For the aleoholie, the warnings should be regarded as special “danger signals.” Barbiturates are defined in the Federal FoodDrug and Cosmetic Act as habit forming.For the aloholic especialy,rigid controlof such sedatives isvital,and the speeial danger is the fact that the alcoholic isnot likely to control self-administered sedatives any better than he controls aleohol. There are, of course, other pills or liquids besides phenol barbital,barous when self-administered.Among the more familiar hypnoties,for instance, is paraldehyde, which also is defined in the federal law as habit forming. There are still other types of drugs which should not be used without both competent and conscientious medical supervision.Benzedrine is one that can be mentioned and there are many others—so many that all cannot be included in this summary. And so many, that the only snfe guide for the alcoholic is never to forget that the use of drugs in any assoeiation with alcohol, or the effects of alcohol, may have unpredictable results, The purpose in this article is not to point the finger of blame. The faet is shared by many—by the careless doctor who prescribes sedatives too casually; the greedy druggist who sells them illegally; the out-and-out dope peddler; lax lawenforcement agents and indiferent lawmakers;andfinally, the individual who buys the pills. Obviously there is Imperative need for correetion to prevent abuses. jngagitationforbetterlawsand betterlawenforcementandinthe coneern being expressed by medical authorities. InthementimeoweverthedangerremainsPromiscuous sefed tives isa fact.Its easy to get pills.Atthis point, thereforeit an indi vidual matter in which the buyer should beware. Anyone who still doubts the risks involved may be awakened by even a brief review of current diseussion and reports in various publieations.For example,theAmerican MedicalAssociationhasissuedabooklet containing reprints from issues of The Jourmal of the American MedicalAssociation. CUOUS USE OF THE BARBITURATES,by W.E.Hambourger,Ph.D,of ClevelandreprintedfromthAil99edtonfhoal.Excerps follow: “At a meeting of the American Medical Association in June, 1937,a [5 ]

Acia and Derivative Drugs…, The evils of these drugs include habit formations,toxic cumulative action,their substitution for aleoholie bever ages for drunken episodes,their use for sueeessful as well asunsuccessful suicidal attempts, their improper use being recognized as the causative etiologic factor in some eriminal assaults… HUGE AMOUNTS SOLD DrHambourger summarizesthischapter ofhis paer with six ponts two of which are particulariy significant toalcoholies: 1.More than 1,200,000,000 grains of barbituric aeid derivatives were sold in the United States in 1936. .. ” 6.Thenumber of suicides by barbiturates has shown a defnite upward trend. .. ” At one pointin the second chapter of the paper,Dr.Hambourger stated .That the constitutional heritage of the individual is an important factor in the development of barbiturate habit ia,however,amply demonstrated…. Curran (F.J.) says:Any substanee…which through its central action tends to soften the emotional stresses and to render less tedious the everydny experienees of life may be a faetor in the development of administration of sedatives and hypnotic drugs to the emotionally unstable An editorial from The Journal also is reprinted in the booklet.Two of itsmost significant paragraphs follow: The barbiturie addiction is partieulnrly vieious.Members of the medpossibility of addietion…. The Couneil on Pharmacy and Chemistry has long adopted the attitude tions on the preseribing of these potentialy dangerous drugs has the whole hearted approval of the Couneil and of The Journal. .. In The Ne York State Jourmel of Medieine, Oetober, 1943,may be found other pertinent discussions in a report on a conference,“Treatment of Poisoning by the Barbiturates.” Here are a few exceprts from the record of the conference: FATALITIES INCREASE “Dr. Milton Helpern:..The statistics of the Chief Medical Examiners Offcewhicharecompiled annuallyshowadefniteincreaseinthenumer of fatal poisonings by the various barbiturate compounds… , There are a barbituratesandit is questionable whether or notalthough the act was deliberate, the intent wes that of suicide..In most suicidal cnses, the individual takes barbiturate medication which has already been preseribed for him. There seems to be a rather indiseriminate or careless prescribing of barbiturate compounds for patients who are suffering from chronie alcoholism, nervous disorders, and depressions. … The patient should not be [ 9 ]

given or allwed to accumulate an amount of barbiturate which if taken at one time would be sufficient to cause death. .. Among lay publieations which have published articlesrecently on the use of barbiturates is The Reader’s Digest which in its May,1945,issue printed a condensation of an article,“Sleeping Pills Aren’t Candy,” by Rita Halle Kleeman, that appeared originally in The Seturday Evening Post. Excerpts from this article follow: We would be outraged at the suggestion that we are becoming a nation of drug fiends.Nevertheless,as long as 1939 there were enough users of sleeping pills-barbituratesto the doetors,goof ballorred devilsor yellowjacketa2to the addict-to accountforthe sale of220000 dosesa day. Today, with the worries,griefs and readjustments of lives and hours caused by the war, the figures show that we are using almost three times agmuch. “In New York City,there were five times ag many accidental denths accidents from them inereased to 150 per cent from 1940 to 1944. “Their continued use leads to shattered nerves and to strange psychological effects, varying from stimulation in certain combinations to drowsiness,coma and deeth.All these dangers are heightened when the drugs are taken by people with kidney trouble or in combination with aleohol. .. SALESOFTEN ILLICIT Included in recent references to the subject in the daily press was a ing pil, which are being sold illieity. Dr, Thomas Gonzales, chief medicalexaminersaid today.Warneuroties and alcoholies,attempting to sootheshatterednervehaveeped inrease salese declared It is entirely too easy for persons who want to quiet jangled nerves to cbtain these hypnotics.Alcoholics,attempting torecover from a prolonged spree,dope addicts who cannot obtain narcotics and even worried of reported deaths are accidental or howmany are suicides cannot be detercovering hypnotics if we would curb the illicit trade. . . *’* [7]

PILLSANDI2thSTEPWORK · THE WIDESPREAD, unsupervised use of the barbiturate group of drugs, luminal, seconal, nembutol and numerous other derivatives, has created,especiallyin thelastdecadeapublie halthproblemwhichas deeply conerd themedicalprofeionpliehealthhoritsandmnypul spirited lay people, The acknowledged inadequacy and lack of uniformity in state and even venal and uninformed people who want to obtain them. All too many otherwise intelligent people use them with a liberality that can only mean they are ignorant of their dangers. We in A.A.should take a grave and serious interest in the subject,paruncomfortable fact that 43 per cent of the victims of fatalor non-fatal were also alcoholics. (Please read that carefully; it does not say that 48 per cent of alcoholies take pills.) The problems of the pil-taker are the same as those of the alcoholic is of drinking — he simply doubles his risks. Just as the alcoholic in drinking dulls his awareness of the unpleasant realities of life go does the pilltakerinerhapsamoreinsidiousmanner,reacthestageoffantasy whe only pleasant visions, if any, are allowed to obtrude on his consciousness. Unfortunately while pursuing this,tohimlaudable objeetivethe aleohlic winds up dead drunk: the pilltaker on the other hand winds up poisoned. The results are identieal; one drinks it and the other swallows it. It hardly holic combines the two, Aleoholics resort to pills to get over a hangover, to prolong a binge in of their alcoholism. Much too frequently, they are introduced to this form of therapy by thelr doctor, who is either unaware that they are alcoholie orunaware ofaleoholism.Just asfrequently,it is the fellowwho is always around, that well-known character, the well-meaning and completely misinformed friend. In defense of the doctors it should be pointed out that the barbiturates with proper precautions are useful and effective drugs.Doctors are realizingmore and more that alcoholies should not be given the opportunity to dose themselves for anunlimited period.Aetive aleoholiesrunk or sober, should never have access to unlimited doses of barbiturates.Acting on the the dose or the frequeney of doses. When drinking, they almost invariabiy forget when they toolc the last dose or how much they did take. The result isa tragedy oranear tragedy andmake no mistae about it,ina ciy f any size these are daily occurrenees. (In a very limited experience, I have personally witnessed this four times.) There is no defense for wel-meaning friends and particularly A.A8 who cannot help but be sware of the dangers involved, espeeially if they have [ 8 ]

had any experience with 12th Step work. They are completely ignorant of such factors as drug idiosyncrasy, early signs of poisoning, and the most important and variable of all, the margin between the therapeutie dose and the toxic dose. This margin is different for each and every one of the members of the barbiturate group and when the patient has also been drinking it is extremely diffcult and usually impossible for even an experieneed physician to estimate it, When, in the course of 12th Step work, you run into prospects who need medication or who have been dosing themselves, you should turn them over comprehend what you are driving at. To steer the prospect to this supervision is a self-imposed obligation and occasionally the prospect, because of gratitude will give you an opportunity to approach him on A.A. Do not delude yourself, however,in feeling that when you give medicinal or eustodial care, you are doing A.A. work —your job only begins when the other ends. turates showed that 70.9 per cent of the pill-takers were found to be psychopathic personalities. These unfortunate individuals need to sober up,of their drug taking is a symptom, not a disease. We in A.A. should only concern ourselves with individuals whose disease is alcoholism. THOSE”GOOFBALLS” MORPHINE, codeine, chloral hydrate, luminal, seconal.nembutol, amytal, these and kindred drugs have killed many alcoholics. And, I once nearly killed myself with chloral hydrate. Nor is my own observation and experience unique, for many an old-time A.A. can speak with force and fervor on the subjeet of “goof balls.” Excepting an infrequent suicide, nobody uses these drugs in the expeetation of death,To many alcoholics, still in the drinking stage,they represent blessed relief from the agonies of a hangover. Some of us, perfectly sober for months or years, eontraet the habit of using sedatives to cure insomnia or slight nervous irritability. I have the impression that some of us get away with it, too, year after year, just as we did when we first began to drink aleohol. Yet experience shows, all too often, that even the “controlled” pilltaker may get out of control. The same crazy rationalizations that once characterized his drinking begin to blight his existence. He thinks that if pills can cure insomnia so may they cure his worry. Now a word about the use of morphine by physicians, Sometimes, a general practitioner, not knowing his patient is alrendy loaded with barbituprates, will give a morphine injeetion. A friend of mine died like that. Sober about three years, he got into an emotional jam. Pills led to aicohol and this combination to still more pills.Hig doetor found an excited heart. Out came the needle and a few hours later out went a very good friend. [6 ]

Another close friend,sober three years, also fell on evil dayspills and liquor. At the end of about three weeks of this diet he was placed one evening ina sanitarium. Nobody told the doctor there about the pills with which cotlein. Before daylight he was dead. Near the end of my ow drinking career I had an alarming experience. Chloral hydrate was preseribed for one of my terrible hangovers. The doctor hotlo.Vhilemy wife slept quietiy beideme Ireached nder the mattress, took out the flask, and guzzled the whole business. I had a narrow shave. Moral:when doctorgives a legitimate sedative preseription dont let the aleoholic have the bottle, As a matter of fact our friends, the doctors, are seldom directly to hlame forthedireregultsweo oftenexperineeItismuh too easy foralhols to buy these dangerous drugs,and one possessed of them the drinker is likely to use them without judgment.Sometimes his well meaning friends, unable to see him suffer, hand him pills themselves. It’s a very dangerous business. EFFECT ISACCUMULATIVE It’s even dangerous to give a suffering alcoholic a drink if he is already loaded with pills,Years ago I had an experience of thig sort. We had an “alkie in towwhom I shall call Slim.He finally consented to go toa hospital. On the way he had a few-but only a small quantity compared to his custo a cab.As he could usually manage a couple of bottles a day when netive, I couldn’t understand this performance at allArrived at the hospital, Slin was still slumped in his seat and I couldn’t move him. Our good friend, Dr.Silkworth,came out and peeredn the cab door.One lokwas apparenty enough. Said he to me,“How is this man’s heart?” Confidently I replied, “He’s got a heart like an elephant. Told me so himself. But I don’t see how he got drunk so fast.I gave him very little liquor.” Out came the doctor’s in here. IIe can’t last long. What clse has he been taking besides liquor? Stunned, I replied, “Nothing, that I know of.” Very gingerly an attendant carried Slim inside, Out came the stethoit fired off the accumulated charge of sedative he had in him. See how blue he is? Iis heart isn’t really working much. It’s just jittering. I can’t even count it.” The doctor rushed to the phone and called Slim’s wife, To my horror she eonfirmed the faet that ho had been taking heavy doses of amytal for abont 10 days.The dortor genty told her she had better hurry, else she might be ton iate.Then le cnlled a fumous heart specialist for consultation and told him to hurry too. They laid Slim on a bed upstairs. The great snecialist came and drew out his stethoscope. At once he lookeci very serious that he did not think my friend could possibly live through the night. Dr. Silkworth agreed. [ 10 ]

THEN A MIRACLE During these proceedings I had been praying as I never had prayed before. After the two doetors had pronouneed the death sentence on Slim I told them ofmy prayers and explainedcheerfully asIcouldthat I had been reading Dr.Alexis Carre’s book,“Man the Unknown,” in which prayer was described as effeeting miraeulous cures. The great specialist took his leave. Dr.Silkworth and I went downstairs to wait for the preseription to come in.A boy finally brought two capsules from the drugstore. The doctor looked at them, saying he hated to give themthey were so powerfl. We went upstairs and as we stepped off the elevatorwe saw someone comming down the hall jauntily smoking a cigarette.Hell, boys,” roared Slim, “what am I supposed to be doing in here?” Never,so long as Ilive,shall I forget therelief nd astonishment whi spread over the doetor’s countenance as he quickly tested Slim’s heart. Loking at mehe said This man’s heart is now normal.Fifteen minte ago I eouldnt count it. I thought I knew these alcoholic hearts pretty well. But I’ve never seen anything like thisnever, I can’t understand it. What out il effeets from his experience. As for me-well I guess I leared my lesson then and there.No more “goof balls’ unless the doctor says sonot for me. No thank you! SEDATIVES EASY,AND DEADLY,TOO · AN ARTICLE in a lay publieation, warning against the use of sedatives onemay givenarctieseativesrhynotisexcpt otor’srds therefore, sedatives should present no problem to the A.A.member doing 12th Step work.In spiteof thelawhowever,it is surprising thenumber f A.A.s who think nothing of giving their prospeet, or patient, one or the other of the barbiturates, when they think it necessary. As A.A, members increase their periods of sobriety, incrense their A.A. knowledge of the disense does not mean an increasing knowledge of its treatment -— except its A.A. treatment. Anongmous) stated,I have no doubt that a man who has cured himself of the lust for alcohol has a far greater power for curing alcoholism than has a doctor who has never been aflieted with the same curse. That this statement is true, no one who has been in A.A. for any time, or who has any knowledge of the sprend of A.A.during the past 12 yesrs, can doubt. But when Dr. Kennedy spoke of “aleonolism” he was actually referring to “alcohol addietion, the illness that has as its main symptom compulsive drinking. It is the compulsive drinking that the A.A,12th Stepper” is treating, or rather, showing the patient how to treat himself. [ 11 ]

One of these problems is acute alooholic intoxication, in other words “drunk. This particular phase of aleoholism often faceg us during our 12th Step work:and it will usualy tax our tolerance,patienceunderstanding and ingenuity if we are to handle it properly. This is especially go when the patient,his family, or both, fatly refuse to have a doetor called in; and this often happens. we must never forget the fact that, while we may be arrested alcoholics ourselves, while we may be veteran “12th Steppers,” while we may have helped many patienta find the road to reeovery; we are not doctors,not even “doetors of aleoholism.”We have no knowledge of drugs,the indications for their use,thir contraindicationsher actionstheir dosage,their dangers or how to treat the patient if he should show a bad reaction to them. The only drug of which we have knowledge is alcohol itself. THOSEVIOLENT CASES Joe Doakes, a new prospect, has telephoned or written to the box asking for help. Or Joe has contaeted us some days ago, has been interviewed a number of times, and has decided to take the A.A. treatment; Mrs, Joe telephones,frantically,that he has come back from town in terrible shape, and she can’t do anything with him. Another Joe has been in A.A. for some time,maybene furbestfriendsand has arelapse slip);wearecalled to straighten him out. may be violent. Perhaps he is abusing the kids, or his wife, or is smashing the furniture. It certainly won’t quiet him down or sober him up to talk A.A. to him. Another drink, obviously, is only going to make him tighter; unless we can get enough into him to make him pass out,” and this type of treatment is not entirely without danger; if he does pass out he may be still more difficult to handle when he “comes to.” Joe, although he is falling all and Mrs.JoeinsistthatnodoctorecalledWecan,ofcousesmackh in the jaw and put him to sleep-if we are the husky type,This treatment, however, apart from the dangers of a broken jaw or missing teeth for Joe and a broken hand for us, isn’t going to be very popular with Mrs. Joe; and Joe is not going to be very enthusiastie about it when he wakes up. suffer; why should we suffer?Let’s give him a couple of “nebs,”or “blue heavens,”or “blue bombers,” or whatever our particular choice of knock-out drops may be,After all we’ve used them before, we’ve seen older members use them, and they seem to work fine. Joe’ll soon get to sleep, we can leave a fewmore for Mrs.Joe to give him if he wakes up too aoon or too jittery (and we won’t get a call in the middle of the night). Tomorrow, after Joe has “slept it off,” or partially so at any rate, we can see him and have a good heart to heart,down to earth A.A.tak,and perhaps get somewhere To a medieal man the number of “12th Stepperswho travel armed with a “mickey”(pint), and one or other of the barbiturates (nembutal, sodiumamytaleconaltuinalphenobarbitalrwhathaveyou),and dishthemu to “drunks” whenever in their judgment, it seems advisable (or the easiest [12 ]

alarming. It is like giving a small boy a high-power, loeded, rifle to play with. Sure, in the majority of cases it works fine. The patient goes to aleep for a while, wakes a bit jittery and his wife gives him one or two more and he goes back to sleepagainwaking stilllater well ontheroad to temporary sobriety. All very nice; no one has had to sit up with him (or on him); no one has a “shiner”; no more furniture has been broken; he hasn’t managed to get out and run up more taxi bills – or smash up his car —or himself or meet the *Law” and spend the night in jail; the family has had a moderately restful night (and so have we); and we’re very popular with everyone. Everybody feels fine (the patient perhaps not so much so).and the whole family is “sold” on A.A. and the fine fellows in it. But – does it slways work this way?— The answer is very defnitely no! OTHER REACTIONS What will be the family’s reaetion if,after our capsule, the patient hecomes much more violent instead ofgoing to sleep?How popular are we going tobeif hegoes intoacomawiththeresultingambulanee and frantic emergeney treatment st the hospital-if the doctor gets to the house in time?Supposing,while he is“out”under our capsule he hasaheart attack dies,and aninuest becomes necessary?Whatifhelater ndevelopsint barbiturate addiet? You sny-Thst can’t happen here!It not only ean,and doesbut it has probably happened in far more cases than anyone realizes. Very frequently we pick up our newspaper and read of someone who has died “from an overdose ofsleeping tabletsNearly all of these sleeping tablets are one or other of the barbiturates,and they can bemuch more dangerous to the personunder the infuence ofaleohol than theyare to the person who simply can’t sleep. Barbiturates,in fact all sedatives and hypnotiesare dangerous drugs If they werenot,the law would not say that they cannot beadministered except under a doctor’s ordersnor would it be necessary tohavea preecription before we can get them from the drug store.True,they have a com paratively wide margin of safety;and for this reason some drugists are rather lax in supplying themand even some dloetors are abit careless in giving out preseriptions.Nevertheless,should we rive an intoxicated alcoholic,or anyone for that matter,a“lue bomber(sodium amytal)on our ownand should thaterondiwemightbe justasguiltyfmanslaugtr as we would be if we got drunk and killed someone with our car-and the coroner’s jury and the law would very possibly take just that view. What are some of the dangers of these harbiturates? One is that the presence of alcohol in the body may slow up the absorption of the drug.The desired action doesnot take place,so we deide that this patient hasmore toleranee than normal and needs a bigger dose.Over a period of time he may have several sueh dosesThen,as thealcohol in his system deereases, in the stomach or intestines; all at once our patient has several doses acting at once – and the results may be disastrous. [ 13 ]

There is another possibility, more likely in the case of an A.A. member who has relapsed (a slipper), than in the case of a new member, Somehow the wires get crossed and s number of A.A.s are called. After our visit and seclative someone else turms up. Joe doesn’t mention our visit -he may not even remember it —and he gets another capsule or so. Perhaps it becomes necessary to call a doctor; he doesnt know of our medicine,aosome more capsules, or perhaps a hypo. The result is the same – an overdose. (I heard of one A.A. member who had given his “patient'” a couple of capsules without much effect, and finally a doctor had to be called. Before he arrived this “doctor of alccholism” said to his intoxicated patient, “Don’t tell the Doc I ave you anything, if he gives you something just dont take it.) There are people who are very susceptible to all the barbiturates, and a very small dose will be too much. There is no way of recognizing these, even for a doetor, but he has the knowledge and the facilities to give immediate treatment, With some patients the barbiturates, in the presence of alcohol, eause Intense exeitement instead of sedation, and they become almost insane. Others have a definite allergy to them, and if given a dose may develop all sorts of things. A patient under the influence of a sedative may swallow his tongue, and choke to death before expert help arrives. Some patients may have a heart condition that we don’t know about; while under our sedative they may have n heart attack and die. Many people are not aware of the fact that sometimes barbiturates can cause a definite hangover. This may be even more unpleasant than an Finally there is the question of addiction. Barbiturate addiction is a defnite conditionand one that can be very diffult to treatThe alcholie ig much more susceptible to becoming an addiet than is the normal person. He has used alcohol for years as a crutch to help him avoid the unpleasant things of life and as an escape from his problems. He is introduced to one of the barbiturates as a cruteh to help him over the jitters; and he finds that, not only does it help him over this trial, but it will partially give him the same escape that alcohol does —and another addietion has been started. Yes, all sedatives are dangerous drugs, except in the hands of the expert. Noneofthemshouldever begivenexcept onthe specifc orders ofadoctor. No “12th Stepper” should have them as part of his “emergeney kit.” If our patientcnteontrolld by actreaningatienrevenlittlemd excellent treatment and the exercise may be good for you at the same time), then you must insist, whether it’s a new contact or a “slipper,” that a doctor be called. On this question of sedatives it might be of interest to know that many doctors are getting away from the use of sedatives in the treatment of acute intoxication,and even in the treatment of delirium tremens. Other treatments are being tried, and some of them seem definitely to be superior to work,isto sho thepatent that there isa“way out”fhistroubleandt try to show him the road to recovery. The treatment of eornplications -— such a3 acute intoxication – must he left to the doctors. [14 ]

DOESA PILL JAG COUNTASA SLIP? I KNOW a person who is planning to celebrate three years of “sobriety.”” He hasn’t had a drink in three years. He has been a sturdy member of A.A., often a speaker.For the past eight monthshowever, he has been using pills secretly. On a number of occasions, he has appeared at meetings and elsewhere under the influence of these drugs. Has he had a “slip?” Can he honestly celebrate three years of “sobriety?” The answers to these questions seem obvious, but it is gurprising how many persons celebrate A.A. anniversaries, although they continue to use pills. In New York and other large cities it is by no means unusual of the strange influence of goof balls. Personally, I think a pill jag is worse than a slip. Surely it is more dishonest. Psychologieally, the pill baby has a worse time than the garden a much worse time. Drugs are not eliminated from the body as quickly as drine habit to combat the sedative-induced depressions.Inevitabty, he winds up in the old squirrel cage:goof ball,hangover;hangover,benzedrine; benzedrine,hangover; hangover, goof balls and so on until he hits bottom. Let’s look at goof balls. Like many other medieines, they come in tablet, capsule or liquid form. They come in all colors, even in stripes. to bring almost instantaneous relief to jangled nerves. Drunks discovered almost as quickly that they would bringat lenst temporary escape from the shakes,insomnia or “that depressed feeling.” Until recently, such pills as barbital and benzedrine could be purehased over the counter at the cormer drugstore. Now most states require a preseription. In some states only the first preseription is required. The purchaser simply takes the box back to the store for refills. In other states barbiturates must be obtained by prescription but benzedrine and,curiously, paregorie may be bought over the counter. In NewYork,where habit-forming drug lawsare strictall of these drugs may be purchased from bootleg druggists and doetors.Priceesdepending on the supply, vary from 10 cents to 50 cents apiece. And so it is quite easy to get goof balls. In fact, many A.A.s, sympathizing with fellow drunkscarry a supply of pills with them on 12th Step calls. It doesn’t occur to these persons that they are not only practieing medieine without a license but may be endangering the lives of their prospects! The reason doctors warn against indiseriminate use of these drugs is the fact that the average layman ioesnt know anything of the history of his “patient” Al too often, the patient may have taken a handful of pills before his rescuers appeared on the sceneWhen he reeives more of the same,he may die from an overdose. [ 15 ]

The A.A. who gets sober on the Program has no need for pills. He will have days when he feels the need for a lift in spirits; when he thinks that knows that he can’t take the first drink. And yet the dry jitters persist. If he knows nothing of pill,he solveg his problem by “toughing it out” or by getting together with other A.A.s to “talk it out.” Jf he knows about goof balls, he may end up by using them. He rational. izes that pills are not alcohol and that he,an alcoholie, can take pills without any of the bad efects. If he resorts to these drugs and finds temporary relief,he may very wellbe on his way to beoming an addict. Some doctors distinguish between “addietion” to and a“dependeney”on drugs. But it is absolutely true that goof balls, like alcohol, develop a tolerance inthebody of theuser.Themore you usethemore you need.The period of relief from the drug shortens and the user compensates by using Jarger doses. Just like whiskey, only the name and the efect are different. Now let’s look at the effect of pills on the user. Some persons become elated after a pill or two. Their reactions sometimes are similar to reactions from alcohol.Others appear only to be quieted fora period by pills.Symptoms of overdosesare drowsinesslackof coordination,digorientation and a general appearance of “goofiness”The hangover eventually becomes jugt as severe as an alcoholic hangover,but it lasts longer.If the drug is with- It has been said by observers that pills bring out allof the“worst quali ties”of the individual. Be that as it may,the reaction is progresive and soon the user suffers viclent withdrawal symptoms.Because there is no odor on the breath of the pill baby,he is often at a loss to explain his eccentric behavior.For thisreason,he becomes all the more secretive,guilt-ridden and frustrated. In my opinion, an A.A. who deliberately gets charged up on pills has slipped. He cannot honestly elaim to have been on the A.A. Program during the period in which he used pills. That the pill habit is dangerous -— indeed, far more dangerous than the alcohol habitis an accepted medical fact. There are many cases of users who suffered permanent brain deterioration. One case on record describes a doctor who built up a seconal habit to 60 grains a day. He was hospitalized for eight months before he began to show signs of slow improverment. pill addicts lose allinterest n he sexurgeThedrugnotnlyineapacitates Another curious effeet of pills on the body of the user is the fact that the addict but destroys the desire. This effect often is the factor that brings about the discovery of the habit in a husband or wife. The A.A. who takes to pills is trading the devil for the witch. If you are using pillsopenly or secretly,dont try to convince anyone that you’re still sober or living the A.A. way of life. It just ain’t so. [16 ]