By LEONORA LaPETER, Times Staff Writer
Some 70 years after the quiet start of Alcoholics Anonymous, its basic formula is applied generously, with a few twists.
LARGO - Inside a church meeting room, six men sat in a circle on brown folding chairs lost in thought.
Among them: Joe P., who has just climbed out of a four-year depression and wants to keep it that way. Tony M., who's trying to accept that he's not going to end up with the woman of his dreams. And Bill M., who has felt lousy for 14 years and is trying to figure out why.
In the next room, a children's choir practiced a hymn about miracles and being born again.
But here, these men, who don't know each other's last names, began to discuss their emotions.
About 1,100 Emotions Anonymous groups such as the one at the First Christian Church of Largo meet around the world every month. But if the men had been gamblers, drug users, overeaters or sex addicts, they also would have been able to seek solace in a 12-step meeting a lot like this one.
Some 70 years after a New York stockbroker and an Ohio surgeon met for the first Alcoholics Anonymous meeting, the 12-step recovery program they pioneered dominates the addiction treatment landscape in the United States today.
But even as researchers have studied and debated its effectiveness in treating alcohol and drug addiction, the program has spread like a blanket of kudzu vines to just about every problem imaginable. In fact, Alcoholics Anonymous has granted permission to use its 12-step model 660 times, according to the organization.
"We have always been generous about that, but we don't judge the merits of any of these 12-step programs: Does it work, doesn't it work," said Gary Glynn, a nonalcoholic past chairman of the board of Alcoholics Anonymous. "We don't have an opinion. We do like to grant copyright use so it doesn't come back and haunt us."
There are now 12-step meetings for shoplifters, clutterers, adrenaline addicts, debtors and diabetics. People with HIV, cancer and hepatitis can find fellowships of fellow sufferers, as can victims of domestic violence and those with attention deficit disorder and depression. There's a camp for anonymous groups and a 12-step cyber cafe.
There's an anonymous program for gangs and criminals. Another for artists struggling to surrender to their creativity. And one called Vulgarity Anonymous for those who can't stop cursing.
There's Media Anonymous for media addicts. They did not respond to a reporter's phone calls.
And another called International Pharmacists Anonymous, which meets in 30 locations nationwide for pharmacists in recovery from various addictions.
They are surrendering their problems to a higher power. Turning their will and lives over to God, as they understand him.
Taking inventory of their lives, admitting their wrongs. Dealing with it together online or in meetings. Helping others.
One step at a time.
When Alcoholics Anonymous first began during the Great Depression in Akron, Ohio, right after the repeal of Prohibition, it filled a void. Treatment for alcoholism was virtually nonexistent in 1935.
Its premise was simple. Alcoholism was a disease involving the mind, emotions and body, and together people who had the disease could work to achieve sobriety and then pass it on to others. In the process, they would turn themselves over to a "higher power."
By the early 1950s, the group reported 100,000 recovering alcoholics, family members had formed Al-Anon, and the concept had spread to drug abusers in the form of Narcotics Anonymous.
Today, Alcoholics Anonymous reports some 2-million recovering alcoholics and more than 103,000 groups around the world. Hundreds of thousands of meetings occur worldwide. On any given Wednesday, there are 95 AA meetings in Pinellas County alone.
Experts say it is popular because it's free and accessible. It has become the dominant form of treatment for alcoholism today, with 93 percent of U.S. outpatient and residential treatment drawing from the 12-step program, addiction experts said.
But how well it actually works is debated. A number of psychologists, psychiatrists and addiction experts say that the United States relies on it too much, and that while it works for group-oriented people, its one-size-fits all approach doesn't work for everyone.
"The real problem is that its value is greatly overestimated by our society," said Lance Dodes, an assistant professor of psychiatry at Harvard Medical School and author of The Heart of Addiction. "Alcoholism is a psychological problem first of all, and AA does address psychology to some degree, but it's not for everybody, and some people can't make use of it."
The program's reliance on religion can make following difficult for nonbelievers.
"It does fit in with the American psyche of being religiously oriented," said Bill Dubin, a psychologist from Austin, Texas, who specializes in addictive disorders. "The problem is that sometimes the people who are (running it) don't know what they're doing. So for many people, it's very helpful. For many others, it's not."
Studies about AA's effectiveness vary. One study showed that 17 percent of alcoholics in an employee assistance program who attended AA meetings remained abstinent two years later.
But another study of 200 alcohol abusers in San Francisco showed that 12-step participation helped alcoholics just as well as outpatient treatment.
"And the AA groups spent about 40 percent less on health care, because AA is free," said Keith Humphreys, an associate professor of psychology at Stanford University Medical School. "We're lucky as a society to have them."
There's no doubt AA's popularity has led the 12-step program to be replicated over and over.
"When one tells about their trials and tribulations to individuals of common understanding, whether it's fishermen, people in the securities industry, alcoholics, artists, they can relate to what they're saying and it becomes a healing process," said Frank Lagerstedt, chairman of the board of trustees of Artists Anonymous.
Sandra Felton was drowning in clutter. Decade-old newspapers and calendars were stacked all over her home. Her children's school papers would disappear into the debris and never get turned in. Whenever a photo was taken, the debris had to be moved so the picture wouldn't show the clutter.
"I had a great deal of fear, so I kept everything," the Miami woman said.
Finally, the clutter became a crisis. A stack of newspapers stashed under her kitchen sink became soaked from a leak. It rotted out her floorboards and water came out beneath a stove.
The seeds of Messies Anonymous were sown. Twenty years later, it's a business enterprise as well as a support group. Felton, a retired schoolteacher, now has written eight books about organization and a Web site touts products such as the "super flipper" booklet for organizing tasks. There are at least 17 12-step Messies groups meeting around the country.
But it is not strict in its adherence to the 12-step program, so 12-step advocates who are pack rats may find Clutterers Anonymous works better for them. A group spokesman will give only his first name and last initial.
"We read directly from the AA book and translate the word alcoholic into clutterer," said Jason C., who lives in Los Angeles. "We consider it a disease and think it has elements of addiction. People who are dealing with clutter can't stop cluttering. It's a big problem and it's getting worse."
And clutterers aren't the only ones who say they're suffering from an addictive disease.
The adrenaline addicts say they are hooked on the adrenaline rush, or a feeling of stress, to fill an emptiness. As do the compulsive debtors who have loaded up their credit cards. And the shoplifters who steal over and over.
"I'm not saying we shouldn't be arrested and prosecuted," said Terrence Shulman, a lawyer, therapist, recovering shoplifter and author of Something for Nothing. "But it's an addictive behavior ... a behavior that creates negative consequences and yet one finds it hard to stop."
Psychologists recognize drug and alcohol addiction as diseases, but say some people are using the term "addiction" to describe normal human foibles.
"The idea is to turn everything into a disease, so any type of problem you have is not your fault," said Dubin, the psychologist.
At the Emotions Anonymous group in Largo, Bill H., a retired cop, threw out the theme for the meeting. It's "acceptance."
Silence. Then Tony M. piped up. He's 44 years old, works in customer service at a big company, comes from a traditional Italian, Catholic family.
"I've had ideas about the person I'm supposed to be involved with, and I've come to realize it's not going to happen that way," he said. "I have to accept that whoever I will get involved with will be divorced and have kids from another marriage. Finding the cute plain Jane that all the guys ignored is probably not going to happen."
Bill M. offered that it's hard to stay positive when you feel bad physically for as long as he has. He began seeing a therapist and found that the EA meetings helped him even more.
"This is the only setting I can talk about the fact that I feel crummy physically and I feel like things are falling apart," he said. "I can't do this at work. Here nobody is going to jump down my throat."
After they'd had their say, the six men stood in a circle, held hands, bowed their heads and began another 12-step tradition, the Serenity Prayer.
"God, grant me the serenity to accept things I can't change . . . "
- Times researcher Caryn Baird contributed to this report.BY THE NUMBERS
660: The number of times Alcoholics Anonymous has granted groups permission to adapt the 12-step program.
1969: The year Debtors Anonymous started when a group of Alcoholics Anonymous members met to discuss problems they were having with money.
550: The number of Alcoholics Anonymous meetings in Pinellas County during any given week.
31,000: The number of weekly meetings of Narcotics Anonymous that take place around the world.
7: The number of countries, including the United States, that have Domestic Violence Anonymous groups.
26: The number of Self-Mutilators Anonymous meetings that take place each month in the United States.MESSIES ANONYMOUS: DELIVER US FROM CLUTTER
Most 12-step programs follow the model developed by Alcoholics Anonymous, while substituting their own problem or concern for alcoholism. Here are the 12 steps of Messies Anonymous:
1. We admitted we were powerless over clutter and disorganization - that life had become unmanageable.
2. We came to believe that a Power greater than ourselves could restore us to SANITY.
3. We made a decision to turn our will and our lives over to the care of God, as we understood him.
4. We made a searching and fearless moral inventory of ourselves.
5. We admitted to God, to ourselves and to another human being the EXACT nature of our wrongs.
6. We were entirely ready to have God remove all these defects of character.
7. We humbly asked him to remove our shortcomings.
8. We made a list of ALL persons we had harmed and became willing to make amends to them ALL.
9. We made DIRECT amends whenever possible, except when to do so would injure them or others.
10. We continued to take personal inventory, and when we were WRONG promptly admitted it.
11. We sought through prayer and meditation to improve our conscious contact with God, as we understood him, praying only for the knowledge of his will for us and the power to carry that out.
12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to others who suffer from disorganization in their lives, and to practice these principles in ALL our affairs.