Twelve Step Lessons Learned -...

East Bay Intergroup, Inc 5/21/2015

Twelve Step Lessons Learned

“When anyone, anywhere reaches out for help, I want the

hand of AA always to be there and for that I am responsible.”

Twelve Step Volunteers:

Please read completely.


East Bay Intergroup

Twelve Step Lessons Learned

1. Introduction 2. Background and Purpose 3. The Twelve Step Call in General 4. Basic Information

5. Some Old Timers Suggest 6. A Few Lessons Learned the Hard Way 7. Medical Issues 8. 12 Step Volunteering- How it works 9. The 12 Step List of Volunteers

1. Introduction

Twelve Step volunteers are an integral part of Alcoholics Anonymous. If

you choose to participate in this service, you may be seen to represent AA.

You may well be the first and lasting impression newcomers have of our

fellowship. To new persons calling us for help, your actions and message

can lead to finding a new way of life in the program of Alcoholics

Anonymous.

The information contained in this handout has been largely compiled

through recommendations based on experience, sought from our Ad Hoc

Committee of Old Timers. It also uses information from AA literature as

well as draws from the 12 Step trainings conducted in other Intergroups.


While the presented information is quite specific, it is not meant to

suggest there is only one right approach. Remember that each of us

already knows how to do a twelve step call because each of us has had the

real and personal experience of getting and staying sober. So we are in a

unique position to convey a message of hope, based on that experience, to

the man or woman who is lost.

Also for your own sanity, please remember we do not have the power to

get another person sober, not even ourselves. Our job is to describe the

actions we have taken which are working for us and to help where we can.

2. Purpose

Over the past decades as alcoholism has become widely

socially accepted as a disease, private and local government treatment

programs and services have gradually become the predominant entry point

for recovery from alcoholism. More recently, however, economic changes

have reduced the availability of these services as medical insurance carriers

and local governments have tightened their belts.

In 1980 in Greater Denver, there were 250 treatment entities. Today, it

is reported that there is less than twenty-five. AA in Denver and other

places have seen that there is now a remerging need for AA to once again

practice its original twelfth step mandate.

Our East Bay AA Hotline works to fulfill our common pledge “to be there

when anyone, anywhere reaches out for help”, by staffing our telephones

24 hours a day, 7 days a week. We served our calls for help by sharing

about our program and experience and sending people to nearby meetings.

Drinkers-in-crisis are referred to our 12 step volunteers. Many of us

remember the paralyzing fear of entering our first meeting unaccompanied

and unprepared for what and who would be there, and many of us found

helpful members who gave us assurance and hope.


3. Twelve Step Calls in General

When the person is looking for help to stop drinking, it is our tradition to

help. These calls can come from anywhere- newcomers at their first

meeting, at work, within the family, but frequently they come to us from

the telephone Hotline.

Sometimes our 12 step work begins by talking over the phone or

meeting with the person, but in general, the form of our help starts the

same way.

We introduce ourselves and let our friend know we are members of AA.

We ask him how he are doing and let our prospect relate the purpose for

his call to AA. We let them talk. We can acknowledge similarities from our

past. On occasion, we might share some of our drinking a little of our

drinking history to show we are speaking from experience.

At some point, we describe our struggle to stop drinking. We tell of the

sickness, frustration, and painful consequences involved. We ask if he has

tried to stop before. We ask if he is ready to stop now. Many need our

program, but some are not ready to stop. If he is not ready, we let them

know if he becomes ready, we would be happy to help, but our program

only works for people who have reached a point of willingness to take

certain steps. We have learned that perhaps John Barleycorn needs to do

some more persuading.

If, he indicates he wants to stop, talk about alcoholism as a disease- its

progressive, chronic and fatal features. Let him know about its two-fold

nature, an obsession of the mind and an allergy of the body.

Our prospect may become curious how it is that we have escaped. We,

then, can share our story, freely speaking of the spiritual aspects, letting

them know that the key is that they be willing to change- that if nothing

changes, nothing changes. Emphasize we do this one day at a time. Outline

our own program of action including how we made an honest self-

appraisal, made an effort to straighten out our past and the importance of

our endeavors to help others.


If he is ready, we explain that we do this program one day at a time and

ask if he would like to stop today. You might ask if he has alcohol (or drugs)

at home and would he be willing to dispose of them. If he does not want

to, don’t try to convince him. He may be able to later. If he is currently

drinking but still lucid, we might still be helpful today.

While we are not doctors and refuse to diagnose, there are times when

going to a medical facility would be the most appropriate action to take.

(We will discuss this more later)

Otherwise, getting to an AA meeting is an important start. If our

candidate is willing, even if he doesn’t feel very good, let him know this call

represents an important opportunity for him and that we encourage him

“to strike while the iron is hot”.

At the meeting, we treat them like any other newcomer. Our newcomer

can be introduced to other AA members that might provide support or

sponsorship. AA literature will help them get started. A cup of coffee, a

cigarette or a donut might also make him feel welcome.

Following the meeting, we may assist the new AA member getting

home, exchange phone numbers and provide a meeting schedule. Help to

identify a meeting for tomorrow and encourage our newcomers “not to

drink in between”. Some of us make a point to ask for the newcomer’s

phone number. If it is provided, we recommend following up with a phone

call within the next 24 hours if possible, being careful not to impart the

impression that we are trying to persuade him of anything.

From this point, much depends on the willingness of prospect. Circling

upcoming meetings you recommend, offering to drive to a future meeting,

inviting him for coffee, including the new person in our conversations, all or

any of these might be helpful for him to make a start.


4. Basic Information on AA*

AA does:

Help people with a desire to stop drinking to find a solution to their

problem.

AA does not:

Furnish initial motivation or solicit membership;

Recommend treatments or rehabs other than AA;

Do interventions and has no opinion on them;

Provide housing, meals or transportation;

Make medical diagnoses or prognoses;

Promote any religious point of view;

Accept money for its services;

Offer professional counseling.

5. Some Old Timers Suggest

“Practical experience shows that nothing will so much insure

immunity from drinking as intensive work with other alcoholics.” Alcoholics

Anonymous p. 89

Does our friend think he has a problem with alcohol? Does he want

to do something about it? We do not sell, we share. If he’s not ready or

interested, leave some literature and move on.

Every 12 step call is different. So stick to our principles, not rules.

Helping one another and especially the new person is the foundation

of our program.


Working together to help someone else is an experience that brings

us close to the newcomer and many times to our fellow 12 steppers.

Some 12 steppers may feel they aren’t ready, or too fearful to help.

Use The Big Book and follow directions. Pray to be useful to our new

friend.

Keep it simple. Have compassion. Tell the person your experience as

a drunk and your early experience in AA.

Explain what a meeting is like, what is or isn’t expected of them.

Bring a meeting schedule and offer to take them to a meeting as

soon as possible.

Bring some basic AA pamphlets. (“This is AA”, “Is AA for Me?”, and “A

Newcomer Asks”)

Encourage them. All they have to do is not drink today; or until the

next meeting.

Listen. Listen. Listen.

Relate and respond to the new person.

We know we are just like they are. They need to know from us, by

our responses, that they are just like us.

6. A Few Lessons Learned the Hard Way

12 Step volunteers provide a potentially life-saving service. We always

try to help. However, should the prospects prove to be uncooperative, too

drunk to be lucid, or abusive, we may decide that this is not the time to

work with them. We suggest that they call back to the Hot Line when they

are ready. With our excessively drunk prospects, it might be best if we call


them back the following day. As our literature suggests, a “jittery”

hangover can often make their problem clearer to them.

Our literature assures us that we needn’t “hesitate to visit the most

sordid place on earth on [our] errand”, but we should be mindful that we

are dealing with sick, sometimes violent people and watchfulness is

warranted. Experience has repeatedly shown that two members should go

on a call and that men should 12 step men and women should 12 step

women.

Each 12 step volunteer needs to use their own good judgment about

driving the callers to a meeting in their own car, but we should discourage

drunk or badly hung-over persons from driving their own car, even if it

means waiting a day to get started.

Also consider that many alcoholics also use drugs. Before driving with

them in your car, ask the newcomers if they have any illegal substances in

their possession and if they do, would they please leave them behind.

Though very infrequently, this has led to problems for the 12 steppers with

authorities.

Unless we can talk to the person himself, requests for 12 step work from

third parties (wives, husbands, parents and friends) have not proven very

useful. We do not do or recommend interventions. We have found we can

only help alcoholics who are open to receiving help. Our task beings when

the alcoholic asks for help. When appropriate, you may direct the third

party to Al-anon or Alateen.

Calls from minors (17 and under) should be referred to Central Office

during business hours.

7. Medical Issues

Alcohol withdrawal refers to symptoms that may occur when a person

who has been drinking too much alcohol every day suddenly stops drinking

alcohol.


In the old days, severe symptoms were avoided tapering off alcohol

consumption using chiefly beer. Beginning at a beer (or shot) an hour and

reducing the amounts gradually used to help avoid dangerous withdrawal

effects on the brain. Today, tapering off methods are not recommended

for the obvious reason that this mode of treatment frequently devolved

into just another spree.

More current understanding of symptoms and treatment is listed in

Appendix 2. Here are a few of the key points.

Summary of key points:

1. Alcohol withdrawal can be harmful, even fatal. It can occur when a

person who heavily abuses alcohol excessively suddenly stops drinking

alcohol.

2. If seizures, fever, delirium or severe confusion, hallucinations, or

irregular heartbeats occur, call 911.

3. Symptoms, as above, usually begin 8 hours after last drink and peak

out in 2-3 days, but can last 7-10 days. (See table in Appendix 2.)

4. Emergency rooms and personal physicians (not detox facilities) can

readily prescribe drugs to eliminate the danger of seizure and ameliorate

withdrawal symptoms.

8. How the 12 Step Procedure Works

When the hotline gets a call involving any of the following:

a. A request to talk to someone at length, thereby tying up the hotline,

b. A request for transportation to a meeting,


c. Need an in-person twelve step call,

d. Or, he hotline volunteer feels unsure of how to handle,

The volunteer should do the following:

1. Take the caller’s phone number, name and location.

2. Go to the restricted Hotline page on the website and click on the

appropriate city/zone.

3. An email form will appear. Fill out the appropriate information on the e-

mail and send, but do NOT include the caller’s telephone number; that will

be given to the first respondent to the call.

4. The first 12 step volunteer to call back on the hotline 510 839 8900 has the

call.

5. After the call is delegated, the hotline volunteer should send a second e-

mail to the same city/zone indicating the call has been handled.

If there is no reply in about 30 minutes, the hotline volunteer should refer to

the 12 Step Back up procedure on the restricted page of the website and call the list of volunteers until someone answers.

9. Becoming a 12 Step Volunteers

If you sign up as a 12 Step volunteer, you will receive emails to respond

to a request for help. While there is no sobriety requirement for 12 step

work, but based on experience, we suggest that 12 step calls be handled by

two members of A.A. with one having at least 1 year of sobriety and a

working knowledge of our steps. Again, we recommend that ideally

women should work with women and men with men.

To be added to (or deleted from) the email list of volunteers, please

email Central Office at [email protected]. Include from

Appendix 4 which Zones you are willing to respond to.


If you are emailed, it is your job to you will be asked to find someone

that can make the call with you. This could be done by contacting a

sponsor, a sponsee, or using a home group list to find someone who can

make the call with you. Make sure your list of numbers is available in

advance of receiving your first call.

Remember the first member calling the Hotline after getting the email,

gets the assignment.

Appendix 1

Basic Background Reading

You have made a commitment to be of service to the alcoholic who still

suffers. Understanding how the 12 Steps and 12 Traditions apply to your

efforts to carry AA’s message of hope is necessary. Please read the

following:

1. Free pamphlet “ Information on Alcoholics Anonymous”

2. AA Tradition: How It Developed, by Bill W.

3. Chapter 7-Working with Others (AA Big Book)

Appendix 2

Alcohol Withdrawal

The following information is chiefly from the National Institute of

Health. AA does not provide medical services, diagnoses or opinions. The

information is offered to help 12 steppers know when the sufferer needs

medical attention.


A. Causes

Alcohol withdrawal usually occurs in adults, but it may occur in

teenagers or children as well. It can occur when a person who uses alcohol

excessively suddenly stops drinking alcohol. Withdrawal usually occurs

within 5 - 10 hours after the last drink, but it may occur up to 7 - 10 days

later.

The following is medically considered excessive alcohol use:

More than 15 drinks* per week for men or 8 drinks per week for

women; or, more than 5 drinks per day for men or 4 drinks per day

for women.

*In this definition, one drink equals 12 oz. of beer, 5 oz. of wine, or

1½ oz. of 90 proof spirits.

The more heavily one drinks every day, the more likely one will develop

alcohol withdrawal symptoms when you stop drinking. The likelihood of

developing severe withdrawal symptoms also increases if other medical

problems are present.

B. Withdrawal Symptoms

The spectrum of withdrawal symptoms and the time range for the appearance of these symptoms after cessation of alcohol use are listed in table below*.

Generally, the symptoms of alcohol withdrawal relate proportionately to the amount of alcoholic intake and the duration of a patient’s recent drinking habit.

Most patients have a similar spectrum of symptoms with each episode of alcohol withdrawal.

Minor withdrawal symptoms can occur while the patient still has a measurable blood alcohol level. These symptoms may include insomnia, mild anxiety, and tremulousness. These alcoholics can experience visual, auditory, or tactile hallucinations but otherwise have clear senses.


Alcohol withdrawal delirium, or delirium tremens (DT’s), is characterized by clouding of consciousness and delirium. Episodes of delirium tremens have a mortality rate of 1 to 5 percent. Added risk factors for developing alcohol withdrawal delirium include concurrent acute medical illness, daily heavy alcohol use, history of delirium tremens or withdrawal seizures, older age, abnormal liver function, and more severe withdrawal symptoms on presentation. Withdrawal seizures are more common in patients who have a history of multiple episodes of detoxification.

Mild-to-moderate psychological symptoms:

Jumpiness or nervousness

Shakiness

Anxiety

Irritability or easy excitability

Rapid emotional changes

Depression

Fatigue

Difficulty thinking clearly

Bad dreams

Mild-to-moderate physical symptoms:

Headache-- general, pulsating

Sweating-- especially the palms of the hands or the face

Nausea and vomiting

Loss of appetite

Insomnia (sleeping difficulty)

Pallor

Rapid Heart Rate

Eye pupils enlarged (dilated pupils)

Clammy skin

Tremor of the hands

Involuntary, abnormal movements of the eyelids


Severe symptoms:

Delirium tremens -- a state of confusion and visual hallucinations

Agitation

Fever

Convulsions

Black outs: when the person forgets what happened during the

drinking episode

*Time Horizons for Symptoms of Alcohol Withdrawal Syndrome

Symptoms

Time of appearance after

cessation of alcohol use

Minor withdrawal symptoms: insomnia, tremulousness, mild anxiety, gastrointestinal upset, headache, diaphoresis, palpitations, anorexia

6 to 12 hours

Visual, auditory, or tactile hallucinations 12 to 24 hours*

Withdrawal seizures: generalized grand mal seizures 24 to 48 hours†

Alcohol withdrawal delirium (delirium tremens): hallucinations (predominately visual), disorientation, tachycardia, hyper-tension, low-grade fever, agitation, diaphoresis (Fatal 1% to 5%)

48 to 72 hours‡

*— Symptoms generally resolve within 48 hours. †— Symptoms reported as early as two hours after cessation. ‡— Symptoms peak at five days.

Withdrawal symptoms may worsen rapidly and may quickly become life

threatening. Treatment typically involves placing the person in a

moderately sedated state for 1 week or more until withdrawal is complete.


Drugs that depress the central nervous system (such as sedatives) may be

needed to reduce symptoms, often in moderately large doses. A class of

medications known as the benzodiazepines (most commonly Valium,

Librium and Ativan) is often useful in reducing a range of symptoms. The

health care provider will watch closely for signs of delirium tremens (DT’s).

Hallucinations that occur without other symptoms or complications are

uncommon. They are treated with hospitalization and antipsychotic

medications as needed.

Testing and treatment for other medical problems associated with use

of alcohol is customary. Disorders related to the use of alcohol include:

Alcoholic liver disease

Blood clotting disorders

Brain disorders such as Wernicke-Korsakoff syndrome (wet brain)

which is a brain disorder due to vitamin B1 deficiency

Heart muscle disorders such as alcoholic cardiomyopathy

Malnutrition

Nerve damage (alcoholic neuropathy)

C. Outlook

Alcohol withdrawal may range from a mild and uncomfortable disorder

to a serious, life-threatening condition. Symptoms usually begin within 8-12

hours of the last drink. The symptoms peak in 48 - 72 hours and may persist

for 7 days or more.

Symptoms such as sleep changes, rapid changes in mood, and fatigue

may last for 3 - 12 months or more. If a person continues to drink

excessively, they may develop many medical conditions such as liver and

heart disease.

Most people who go through alcohol withdrawal make a full recovery.

The long term outlook depends on how much organ damage has occurred

and whether the person can stop drinking completely.


D. When to Contact a Medical Professional

Alcohol withdrawal is a serious condition that may rapidly become life

threatening. Call your health care provider or go the emergency room if

symptoms suggest alcohol withdrawal, especially in a person who has a

history of habitual use of alcohol, or a history of stopping use of alcohol

after a period of heavy alcohol consumption. Call your doctor, if symptoms

persist after treatment. Call 911, if seizures, fever, delirium or severe

confusion, hallucinations, or irregular heartbeats occur.


Appendix 3

RESOURCE TELEPHONE # NOTES

CRISIS HOTLINES

Alta Bates Hospital 510-204-4405 24 Hours - Psychiatric Unit

Crisis & Suicide Intervention 800-309-2131 24 Hours

National Domestic Violence Hotline 800-799-7233 24 Hours

A Safe Place (Battered Women) 510-536-7233

TREATMENT REFERRALS

2-1-1 Treatment- Referral 24/7 Dial 2-1-1 Alcohol, Drug, Housing, Food, Mental Health

ACCESS Alameda Cnty.- Referral 800-491-9099 8:30am – 5pm / Monday – Friday (Medi-cal)

ACCESS Contra Costa Cnty. - Referral 800-846-1652 9am – 5pm / Monday – Friday (Medi-cal)

Alcohol / Drug Treatment - Referral 800-454-8966 Private Pay & Insurance

National Council-Alcoholism 415-296-9900 24 Hours – San Francisco & Alameda County

Watershed Treatment Prog. - Referral 800-711-6375 Alcohol, Drug, Psychiatric Crisis Line

DETOX CENTERS- Call 1st

for Availability

Detoxes will not prescribe meds, MD 1st

Cherry Hill Detox: (CC County charge) 866-866-7496 2035 Fairmont Drive/San Leandro

East County Detox - (Alameda charge) 925-458-1616 500 School St., Pittsburg

Highland Hosp. Emergency- No ins ok 510-437-4800 1411 E. 31

st Street, Oakland

Pueblo Del Sol - (Alameda charge) 925-676-2580 2090 Commerce Ave., Concord

West Cnty (Holoman) – (Ala. charge) 510-233-1270 820 23

rd St., Richmond (Neighborhood House)

TREATMENT/RECOVERY - No Detox

Chrysalis – Women only 510-450-1190 3843 Telegraph, Oakland

Cronin House – Men & Women 510-784-5874 2595 Depot Road, Hayward

Duffy’s 707-942-6888 Res & Detox, 3076 Myrtledale Rd., Calistoga

El Chante Recovery (Sp) (No Detox) 510-465-4569 425 Vernon Street, Oakland

Fremont Hospital 510-796-1100 39001 Sundale Dr., Fremont

Highland Hospital 510-437-5192 1411 E. 31

st St., Oakland

MPI (Summit Hospital)- 510-652-7000 Res + Day + Outpatient, 350 Hawthorne Ave, Oak

New Bridge Foundation (No Detox) 510-548-7270 Res & Outpatient / Detox, 1820 Scenic Ave, Berk

Options Recovery Services (No Detox) 510-666-9552 1931 Center Street, Berkeley

Second Chance Recovery (No Detox) 510-792-4357 6330 Thornton Ave., Newark

Thunder Road Recovery (No Detox) 510-653-5040 Adolescents (13–19 years old), 390 40th St, Oak.

OTHER REFERENCE NUMBERS

Asian Mental Health (Tagalog also) 510-451-6729 Alcohol / Drugs / Mental Health Problems

Helplink English & Toll Free 800-273-6222 Crisis Hotline & Referrals

Spanish 415-772-4444 Alcohol/Drugs / Health Care / Housing

Spanish AA Hotline 408-417-1593 24/7 AA Hotline


Appendix 4

Zone 1 - Berkeley -Berkeley -Albany -El Cerrito -Richmond -El Sobrante -San Pablo -Pinole Zone 2 – Oakland Zone 3 – Alameda Zone 4 – Hayward -Hayward -San Leandro -San Lorenzo -Castro Valley Zone 5 – Fremont -Fremont -Union City -Newark


Appendix 5

“Working With Others” condensed from Alcoholics Anonymous

PRACTICAL EXPERIENCE shows that nothing will so much insure immunity from drinking as intensive work with other alcoholics. It works when other activities fail.

This is our twelfth suggestion: Carry this message to other alcoholics! You can help when no one else can. You can secure their confidence when others fail. Remember they are very ill.

When you discover a prospect for Alcoholics Anonymous, find out all you can about him. If he does not want to stop drinking, don’t waste time trying to persuade him. You may spoil a later opportunity. This advice is given for their family also. They should be patient, realizing they are dealing with a sick person.

Get an idea of their past behavior, their problems, their background, the seriousness of their condition, and their religious leanings. You need this information to put yourself in their place, to see how you would like him to approach you, if the tables were turned.

Don’t deal with him when he is very drunk. Wait for the end of the spree, or at least for a lucid interval. Call on him while he is still jittery. He may be more receptive when depressed.

See your man alone, if possible. At first engage in general conversation. After a while, turn the talk to some phase of drinking. Tell him enough about your drinking habits, symptoms, and experiences to encourage him to speak of himself. If he wishes to talk, let him do so. If he is in a serious mood dwell on the troubles liquor has caused you, being careful


not to moralize or lecture. If their mood is light, tell him humorous stories of your escapades. Get him to tell some of their.

When he sees you know all about the drinking game, commence to describe yourself as an alcoholic. Tell him how baffled you were, how you finally learned that you were sick. Give him an account of the struggles you made to stop. Show him the mental twist which leads to the first drink of a spree.

If you are satisfied that he is a real alcoholic, begin to dwell on the hopeless feature of the malady. Show him, from your own experience, how the queer mental condition surrounding that first drink prevents normal functioning of the will power.

Continue to speak of alcoholism as an illness, a fatal malady. Talk about the conditions of body and mind which accompany it. Keep their attention focused mainly on your personal experience. Explain that many are doomed who never realize their predicament.

Even though your protégé may not have entirely admitted their condition, he has become very curious to know how you got well. Let him ask you that question, if he will. Tell him exactly what happened to you. Stress the spiritual feature freely. The main thing is that he be willing to believe in a Power greater than himself and that he live by spiritual principles. Outline the program of action, explaining how you made a self-appraisal, how you straightened out your past and why you are now endeavoring to be helpful to him. It is important for him to realize that your attempt to pass this on to him plays a vital part in your recovery.


Unless your friend wants to talk further about himself, do not wear out your welcome. Give him a chance to think it over. Tell him that if he wants to get well you will do anything to help.

Do not be discouraged if your prospect does not respond at once. Search out another alcoholic and try again. You are sure to find someone desperate enough to accept with eagerness what you offer.

He may be broke and homeless. If he is, you might try to help him about getting a job, or give him a little financial assistance. But be sure you use discretion. Permit that [abuse] and you only harm him. You will be making it possible for him to be insincere. For the type of alcoholic who is able and willing to get well, little charity, in the ordinary sense of the word, is need or wanted. Some of us have taken very hard knocks to learn this truth: Job or no job—wife or no wife—we simply do not stop drinking so long as we place dependence upon other people ahead of dependence on God.

Burn the idea into the consciousness of every man that he can get well regardless of anyone. The only condition is that he trust in God and clean house.

Assuming we are spiritually fit, we can do all sorts of things alcoholics are not supposed to do. So our rule is not to avoid a place where there is drinking, if we have a legitimate reason for being there. That includes bars, nightclubs, dances, receptions, weddings, even plain ordinary whoopee parties. To a person who has had experience with an alcoholic, this may seem like tempting Providence, but it isn’t.

Your job now is to be at the place where you may be of maximum helpfulness to others, so never hesitate to go anywhere if you can be helpful. You should not hesitate to visit the most sordid spot on earth


on such an errand. Keep on the firing line of life with these motives and God will keep you unharmed.

Good Luck,

East Bay Intergroup of AA

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