High level of medical treatment in early AA: the lack of it in SA

Doctor William Silkworth

Dr. Smith and Sister Ignatia agreed on one thing — alcoholism could be controlled by medical attention coupled with spiritual attention. 

Sister Ignatia And The A.A., By Gerard E. Sherry. The Sign, Vol. 35: 9-11, May, 1956

Dr. Silkworth wrote much of the contents of The Doctor’s Opinion, Alcoholics Anonymous Big Book. His  obituary in Grapevine, the AA newsletter, in 1951 described Dr Silkworth as:

doctor, a neurologist, a specialist in alcoholism, at Charles B. Towns Hospital, New York, a private hospital specializing in alcoholism and drug addiction.”

he was the world’s greatest practical authority on alcoholism

he was never in a hurry

he had no “formulas,” no stock answers.

the unexpected was to be expected in alcoholism

he came to each new case with a wonderfully open mind.


Doctor Robert Smith (Dr Bob) AA Co-founder

Dr Bob

To 1950, the year of his death, he carried the A.A. message to more than 5,000 alcoholic men and women, and to all these he gave his medical services without thought of charge.
Alcoholics Anonymous p 171

Bill Wilson AA Co-founder

Had Bill W been successful in his mission to incorporate vitamin B3 niacin therapy into AA the entire face of addiction and mental health treatment might have looked very different today. The story goes that before Bill Wilson passed away he was asked what he would like to be remembered for in the history books. Much to the chagrin of experts and those who have benefited from 12-step groups he chose niacin therapy over AA.

Alcoholics Anonymous Founder Bill Wilson’s Long-Lost Treatment Paradigm

Sister Ignatia – Angel of Alcoholics Anonymous

Dr Bob ….. was well assisted by Sister Ignatia at St. Thomas Hospital in Akron, Ohio, one of the greatest friends our Fellowship will ever know.

Alcoholics Anonymous p 171

…in 1952, she was transferred to St. Vincent Charity Hospital at Cleveland, where she was placed in charge of its alcoholic ward. Upon arrival, the ward at “Charity” was part of a dilapidatedwing and was in great need of rejuvenation. Through the Sister’s urging and much assistance from A.A. members with carpentry skills, the ward was soon transformed and named Rosary Hall Solarium.

Sister Mary Ignatia 1889-1966

15,000 alcoholics recovered under the direct care of Sister Ignatia…. They were treated with castor oil, vitamin injections and a membership to AA.

‘Angel of Mercy’

Dr. Smith and Sister Ignatia agreed on one thing — alcoholism could be controlled by medical attention coupled with spiritual attention.

Sister Ignatia And The A.A., By Gerard E. Sherry. The Sign, Vol. 35: 9-11, May, 1956

Bill W’s tribute to Sister Ignatia following her death

A Manual for Alcoholics Anonymous 1940 – AA Group #1 Akron

This pamphlet assumes hospitalization at St. Thomas Hospital under the care of Sister Ignatia and the overall supervision of Dr. Bob as the normal first step in recovery…parts of its advice are still very relevant, and it makes very fascinating reading even today. We must assume that Dr. Bob himself (and probably Sister Ignatia too) gave their approval to the statements made in this little booklet.


One section of the manual focusses on the role of diet, supplements and sleep in recovery:

DIET AND REST play an important part in the rehabilitation of an alcoholic. For many we bludgeoned ourselves physically, eating improper foods, sleeping with the aid of alcohol. In our drinking days we ate a bowl of chili or a hamburg sandwich because they were filling and cheap.… Our rest was the same…. We now find that it is wise to eat balanced meals at regular hours, and get the proper amount of sleep without the unhealthy aid of liquor and sleeping pills….Vitamin B1 (Thiamin Hydrochloride) or B Complex will help steady our nerves and build up a vitamin deficiency. Fresh vegetables and fruits will help. In fact, it is a wise move to consult a physician, possibly have a complete physical examination. Your doctor then will recommend a course in vitamins, a balanced diet, and advise you as to rest. The reason for this advice is simple. lf we are undernourished and lack rest we become irritable and nervous. In this condition our tempers get out of control, our feelings are easily wounded, and we get back to the old and dangerous thought processes – “Oh, to Hell with it. I’ll get drunk and show ’em”

Member Stories – AA Big Book first edition

The stories in the first edition of the AA big book mention the word hospital 100 times and sanitorium 16 times. In modern terms, a sanitorium is a health retreat. Sanatoriums focused on fresh air, nutrition, healthy exercise and even things like Saunas which we now know have amazing neurological and other health benefits. Innovative modern rehab centres include similar practices.

Many early AA groups would only admit new members who had undergone hospital treatment Alcoholics Anonymous (AA) Recovery Outcome Rates p 25

If you ring AA or NA, as an alcoholic or addict they will assess to see if you need medically supervised withdrawal at a detox unit. In some cases, unsupervised withdrawal can be dangerous or even fatal.

Medical treatment in SA

  • In Sexaholics Anonymous (aka The White Book) Roy K, the SA founder, dismissed the role of medicine and therapy in his recovery.

Medicine, psychotherapy, and psychoanalysis didn’t work.  Alcoholics Anonymous did! 

Sexaholics Anonymous p21

In SA Member Stories 2007 and in Essay, the official SA newsletter, occasional reference is made to addiction treatment, which has traditionally been psychological, with limited focus on physiological issues. There is also some mention of treatment for physiological conditions but this is not linked to addiction recovery.

In contrast with AA and NA, in SA, we expect most members to go through cold turkey with its associated risks 

NEXT – SA Founder’s Step Minus One