Healing Modern Addiction
A conversation with Alex Olshonsky
Throughout history (and to this day), it’s common for many to view addiction as a moral failure. Yet, back in the 1930s, an Army veteran and New York stockbroker, Bill Wilson, also a struggling alcoholic, embraced a different perspective.
To him, “alcoholism was a malady of mind, emotions, and body.” He viewed addiction as a “spiritual malady” that required a “spiritual remedy."
His perspective was shaped during a fourth inpatient stay at a local hospital when he had a “White Light” spiritual experience, became sober, and never relapsed.
He began to spread this message and support other alcoholics in what he called a “nameless squad of drunks.” With a few groups, he helped 100 alcoholics get sober and then published the book “Alcoholics Anonymous” which included the now-famous 12 steps. He kicked off a movement that still continues to grow almost a century later. Today, there are more than 100,000 groups in 180 countries and over 2 million active members.1
Despite how much substance use and addiction treatment have evolved over the last 100 years2, AA remains largely the same and still plays a central role in modern addiction treatment. The grassroots, community-based, and, yes, spirituality-informed nature of AA has helped shape the broader culture of treatment. There’s an ethos of dogged persistence, comprehensive support, and holistic care that is present in most modern addiction treatment.
I saw this firsthand when I worked with the largest safety net hospital system in Boston. To get to our corporate office, I walked past what is often called “Methadone Mile” or “Recovery Road.” Here, I would see hundreds of people living in the throes of deep addiction and all of the hospital services and community organizations set up to support them. The severity of the suffering was vast and visceral. But so was the depth of commitment and collaboration to help.3
In many ways, we’re still wrestling with the question of whether addiction is a moral failure, a “spiritual malady,” or some “secret, more complex, third thing.”
This same debate is now spreading to the world of chronic illness, where people are discussing if conditions like obesity and type 2 diabetes are more indicative of individual character deficits or a deep spiritual crisis in modern life.
So, it’s worth exploring this question through the lens of how people have healed severe addictions. There are valuable lessons we can take by looking at what makes AA, spirituality, and psychedelics so powerful for so many people on the road to recovery.
To do this, I spoke with
about his journey into and out of addiction. We discussed how addiction is a defining characteristic of modern life, how it affects most people in subtle but significant ways, and what we can learn from how people heal from it.Alex is not only someone who has healed a severe polysubstance addiction but is a prolific writer, experienced meditator, and deep spiritual practitioner. He’s the founder of a non-profit addiction program, an executive coach, a somatic practitioner, and an expert group facilitator. Most of all, he’s a deep believer in and champion of people waking up into a more free and joyful life.
You can listen to the full conversation here:
For those of you who aren’t podcast people, I’ve highlighted some of the things we can learn from Alex’s story and the perspective of addiction as a spiritual malady below.
Episode Highlights and Takeaways:
How can we understand addiction?
To orient the discussion, Alex defines addiction as “something that is done compulsively that creates negative consequences.”
To him, Addiction is a spectrum that “modern life is really swimming in”. It’s not just hard drugs but shows up in our relationship with things like screens, social media, and food.
Alex view’s addiction as a way we “distract ourselves from our emotions. So you can really become addicted to anything, any behavior or substance that distracts you from your emotions.”
In what ways was his addiction itself spiritual?
Alex’s addiction was the “gnarly” type and included a severe dependency on drugs like “opiates, amphetamines, and benzos.”
This led to a dark place where “I was in six figures of debt, and my relationships were in shambles. I was pawning electronics to get my next fix.”
Alex shares the perspective that addiction is “a spiritual malady”:
“I was viewing the world as a dead, inanimate, cold universe. I was able to create a cocktail of narcotics that gave me this feeling of aliveness and freedom.”
“When you combine that with then risky behavior like seeing if I can make it in the Tenderloin as a guy who shouldn't ostensibly be hanging out there… there was something deeply spiritual about that.
And I think in hindsight now too, I see that like what I was seeking and all that was just the pure bliss of this moment that you don't need anything to access.”
It’s may seem counterintuitive but there are ways addiction is protecting or even serving the person. For Alex, it was the only way at the time he knew how to get the aliveness and freedom he was seeking.
What did his path to recovery look like?
This led to Alex rock bottom, where “I was so broken and so humbled that I was just ready and open to try anything.”
So, he finally and fully committed to treatment:
“I had to do medically supervised detox for a year in an outpatient program to detox off all the substances. And then simultaneously, I plunged really into AA and the steps… I started working out a lot, eating healthy… and then Buddhist-based recovery and yoga, and then the healing arts, somatics, plant medicines, then onwards.”
It wasn’t about picking between modern traditional medicine and holistic or spiritual-based interventions. It was embracing all of them.
He wouldn’t have been able to engage effectively with AA without the medically assisted detox. But also, his recovery would have stalled and even regressed if he hadn’t deepened into AA, fitness, Buddhism, and psychedelics.
What makes AA so powerful?
Alex described the elements that he felt make AA so transformative and healing, specifically:
Community and Open-Sourced
First and foremost, it’s the people and the tangible support around doing the work:
“The community is what really did it for me… the men in those meetings just really took me in… I needed the practical help of making it through the next day and not relapsing, but also, what do I do about this situation? I'm in debt, my marriage doesn't look so good, now I'm out of work”
“AA is open-sourced, right? Here's the playbook, here's how you can make your own chapter anywhere, but we're not gonna do anything around self-promotion. It's all about the work itself and the members. It's free, and there's a recipe here.”
Self-Awareness and Ownership
It puts ownership fully on the person to understand how they got here:
“In my opinion, why it's been so successful is that it points people to deep inquiry into your own, what they call resentments or character defects…
It forces people to actually look at yourself and produce ownership in your experience. Not blaming other people, but just taking ownership for the situation you have got yourself into.”
Surrender and Spirituality
It asks members to surrender to something bigger than themselves and to go on a spiritual path:
“And then I think the biggest thing is that it's fundamentally a spiritual program, right?”
“A program where you are asked to surrender yourself to any version of that higher power that's bigger than you”
“For instance, the serenity prayer. I recited: God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
In those early days, I was reciting that thing like a mantra. You know, I was in that much pain. I was in and didn't know what to do. And they said, say this prayer over and over again, and you don't know what to do. And I did it hundreds, thousands of times a day.”
Service and Helping Others
It nudges members toward service and helping others:
“Another thing that is beautiful about the 12 step community is that it orients towards service. Even when you're new, and you feel like your life is falling apart, they'll be like, okay, you're gonna do the coffee at the meeting, or you're gonna collect donations.
“And it forces people to really orient to the idea that we keep what we have by giving it away. And that is really a heart-centric opening. I'm going to help others”
“Then step 12, after having a spiritual awakening as a result of these steps, you then help others. It's in the damn steps.
In these descriptions, it’s striking how different and deep the process is than most approaches to healing. It blends tangible peer support with extreme ownership. It invites full acceptance while demanding concrete action. It forces you to simultaneously look in the mirror and step out beyond yourself.
Does this Spirituality create challenges?
It’s clear that AA is a spiritual program and that this has led to controversy. Alex explained how it can even create a barrier for many people:
“This is the biggest hang-up that that most people, including my former self have… when I first started this, I was like, all right, my higher power is like nature or it's something else, but it's not God.”
“A lot of modern people are like, no, that's just not me. There's some people who just, for that reason, still won't go near it.
And I know people in successful recovery who don't view it as a spiritual problem, but I would just strongly disagree with that.”
Despite the challenges, Alex, like Bill Wilson before him, fundamentally views addiction as a “spiritual malady” requiring a “spiritual remedy.”
What makes Spirituality so valuable for recovery?
To understand why, Alex highlights the way addiction involves contraction:
“Addiction is a reciprocal narrowing of the things that bring you pleasure. You start to lose agency in your life to interact with the world because you're only caring about that thing. And it just gets worse and narrower and smaller and smaller and more contraction.”
While the spiritual path involves expansion:
“Spirituality is like this opposite move where you continually open yourself to possibilities in the world.”
This path of expansion can create a shift that heals the core wounds that were contributing to the addiction in the first place:
“A spiritual orientation is deeply rooted in the understanding that there's nothing wrong. There's nothing wrong with you. There's nothing wrong with how you're feeling, that you belong here on this earth, and that you can open yourself to whatever it is that you're experiencing.
When done on its own time, this just unlocks deep happiness and joy for no reason that you didn't know was possible previously”
What takeaways can we bring to other health conditions?
Toward the end of our conversation, we explored similarities and applications for the current chronic health crisis.
Conditions like obesity and diabetes are not only also often viewed as moral failures but involve similar interactions between behavioral, environmental, and genetic components.
In listening to Alex’s story, I was struck by even deeper similarities around self-image, identity, loss of meaning, disconnection from the body, lack of safety, and contraction of what feels meaningful or possible.
So, this discussion left me even more convinced that there is so much more we can and should be doing to fully support people navigating chronic illnesses and the challenges of modern life.
To learn more about Alex, please check out his website, where he has more on his journey and programs. If you’d like to listen to the whole thing, you can access it here:
Thank you for reading. As always, I’d love to hear from you with any reflections, questions, or ideas in the comments or by replying directly to this email.
The story of the founding of AA and statistics on groups and member numbers come from the organization’s website.
In the 1970s, there was an influx of Vietnam veterans addicted to Heroin; in the 1980s, there was the crack epidemic, and now we are in the throes of an opioid crisis. What once was viewed as just a moral failure evolved into a disease model and then expanded through behavioral frameworks, brain imaging, medical-assisted treatment, and now harm reduction strategies.
It’s organizations like these that I believe most embody the idea of Finding the Humanity In Healthcare.
I've just read The Awakened Brain by Lisa Miller which is basically saying the same thing as this - that the remedy we need is often spiritual, but talks a lot about the neuroscience etc. backing this up too.
I think there is a really interesting question of how to provide spirituality for the non-religious. It's interesting seeing the different ways that different types of therapy trying to do that.