Before Bill Wilson founded Alcoholics Anonymous in 1935, there was little hope for those with a drinking problem. Intelligent, highly successful people could not understand why they consistently got into trouble when they drank. Moreover, they could not fathom why they repeatedly returned to the bottle despite pledges of total abstinence.

Alcoholics frequently visited hospitals for treatment but the medical community could not come up with any lasting plan that ensured sobriety once they were sent home. Doctors, too, were stumped about why people who were dramatically affected by ethyl alcohol could not simply avoid it. There seemed to be both a physical and a psychological craving; however, the best minds in the field could not put their finger on its cause or its cure.

Some alcoholics were left at the doors of psychiatric institutions with a diagnosis of insanity. Here, too, their illness went largely untreated.

Alcoholism destroyed lives. Families were torn apart. Professional reputations were permanently marred and careers ruined. In fact, although Wilson once enjoyed a lucrative livelihood in the world of finance, alcoholism stole his self-esteem, trustworthiness and ambition and rendered him unemployable.

Fortunately, Wilson found sobriety through an honest conversation he had with a friend from college. This man described how he was able to sustain abstinence by applying the spiritual principles practiced by the Oxford Group, which was a popular religious movement at that time.

Wilson was skeptical. However, shortly after this conversation took place, he was once again treated for alcoholism at a local hospital. The difference this time was that Wilson underwent not only a profound physical change but also had a powerful spiritual experience which led to him and his wife, Lois, joining the Oxford Group.

The fellowship of Alcoholics Anonymous started to come together when Wilson met "Dr. Bob," another alcoholic and co-founder, during a business trip to Akron, Ohio. Wilson recounts in the book Alcoholics Anonymous about the difficulty of maintaining his sobriety when he was away from his spiritual group and family. Longing to talk to a fellow drunk who would offer some consolation and support, Wilson called a local church for assistance. And, although the minister connected him with someone in the community, it was an alcoholic who was in the throes of his disease and in far worse shape than Wilson.

Wilson was able to share his personal story about finding sobriety by using spiritual principles. These principals became AA's "Twelve Steps" and incorporated into the recovery program.

According to its preamble, "Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism."

This statement, which is read at the start of every meeting today, goes on to say that "the only requirement for membership is a desire to stop drinking."

There are no dues or fees but a free will collection is taken at each meeting to pay for its expenses. AA meetings typically take place in a community room at a church or hospital.

Like other organizations, there is not one designated leader. AA members take turns acting as the group's chairperson and treasurer. Those who have some continuous sobriety may also be asked to take on the role of `sponsor'. Acting as a guide through the AA program, a sponsor is someone whom the newcomer could turn to with questions and concerns.

Long term members of Alcoholics Anonymous concur that having a sponsor that one trusts and speaks to regularly is a key ingredient for achieving physical and emotional sobriety.

After all, AA's primary goal is: "to stay sober and help other alcoholics to achieve sobriety." This could only be done by not drinking and showing up at meetings on a regular basis.

And, for the most part, the medical community enthusiastically partners today with the Alcoholics Anonymous program in treating alcoholism. For example, although the Recovery Center of Westport provides individual and group counseling with its on-site psychiatrist, Dr. Joseph Russo and therapists, they are strong advocates of the AA fellowship

"In our work, our goal is to incorporate those with substance abuse problems into AA," said Clarisse Loughran, a licensed drug and alcoholism counselor at The Recovery Center.

Loughran noted that alcoholism affects one in four families. "It's a progressive illness and it's not going to go away," she added. "The longer you wait for treatment, the longer it will take."

Although there are many in patient and out patient treatment facilities in the area, The Recovery Center offers a personalized approach and its staff works together as a team.

"You can't stereotype addicts," said Jeff Klomberg, LCSW, another therapist at the Recovery Center. "It's dehumanizing. Everyone is unique and needs individual attention."

In addition, a basic tenet of addiction is that addicts tend to self-medicate by using alcohol and drugs because they are attempting to escape a feeling or situation. "With all addictions, there is some kind of underlying issue," said Russo.

As the staff psychiatrist for Adult Patient Services at St. Vincent's Behavioral Health Services at Hall-Brooke in Westport, Dr. Zinaida Boutaeva often sees patients with co-occurring illnesses, such as substance abuse and bipolar illness. Her job in the acute care facility is to diagnose and treat the patients during their stay, which is usually about one to two weeks.

Boutaeva also recommends treatment plans that often include incorporating some kind of out-patient therapy with regular attendance at AA meetings.

"Things start to get better and I notice that people relapse during this rosy period," she said.

Loughran agreed. "With our team approach at The Recovery Center, we are all able to watch our clients while they begin to interact soberly with the world," she said. "This could be a very traumatic experience and, unlike some professionals, we are available seven days a week, if necessary. No one is left stranded out there alone, after-hours. That is why we started this group. We saw so many people relapsing on the weekends or holidays when their therapist was not available."

This approach is undoubtedly one of the factors contributing to their clients' overall success rate.

Unfortunately, though, sometimes relapses from abstinent behaviors occur.

"We look at relapse, though, as an opportunity to grow and move forward," noted Russo. "It's a learning process."

Long time AA members say that a relapse, also called a `slip,' happens long before the alcoholic picks up the drink.

For this reason, it's helpful to have a sponsor, therapist or psychiatrist around to sort through the recovery process.

"People have the choice of whether they are going to invest in their life or invest in their illness," added Russo.