ABSTRACT
Late stage treatment concerns with the addicted individuals will be dominated by two distinct issues that are related and closely intertwined throughout all phases of the treatment process. Foremost is the need to ensure abstinence while simultaneously addressing the need to bring about characterological change in addicted patients. As treatment progresses and as the individuals are able to put more time between the present and their last use of a substance, more emphasis must be gradually shifted to addressing the characterological features that usually dominate addicts' and alcoholics' personality makeup. Within the twelve-step treatment community, these two issues are often categorized under the rubric of relapse prevention and the removal of character defects. AA and other twelve-step programs have long recognized and intuitively known that if healthy sobriety is to be achieved and maintained, it requires the alleviation, modification, or removal of personality characteristics that are incompatible with recovery. From AA's perspective, the removal of character defects is essential if addicts or alcoholics are ever to obtain the only true aim of recovery, which is serenity. Long-term recovery from addiction requires much more than just stopping the use of alcohol and drugs. It requires "working the steps of the program" or employing some other viable alternative so that individuals can alter thenbasic character. Unless this is accomplished, they will stay as miserable as they were when they were using drugs or drinking. In such cases, a relapse is inevitable; the alcoholic or addict is a time bomb waiting to go off. "White-knuckled sobriety" leaves the person angry, dissatisfied, and miserable. AA views such an individual as essentially unchanged, "a dry drunk" who has only given up the use of chemicals, but whose personality or character remains unaltered. AA is well aware of the paradoxical dilemma that abstinence and long-term recovery cannot be maintained without the "removal of character defects," and that character defects cannot be altered or modified until abstinence is first achieved.
