SOBERING TIMES FOR A.A.

Alcoholism used to be a secret held close, known only to the sufferer's loved ones, and carrying a harsh social stigma. But anyone walking the streets of downtown San Diego last weekend would have seen little sign that any of the estimated 60,000 recovering alcoholics and Al-Anon members attending the Alcoholics Anonymous convention there were anything but loud and proud. Celebrating the group's 60th anniversary, participants from 72 countries sporting first-name-only registration badges flashed smiles and offered greetings to the people they passed along the San Diego waterfront.

Clearly in its prime, the nation's preeminent alcoholism-treatment organization is also undergoing something of a mid-life crisis. Though A.A. claims nearly 2 million members worldwide, in the U.S. its growth has come at a cost. Founded in 1935 by New York stockbroker Bill Wilson and Ohio surgeon Bob Smith, A.A. is no longer just a fellowship of down-and-out men whose drinking has led them, in A.A. parlance, to "hit bottom." The veterans are being joined by younger people--and women, gays and minorities--as well as by those who are sent to A.A. as part of a court sentence. The newcomers often bring an array of ancillary problems to meetings, including emotional trauma and addiction to other drugs. As the organization metamorphoses, its supporters wonder whether A.A. can or should be such a big tent. "That's a real question," says George Vaillant, professor of psychiatry at Harvard Medical School and an expert on A.A. "Where is the line? What is the responsible limit of tolerance?"

At A.A. meetings everywhere--in church basements, on campuses and in hospitals and prisons--certain basic principles hold. Under a cloak of strict anonymity the "drunk," to use a popular A.A. word, often admits his alcoholism before the group, acknowledging that alcoholism is a disease for which abstinence is the only answer. Most adherents also believe they will never recover but instead will always be "in recovery." Though many who feel they have been saved by A.A. cannot explain exactly how or why it works, they do believe they stay sober by helping others stay sober too.

For some A.A. veterans, this role becomes complicated when other kinds of highs are involved. Helen, a member for 21 years, recalls a young woman who told the group at a meeting a few years ago that her biggest thrill had been going to a "shooting gallery," buying drugs and injecting them. Hearing that, Helen told a friend that her biggest thrill had been going to the cocktail lounge at New York City's Sherry Netherland Hotel because they had great drinks and hot hors d'oeuvres. "The old-timers are being driven away by not being able to identify with the specifics of people's drug stories," agrees Peter, a six-year veteran. "The issue isn't getting more people into A.A. but keeping the ones we have."