# Does the Big Book say alcohol is "but a symptom"? Is drinking the real problem?

**In short:**
- Yes, on page 64 of Chapter 5: "Our liquor was but a symptom." (p. 64) The next sentence: "So we had to get down to causes and conditions." (p. 64) In place, it explains why the Third Step decision has to be followed at once by the Fourth Step inventory.
- So in Chapter 5 the book does treat drinking as the visible sign of something underneath, which it names as self (pp. 62, 64).
- But the same book insists that alcoholism has a physical side too. It says "the body of the alcoholic is quite as abnormal as his mind" (p. xxvi), and "any picture of the alcoholic which leaves out this physical factor is incomplete" (p. xxvi). The doctor's remedy is "entire abstinence" (p. xxx).
- Context complicates the line. Quoted alone as "drinking isn't the real problem," it drops what the rest of the book says: the alcoholic can never drink safely, and even after recovery "We are not cured of alcoholism." (p. 85)

## The sentence in its place (pp. 63–64)

The reader has just made the Third Step decision. The book says that decision, however vital, "could have little permanent effect" unless it was followed at once by a hard effort to face and be rid of "the things in ourselves which had been blocking us" (p. 64). Then: "Our liquor was but a symptom." (p. 64) "So we had to get down to causes and conditions." (p. 64) "Therefore, we started upon a personal inventory." (p. 64)

The causes, in the next paragraph, are "the flaws in our make-up which caused our failure" (p. 64), and the book has already named the root: "Being convinced that self, manifested in various ways, was what had defeated us" (p. 64). Resentment is the first of those manifestations (p. 64).

So "but a symptom" is the book's reason for the inventory: stopping drinking isn't the whole job.

## The same word, used at another level

The book uses "symptom" in more than one place, and not always for the same thing.
- In the Doctor's Opinion, Dr. Silkworth says that all the types of alcoholic he describes "have one symptom in common: they cannot start drinking without developing the phenomenon of craving" (p. xxx). There the symptom is the craving that alcohol sets off in the body.
- A few pages after p. 64, the book uses the word for the people we resent. They were perhaps spiritually sick, and "we did not like their symptoms" (p. 67).

## The physical side the book won't drop

The Big Book opens with a doctor, and with the members agreeing with him:
- "In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete." (p. xxvi)
- Dr. Silkworth's theory is an allergy: "the phenomenon of craving is limited to this class and never occurs in the average temperate drinker" (p. xxviii). "These allergic types can never safely use alcohol in any form at all" (p. xxviii).
- "The only relief we have to suggest is entire abstinence." (p. xxx)
- Chapter 2: once the alcoholic takes any alcohol, "something happens, both in the bodily and mental sense" (p. 22), that makes it virtually impossible to stop.
- Chapter 3: "We know that no real alcoholic ever recovers control." (p. 30) The illness is progressive, and "Once an alcoholic, always an alcoholic" (p. 33).

## And the mind, and beneath it

The book also says where the main trouble lies. Since the cycle can't start without the first drink, "the main problem of the alcoholic centers in his mind, rather than in his body" (p. 23). Even the doctor writes that unless the alcoholic can experience "an entire psychic change there is very little hope of his recovery" (p. xxix). Chapter 5 goes a level further down, to self (p. 62).

Read together, these pages describe three layers (the grouping is ours, not the book's): a body that can't take alcohol, a mind with no defense against the first drink, and beneath both, the self that the Steps work on. "But a symptom" speaks about the last of these. It doesn't erase the other two.

## Is drinking the real problem?

The book's answer is both. Drinking is what kills the alcoholic: "with us, to drink is to die" (p. 66). He can never safely do it, and he's never cured (p. 85). Drinking is also the sign of something deeper, which the inventory and the Steps go after. And by Step Ten, the book says, the drink problem goes too: "Instead, the problem has been removed." (p. 85) Even then, that holds only "so long as we keep in fit spiritual condition" (p. 85).

## Read it yourself
- Chapter 5, "How It Works" (pp. 58–71), free from A.A.: https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt5.pdf
- "The Doctor's Opinion" (pp. xxv–xxxii): https://www.aa.org/sites/default/files/2021-11/en_bigbook_foreworddoctorsopinion.pdf
- Chapter 3, "More About Alcoholism" (pp. 30–43): https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt3.pdf
- Related: *What does the Big Book mean by alcoholism as an illness?* · *What is "The Doctor's Opinion," and who wrote it?* · *What is the "spiritual malady"?* · *What is the "daily reprieve," and what is it "contingent on"?*
- The full book, *Alcoholics Anonymous*, is sold by A.A. World Services at https://onlineliterature.aa.org.

## Sources
| Source | Pages | First published |
|---|---|---|
| *Alcoholics Anonymous*, "The Doctor's Opinion" | xxvi–xxx | 1939 |
| *Alcoholics Anonymous*, Chapter 2, "There Is a Solution" | 22–23 | 1939 |
| *Alcoholics Anonymous*, Chapter 3, "More About Alcoholism" | 30, 33 | 1939 |
| *Alcoholics Anonymous*, Chapter 5, "How It Works" | 62–67 | 1939 |
| *Alcoholics Anonymous*, Chapter 6, "Into Action" | 85 | 1939 |

Big Book page numbers are from the fourth edition (2001). The Preface says the program text "has been left largely untouched" since 1939 (p. xi); our sources have no first edition to compare page numbers against.

*Recovery Starts is independent and not affiliated with Alcoholics Anonymous. Quotations are brief and cited; the Big Book is © A.A. World Services, Inc.*