There's a reason the entire first 44 pages of the main text of Alcoholics Anonymous, as well as The Doctor's Opinion, are devoted to step 1. Without a thorough understanding of this crucial step, our powerlessness over alcohol and drugs, and the insanity that leads to the first drink, we are unable to see the need for the rest of the steps. The alcoholic or drug addict has to come to terms with this truth about himself in one way or another before any actual step-work can commence. Usually the "work" of step 1 is done while the alcoholic or addict is out drinking or using, it's what brings us to the point of asking for help to begin with.
The Big Book defines alcoholism as a two-part illness. The first part being our powerlessness. This is described in The Doctor's Opinion as an allergy, an allergy which manifests itself as a craving and results in an inability to control our drinking. If we look back on our own lives, our drinking or using experiences should confirm this. Once I start can I stop? Can I call my numbers? Or is it more like the law of inertia where I continue uncontrollably down the path that I'm going until acted upon by an outside force. i.e. jails, hospitals, running out of money, the family leaving, etc. This conclusion is usually a fairly easy one to come to. It's obvious to the alcoholic or addict and the people around him if he can't control his consumption.
It's important to note here that if the only problem we had was an inability to control our drinking or using once we started, the solution would be simple. Just don't start, say no, avoid people places and things, and remember how bad it was. Detoxes would be churning out success story after success story on a daily basis. Yet unfortunately they don't. How many times have we tried this to no avail? Undoubtedly countless if you're the real deal alcoholic or drug addict.
This leads us to the second part of the illness, which is almost two-part in itself. The insanity and the mental obsession, or the unmanageability. This is what drives us back to drinking and using every time. This is what kills us. The mental part of alcoholism is summarily described in a couple places in The Big Book:
"The fact is that most alcoholics, for reasons yet obscure, have lost the power of choice in drink. Our so-called will power becomes practically nonexistent. We are unable, at certain times to bring into our consciousness with sufficient force, the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink." (Alcoholics Anonymous p.24)
"The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death." (Alcoholics Anonymous p.30)
When given a good enough reason to stop, can I? Or do I convince myself, usually in short order, even after terrible events caused by drinking and using, that "this time it will be different" For the true alcoholic or drug addict the answer is usually the latter. For this reason the real problem lies in our minds. We are truly insane when it comes to drinking and using. Time after time we've proven to ourselves and everyone around us that we can't drink or use like normal people, yet we still continue to telling ourselves we can control it. We do the same thing over and over and expect different results. What is that other than pure insanity?
Alcohol and drugs are not our problem, we are. Alcohol and drugs were the solution. Now that we understand what the problem is, and is not, it helps put things into perspective. I can't fix a mental problem by arranging my external circumstances, or going to enough meetings, or moving away, or leaving a relationship, or making enough money.
Page 44 of Alcoholics Anonymous sums up step 1 and leads us directly into step 2. "If, when you honestly want to, you find you cannot quit entirely, or if when drinking you have little control over the amount you take, you are probably alcoholic. If that be the case, you may be suffering from an illness which only a spiritual experience will conquer."