The Doctor's Opinion in the AA Big Book is an interesting document. It reflects the joint thinking of Bill W. and Dr. Silkworth that alcoholism, while certainly having a physical and mental component to it, could not be cured by purely physical or mental means. Overruling any understanding by the alcoholic of her condition was the "elusive" phenomenon of craving and its inevitable cycle of binge, remorse, swearing off, followed by another binge.

Dr. Silkworth hints that there is a moral component to any solution to the problem of addiction, but he notes that attempts to impose a moral solution also seem to encounter a significant problem. In other words, morality on its own won't help. The recovering addict's moral response apparently needs to be based on something else -- by itself, "moral psychology" can't effect a "cure."

Indeed, Dr. Silkworth basically says that there is no medical solution to the problem of addiction, and strongly hints that only the intervention of a Power greater than herself can guide the addict towards recovery.

The dependence of our moral conduct upon our spiritual foundation remains the case when we start to work the last three Steps. Even with many years of recovery under our belts, we tend to believe that our relationship with God as we understand God has to be based on how well we behave. In fact, as the Western religions maintain, it's the other way around. Only a life based on an acceptance of God as we understand God can help us to live as we should. We can't force God's grace by attempting to behave appropriately and then inviting God into our lives. Recovery must always be based on the complete opposite.