'My name's Mike, and I'm an alcoholic."

The introduction packed more pathos than usual. Mike's venue was not an Alcoholics Anonymous meeting, but a roomful of clergy and clinicians at a conference in Boston last week on spirituality and adolescent addiction. It became more poignant as Mike, 23, who requested that his last name not be used, explained to the audience, which included his parents, that he had started drinking at 14.

During those years, he managed a brief respite of sobriety, but returning to the bottle aroused a sense of youthful fun that proved ephemeral. Within five months, he had dropped 60 pounds, begun shooting heroin, and wanted to die, he recalled. This time, helped by his parents, he cycled through several treatment centers and AA. Besides addressing his battered mental and physical condition, they added a spiritual component to sobriety that he had missed before

Part of AA's famous 12-step recovery process is to surrender one's fate to a higher power. The key to helping many young addicts, Mike said, is to let them define their higher power, which may mean divorcing it from religion. "I had these ideas in my head, whether they were fabricated or not, when I got sober of a revengeful God, thunder-and-lightning type of thing," he said. "I choose to call my higher power God today, because it puts a name on it and makes it easy."

... A fact sheet distributed at the gathering suggested the collective nature of the problem in Massachusetts. Citing figures from the state health department, media reports, and the Hazelden Foundation (a Minnesota-based nonprofit with treatment centers in several states), the sheet said that a third of the Commonwealth's high school students reported binge drinking (five or more drinks in one night) in the previous month; Massachusetts ranks fifth among states for adolescent binge drinkers.

The public is clearly concerned: In last month's elections, voters defeated a proposal to let convenience stores and grocers sell beer and wine after opponents warned it would worsen youthful alcohol abuse, among other problems.

Several speakers at the conference, including a Methodist minister, emphasized the nonreligious aspect of spirituality. Spirituality, properly defined, refers to the quality of a person's relationship with a higher power, their self, and other people, said the Rev. John MacDougall, director of spiritual guidance at Hazelden. A recovering alcoholic himself, MacDougall said he encourages nonbelieving alcoholics to follow the 12 steps and their associated behaviors to achieve a spiritual awakening.

Anonymity, which he defined as "equality in fellowship," is "the spiritual foundation of all our traditions," because it places the principle of equality above personality.

"We all have the same value as children of God," MacDougall said . ". . . That means we behave toward people not according to who they are, but who we are, and more importantly, according to who we believe God wants us to be.

"This is necessary for survival for alcoholics and addicts," he said, because if they think they're worse than others, that sense of inferiority will careen them back towards drink, while if they think they're better, that self-importance might tempt them to think they can handle the bottle.

Twelve-step programs such as AA emphasize that "it is your understanding" as an addict of what "higher power" means, agreed Kris Kampf, the clinical supervisor of Gray Wolf Ranch, a residential treatment program in Washington state.

Not all of what was said met unanimous agreement, as when MacDougall suggested that alcohol and drug abuse are primary diseases that don't require some underlying depression or problem as a trigger. "That's only an opinion," muttered one counselor in the audience.

What did emerge as consensus was that addiction lacerates the addict's spirit, as well as body and mind, and that addressing that spiritual wound is essential. "Being human means not being satisfied with where you are," said the Rev. Bob Hargreaves, a retired Episcopal priest who counsels addicts in two Maine prisons and is a recovering alcoholic. "That's part, I'd say as a Christian, of being made in God's image. And there are all different kinds of ways of going after that stuff. And a lot of people use alcohol and drugs to do it."