Having set this sinister stage, Glaser urges women struggling with alcohol to seek out alternatives--to explore what she, with no small bias, calls "Twenty-First-Century Treatment." And what does this entail? Well, for starters, you send in a deposit check of $2,500 (to be followed with an additional $8,750 for five days of therapy, a medical evaluation, and three months of follow-up through a California treatment business called Your Empowering Solutions. Glaser helpfully notes that this is "a bargain by the standards of private rehab, never mind that most alcoholics can likely afford neither), book a plane flight, and reserve a room "at a luxurious inn near the ocean" where you'll stay during your five full-day sessions. Once there, in addition to undergoing counseling, you're likely to be prescribed the drug naltrexone, which reduces the pleasure of drinking--and thus its appeal--through endorphin blocking and costs about $100 monthly. (There's also an injectable form costs up to $1,000 a shot, Glaser notes). At least that was how things unfolded for "Joanna," Glaser's sole example of a woman embarked on this regime, whose treatment story occupies a good part of a 30-page chapter.

Think this could be hard to pull off for anyone besides the wealthy? Not to worry, Glaser has a plan--albeit one that seems unlikely to materialize in the foreseeable future. "Rather than entrust recovering drinkers as the first and last mechanism of support, we need to convince insurance companies and federal insurance programs to reimburse doctors for their new role, and patients for expensive medication." Good luck with that. In the meantime, there are millions of women (and men)--many un- or under-insured--suffering, who need help. AA is free--and it is everywhere.

In fairness, I share more than a little of Glaser's frustration with AA's failure to move with the times in its treatment of women, as well as with some of the religious framing that so antagonizes her (and, as she observes, the two are often related). For me, this has centered on out-of-date AA literature, including the seminal text known as "the Big Book," in which women appear primarily as the beleaguered helpmeets of alcoholic husbands, and not the alcoholics themselves. Well into the 21st century, there continues to be a Big Book chapter addressed "To Wives," replete with exhortations of patience and compassion. "Try not to condemn your alcoholic husband no matter what he says or does," is one such admonition.

The book's pervasive focus on male alcoholics, a vestige of the era when AA was founded, even led one anonymous AA member to pen a "contemporary translation" that dispenses with many masculine pronouns and otherwise attempts to make the Big Book more inclusive. "Women today frequently feel excluded by the Big Book, sometimes even hurt. They are forced to rewrite it mentally in order to include themselves," writes "J" in the introduction to A Simple Program, published by Hyperion in 1996. Similarly, where the 12 steps include the language "God, as we understand him," I--and a growing number of people in meetings I attend (not all of them women) have taken to reading "God as we understand God." (As to why AA doesn't simply change this language when any number of churches have managed to update hymnals and prayer books, all I can say is that an astonishing number of women AA friends, including lesbians and self-proclaimed feminists, have looked at me blankly when I raise the issue. "It doesn't bother me," they say.)