Recovering alcoholics who find their way into the rooms of AA are told to expect dramatic changes in attitude and outlook. Their feelings of uselessness and self-pity will disappear, they are told, as will their interest in selfish things. They will become more intuitive about life, and experience serenity and peace. Their haunting fears will diminish. They will experience a new kind of freedom.

These are known as the “promises” of AA, and they are a cornerstone of 12-step recovery. But there is no timetable given. Indeed, alcoholics are told only that these results will materialize “sometimes quickly, sometimes slowly,” and only with painstaking work. In other words, the promises require patience.

And there’s the rub. Patience is not a virtue that most addicts are famous for. In fact, addiction by definition is an inability to delay gratification, to tamp down immediate appetites for greater rewards later on — rewards like happiness and peace. Addicts share this pathological impatience with lots of other risk takers, but theirs has some of the saddest outcomes.