What Does "First Things First" Mean?

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Triage is the method used in emergency medicine to decide priorities. For individual patients, it comes down to a stepwise assessment and addressing the most important problems before the less important. The basics are: Start the breathing, then stop the bleeding, then protect the wound, then treat for shock. There's an important sequence. It does little good for instance, to stop the bleeding if the patient isn't breathing.

For alcoholics the meaning of "first things first" is simply a way to keep sobriety front and center. Without abstinence, all of the other problems can't be "fixed." For alcoholics, the "first thing" is not drinking.

In the Big Book, it is explained this way:
Above all other concerns, we must remember that we cannot drink. Not drinking is the first order of business for us, anywhere any time, under any circumstances.

Some have asked us, "Does this mean you rank sobriety ahead of family, job, and the opinion of friends?"

When we view alcoholism as the life-or-death matter it is, the answer is plain. If we do not save our health — our lives — then certainly we will have no family, no job, and no friends. If we value family, job, and friends, we must first save our own lives in order to cherish all three.

Does this mean that sobriety alone is a cure-all? No. There will be other problems -- most alcoholics have many. The important point is to keep one eye firmly fixed on this first thing -- sobriety. Without that, the patient dies. With that, there is hope.

Keeping this phrase in mind also helps fight off a common excuse to go back to the bottle. It’s the pity party and the depression that comes from not being able to repair a relationship or get a job or any of a thousand things that can go wrong in life. Sticking with the “first thing” means that no matter what else is going on I won’t drink. Period. This has to be the most important thing because without it, nothing else will change.

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