Good points Cosima. The basic text suggests that "the main problem centers in the mind", I think it may be in the 12 and 12 where Bill opined that it was possible to help someone see the trajectory of their illness and thus bring the bottom up to hit them. Thus such people had hit bottom as sure as any of us, but may be spared that last years of horrendous suffering. Also I agree that AA does not need to be and is not in practice reserved only for end stage alcoholics. But the experts seem to suggest that there is a certain group at the extreme end of the AUD spectrum, whom we might call end stage alcoholics, for whom some kind of conversion experience is the only possible solution. Dr Jung told Rowland H that, he found a way to have his experience and recovered thereby demonstrating the efficacy of the vital spiritual experience as a path to recovery for the hopeless case. This led indirectly to the ideas that became the founding principles of AA.
For myself, I am not sure one can truly hit bottom while there are still options on the table. That destruction of the ego and admission of complete defeat seem to be the fundamental starting point for spiritual experience which is why I feel it is not such a bad idea to exhaust all other avenues before coming to AA. It certainly does wonders for the motivation to know this is the last hope.