Posted on 03/23/2014 4:04:01 PM PDT by nickcarraway
Since its founding in the 1930s, Alcoholics Anonymous has become part of the fabric of American society. AA and the many 12-step groups it inspired have become the country's go-to solution for addiction in all of its forms. These recovery programs are mandated by drug courts, prescribed by doctors and widely praised by reformed addicts.
Dr. Lance Dodes sees a big problem with that. The psychiatrist has spent more than 20 years studying and treating addiction. His latest book on the subject is The Sober Truth: Debunking The Bad Science Behind 12-Step Programs And The Rehab Industry.
Dodes tells NPR's Arun Rath that 12-step recovery simply doesn't work, despite anecdotes about success.
"We hear from the people who do well; we don't hear from the people who don't do well," he says.
Interview Highlights
On Alcoholics Anonymous' success rate
There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don't seem to know that because it's not widely publicized. ... There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.
It's not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we'd say OK. But it's harmful to the 90 percent who don't do well. And it's harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it's you that's failed.
On why 12-step programs can work
The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves, it has to do with the camaraderie. It's a supportive organization with people who are on the whole kind to you and it gives you a structure. Some people can make a lot of use of that. And to its credit, AA describes itself as a brotherhood, rather than a treatment.
So as you can imagine, a few people given that kind of setting are able to change their behavior at least temporarily, maybe permanently. But most people can't deal with their addiction, which is deeply driven, by just being in a brotherhood.
On a psychological approach to addiction
When people are confronted with a feeling of being trapped, of being overwhelmingly helpless, they have to do something. It isn't necessarily the "something" that actually deals with the problem ... Why addiction, though, why drink? Well, that's the "something" that they do. In psychology we call it a displacement, you could call it a substitute ...
When people can understand their addiction and what drives it, not only are they able to manage it but they can predict the next time the addictive urge will come up, because they know the kind of things that will make them feel overwhelmingly helpless. Given that forewarning, they can manage it much better.
But unlike AA, I would never claim that what I've suggested is right for everybody. But ... let's say I had nothing better to offer: It wouldn't matter — we still need to change the system as it is because we are harming 90 percent of the people.
If that’s true then it’s been “not working” for me for almost 18 years.
It’s also a program of want, not need. It is not a panacea.
NPR staff. Bah
Sour grapes. His “program” probably costs money. AA does not. It has helped millions of people. Nothing’s perfect, except in the imagination of a liberal.
The main reason that is “doesn’t work” for the NPR crowd is that is based on a belief in a higher power than man. That is something they just can’t stand.
Look at the picture of the guy in the article. Typical hippy dippy know it all. He doesn’t like it because it brings people to God instead of knocking on his door. I’m okay with some stats that say it doesn’t work for everyone but the idea that its actually harmful is cr*p. No way that they can prove that. The people in the 12 step programs are damaged but the addict is going to hang out with damaged people whether he/she is in the program or not. 90 meetings in 90 days works. I was a grateful member of Al-anon for eight years. It got me through a lot. I’m now very busy with Church and I’m sure Dr. Dode thinks that’s a bad thing.
camraderie?...that's a bad thing?....
those same principles are used in weight loss groups, in study groups, in the miltary, etc...
I cheer AA for helping those they can....even if its ONE person, that's one person not on a perpetual binge...
It doesn’t work for everyone.
All it did for me was provide me with a new bunch of drinking buddies. What eventually worked for me was making a conscious decision to quit and toughing it out. Its been 12 or 13 years since I quit.
I am truly bothered when mental health officials are critical of AA. Treating addiction is amazingly difficult. God bless AA and any other program that can heal the addict.
Good for you, man. It’s definitely a softer way of life, isn’t it?
A person close to me once said “First I lost my mother to alcoholism, then I lost her to AA”. In a way it is a substitution for an addiction. But if it works for some I accept that.
“Not working” for me for 38 years. Continuous sobriety, nights and weekends included.
The article seems to equate fellowship (”brotherhood”) with the 12 step process. I currently see about 30% of the fellowship actually doing the 12 steps. Most stay try to stay abstinent on fear and fellowship.
I will look for some raw data from one of the medical insurance companies about the percentages for people who do the process through step nine. Those people show much higher success. “Anecdotally”, I see >50% for those people who do that.
AA works for those who work AA.
AA claims it works for everybody? This guy is full of chit.
Welcome to the 10%..........
Alcohol abusers (”heavy drinkers” who still have the power of choice) can quit. Many do. I quit smoking the way you quit drinking.
As a recovered, it depends on the individual and their willingness to accept and change on their own honor.
It works...but it is only successful for those who actually try. If the alcoholic puts in the minimum, then they will fail and end up using again. It’s a lifelong activity/commitment, you’re never cured, only in remission.
Its definitely made me stronger and led me to much more productive pursuits and interests. Its nice not sitting at the gas pump figuring if I can squeeze the miles I need out of a gallon of gas and get a 12 pack.
I tortured myself when I quit. I carried an unopened can of beer around with me for months figuring that if I opened it, I had failed. Finally I ditched it.
Placebos work too. Self-hypnosis works. Got to believe. For skeptics, programs of this type will never work.
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