Review Sees No Advantage in 12-Step Programs

The Treasonous NY Times ^ | July 25, 2006 | NICHOLAS BAKALAR

[neverdem]

When Alcoholics Anonymous and other 12-step programs are examined in controlled studies, a new review reports, scientists find no proof that they are superior to any other intervention in reducing alcohol dependence or alcohol-related problems.

The researchers, led by Marica Ferri of the Italian Agency for Public Health in Rome, found little to suggest that 12-step programs reduced the severity of addiction any more than any other intervention. And no data showed that 12-step interventions were any more — or any less — successful in increasing the number of people who stayed in treatment or reducing the number who relapsed after being sober.

Alcoholics Anonymous is a self-help group that offers emotional support for alcohol abstinence and holds that alcoholism is a spiritual and a medical disease.

In some of the studies reviewed, A.A. was compared with other psychological treatments including cognitive-behavioral therapy, which encourages the conscious identification of high-risk situations for alcohol use; motivational enhancement therapy, based on principles of social and cognitive psychology; and relapse prevention therapy, a variation on the cognitive-behavioral approach. It was also compared with other spiritual and nonspiritual 12-step programs.

One study compared brief advice to attend A.A. meetings to motivational methods for encouraging 12-step involvement. Another evaluated the effectiveness of hospital-based 12-step programs, compared with community-based 12-step efforts.

The paper was published last week in The Cochrane Library, a journal devoted to systematic reviews of health care interventions. In all, the researchers examined eight trials involving 3,417 men and women ages 18 and older.

None of the studies compared A.A. with no treatment at all, and the researchers said that made it more difficult to draw conclusions about effectiveness. About one-fifth of alcoholics achieve long-term sobriety without treatment.

There is no single known cause of alcoholism, but the researchers wrote that...

[RobFromGa]

PING from London, this thread might be of interest to you! Freegards, RobFromGa

[wildcatf4f3]

If aperson can drink moderately then they are not a true alcoholic. For Alcoholics , the drug alcohol IS n addictive drug like heroin. Never heard of a successful "social heroin user".

[RobFromGa]

In my experience the key is a total sincere desire to quit. See this thread if you think you might have a problem.

If You Suspect You Might Have A Drinking Problem (An Open Letter)

[SeaBiscuit]

Good for you, hold on to it.

[CurlyDave]

I am shocked, I tell you, shocked, that a group of psychologists would find that AA is no more effective than psychological treatment.

Those who have "been there and done that" know which method works better, and it is not psychological.

[wildcatf4f3]

Good for him. I'm truely happy when the scourge of alcoholism is lifted from a family. For me AA was a way back to God. I was estranged from the Lord by my own actions but through AA I was able to come home. AA says that it is only the beginning and that many of its members seek spiritual growth in the church/temple whatever...the 12th step is not the end. It says that "Having had a spiritual awakening..." Its just a awakening...the begining of a new day...theres alot more to do....For people as hardheaded as me, AA worked but only after I had pretty much trashed my life.

[Myrddin]

I very much enjoy a good glass of beer and a fine steak. That enjoyment has put 25 lbs back on my hide...weight that was a real bear to work off. Recently, I returned from an early evening meal at Applebee's. A 23 oz glass of beer went just fine with the apple walnut chicken salad. I was driving toward the house when I realized the air was clear and calm. A rare, perfect day for some precision target shooting. A rare opportunity that I had just squandered with a glass of beer. Not only was shooting out of the question, so was any other productive use of time debugging my embedded systems boards. What a damn waste. All for a glass of tasty, fattening beer.

I'm back on my salad and ice tea routine gain. The scale is beginning to succumb to the lowered calorie intake. A regular vigorous interlude with kettlebells is kicking up the metabolism as well.

Step #12 can be a real epiphany when you realize all the good stuff you're missing in exchange for an alcoholic beverage.

[peggybac]

Great letter, Rob. Thanks for posting it.

[ByDesign]

"Why should abstinence by the goal? Why not moderation? That has always been a question I've had about AA. When abstinence is the goal, one slip and you are a failure.

Should that be considered acceptable and realistic?"

Honest question, here's my honest answer:

If they, the alcholic/addict had the ability to do things in moderation, there would be no problem in the first place.

Addiction is the loss of control in using a substance, be it alcohol, tobacco, heroin, coke, whatever, and the behavior that goes with it, and the impact of the abuse on the addict, and the people around them.

Drinking every day does not make you an addict. *Needing* to drink every day does.

I had an alcoholic father, drug addict sister, and many friends who abused every substance you can imagine. I've been through rehab with them, many AA meetings, family counseling, and been to far too many funerals. Trust me, moderation is impossible with the addict, and is just controlling how fast they commit suicide, not stopping it.

As for "one drink and you're a failure", that's not what I've seen taught or practiced at AA at all.

I would encourage you to find a local AA group and attend a meeting - you're more than welcome, and while it may be tough to hack the first time, it'll show you the way they work, and dispell any doubt you may have and answer any questions you might have.

[wildcatf4f3]

Jugging by your screen name, I predict your interaction with AA is not over. In my drinking days I used to scoff that maybe if I kept drinking long enough and lost enough brain cells I'd be able to believe that AA crap...

[peggybac]

"Drinking every day does not make you an addict. *Needing* to drink every day does. "

In the last year of my drinking, I drank at a very early hour just to feel "normal."

[wildcatf4f3]

People who are adamantly against AA...kind of makes you wonder eh? Why is it so important to them...know what I mean?

[Rembrandt_fan]

You wrote, "My husband quit on his own after 24 years of drinking..."

Speaking only for myself, I couldn't do it alone. I tried and tried. Finally hit bottom--homeless, jobless, newly divorced, I came out of a blackout in jail, covered in someone else's blood from a bar fight, looking at seven years' hard time for felony assault, with no memory of any of it. It isn't necessary for one to give it all away to get sober: job, home, marriage, freedom, but it was necessary for me. At that point, I asked a God I didn't believe in to make me well or let me die.

Thankfully, the criminal charges were reduced to misdemeanors, so I only did a few months in county jail, not years in prison. I went from jail to a rehab center, from the rehab center to a halfway house, from a halfway house to the world.

AA saved my life, but I believe there's many paths leading to the same clearing. If your husband can stay sober on his own, then good for him. I mean it.

[tina07]

I'm glad that AA worked for you. And yes I couldn't be happier either that alcohol is no longer part of my marriage, and immediate family. It was a real 'three's a crowd' feeling in the marriage. I haven't seen anything good come from drinking and I've seen a lot of the bad. I've never been drunk ever, so I am totally biased and anti-alcohol but I have 3 out of 3 siblings that are alcoholics. One is disowned for the last 5 yrs. so I don't know about him today, my one other brother has been heavily drinking for the last 3+ yrs. from financial problems and took up pot too (yeah, that's cheap on the budget, NOT!), and my sister has been drinking every day for the last 16 yrs. or so. As I used to say about my husband when asked if I drink, I said no, he drinks enough for the both of us, now my siblings do.

[peggybac]

Wow, Tina. Prayers out for your family.

[wildcatf4f3]

like your post. I used to be an "intellectual" but then I wised up. At 8 years sober, this is the best my life ahs ever been....even with all the troubles it's great.

[SeaBiscuit]

Thanks for the mini fourth, that was a meeting in itself. Hang on to it.

[Canedawg]

"People who are adamantly against AA...kind of makes you wonder eh? Why is it so important to them."

Being the cynic i am about these "studies", I suspect they dont like the God references in the 12 Steps.

Congrats to all of you who have succeeded in staying sober.

[bad company]

I am shocked, I tell you, shocked, that a group of psychologists would find that AA is no more effective than psychological treatment

I'm shocked too. As much money as psychologists lose to AA You'd think that they'd be more generous in their opinion.

[tina07]

Thanks. I don't see my brother who's been drinking for the 3+ yrs., it's sad to see how he's withdrawn himself from family, he's a great person but lost right now. My sister lives far away, but we are close by phone. My son dabbles with drinking which scares the hell out of me, like watching the past come alive. Alcoholism on both sides of his family.