Challenging Alcoholic's Anonymous As The Leading Form Of Addiction Treatment

Opposing Views ^ | 02/13/2014 | By Will Hagle

[Responsibility2nd]

Alcoholics Anonymous and its related groups for other substances are undeniably the de facto standard for addiction treatment. The AA meeting is so prevalent throughout society that it has become a cliché in cinema and television. To many, it seems like the only solution. 

Pacific Standard recently ran a piece with the headline “After 75 Years of Alcoholics Anonymous, It’s Time to Admit We Have a Problem.” According to the article, “90 percent of American addiction treatment programs employed the 12-step approach” by the year 2000." The article argues that although it is the dominant form of addiction treatment, Alcoholic’s Anonymous’ religious-based, 12-step approach might not be the best option.

In his new anti-AA book Clean: Overcoming Addiction and Ending America's Greatest Tragedy, former director of Harvard's substance abuse treatment unit Dr. Lance Dodes writes the following: “Alcoholic’s Anonymous was proclaimed the correct treatment for alcoholism over seventy-five years ago despite the absence of any scientific evidence of the approach’s efficacy. And we have been on the wrong path ever since.”

In fact, several alternatives to AA do exist. HAMS, for instance, is a harm reduction program that encourages addicts to complete small, realistic goals such as slowly reducing alcohol or drug use. There is also the Secular Organizations for Sobriety, a method that emphasizes participants need not submit to a higher power as AA requires them to do. There are many other addiction recovery options.  

None of these options, however, have taken over AA’s spot as the most prominent pathway to ending addiction. The difficulty in establishing an effective treatment program is that many of the programs require mental and behavioral therapy rather than medical treatment. SMART Recovery, the first result returned on Google after a search for “alternatives to Alcoholic’s Anonymous,” refers to addiction as a “bad habit” rather than a disease, emphasizing the “motivation” to quit. 

The ways in which American society treats nicotine addiction has always differed from the ways in which it treats alcohol and other drugs. There are nicotine patches, gum, and now electronic cigarettes that purport to lead to smoking cessation.  Medication in the form of a pill even exists. Varenicline, most commonly known as the brand Chantix, reduces an individual’s urge to smoke and even causes cigarettes to taste worse.  

There are also pharmaceutical drugs on the market that help reduce the urge to drink alcohol or other drugs (methadone being a common example for use in drug detoxification). But, of course, using medication to curb the problem is simply introducing a to which an addict’s body and mind becomes accustomed. 

As Pacific Standard notes, addiction is a multifactorial disease about which we still know extremely little. Treatment programs such as AA might be beneficial to a certain degree, but it’s time to increase the collective effort to discover better treatment options. 

Get More: addiction | Alcohol and Drugs | alcoholics anonymous |

[TNoldman]

Ping 12 steps

[Wicket]

good guess.

[socal_parrot]

Alcoholic’s Anonymous’ religious-based, 12-step approach might not be the best option.

Stopped reading right there. AA is not religious or even God based. It's a spiritual program based on the belief a higher power (of our understanding) can restore us to sanity. The program also states the concept of a higher power can be anything that makes sense to you. There are plenty of Christians in the program, but there are also Buddhists, Hindus and lots of atheists (although I have yet to meet a Muslim in the program).

AA does not set itself above any other program as the be all and end all of recovery programs. It works for me and has for several years.

[Jeff Chandler]

Their personal testimonies which have been witnessed by millions and millions.

All hearsay.

Of the people witnessed to be claiming to be helped by AA, how many were telling the truth? And many more AA members might have been quit drinking outside of AA?

For all we know, AA could be holding more people back from sobriety than it is helping.

[Jeff Chandler]

The most an individual can honestly say is, "I believe AA helped me," or, "I heard a person (or some people) claim that AA helped him (them)."

Anything more is speculation.

[Psalm 73]

"We just don't know, and we cannot know."

I understand your point.
But sometimes we must "walk by faith and not by sight".

[Paleo Conservative]

Most modern rehab programs are: Pay them $20,000 to dry out for a month, and then they tell you to go to AA.

We put my father though a month treatment 30 years ago. The money was well spent. They did more than just detox him. It wasn't till after being fully detoxed that he started the treatment program. The treatment center hosted several AA meatings each week. They did a full physical and lab tests, and discovered albumen in his urine indicating that he needed to have his kidney functions monitored. If he hadn't gone into treatment and started going to AA meetings, I doubt he would have lived more than another 5-10 years. He ended up living almost 27 more years.

[Jeff Chandler]

I used AA to get sober - that and God. Worked for me.

I believe you.

[circlecity]

"Of the people witnessed to be claiming to be helped by AA, how many were telling the truth?"

If you've got evidence they are lying then lets hear it. Until then they have provided first hand evidence and have satisfied the burden of proof unless you can impeach their personal testimony. And it's not hearsay, it's first hand testimony these people have put forth. And for all we know there are billions more people who could benefit from AA if they gave it a try. You see, mindless speculation works both ways. In any event, AA costs nothing, has millions of successful devotees and there is nothing to lose for the alcohol addict who wants to get sober by checking it out. Nothing to lose and the world to gain.

[Mears]

“In his new anti-AA book Clean: Overcoming Addiction and Ending America’s Greatest Tragedy, former director of Harvard’s substance abuse treatment unit Dr. Lance Dodes writes the following: “Alcoholic’s Anonymous was proclaimed the correct treatment for alcoholism over seventy-five years ago despite the absence of any scientific evidence of the approach’s efficacy. And we have been on the wrong path ever since.””

---

I think this is incorrect -—I don’t see Dr. Dodes as the author of this book. I show a David Sheff.

.

[Jeff Chandler]

for all we know there are billions more people who could benefit from AA if they gave it a try.

I don't have to provide evidence because I am not the one making claims.

Claims which cannot be backed up with evidence, but which must be taken on faith.

For all we know, AA hurts more people than it helps.

[circlecity]

"The most an individual can honestly say is, "I believe AA helped me,"

And the fact that millions and millions have said this is powerful evidence as to the effectiveness of AA for many (but not necessarily ALL) people.

[circlecity]

"Claims which cannot be backed up with evidence, but which must be taken on faith. For all we know, AA hurts more people than it helps."

Personal testimony is the most common form of evidence known in law. There are millions of personal testimonies as to the effectiveness of AA for those people. This constitutes substantial evidence. If you've got a shred of evidence for the claim that "AA hurts more people than it helps" then lets hear it otherwise it is just a "claim which cannot be backed up with evidence".

[Revolting cat!]

There are alternate methods? Good, the more the merrier. I’ll drink to that! Is AA some kind of cult that it has to be defended?

[brooklyn dave]

I have been to those meetings —and I am glad there are other alternatives. But there have been other alternatives around both religious and secular for years. I know those of the agnostic / atheist persuasion bitch and moan about the “God” component — but I find it’s not so much about believing in God that’s a problem —it is that AA claims it’s not a religion but a spiritual fellowship...except it functions in many ways as a religion....and I am not talking about passing the basket at the end of a meeting. It comes from a primarily moralistic perspective and the founders “Wilson & Smith) —who were very good men (esp Smith) are treated like saints or prophets and the literature— the “Big Book” as if it were inspired scripture. Many in AA quote this book like street corner evangelists page and paragraph. Steps 4&5 have a very confessional aspect to them. In the faith I was raised in —I could choose to go to confession —why do I need some unprofessional person in AA to do this?... one who may or may not keep the confidences I shared —no guarantee. These same steps are treated in a way like boot camp or a young man or women going through some initiation rites — ok kids, you’ve passed the test. Now there are many who have benefitted from AA and countless numbers of good sincere people there —but in this day and age shouldn’t be above criticism. Another little problem I have is also a percentage of folks who really don’t have a problem with alcohol. Folks who have serious other mental issues, folks who go to meetings and treat it like a lonely hearts club -and those looking for a relationship (if that happens intrinsically—not a problem). There was a book written quite a number of years ago by the founder of Rational Recover —he called his book The Small Book. I did peruse it and saw many things I agreed with —but the general tone was that this author was still dealing with his anger at the “God” component of AA —and it came through in the writing. Just the observation of one dude.

[discostu]

Pretty much all of the programs (including AA) have about the same success rate of about 20% for 1 year with each further year reducing a bit. There’s a few really crooked ones with much worse success rates (and high profitability), but all the ones that are actually trying to help people score about 20%. In the end it’s mostly about effort, people willing to put in the work will find a method that works for them, people that aren’t will look like they’re trying and fail.

[Repealthe17thAmendment]

The most an individual can honestly say is, "I believe AA helped me," or, "I heard a person (or some people) claim that AA helped him (them)."

Anything more is speculation.

Of course, this is true. But even at that, it's pretty powerful. Decades of research doesn't seem to have created any alternative that has supplanted AA as the dominant resource for alcoholics. Maybe some day there will be one. It doesn't really matter.

I believe it's worth noting that AA addresses much more than the physical addiction. I'd say that I regained much of my moral character after working the steps, except I didn't have any to start with. So, I developed my personal morality through the process of working the steps.

Also, another factor that is not measurable is the depth and value of the fellowship. There are certainly all kinds of people in recovery, but it's startling that I have an immediate trust and affinity for just about everyone I've met at a meeting.

I wouldn't be so bold to say that it is the best way, or the only way. But, for me and many others, it works, it really does.

And that's all that matters.

[Revolting cat!]

It works. Misery loves company.

[meadsjn]

It might actually hurt more people than it helps. We just don't know, and we cannot know.

Yes, there is a way of knowing; perhaps two ways. One would be from personal experience; another would be learning from those with personal experience.

From the Foreword to the Second Edition of the Big Book:

Figures given in this foreword describe the Fellowship as it was in 1955.
...
While the internal difficulties of our adolescent period were being ironed out, public acceptance of A.A. grew by leaps and bounds. For this there were two principal reasons: the large numbers of recoveries, and reunited homes. These made their impressions everywhere. Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with A.A. showed improvement. Other thousands came to a few A.A. meetings and at first decided they didn’t want the program. But great numbers of these—about two out of three—began to return as time passed.
...
Those numbers above demonstrate a 75% rate of recoveries within AA prior to 1955. I've seen that same rate occur within AA since 1984, wherever people work the program as suggested.

If some other program could realistically claim a 10%, or a 5%, or even a 2%, rate of recovery, it would be making headlines.

Religions, if they could be honest, would be showing far below a 1% rate of recovery.

[midnightcat]

has anyone heard of America’s Keswick? They have a rehab place there for men. I know some people who’ve been through their program. I”m not sure if it has 12 steps but it is faith-based.