March 18, 2015

"The debate over the efficacy of 12-step programs has been quietly bubbling for decades among addiction specialists."

"But it has taken on new urgency with the passage of the Affordable Care Act, which requires all insurers and state Medicaid programs to pay for alcohol- and substance-abuse treatment, extending coverage to 32 million Americans who did not previously have it and providing a higher level of coverage for an additional 30 million," writes Gabrielle Glaser in The Atlantic.

Nowhere in the field of medicine is treatment less grounded in modern science. A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University... stated: “The vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.”

Alcoholics Anonymous was established in 1935, when knowledge of the brain was in its infancy. It offers a single path to recovery: lifelong abstinence from alcohol. The program instructs members to surrender their ego, accept that they are “powerless” over booze, make amends to those they’ve wronged, and pray.

Alcoholics Anonymous is famously difficult to study. By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous....
ADDED: There is a lot in this article. I can't excerpt everything, but look at the author's description of her sampling of the prescription drug naltrexone (which her doctor wouldn't prescribe to her because she doesn't have a drinking problem):
The first night, I took a pill at 6:30. An hour later, I sipped a glass of wine and felt almost nothing—no calming effect, none of the warm contentment that usually signals the end of my workday and the beginning of a relaxing evening. I finished the glass and poured a second. By the end of dinner, I looked up to see that I had barely touched it. I had never found wine so uninteresting. Was this a placebo effect? Possibly. But so it went. On the third night, at a restaurant where my husband and I split a bottle of wine, the waitress came to refill his glass twice; mine, not once. That had never happened before, except when I was pregnant. At the end of 10 days, I found I no longer looked forward to a glass of wine with dinner. (Interestingly, I also found myself feeling full much quicker than normal, and I lost two pounds. In Europe, an opioid antagonist is being tested on binge eaters.)

75 comments:

traditionalguy said...

Addictions, addictions. There are so many to chose among.

chickelit said...

Is seems self-evident that any faith-based method of treatment will fail if the patient rejects faith. Those sorts of people need a more cynical -- perhaps chemical -- method of treatment so let them have that instead. Otherwise, this just seems like another obvious swipe at faith-based anything. Yawn.

Next question?

Big Mike said...

There's an unbelievable amount of junk science embedded within the ACA.

EMD said...

Maybe 12 is the wrong number.

Anonymous said...

Can we find a treatment for the addiction to political power, which Professor Tolkien so memorably warned against?

Eric the Fruit Bat said...

I guess some people are having a difficult time deciding whether drinking too much on a regular basis is a bad habit, a vice, or a disease.

Jane the Actuary said...

This was an eye-opening article. I was shocked at the fact that these programs have not been exposed to any rigorous testing, when that's foundational to healthcare. Yes, when it's just a bunch of people meeting voluntarily, come and go as you wish, that's one thing. But if a rehab center rehabs on these principles, and charges the patient, or more likely the insurer, for it, they shouldn't get a pass on this.

And the statement that, if the program fails for a person, they didn't try hard enough? That's suspect right there. And I'd never thought before of the faulty logic behind needing to "hit rock bottom."

So, yeah, very worthwhile piece. Wish The Atlantic was more consistent; I'd read them more often.

traditionalguy said...

The IRS that enforces the ACA has developed its own program called the 12 Gauge Program.

Michael said...

Give a monkey drink enough whiskey and he will become addicted to alcohol. Take the alcohol away and in a few days time his cravings will subside and then disappear.

The monkey does not drink because he did not get enough bananas when he was a baby monkey, nor does he drink because he was not groomed enough by his mother.

The recovery industry thrives nonetheless. People are special.

MadisonMan said...

Today, for instance, judges routinely require people to attend meetings after a DUI arrest; fully 12 percent of AA members are there by court order.

I don't suppose that a person before the judge can object to this on scientific grounds, either.

What a racket. I guess the Judge has to "do something".

david7134 said...

There is no such thing as "addiction", at least in the way that it is portrayed to non-medical individuals. You can not be exposed to a drug or alcohol and then be dependent on that substance for the rest of your life. In this, the 12 step program is a fake. Yes, I know that people can be physically dependent on a drug if they take large quantitates for a long period, but weaning an individual from these drugs is done every day. What is happening to alcoholic and those that abuse drugs is that they are self medicating and thus treating underlying psychological issues. Getting them away from the alcohol or drugs still leaves you with an individual that is sick, just now coherent. In the case of alcoholic, these people are extremely dependent and manipulative. Thus, a system is needed to treat those underlying mental issues and not focus on the "addiction". Also, 90% of people can take opiates and other drugs for pain and not be "addicted" and this should be a call to do away with our extreme regulation of drugs, which is not working, and is keeping needed pain meds from those that need them. Currently heroin use is greatly increasing due to cut backs on delivering opiates to those patients that need the drugs. This is also fueling the use of other street medications by legitimate patients to compensate for the severe restrictions that states and federal agencies have placed on narcotic use. Enough is enough, we need liberal drug laws like other countries that are much freer than the US and have far less problems as a consequence.

gerry said...
This comment has been removed by the author.
Tyrone Slothrop said...

I quit drinking twenty years ago. I went to one AA meeting, because I was willing to try anything that might help. What I saw was a crowd swilling gallons of coffee and chain smoking cigarettes, followed by a parade of speakers who admitted falling off the wagon and vowing to get back on. I wished them all well, but it didn't seem like a healthy atmosphere to me. I never went back and never missed it. Some things you can do on your own.

pduggie said...

I always wondered why 12 step progams were not used for homosexuality. (One of the AA starters is sometimes accused of being a closeted gay, and he often wierded people out by zeroing in on others secret homosexuality)

I came to the conclusion that having a group of (same gender) people openly and honestly struggling with same-sex attraction is like having an open bar at an AA meeting.

It only wouldn't 'work' because of the nature of same sex attraction as a phenomenon.

Quaestor said...

12-Step is religion isn't it? So what's government doing subsidizing religion?

Bob Ellison said...

Cult.

David said...

Twelve Step works pretty well for some people, not so well for others. It's a great voluntary program, inexpensive and community based. The fact that it fails for many people does not make it ineffective, but it's not universally effective.

Can the government with its money and power screw up this useful tool? Probably can.

I Callahan said...

Can anyone in this thread, or the Atlantic thread for that matter, come up with a better way to wean people off alcohol?

The reason it's existed since 1935 and is used by judges is really simple: it works better than anything else. GWB was lambasted for trying to put in place faith-based drug addiction programs. They ALSO work better.

I don't know why this is so hard to understand. And I'm surprised that a bunch of reasonable people would be so quick to believe something in the Atlantic, being as biased as they are.

Roger Sweeny said...

The placebo effect is faith-based by definition.

Michael K said...

"There's an unbelievable amount of junk science embedded within the ACA."

Most of it is junk, including "preventive medicine."

The left has great faith in the ability of planning to prevent "unintended consequences."

The war on tobacco and the support of legal marijuana is just one small example.

Your Husband said...

What the 12-step program truly treats are the underlying causes of the addiction. Dealing with the physical addiction is hard but controlling the mental and emotional addiction is harder and that is where the 12 Steps help. As one who has been in 12 Step meetings, I can tell you that it has saved countless lives & families. It may not work for everyone but it's been a godsend for those for whom it has worked.

Laslo Spatula said...

I take the middle path: The 12-Hour Program.

Every day you refrain from drinking for twelve hours.

Some days are easier than others.


I am Laslo.

mccullough said...

AA is free

SJ said...

@ICallahan,

in 1935, the principles of AlcoholicsAnonymous were a new thing.

The principles look like some kind of social hack; a way to integrate people who wanted to give up alcohol into a community of the like-minded.

As has been said several times here, the program appears to work for some people. (Possibly many people.)

One important point: the success of AlcoholicsAnonymous appears to depend on a person who wants help from the program.

Thus, a judge ordering a person to attend may be trying to force a person to accept help that they don't want.

Or, that judge may be pushing a person into a situation in which they have an opportunity to seek help, if they want to.

What's debatable is the wisdom of (A) charging insurance companies for such programs, and (B) forcing attendance at a program whose core virtue is that it works for people who voluntarily choose to follow it.

Shanna said...

And the statement that, if the program fails for a person, they didn't try hard enough? That's suspect right there.

Today, for instance, judges routinely require people to attend meetings after a DUI arrest; fully 12 percent of AA members are there by court order.

I feel like these things might be related, though. You can’t change someone who doesn’t want to change. I think when AA is useful it is likely because you are meeting in a group and you have that social support, the sponsor, not because the 12 steps are magical.

There are other evidence based treatments for addiction and of course there are drugs. AA probably doesn’t work as well for some people.

but it's not universally effective.

I don’t think any drug treatment program has ever been universally effective.

Zeb Quinn said...

I'm sure the government can come up with something better. They always do.

Mid-Life Lawyer said...

I've been sober for 18 years. The amount of misunderstanding in the article and in the previous comments, is typical but I don't debate about it.

The fact remains that prior to Alcoholics Anonymous, there were hardly any cases of alcoholics stopping drinking and leading normal lives. In the old days, the recovery rates for those coming to AA were close to 50%. Now, it might be 5%. The reason for this dramatic reduction in recovery rates is that AA has been watered down by pop psychology through the years so much that you rarely find groups in which the simple 12-step program is actually practiced, shared, and experienced. Anything goes in most groups.

The successful practice of a 12-step program does require the belief in a higher power and to many this is unacceptable. It was to me until I woke up one morning after another binge and rather than scrambling around and cleaning up my messes (missed work, floated checks, didn't come home until 6 a.m. etc....) and vowing to never drink again, I knew that I would drink again the next time the notion hit me and and that there was absolutely nothing that I could do about it. For me, that was hitting bottom. Surrender. At this point I became willing to follow directions, was led to AA, had a spiritual experience, and helped many others to do the same.

Addiction specialists my ass.

lgv said...

Some great comments here.

Forcing someone to go to AA is like forcing someone to go to church. They may go through the motions, but some may actually become Christians, but the failure rate will be much higher than those who go voluntarily.

Is it science and can success be measured? No and yes. It doesn't have to be science. It just has to work. Take all those rehab centers and scientifically measure their success rate by testing patients at different times after their release.

The issues of whether the ACA should cover these treatments that are not very successful is worthy of discussion, as is the forced use of a faith based AA program. Also, since obesity is an epidemic, I wonder if Overeaters Anonymous or Jenny Craig will or should be covered? Nothing like diet clinics getting federal largesse. But it's for the health of our population.

MadisonMan said...

The fact remains that prior to Alcoholics Anonymous, there were hardly any cases of alcoholics stopping drinking and leading normal lives

We know this how?

FullMoon said...

AA works.
AA is free.
AA is not a cult
AA in not a religion
Recovery centers are based on the AA principles because they have nothing better,and because it works.
Nothing works 100 percent of the time.
There are AA meeting everywhere. If you don't like the one you are at, go elsewhere for free. A dollar in the basket if you choose.

Anybody can go to a meeting and check it out.
Nobody will bother you.
But, I guess it would be wonderful to build another drug related recovery program. You know, like the nicotine patch, e-vape cigarettes, nicotine gum etc.
That stuff is for assholes too weak to quit on their own.
The government and insurance companies should not pay for room and board at AA based recovery centers.
Judges will send people to free AA meeting, where they have to have an attendance card signed.

If you want to quit drinking. try it. You have nothing to lose but misery.

Oh, and hitting "rock bottom" means different things. One guy can quit because he lost home, family, business because of being drunk all the time.
The other guy quits because he accidentally voted for Obama while drunk.


Shanna said...

J.G. says it was this message—that there were no small missteps, and one drink might as well be 100—that set him on a cycle of bingeing and abstinence.

From the article, the guy was drinking a liter of jameson a day and he blames AA for 'bingeing'? Or does he blame them for being occasionally not drunk?

jr565 said...

With drug legalization also comes the demand to treat said addiction for free ostensibly. And I'm sure the call will also come to treat the uninsured for addiction as well. So, on one hand we need to let people do what's they want with their bodies. But when they get addicted snd need rehab, we have to cough up the bucks.

Mid-Life Lawyer said...

"The fact remains that prior to Alcoholics Anonymous, there were hardly any cases of alcoholics stopping drinking and leading normal lives.

"We know this how?"

By reading about it. The medical community didn't know what to do with them. Carl Jung et al. Jung played a rather large part in the founding of AA, both by his treatment of one of the early members and with his later correspondence with Bill Wilson, one of the founders of the fellowship. Jung noted that in the medical literature the cases of recovery seemed to only come about due to a "psychic upheaval" such as is generally brought about by a "profound spiritual experience." William James's "On the Varieties of Spiritual Experience" was an influential work in the founding of AA, as well.

Peter said...

At the core of addiction treatment methodologies we have the disease model of addiction, and its medicalization. Yet no addiction treatment is likely to work on subjects/patients who are not motivated to change.

Which at a minimum indicates weaknesses in the disease model, and appropriateness of medical treatment. And while neuroscience may reveal methods to reliably reinforce motivation, there doesn't seem to be any way to create motivation where little exists.

Which brings us back to 12-step which at least identifies the concept of "hitting bottom" as a source of that necessary motivation to change. In any case, if all treatments for substance addictions have truly dismal long-term success rates (as seems to be the case), then perhaps the scientific basis of all (and not just 12-step) should be called into question.

A larger question is, how willing are the assorted psychological/psychiatric "helping professions" to open all their methodologies to serious scientific evaluation? As the costs of assorted therapies become more public than private, I'd expect a lot more pressure to show that professional treatments are significantly more effective than informal no/low-cost "treatments," such as discussions with family, friends, or untrained volunteers (and perhaps religious counselors, for those of religious faith).

jr565 said...

I don't know why AA wouldn't work. What drug dealers need is a structure they can use in place of the drug thsts taken over their mind. And an idea that there is something above you you can put your faith in. That's the exact problem of drug addicts, they only have their own thought which are predisposed to seek out drugs instead of something else.

SJ said...

@MidLifeLawyer,

I was probably sloppy in my phrasing. I said something like "social hack" (a use of social pressure to achieve a result).

I think you have the better description. It is an experience that is best described as religious. (Though one that has components that can be described as psychological.)

Especially the information about Carl Jung, William James, and their interactions with Alcoholics Anonymous.

I have no experience with Alcoholics Anonymous, though I've taken counseling from a minister who was heavily influenced by AA. (I also took part in support groups led by that same minister...but the focus of that group was not addiction to chemical substances.)

I think I agree with @Peter:
Which brings us back to 12-step which at least identifies the concept of "hitting bottom" as a source of that necessary motivation to change. In any case, if all treatments for substance addictions have truly dismal long-term success rates (as seems to be the case), then perhaps the scientific basis of all (and not just 12-step) should be called into question.

Though I'm also interested in prescription drugs like Nalxotrene, described in the article excerpt above.

Danno said...

I'm sure AA could cure my internet addiction. All she has to do is bring Crack Emcee (or select others) back to hijack a few threads and that cures me every time!

Rae said...

AA doesn't charge anything. This is a problem if you need somewhere to sink money to justify a budget increase.

AA does take free will donations.

Danno said...

Back to reality, the mandated drug rehab and mental health coverage in Obamacare is one of the reasons it isn't affordable.

Birches said...

I know a few people who participated in 12 step programs, one for substance addiction, one for non-substance related addiction. They are both "sober" now and have been for years. The thing that I thought was most effective about the programs was the "clearing the air" mentality that went with it. Both of these people were hiding their addictions, for legal and social reasons, and the hidden nature of their habits were part of the reason why they were so addictive. These people weren't social drunks. By attending meetings and openingly acknowledging their bad (and illegal) behavior, a lot of the addiction's power went away. I think 12 step programs help a lot of people like this.

FullMoon said...

SJ says
blah blah blah etc,,,,,,
Though I'm also interested in prescription drugs like Nalxotrene, described in the article excerpt above.


So, you are interested in taking another prescription drug to cure a problem you do not have? What a novel idea!

Birches said...

I always wondered why 12 step progams were not used for homosexuality.

These things aren't talked about openly because of the Politically Correct nature of our society, but versions of it do exist I believe in various churches. The interesting thing about these programs is that for most of the people who start these programs, they're trying to be "cured." But instead of being "cured" they have to openly and honestly acknowledge their sexual orientation and that their orientation conflicts with their Faith. Essentially, they come out and are ok with it. It works for some people, but I'm not sure how many---I've just read various things on the periphery.

cubanbob said...

All of the above aside, how does the ACA mandate what a state licensed and regulated insurance company must provide in intrastate service?

Birches said...

Going to a rehab center (that might use 12 step programs) and attending AA are two completely different things. The fact that the author of the article conflates the two is the first problem with this article.

Shanna said...

Going to a rehab center (that might use 12 step programs) and attending AA are two completely different things.

Yes, I don't like that either. Digging into the article, the first week of rehab is for drying out, basically. What the author has an issue with is mostly that the therapy isn't 'scientific' and that she hates the idea of non-clinical people helping other alcohols. Everyone should have degrees, everyone should be trained, etc.,etc.

She also wants to recognize less serious alcohol use, where you can just cut down on drinking rather than eliminate it. If you look at the govt standards, most college students would be listed as having a drinking problem, but they are not alcoholics in the traditional sense. I think that's a fair bit of what she is focused on.

CStanley said...

All psychological treatments should be subjected to much better scientific scrutiny. In this case my hope would be that they don't throw out the baby with the bath water (driving out the spiritual elements of AA as programs are forced to comply for ACA finding.)

The general topic of mental health and spirituality interests me greatly because personal experience leads me to believe that it is not one or the other, but both that must be addressed in tandem.

Brian said...

"Nowhere in the field of medicine is treatment less grounded in modern science."

I really feel like this gives short shrift to the rest of psychiatry - and possibly also to managing back pain.

Mid-Life Lawyer said...

"Going to a rehab center (that might use 12 step programs) and attending AA are two completely different things. The fact that the author of the article conflates the two is the first problem with this article."

Yes.

To the extent that treatment centers introduce AA to the alcoholics, and the alcoholics follow up and find good meetings and sponsorship, the treatment centers are effective. I would prefer to talk to someone who has been detoxed, if they need it, and that's all. Most treatment centers seem to serve up some kind of trendy The Road Less Traveled meets Bill Wilson nonsense (for example - that's what was hot when I first came around) that generally is more apt to kill them than help.

Michael K said...

" Most treatment centers seem to serve up some kind of trendy The Road Less Traveled meets Bill Wilson nonsense (for example - that's what was hot when I first came around) that generally is more apt to kill them than help."

There are some that are very effective and do a lot of life altering advice to reduce the lure of alcohol. I have had a family member saved by such a program, that also used AA methods as an adjunct and I used to take medical students to AA meetings to introduce them to the methods.

AA would be better off to avoid any connection with Obamacare. It is voluntary and should stay that way.

Mary Beth said...

With all of the (very expensive) Narconon rehab centers the Church of Scientology owns, they're going to benefit more than AA will.

Fernandinande said...

EMD said...
Maybe 12 is the wrong number.


Nice one. Funnily enough, "choose your own treatment" works slightly better than AA (hospital treatment was best):

"The first, a clinical trial of compulsory treatment that randomized individuals to attend AA, attend hospital inpatient treatment, or choose their own treatment or service provider [23] found significantly lower rates of alcohol abstinence for the AA and the choice conditions, with over twice as many individuals abstinent at 2 years in the hospital inpatient condition (Figure 4a)."

Steve Uhr said...

Help me out -- why no tv ads for the drugs? The manufacturers wold make a boatload.

Scott said...

Fisking this article would take a long time, because there are so many misrepresentations about the AA program. Maybe the word "program" has changed since 1935. Then, it may have had looser connotations. Now, it's more a synonym for "regime" -- follow this method for achieving these results. AA is not like that. Basically, the AA program is a collection of tools that people use as it makes sense to them.

And honestly, I really don't care if others think AA is a fraud. If she longs for a secular, science-based regime for changing a person's ability to make choices, then God bless her, I hope she gets what she desires. And I wouldn't mind if treatment programs and the courts left AA alone to do its own thing.

Then again, if drugs or "scientific" therapy can compel a person to make different choices, what if similar techniques could be used to influence people to recycle, or use their turn signals when they drive, or have responsible sex, or not eat so much, or go to the gym, or not say hurtful things, or never touch women without their prior explicit permission, or accept direction from superiors without argument, or no longer deny antropogenic global warming, or think progressively, or shun Republicans, or vote for Democrats?

Birches said...

Help me out -- why no tv ads for the drugs? The manufacturers would make a boatload.

Good question. Perhaps there's more to it than Glaser wants to report.

Shanna said...

Help me out -- why no tv ads for the drugs? The manufacturers wold make a boatload.

The article mentions that it's currently in a generic.

mrs.e said...

What the 12-step program truly treats are the underlying causes of the addiction. Dealing with the physical addiction is hard but controlling the mental and emotional addiction is harder and that is where the 12 Steps help. As one who has been in 12 Step meetings, I can tell you that it has saved countless lives & families. It may not work for everyone but it's been a godsend for those for whom it has worked.

100% this.

Michael said...

AA happens to be one of those rare "organizations" that cannot be ruled. Get a few willing drunks together to share their stories and their program and you have a meeting. Worse than the Tea Party when you come to think about it.

All of the stories are the same, by the way. Plumbers, bikers, bankers, heiresses, insurance salesmen, housewives. All the same story. AA is the place to go to rid oneself of terminal uniqueness. All of the stories are the same.

Unknown said...
This comment has been removed by the author.
Birches said...

@ Mid-life lawyer

Can I ask if you ever entered a rehab center? Or did you just go to meetings on your own?

Tyrone Slothrop said...

Years ago I knew a guy who really, really needed to do something about his alcoholism. I would see him during the commercial fishing season and lose touch over the winter. One season he showed up singing the praises of an aversion therapy program he'd been to, where they gave him a drug that made him puke and then encouraged him to drink. Supposedly it taught one's body to loathe alcohol. He thought it worked. The following winter he murdered his sweet, lovely wife with his bare hands. I've always wondered how one thing might have led to the other.

The Godfather said...

I've known quite a few recovering alcoholics who were in AA, and quite a few practicing alcoholics who weren't in AA. I've never personally met an alcoholic who stopped drinking (long-term) without participating in AA -- although I've heard of some, from credible sources.

Not a statistically valid sample, of course, but I offer it for what it's worth. If I were an alcoholic who wanted to quit, I'd go to AA.

n.n said...

Obamacare has consequences. Whether it will force rationing or reform remains to be seen. I wonder if either is intentional or incidental to progressing the status quo.

Revenant said...

The problem I have with AA, and the notion that it represents "tools" for dealing with a drinking problem, is that the reality tends to break down like this:

If a person tries the "tools", and cease to have a drinking problem, the tools are credited. If a person tries the "tools", and continues to have a drinking problem, the person is blamed.

There is literally nothing you can't claim solves a problem, if that's the standard you use for measuring its success. A 12-step program, a sugar pill, animal sacrifices to a stone idol, etc.

I Callahan said...

Forcing someone to go to AA is like forcing someone to go to church. They may go through the motions, but some may actually become Christians, but the failure rate will be much higher than those who go voluntarily.

And yet it is MUCH higher than the rate of not trying at all. And I would suspect it's still higher than any other method that may exist. Which is still why it is praised and practiced by so many.

It's the "higher power" or religious aspect of it that has people on that Atlantic thread getting the vapors. And why the original article was written the way it was as well.

whitney said...

If a court orders you to AA you don't have to go. When I was ordered to go, I took the fill out sheet to the bar and got the other patrons to fill out each line. I had a list of meetings for them to choose and their own names. First name, last initial. Anyone who goes to AA who doesn't want to really hasn't thought it through.
I don't drink anymore for reasons that have nothing to do with any court or government agency.

Mid-Life Lawyer said...

Birches,

"@ Mid-life lawyer

Can I ask if you ever entered a rehab center? Or did you just go to meetings on your own?"

I was introduced to AA in a treatment center in 1986. I thought I was a cocaine addict and that was better than being an alcoholic, somehow. Rock stars were cocaine addicts so it was kind of cool. Had I known they were going to take me to AA meetings and talk about God, I may have held out a little longer. I found out I was just a run of the mill alcoholic who likes to be wide awake in his black outs.

I stayed sober for about 3 years after treatment then decided I wasn't an alcoholic. I had done very well during this period and felt like I could now control my drinking. I drank and used whatever for the next six years, bouncing in an out of AA occasionally. When I finally surrendered again, to a deeper level than I had the first time, I limped back into AA with enough humility to pay attention. I watched a lot of people move from AA into counseling work through the years and considered it myself in my first sobriety. But that was kind of the problem for me. Straight AA wasn't good enough for me, I thought, I wanted to get a Ph.D in Psychology and become a great healer.

When I came back to AA, I ran across some old time AA people and they helped me to stick to basics. In fact, I was told to take all those psycholgy books I had amassed and put them in a box and put them in my attic because "people like you get confused real easy." Best advice I ever took. I didn't read anything recovery related but AA literature for two years.(I read a lot of literature, poetry etc. but no psychology related stuff, pop or otherwise) I loosened up as time went on and I am actually a Lutheran now, of all things.

Birches said...

Thanks Mid-Life Lawyer. That's a great story.

It's the "higher power" or religious aspect of it that has people on that Atlantic thread getting the vapors. And why the original article was written the way it was as well.

Yeah, I just went through a few of the comments back there. Yikes. There are some bitter people out there.

FullMoon said...

Revenant said... [hush]​[hide comment]

The problem I have with AA, and the notion that it represents "tools" for dealing with a drinking problem, is that the reality tends to break down like this:

If a person tries the "tools", and cease to have a drinking problem, the tools are credited. If a person tries the "tools", and continues to have a drinking problem, the person is blamed.


That is a big fat ugly lie.

If you continue to have a problem, AA just didn't work for you. Try something else. What is so hard to understand about that?

When you come right down to it, there is not a single thing wrong at all with AA.
Don't believe in God? who cares?
Don't follow all the steps? So what?
Don't like the assholes at the meeting? Go somewhere else, or just quit.
It ain't the military, you can leave when you want. You don't like A? Don't go. No need to expound on why it can't work.
As for AA statistics, there are none.
Want a real study? How many commenters here tried it and failed, how many succeeded?
Contempt prior to investigation seems pretty common among people willing to give opinions on how "bad" AA is.

Francisco D said...

The success rate for addiction programs is about 10%.

iowan2 said...

The Revenant said:
"The problem I have with AA, and the notion that it represents "tools" for dealing with a drinking problem,"

No, big swing and a miss. Alcoholics have a living life on lifes terms problem. It manifests itself as a drinking problem.

Trying to explain AA to normals is useless. Until your world is seen thru the prism of a drunk, normals just cant grasp what is going on in the head of an alcoholic. Hell even alcoholics dont get it right away. Thats what the steps do. They are numbered for a reason, and until you grasp one, it is futile to move to the next one.
Are you an alcoholic? Step one.
Until you come to grip with step one, accepting the fact that there is a power greater than yourself, is meaningless dogma.

Every AA that has went back to drinking and found their way back to AA has admitted that they quit working the program. Everyone.

I have yet to meet a single alcoholic that has returned to social drinking, not a one.

iowan2 said...

As far as Obama care utilizing AA, no.
There is no opportunity for graft.
Besides there is no one to say yes or no. Its free and voluntary. Someone up thread said they take donations, true. But not big ones. Our group has turned down $5000 donations because we have no use for money. Other than the basics, which are met by passing the hat, extra money only diverts from our primary mission. To carry the message to other alcoholics still suffering.

Trashhauler said...

"The only requirement for AA membership is a desire to stop drinking." "There are no dues or fees for AA membership. "AA takes no outside contributions." From the 12 Traditions of AA.

As is constantly said at AA meetings, there are countless ways to try to get and stay sober. AA membership being entirely voluntary, anyone can try those other programs. Let us know how those work out for you.

The problem experts have with AA is that there is no way they can make money off the program. The problem with most rehab centers is that they can dry out a drunk, but after that they abandon them. AA does not.



Trashhauler said...

"12-Step is religion isn't it? So what's government doing subsidizing religion?"

Nope. Step 12 says, “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.”

No organized religion required at all. Eventual belief in a higher power (as understood by the individual) is considered necessary, but AA doesn't require any particular sort. It can be the group or, as often said, "the door knob." The purpose is to get the alcoholic to consider things beyond himself, which, as any alcoholic will tell you, is plenty difficult. But don't worry - if you can get to Step 12, you will have already seen many changes in yourself.

Robert Cook said...

A person close to me is an alcoholic and it was AA that has helped her become and stay sober, coming up on three years now.

Naysayers' gripe seems to be that it's not a universal panacea, but then nothing is, or can be. What it is is a resource freely available to those who sincerely want to try to become sober, and, without requiring any payment from the individual addict who seeks them out, they do help a great many people.

I say all kudos to AA!

Brent Newby said...

SMART Recovery (Self Management And Recovery Training) provides an evidence based process for dealing with addictive or maladaptive behaviors. It provides an alternative to AA and focuses on 1) enhancing motivation, 2) understanding the nature of urges and cravings, 3) dealing with the irrational thinking they we use to rationalize and justify behavior that may not be the best for us, and 4) attaining and maintaining a more balanced and healthy lifestyle to prevent relapse.

www.smartrecovery.org