Everyone's different - you gotta find the way that works for you and stick with it. No one should belittle anyone's method if it works for them, be happy that they found something!
3
I'm so happy to have found SMART Recovery, which is based on CBT, and also costs nothing. It's really annoying that the article was so misleading about that particular fact.
14
Great, now can the NYT please stop publishing all these opinion pieces deriding 12-step programs? It’s great that other people have found different paths to sobriety but why do they have to continually bash 12-step in the process?
13
If you’re not sure AA is for you, read the last chapter of the Big Book titled “A Vision for You.” The first two paragraphs tell the story of an alcoholic’s journey.
6
As an ex-Alcohol and Drug Abuse Counselor one difference that can skew the rates are the court appointed cases, which where a much higher ratio compared to those that the court sent to AA, and where in my time, the success rate was around 8%. Many of these were court ordered OUI's where it was either 10 - 15 sessions at private outpatient vs. 6 months to 1 year attending AA meetings. Non-court ordered patients success rate was greatly higher for me, around to 35%. In my opinion, for this study to really be complete, court appointed people have to be shown as a separate, and included in the percentages of both studies (medical vs AA).
9
@Brian You raise a great methodological point. One thing that I might point out, however, was that the article refers to a "systematic review" or "meta-analysis"--that is, a summary of many studies (27 in this review)-- and not a lone, one-shot study.
I'm not sure if any of these studies address your (very astute) methodological observation specifically, but 21 of the studies are random controlled trials (RCTs). Random assignment of study participants to different treatment options (and, presumably, to a "control" group of no treatment) assures that the groups of people undergoing each treatment are identical, or at least highly similar, to one another. So, in a randomized study--assuming the randomization is done well--you should have similar proportions of court-ordered and non-court ordered who go through AA as go through other types of treatment.
2
My AA sponsor shared this gem with me when I began my recovery 12 years ago: AA is just people -- so if you go to a meeting and don't like it or how it's run, go to a different meeting. You don't have to like everyone you meet in the program: Just listen, learn, and practice the 12 steps. Going in with this knowledge helped me keep an open-minded perspective. I love AA; practicing the steps brings me strength, good coping skills, and a measure of serenity. AA has also brought me an abundance of loving friends.
15
Thank you so much. 10-20-1973. Grateful beyond measure. Have addressed, trauma, co-dependency, stress, anxiety, depression, abandonment, life through the years. Grateful for those that are doing the research to show the benefits of fellowhsip. The halls are full of young people on medication assisted treatment, but living the principles of the fellowship. There are too many assumptions that the professionals are making without really understanding the positive impact of the fellowship. Three fold disease, mental, physical, spiritual, One needs to address all three. The support is amazing and the entire concept of Recovery Coaches is simply AA at its best. The program is a life saver among the treatment world, please utilize it with other modalities.
10
This disease is three fold, Spiritual, Physiological, and Physical. If one is off or not treated you may drink again. My mental health was unbalanced and untreated and I would always drink again. You don't need to believe in God. You need to find a power greater than yourself and could be for example the ocean. The ocean is very powerful. You need to have the wiliness to stop drinking. My son passed away at 27 from this disease. The program works if you work it. Just like weight watchers.....
8
That's great, but I know at least three people who are dead because AA did not work for them. One size does not work for all. Some people can't force themselves to believe the god part of it no matter how hard they try. Alternative approaches are needed.
8
@RK - the people you know who died, did not die from anything aa did or did not do. They died of alcoholism. AA is not a "one size" option, there are many people who are helped in AA who are athiest or agnostic.
18
@RK There is no god in AA. One can believe in a higher power. You can even believe your sober self is your higher power, which it certainly is, compared to your drunk persona. AA makes the distinction very, very clear that belief in God with a capital G is not demanded of anyone. No one speaks of God, they speak of "my higher power" and rarely get more specific than that. Sometimes a Jesus freak shows up and demands everyone be saved and come to jesus and all that, but they never last long because that is not what the group wants.
7
@Anonymo That is not my experience in California where most people talk about God. That is why I quit. Still sober after 30 years.
11
Thanks a lot for validating the skills & the qualifying performances of Alcoholic Anonymous , to assist the members to maintain abstinent from Alcohol & or other substances that might interfere with their way of life, including family, employer & proper social behaviors. Maintain sobriety it's consisting on a "one day at a time" basis, all depends on an individual's efforts. The main key towards recovery it's not to pick up the first one. By the grace of God it's working for "ME for 40" (1DAY @AT A TIME) years. I did enter the program 5/14/1980 .I'm Grateful to Bill W. Dr. Bob & those ones whom helped to initiated this, God giving program. "That have save my life"!! Sincerely Rudy G.R.
14
I can attest to the power of AA. I've been a member for years and it has saved my life. Whether or not I wanted them too. It's a great organization, founded on amazing principles. Great article. Thanks.
9
Cults that tolerate pedofilia and advocate guilt exploit trust and destroy lives seeking unrestrained authority & power. They are blinded by the illusion of the central position.
Every life begins as an empty vessel, shaped by DNA, culture, family, & environment. The vessel that holds our spirit is initially a void. Our spirit defines us. We’re nothing without it. Nurturing begins the process, experience broadens it. How we fill it shapes our destiny. We know nothing beyond our own experience. Everything we think we know is a mirror of ourselves, except for one person, bound by love in a life-long relationship.
What we think we know about others is constructed from our own lives.
If we are interested in others, we will try to understand them. A-A gatherings do that. They draw people together who are different; yet will all find they are the same -- if they look for what is good.
All people are inherently good. No one wants to destroy the world, but we could be driven to it.
Wisdom, not dogma, determines how we live our lives. We get it from experience and fellowship. Not to destroy life, but to preserve it and do no harm. "God" is the choice mechanism to do good, to preserve life & relationships; not for one cult or belief, but universally.
In the shared experience of independent discoveries we ultimately discover, as the prodigal son did (when "he came to himself") and found we are more alike than different. That moment of that discovery is when an alcoholic is healed.
3
If AA rejects you because you have values, don't despair. Recovery is possible. Don't let the tyranny of the mob discourage you. 6 sigma.
6
@David Who doesn't have values?
6
This was a very helpful article. I’m trying to find help for a loved one that refuses to go to AA because of the religious affiliation.
Does anyone suggest any other programs based on research or anecdotal that have helped? I’m desperately trying to help.
@Kris Try SMART Recovery. They are entirely secular and science-based. They have meetings around the US.
There is also Rational Recovery, but that can be expensive. I think it's entirely online; RR has no meetings.
LifeRing is entirely secular and has meetings and email chat lists.
Women for Sobriety is entirely secular.
I hope this helps. Be well.
7
@Kris There’s no religious affiliation, just have to admit there’s something out there that can help you. Was scared off initially as well, but it’s the greatest thing I’ve ever done
8
@Kris I have been to many meetings--AA and Al-Anon--to support my son's addictions and also to help me to deal with these issues effectively. If someone wants to get sober, really wants to get sober, they will find a way to overlook the religious rationales (magical thinking about the "higher power" and talk of God in the 12 steps) of many members. AA teaches us, tells us in these words, to take what you can use and leave the rest. And at almost every other meeting I have attended,I have heard people say they first didn't think it was for them because they objected to the "god stuff," but then they found their own way to make the 12 steps and the community useful. One thing for sure. You should look for an Al-Anon meeting. My wife and I are non-religious and I can tell you, it has helped a lot. Give it time, try different meetings until you find the right group, read the books, and it will help you steer through this terrible experience.
11
AA works by offering frequent peer supported affirmation of an individual's acceptance that they will never be a person who can drink reasonably and safely. The fact that millions of people from every walk of life are in exactly the same situation helps to de-stigmatize this conclusion.
Actually participating in this program with people whom one respects brings a whole new light into the subject.
Personally, I could do with out the religious slant of the old timey literature but this is the most altruistic treatment I know of.
9
The AA program in itself is more or less perfect. Some group's meetings and the motives of some of the people attending can be suspect. it is up to each individual to seek out a group that suits. Abstinence doesn't suit everybody either. Statistically ten percent of the drinking population are alcoholic and from memory ten percent of those who go to AA have long term sobriety.
2
@Chris Mann It’s actually 75% of those who regularly go to AA who attain short term sobriety (see Fiorentine 1999) and 67% of those who reguarly go to AA who achieve long term sobriety (Moos and Moos 2006).
To get those results, however, the alcoholic has to decide to go to AA; there is no treatment which will force people to engage in the AA program.
5
@strenholme What lengths of time are considered, "short term" and "long term"?
Also, would you have any percentages on the people who come into AA, then become one of those who "regularly attend" with and without active court cases? I don't think numbers including active court cases can be trusted.
@strenholme I have been in there for 30 years and know what I have seen
3
I'd like to see a comparison between AA and things like the Sinclair method (i.e. using medications like naltrexone or nalmefene to chemically extinguish the addiction). An assessment of its effectiveness isn't helpful, otherwise.
1
@PsiCop Well, the closest I think we can do an Apples to Apples comparison is comparing the Cochrane review on Naltrexone and nalmefene for alcohol dependent patients to the Cochrane review which is the subject of this article.
The results for Naltrexone are described as “moderate”, and they appear to reduce drinking by 17%.
Alcoholics Anonymous’s most recent Cochrane review is the subject of this article, and they see a 22-37% abstinence rate.
AA seems to be a little more effective than naltrexone just from comparing their respective Cochrane reviews, but in both cases we get moderate improvement (a moderate number of people directed to AA get abstinent; naltrexone reduces heavy drinking by a moderate amount).
All I can say is AA saved my life and has enhanced my sobriety in every way. Pure abstinence alone leaves us with a mostly miserable individual. AA puts the happiness of the sober person squarely upon the individual to work for by self-evaluation and daily improvement. The program 'works if you work it'. I an attest to its amazing way of life and the way I feel about others. I have always been the problem and I will always be the problem. If I can realize that I am the only thing I can 'fix', I can then handle the issues of the day, and am left as a reasonably happy individual. God bless Bill W and Dr. Silkworth!
10
For me, I found there to be too much deception, too much judging, and too much preying on newcomers.
The deception comes with too many people trying to get out of trouble with the courts. Courts require people to go to X number of meetings, some for a few weeks some for years. Those people have to get the AA group leader to sign there "slips". I could see asking the offenders to go to a couple meetings to get a feel for AA, but most don't want to be there,and remain active abusers, who would not return on their own. Their being there, makes it difficult for people to share, and in my opinion, makes it much harder on the people who are truly trying to get help. The courts have ruined AA.
Then there are the "old-timers" with X amount of years, many stayed sober from day one, and are critical of those who can't get the program from the beginning. People get tired of the judging and don't come back, some die. The old timers will chalk that up to, "They didn't want it bad enough." I don't see how any true alcoholic quits the first time.
Lastly, while there is a rule about not dating anyone with under a year sobriety, it is seldom followed. I've seen, so many times, the newcomers become prey to those old-timers who think they run the show. Men and women alike.
There is just too much mental illness in those rooms for AA to be called a success. AA doesn't keep records, so there is no hard data, and you're not getting real facts from people afraid of legal consequences .
7
@bhist You need to search out other meetings then.
7
@bhist with all those issues I'm surprised anyone goes! But lots of people go, including me. And in the 30+ years I've been going, I've seen a few of those things happen now and then, because people are people. But those things you mentioned are BY NO MEANS representative of an average AA meeting. I have to ask how many different meetings did you try? One and done? Don't judge the entire program or those of us in it because of your unhappy experience. AA works just fine the way it is. Join us if you want. If you don't, don't scare someone else who might benefit from it.
6
@bhist It’s not a perfect program that’s for sure it is subject to controlling members who run the groups in theory however it is possible to have a well run group and I’ve seen many in my day
That said I’ve been more and more disappointed as time rolls on with the influx of a higher proportion of drug addicts some of whom are earnest and do improve, but of many of whom have ineradicable criminal tendencies and an overall negative influence
We do have members that stick with it after being court ordered and some of them had to be court ordered more than once but their contribution to our meetings is invaluable and the recovery is such a major source of joy for all of us
1
For decades it was the ONLY treatment for alcoholism.
I'll drink to that!
1
To steal from Dear Abby, as obvious from the thousand or so comments, the reason there’s no cure for it is that it’s not a disease.
4
@Horse Trainer I struggled with the "disease" part of it when I was younger. AA worked for me, and I don't really care what you call alcoholism. It was killing me, that's all I know. To your particular point, if it's not a disease, what is it, in your opinion? Do you think other conditions with no cure, like cancer or diabetes or bipolar disorder are not diseases?
5
@Horse Trainer Please read To the Doctors chapter of Alcoholics Anonymous. Are you aware that one of the founders was a doctor? Alcoholism is progressive and incurable. AA helps the alcoholic by giving them support and the tools to stay away from a drink a day (or hour) at a time until the compulsion is lifted. But the person is never CURED. (Just like diabetes) It is a reprieve a day at a time. I know people who are sober over 40 years who still go to meetings because they need to show up and show the newcomer that this is possible. But also, they need to "Keep it green" and remember that, they too, are still alcoholics and drinking can still kill them. That's the disease.
AA doesn't heal anyone. Faith heals, faith in God and not in psychologists. No one is ever healed of anything in clinical psychology. Psychologists pathologize people then can't heal people. Psychology is a cult, a faith (without God).
God is not a religion. God is Love and Love heals.
AA is deeply flawed "you ARE an addict!" (even after 20 yrs of not drinking). It only works for those who surrender unto God. They are the ones that heal. There is no God in Psychology so no one is ever healed of anything with shrinks.
Ask God to heal you and you are healed. If you have faith.
If your faith is in illness then you will be ill.
Peace
3
Couldn't stomache the 'higher power, works if you work it' stuff, so I just stopped drinking for 17 years. I began drinking again when I quit smoking. Unlike the desperation of 'needing' a cigarette, I find that the alcohol addiction is relatively mild. Like, I won't go out for alcohol if it's too cold out or too late. I don't feel desperate. The only probem is: it's really hard to fall asleep without an alcoholic beverage.
1
@Jenifer Wolf I, too, quit for 17 years. The first 6 or so were in AA and it was all I could do to "keep coming back". There are meetings that appeal to a secular person like me, but most are filled with religious nutters and new-agey "spirit of the universe" type people. I was told on my 5th anniversary that unless I prayed I would get drunk again. I left shortly after that and helped start a Secular Organization for Sobriety meeting in Toronto, Canada. Its still running.
I had a drink after 17 years and was surprised I did not feel any cravings like I used to. I can have one pint at the pub and say no thanks to a second one. I couldn't do that before and it contradicts the accepted wisdom that one is always an alcoholic. My life today is quite different than it was in my 20s and 30s, less chaotic and more secure, emotionally and financially. Perhaps environmental factors and age contribute to sobriety. this might not be picked up in these studies.
2
@Charles that's really interesting. I know the fact that you can drink in moderation again wouldn't be a welcome story in AA!
Gabor Mate, a Hungarian Canadian physician, says the research strongly suggests early childhood trauma is at the root of addiction. People who experience trauma in childhood can be as much as 46 TIMES as likely to struggle with addiction.
I couldn't get through a day without getting drunk for years. Thanks to AA, I've been sober for almost 30 years. I never was religious and I'm still not. I'm one of the people that first thought you needed to believe in "god" to be in AA. You don't, you only need to accept that there is a power greater than yourself. That could be god, but it can be just the power of a group of people who have the same disease helping each other arrest that disease one day at a time. It works for people who are willing to show up and take the suggestions of those who came before them.
7
Sadly, AA doesn't work for people with a social anxiety disorder, or abhor the heavily religious aspect. Additionally, the second step is a complete cop-out: "Step 2: Hope. “Came to believe that a power greater than ourselves could restore us to sanity.”" No, WE as individuals are responsible for our lives. Putting hope in a "higher power" (God or Jesus) is us absolving ourselves of our personal responsibility. The approach should be to enforce and improve our own self-worth based on our untapped inner strengths. I've been to AA meetings a few times in my life hoping I was seeing it all wrong; I never went back for a second meeting, not because I prefer to drink but because the approach is entirely the antithesis of how I need it to be approached. I'm really tired of drinking, but I can't stop. I need my personal self-worth and confidence boosted, not to degrade it by claiming I'm powerless and hoping for divine intervention.
5
@Fresammis I'm an atheist who abhors religion, and I have social anxiety disorder. I also have 23 years sober in AA. So I guess it does work for atheists with social anxiety. You say you've been to a couple of meetings but never went back for a second one. You also say that only we as individuals are responsible for our lives. And then you say that you are really tired of drinking but can't stop... So maybe that self will of yours isn't working. A higher power for me only need be a power greater than myself. It doesn't need to be anything d/Divine. For me, the fact that I couldn't stop drinking meant that there was a power greater than myself, and if there was one, why not another? If there wasn't, my will alone would have been all that was needed to stop. Truth is, my will has proved to be woefully inadequate at fixing most things. It's mostly just a source of trouble. Letting go of the notion of the almighty power of my will (which is what I believe the second step does) is most likely the reason I am still on this planet today.
6
Thank god i stopped drinking. And thankful AA is there if I need it.
6
As an alcoholic in remission for a decade my observation on A.A. is to take from it what you can use, leave the rest, & don’t sweat what you don’t get.
7
Fifteen years sober in AA. Unbelievable life. I am not here to convince anyone that AA is for them or to defend from the critics. What I can tell you is that I live in the same house, have similar cars and lifestyle that I had is 2005. Yet everything is different. My view, my perspective on everything is different. If AA was just about not drinking, I would not still be actively engaged. It is about the maintenance of my recovery and my spirit. And it is about helping the next guy who shows up with his life all kinds of screwed up. They can do all the studies they want, people can poo-poo AA all they want. I know what I know: it works for me and my friends. I have relationships with people I never knew possible. People count on me and I count on them. I see myself as a spirit on a human journey, not a human on a spiritual journey. I can breathe!
15
I visited a few meetings to support my friend who was in AA. It does seem to work for those who can wrap their arms around the "higher power" idea, but everyone I saw was still addicted to nicotine. Everyone.
7
@Steve Mills - Nicotene, coffee, donuts, and gossip.
5
@Steve Mills And caffeine.
1
AA was great for awhile, then it came to feel like my dysfunctional family and I left. But, that's OK, I'm still sober after 20 years.
The principles stuck, the people didn't.
The thing most people seem to miss is that AA is a discipline and it takes more than once thru the steps to get them. We grow, hopefully, and learn how deep they can go.
It also is VERY hard to find a sponsor when you're up there in years and people get funny about their years and think they are a sign of personal accomplishment. They are NOT.
Years are a sign that you've maybe learned something (and maybe not)...nothing more
5
1. AA not only costs less, it is free.
2. AA does not do research or keep records on its members.
1
Saved my life, when I didn’t believe in a “God”, enriched my life beyond measure when I chose to live by the principles (which include my own conception of God — as long as its not me)
9
A group of untrained non-medical experts who are at bottom ‘counseling’ each other through listening to confessions for free of the medical insurance grid or a group of medical experts that take insurance and are trained to focus on the patient. Which will win? Which do you want?
5
@Not Pierre
Apparently you see that as clear-cut …
@Not Pierre It's worked for me for over 40 years. Watched a lot of people over that period of time that listened to all the newest psychobabble and snake oil go out and die. Also watched more than a few of the "medical experts" drink themselves to death.
7
@Not Pierre You can word it differently: Which would I want to help me? Sober alcoholics who have demonstrated for years they have what it takes to get sober and stay sober, or some newbie shrink at the bottom of the insurance pool who thinks they know everything because they have a license nailed to their wall? I've had both over time. I'll take the recovering addict any day.
People who have been there and overcome their addictions know FAR more than any graduate whose only skill is to regurgitate answers from "book learnin'". The meetings I go to are full of sober people who know more than most therapists. Ironically I currently sponsor two therapists in recovery. NOW they are starting to truly learn about recovery from addiction, and they will be better therapists because of their first-hand experience in addiction.
13
My experience: the vast majority of people I have known who are trying to recovery from addiction and pursue recovery in AA do recover. Further, they change dramatically as does their family life.
I have seen many people thumb their nose at AA and claim it is not for them because of the higher power suggestion or the way it is structured or even that people sometimes use bad language in meetings. Many times these reasons not to pursue recovery comes from someone who doesn't really ant to be sober and, thus, they look for a reason for it not to be for them.
If someone is truly ill and something is presented that has worked for millions of people for many decades, they will pursue it if they want to have a new life. Most people who don't get sober (in or out of AA) are not clear (or honest) enough with themselves to see that their disease itself wants them to keep arguing around the margins.
If you want to get sober, go to AA. Nobody will "tell" you anything you have to do. But at some point you may see that the suggestions are there for a reason and it's an efficient and powerful path to a new life.
17
AA survived before and after this report. I suppose it’s nice ammo for those who defend it against recovery professionals who speak poorly of it.
AA’s early success made created the recovery community that now recommends AA to people who don’t want to recover and supports court-ordered AA in the hopes that “something sticks.”
There is no medicine or week-long hospital stay that replaces the action you take by following the 12 steps. You must admit you’re powerless over alcohol instead of taking an oath to fight it; you must face your fears and resentments instead of denying they exist, and you must take responsibility for your wrongs to the very people you hurt.
And hey! If it doesn’t work for you that’s OK! AAers will be the first to admit there are plenty of other options that actually do work for some. But if you decide to stay in AA - maybe keep your mouth closed and listen to our experience.
11
@Mike Magan : We tell them "we will gladly refund your misery." 😄
3
Its about time! I have had a front row seat watching AA save lives for almost 40 years. it is everywhere. it is free. and if you are an alcoholic, cognitive behavioral therapy will not help you. it will work maybe on drinkers who are not alcoholics.. AS is the last place I wantto go like most of us but it saved my life.
For years now I have listened to nonlcoholic "addiction counselors" discount AA. If you are not an alcoholic, you don't get it. Take it from me. I am a daughter, sister, wife lawyer, mother & grandmother who did not think she needed AA. I am not unique. A A
12
As a recovering alcoholic, I must say that CBT certainly does work for alcoholics. I am one of many it works on and I have 35 years sober this year.
What turned me off to AA is the religious overtones. Definitely not for me.
9
@Paula Lynch
Congratulations on your success and your sobriety. Truly that's wonderful.
I have thumbed-up/recommended post after post below yours which attest to success alcoholics had in AA. But you're taking a different tack that I cannot agree with. What has worked for you does not work best for everyone. It's surprising this has to be said. The same is true of treatment for most every disease. There is no One Way that works best for everyone. Some people will do better with a different approach.
4
My late husband's sister is a functioning alcoholic who attends Al Anon meetings
What it seems to have done for her is make her better at using the 'language' of A.A. while denying her own disease. She skillfully deflects using the program to justify her position
I am wondering if others have seen this happen???
1
It’s not wholly unusual for someone in denial to take away from attending A.A. meetings that they are _different_ from the “real alcoholics” they see at those meetings. They can become quite adept at telling you how their drinking is so different from that of an alcoholic. Unfortunately, this often means that they simply haven’t yet hit their bottom and realized the extent to which they are just like the people they find in meetings.
3
It’s not wholly uncommon for someone to derive from A.A. meetings that they are _unlike_ the “real” alcoholics in the meetings they attend and therefore don’t have a drinking problem. Unfortunately, this often means that they just haven’t yet hit their bottom and discovered how much they truly do have in common with “real” alcoholics — that, in fact, they are _just like_ them in every way.
2
@Patti
In my 11 years in the program I have seen quite a few people who 'backdoored' their way into AA-women, and quite a few men too, who started in Alanon and realized their own alcohol dependence problem and joined AA.
We call them 'Double Winners'.
Sometimes this happens in months. Sometimes it's years. We can't force someone's A-ha! moment on them. We listen. We identify. We may guide and suggest. We have faith.
4
It works if you work it. AA has been saving my life, one day at a time, for 27 years.
16
Some critics would say that abstinence based programs does not work. Yes, it is not for everyone, but what these critics fail to see is that AA offers more than abstinence. It offers a support system that many addicts lack of and need. AA gives addicts an opportunity to be a part of a community where society had kicked them to the curb and allows them to do greater things in life.
14
@Diego An interesting piece of research would be to determine how many alcoholics--defined usually as someone whose life has become unmanageable because of their drinking--have, through whatever kind of therapy, been able to recover from problem drinking and maintain a stable level of social drinking, say one or two drinks a week. I bet not many. Probably the most common phrase at AA meetings is "I cannot drink in safety."
1
@LongTom It’s been a done. A 2002 survey found about 18% of alcoholics self-reporting as moderately drinking again. As a point of comparison, among alcoholics who choose to regularly go to AA meetings, 75% are sober short term and 67% are sober 16 years later.
The reason why this report only sees 22-37% is because it’s for doctors trying to figure out how much it helps to try and get a patient comfortably going to AA meetings; not all patients respond by starting to go to AA.
1
Like so many of you who responded, I too find it so moving and helpful to read the comments of people who have found their way toward sobriety, or not. I’m a psychotherapist and I know from experience how important AA can be in the lives of my patients. Often, if affordable, the combination of therapy and AA is powerful, needed, but not necessary for all people. I’d like to see more research in this area, because untreated mental health issues can be underlying substance abuse. There are also other creative “no fee” paths toward promoting an interest in sobriety today. KEXP, a gem of a radio station in Seattle, hosts a day of programming once a year where hosts who have been in recovery tell their stories and read letters from listeners who are struggling with alcohol or drugs. Listener’s whose letters are read (and who hear their letters read!) can experience a kind of relief, a bonding with a community of others who are struggling, and a surge of motivation that can help them explore approaches to sobriety.
9
People who are comfortable with their own sobriety, in my opinion, don’t feel the need to take somebody else’s inventory. Or remark about how they should be working their own way of successfully staying sober in a different way.
Of course, all of us in the rooms know people who do that. I just avoid/ignore them and stick with the winners that have what I want.
7
AA saved me. For so long I felt as though I was on the wrong planet, never fitting in anywhere. I never thought it was my responsibility. I have been fortunate to be sober since 1988, and many life miles have been logged in that time. I owe my happy sober life to AA and the people there who lovingly helped me as I learned the steps for living and greater self reliance, as well as the humility required to admit the need for help and trust the result to a spirit which is all around me.
13
Interesting article, and, as always, an even more interesting comments section. For what it's worth, I am an atheist who has been sober in AA for just under 38 years. I have had my struggles with "the God thing" from time to time, and my solution has been to gravitate to more agnostic meetings when possible and to decide not to let the mentions of a higher power drive me out of the program. My reward, if you will, has been a productive life, a successful marriage, good and deep friendships, and some real sense of being useful to others. I have also attended Smart Recovery meetings and find that approach very useful as well. I hope this might help someone.
20
Yep, all of this. If you don’t already own it, the book “Staying Sober Without God” is a very good read.
2
@John in Maine Me too: big ol' atheist, 12.5 years so far. "Decide not to let... drive me out" is exactly right. I think of it as "thinking my way in, not thinking my way out".
4
I am happy for all who have found success in AA, but a 22-37% success rate for a disease is an abject failure. All the more so because politics and vested interests have actively hindered exploring and developing other forms of treatment. Please consider reading this with an open mind, it is simply an alternate point of view:
https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/
7
@PG The numbers in the five-year-old linked article showing a low success rate for AA are outdated. That article, as it turns out, quotes the old Cochrane review from 2006, so the author considers Cochrane reviews to be reliable.
A 22-37% success rate is not, by any reasonable definition, an “abject failure”. It is an order of magnitude higher than the outdated 5% success rate figure that outdated article you link to uses.
9
Forget the religious part if you want. AA offered me the blueprint for life that I thought everyone else understood but me. I learned how to be an active participant in life and actually work through my emotions without suppressing it all with alcohol. I also learned that I was loved. Priceless.
13
@Sara
1 thing you said right, AA is designed for living sober, sobriety is priceless.
1 thing you said wrong, there is no religion in AA, but find God or die and you get to chose your God.
4
My story about the AA people telling me to go to NA instead was completely true.
1
@Ben
Maybe, don't go to NA INSTEAD, go to NA in addition.
4
@Chip James
Yes. The people I know who have done 12 step programs, go interchangeably to most of these groups. NA can be the right place for an alcoholic, AA can be the right place for someone who abuses other drugs. The doors are open and as long as you're sincerely seeking help, AA is not going throw you out because your drug of choice is not alcohol, or vice versa.
2
@chip: Let’s be honest. Heroin and alcohol are two very different substances and should be treated differently.
I am pleased to see this article. As from my own experience along with thousands of others I know AA works. It is one thing to get sober and another to remain sober. These miracles happen..and also I would like to emphasis, it even happens to those who are not initially motivated. The article mentioned “we are motivated to stay sober”. There are those of us who are court ordered to attend, or attend for other demands made upon them. During their required time spent in AA many have turned around voluntarily to remain and have experienced the joys of sobriety.
7
AA saved my life.
6
AA saved my life.
6
I look at this like walking vs skiing, golfing, or climbing Everest or goodness sake. It's free, the others are not, what is more you constantly have to upgrade equipment. Years ago after a bad, bad hangover I went to the Betty Ford website. Granted it was a while back but the price was about $35000 for a month or two. Maybe three. The AA group in my town meets across the street at the Catholic church -- it's local -- and if I wanted to go it would cost nothing to cross the street and take about 30 seconds. What's more you are with people you will see at the PO, the grocery store - your friends and a built-in support group. You don't have to PAY for everything to get well, get exercise, to feel healthy. I applaud everyone who parks across the street every Friday night. They are heroes to me.
34
@Anne R.
All true, but the reality is, someone who is deeply into misuse and overuse of alcohol (and/or drugs) often need the confined and controlled time of 30+ days without use in order to get some clarity of mind and generate positive momentum to voluntarily working to start a program for recovery.
You bet its expensive, but for me it was worth it, as my first and only 30 day rehab has helped keep me sober for approaching 9 years. My insurance did eventually (14 months) reimburse me for much (80%?) of the cost, but regardless, it saved my life and I have clearly saved thousands in the direct cost of booze, and tens of thousands in reducing the secondary costs of my drunkenness - costs both to me and to society at large.
4
AA is one of the best things happened in my life. 34 years sober from alcohol and drugs and almost as many happy, joyous and free —- one day at a time.
6
@Anne R.
This article's "opinion" of new testing basically says more people stay sober when they have been participating in AA for a year - duh! They just throw away people who can't stay sober a year. AA total abstinence causes alcohol deprivation effect resulting in worst binge relapses. Dr G Vaillant recorded a 30% death rate from AA facilitated rehabs, which AA never warns victims about. AA calls its relapse victims - dishonest, AA is deadly dishonest. AA's dishonest math has been opinionated in articles many times before - under the endless heavy influence of the 50billion/yr AA rehab lobby.
1
The healing magic of AA is self-acceptance and empowerment. Let’s me show you. I’m going to introduce myself AA style and you respond with “Hi Chris.”
“Hi, my name is Chris, and I’m an alcoholic.”
“Hi Chris.”
What I have just done is come out of the closet, acknowledged that I deserve to exist, and that I have a stigmatized disease for which I am shunned. My willingness to open up and accept help is empowering.
What you have done is accepted me for who I am and acknowledged my disease instead of shunning me. You accept me at face value and support my efforts.
Now I can start to heal.
19
Being in a group you want to be part of, having others who really understand your problem, being able to talk freely and wanting to do the right thing for yourself and also your "tribe".
We humans need others .
5
Have you been saying things to yourself like --
" I need to cut down on my drinking" -
"I'll only have two glasses of wine with dinner tonight" --
"I'll only drink on the weekends" -
"I could never go out with him/her because they don't like to drink"
Do you need to "pre-load" with a couple of cocktails before going out for the evening - ?
Have you ever left a party early because there wasn't enough alcohol - and then went to the bar where you could "really drink" --?
Have you ever drifted away from a friend who stopped drinking because "They're no fun anymore" --?
Is it hard for you to imagine going to a movie - the theater - a ball game - without drinking - ?
When you go to dinner with other people - does it not bother you when others at the table don't finish their meal -- but you find it DOES bother you when they don't finish their drink and - "Let all that good alcohol go to waste" -?
When something good happens - do you "reward" yourself with alcohol - ?
When something bad happens - do you drown you sorrows in a bottle of wine - ?
When somebody makes you angry or hurts your feelings - do you think to yourself - "I'll show them!" - and then spend the night at the bar drinking with happy strangers --?
Has a friend ever suggested you may have a drinking problem - and you've dismissed it by saying "I can stop whenever I want - I just don't want to stop right now" -?
There's a saying in AA - "My will and my best thinking took me to my bottom"...
7
I would have said yes to many of those questions when I was younger, but I drastically cut down on my drinking by myself and now would say no to almost all of them.
I went from a very heavy drinker to a light drinker, without AA. Not everybody needs AA, and AA has many Christian cult qualities that I for one find deeply objectionable. It's scientifically unsound, and not the best option out there. There are other ways to reduce your drinking that don't brainwash you into falsely believing you're "diseased" for the rest of your life.
6
Thank you for sharing how you were able to curb your drinking. I am happy for you. What makes our world more pleasant are options. What may not work for one, just may save another from dying.
That is the perspective which allows us to collaborate for the betterment of every struggling person.
Sharing your negative feelings about AA as a solution to a drinking problem may prevent your friend, child, mother, brother, sister, father and/or neighbor the ability to experience recovery.
Only when you are swirling the drain, grasping at anything which will bring relief from pain you wouldn't wish on your worst enemy, will you understand the extreme power and relief of the fellowship in AA.
May the hand of AA forever be outstretched to grasp the next suffering alcoholics hand. That hand saved me for which I will always be grateful.
7
Read Augusten Burroughs' s books. He gets it.
1
Nope. Maybe if they kept religion out of it. AA is a gateway indoctrination into the church. They are just switching one addiction with another and I prefer not to believe in imaginary beings.
7
@MushyWaffle
There is no religion in AA. There is spirituality, which is different from religiosity.
In my case, being Catholic drove me to drink.
Denver, coincidentally was where I lived during the final stages of my drinking career. 3 martini lunches and expense account bar tabs were my life then.
When I finally got to AA in August of 1986, I was relieved to discover that the Higher Power that I came to understand and believe in was not a Catholic Subscriber either.
Today, I have not set foot in a church, catholic or otherwise, for more than 30 years. Nonetheless, I have a firm belief and a close relationship in a Power Greater Than Myself [whom I choose to call God], who cares for me and who is omnipresent in my life, caring for me and the persons whom are dearest to me. Often doing for me, what I cannot do for myself.
In AA, I have seen miracles happen - not the Burning Bush variety described in the christian bible, but events that often are not explicable. The miracle of my sobriety being among them.
I had quit so many times, without success. It was not until I gave up trying to quit and asked my Higher Power to help me that I finally was able to find and maintain sobriety, one day at a time for over 33 years now.
I too originally thought AA and Religiosity were synonymous. I am glad to have learned otherwise.
7
@JA Herrera
I have had to explain this to numerous people who try to defend AA as not religious. Using the term 'higher power' implies some sort of godlike power. You can claim it isn't religious but it's certainly not referring to willpower.
3
@MushyWaffle
I don't know what meetings you've been going to, but in 31 years of going to AA no one has ever tried to change this OPENLY agnostic person into a believer. Not even once. Yeah, there is is God Stuff in the literature, and the occasional person will talk about Jesus or Buddha, but the literature is full of stuff saying it's OK to not believe too.
1
First and foremost .. You have to want to get sober! For many that is a hard bridge to cross, but once you are ready .. and you'll know when you are- AA will be here to welcome you with open arms. It's one of the few clubs you can't get kicked out of... [yes yes there are exceptions] but for the most part the halls of AA have seen it all, heard it all and done it all.. they are non judgmental and willing to help.
... IF YOU WANT IT!
3
Alcoholics Anonymous is the mother fellowship to Narcotics Anonymous.Twelve Step programs have helped people with addictions for years with little fanfare. A cup of coffee and fellowship with people like you is invaluable for people seeking recovery. There is help out there for people that doesn't cost a dime. A Day at a Time!
2
How well does a 12-step program work for other types of addictions?
@BC
12 Step Programs work best when one practices the 12 Steps
@BC
There are about 35 12 Step based programs for all types of behaviors and addictions. Their existence supports their benefit.
@BC
I go to AA and also go to Sex and Love Addicts Anonymous. I have 22 years sober and 22 years abstinent from my Bottom Line behaviors. Works for me.
Oh my gosh, look at the contest!
I’ve been sober 792 months and you didn’t work the program correctly!
In San Francisco in the 80s there were celebrity speakers that made the AA tour and were even advertised in programs. We knew one and I went to several meetings and watched her give her performance. She went to Macy’s on Saturday morning and left her eight-year-old in the toy section and snuck off with her drinking buddy and waited until an announcement was made that security had found her.Once they knew she was safe, they both went off and got drunk. Everyone in the meetings fell off their chairs in paroxysms of laughter.
Really funny.
I lost my dad to Al-Anon when I could’ve really used the information on how to like, shave, and get girls and he was getting all the love from these meetings he just couldn’t believe it he would tell me.
Many social scientists don’t even use the word alcoholism in their studies.
It’s the only disease I know that can only be diagnosed by ex-wives other family members or fake doctors and nurses in uniforms selling rehab.
I always felt it was a disease that you caught by sitting on a barstool too long.
Do diabetics have to sit in horrible meetings for the rest of their life when they could’ve gone out and done something like, well, learn how to play the violin or become a horse trainer.?
If you slobber on people when you drink and go facedown in your spaghetti, I truly believe it’s a moral failure.
4
You should stick to horses, perhaps.
5
@J thanks for your advice, I always love getting advice, But you missed my point.
I did stick to horses
1
I never could understand how people put up with the awful taste of alcohol.
1
@A. Stanton
That is because you may not be alcoholic. For me, the taste of Scotch and the taste of chocolate were virtually indistinguishable
Thank you to the NYT editorial staff and to authors Frakt and Carroll for helping to set the record straight regarding the efficacy of the AA program. The publishing of this piece is especially welcome given other articles the NYT published over the past year or so that either failed to honor AA’s tradition of personal anonymity, or allowed the use of the AA name for controversial promotion of a for-profit, venture-backed commercial enterprise.
Further, the enabling of comments on this article is also welcome, whereas comments were not allowed on the aforementioned PR piece that used the name Alcoholics Anonymous for the promotion of the founder’s private business at the expense of AA.
Most importantly, this article, and the comments, will hopefully serve those who need AA with a fact-based account of a program that genuinely serves to help anyone who chooses to ask for that help.
6
I love it when the NY Times does an AA story-
but even better i love the comments -
so many opinions and so many different ways of getting sober -
or not...
in a way I take what i need and leave the rest..
thank you for your shares.
7
This study confirms what many of us sober in AA have known for a long time.
"It works. It really does."
AA offers a spiritual solution to the problem of alcoholism. It's a solution that is not religious, but based on an alcoholic's own conception of a higher power.
Treatment centers don't keep alcoholics sober, though they may help to jump start recovery. Self-knowledge and will power won't keep an alcoholic sober. But dependence on a higher power and following a few simple steps can bring about a spiritual awakening that keeps an alcoholic sober.
Psychologist Carl Jung was an early contributor to the birth of A.A. because of his experience treating alcoholics. He said, "spiritus contra spiritum." which literally translates to “spirit against spirit”.
Loosely translated, it refers to “a spiritual experience to counter addiction to the spirits (alcoholism).” Spiritus in Latin means both alcoholic beverages, i.e., spirits, and the highest religious experience. In relating this simple phrase, Jung confirmed for Bill Wilson, co-founder of A.A., that the A.A. program aimed at spiritual development and a spiritual awakening, as treatment for alcoholism, was the correct direction.
5
I went to an AA meeting once. It was a mandated appearance, not by a judge, but by a doctor. They went around the circle. I was about 2/3 of the way through. Most of the people seemed sincere. There were two guys who were there by court mandate, ordered by a judge, and they seemed like the frat guys at University of Florida. They barely spoke. Everyone else told their stories though. Then they got to me. I said, I used to drink every day but then I stopped doing that because I started taking drugs every day. They told me to go to NA instead. I used to love the movie “Days of Wine and Roses.” Jack Lemmon is really good in that, and he joins AA and makes his life better.
1
Modern psychiatry has zero- zilch, nada to treat addictions. They tell their substance abusing patients to "come back when you are fixed, and then I can treat you"...yes, our wonderful mind- healers defer to charismatic support groups. Go figure...
2
The other option, sadly, is to keep drinking.
1
My experience in AA was unpleasant despite attempts on the East and West coast. In NYC and Los Angeles, the meetings can be huge. AA is a cult within itself. Full of self-centered “Bill’s Big Book” addicts who seem unable of independent thoughts of their own. There are “in-crowds” and “out-crowds.” Old timers who do nothing but attend meetings and then go out to eat in large groups after because they are an already established group of mutual friends through AA. I have witnessed gossiping about each other in a derogatory manner. Attendees are supposed to be able to remain anonymous, but if you’re a celebrity or well-known person, other members whisper your name out to non-AA members everywhere. This is why celebrities and the wealthy pay for fancy private rehabs. There is no actual “anonymous” in A.A. Their advice is to “chase meetings, work the steps and keep coming back.” Come back to what? A room full of alcoholics who repeatedly do nothing but talk about booze, relapsing and how awful drinking made their life? That in itself will make you want to drink again. Alcohol is a drug. Once it takes hold of you, it is like all other drugs. When you’ve had enough you need to detox. I recommend seeing a doctor to check your health overall. See a psychologist. See a psychiatrist. An alcoholic needs to drastically change their life. Change your friends. Change your job if you have to. Get away from toxic people. Guess what? AA is FULL of toxic people. Get a hold of your own life.
9
I agree so much! I got some positive things but there are so many toxic people who are so self righteous and judgmental. I had some experiences that have scarred me for life by some AAfolks. I found my dog dead (12yr old friend) in the backyard. He was old but not sick. I was devastated! I brought him to be cremated and got some wine. I was just sitting on my couch crying, sipping wine. An AA “person” came over. I think my daughter called her to check on me. She was in my house for 5 minutes called 911 and when the policeman showed up she said I was suicidal!! I was Baker acted for 3 days!! I said I just found my dog dead!!, that’s why I am crying. Policeman said we can’t take any chances! I found out she does this. It is called 12stepping! There are some good people inAA but some really crazy ones. I don’t attend meetings much. Too judgemental.
4
@Judith Ann I had this kind of experience at first, and Elizabeth A., I was in LA and saw and heard the same kind of things you did.
However, my (free) therapist suggested I try small women's meetings instead, which I did.
For five years I went to two women's meetings a week in Pacific Palisades. There were several celebrities attending regularly and semi-regularly. No one ever breached their anonymity. Rigorous honesty and following the steps and traditions were too important to our own sobriety to ever allow that. You may have seen paparazzi or groupies pretending to be sincere AA members. Or you may have just been more unlucky than I was.
In any event, along the way I decided people who are cancer-free for five years get to have fewer check-ups and people who lose enough weight get to go on maintenance diets. So since I had five years--in 1990--I go back to AA meetings only when the other things I adopted to maintain my grateful spirituality are not working.
That has worked for me for another 30 years. Everyone around me either never had a problem or has long-term sobriety in AA and still goes to meetings and sponsors other alcoholics. So my life is a mini-meeting. Again I am lucky.
I would never suggest anyone take what works for me over 85 years of AA experience. I also would never presume I know why what I did and do works for me. Or what factor(s) are crucial to its working. Research would be needed for that.
1
@Judith Ann
I am sorry for what happened to you. It was obviously screwy. However, just to give you an outsider's perspective on your experience - I really think she was well intentioned, even if her efforts to help were clumsy. And the police - yeah, when they're told someone is suicidal they're supposed to try to save the person's life, which a lock-up will do, at least temporarily.
Worse things can happen to a person than for her daughter, an AA acquaintance, and the police to converge to try to save her life or stop her from going on an alcholic binge. I do not feel you were as poorly done by as you seemed to feel. That said, I don't doubt the experience was very unpleasant.
AA works. I know this but the obscene focus on cost cutting in this article has got to go. AA is a voluntary organization of discarded people helping other discarded people make their way in the world. It does many great things and it is also entirely amateur and fairly random. sometimes you get a good sponsor who can help you stay sober, sometimes you find a con artist who is trolling the meetings for marks and sometimes . . .
What you never get is a trained qualified therapist who can help you through your past traumas. Responsible people in program will tell you that you need this help and try to help you patch together your life without this help but nobody should expect a group of unpaid volunteers to get that help regardless of the positive impact that it might have on public budgets.
5
Alcohol is metabolized differently by different people. People of Arab descent have a very difficult time metabolizing it thanks to over a thousand years of most people in their ancestry eschewing the substance. Slavs and the Irish and Scandinavians all seem very susceptible to loving alcohol. All of those long cold winters. It is a drug. It should be seen as such. It is a legal drug and one which has defined cultures.
5
Double blind randomized trial confirms that dogs really do have emotions!! That humans are hard wired to find babies and puppies cute! Millions of people around the world know that AA works. Millions more people have family members and loved ones that have gotten sober in AA. In my experience the people who really want to see that AA doesn’t work are not drug companies or rehab companies, but alcoholics who would like to keep drinking.
4
I once heard someone at an open AA meeting (meetings that are open to "normies", AA slang for people who can drink alcohol and not become addicted) say "The only thing I need to know about God is that I am not It." I also heard "Take what you like and leave the rest," and "we suggest that you try at least 6 meetings before you decide if this program is helping you or not, and to try several different meetings, because each one has a different personality. We will cheerfully refund your misery if you decide this program is not for you."
So to atheists and agnostics out there, don't let the Christian origin of AA keep you from seeking its help. To anyone suffering as a result of their drinking or someone else's drinking, AA and Al-Anon/Alateen offer fellowship, support, and a way back to sanity. The 12 Steps and Traditions also provide guiding principles that serve in every aspect of life and go way beyond keeping people from reaching for the bottle.
6
I find this article to be irresponsible. The authors should have specifically noted that AA is not run by medical or mental health professionals at any level.
3
To quote the Geico ads, everyone knows that.
3
It is really great when experts agree on what we of common sense has said all along! Especially now when terror is gripping the heart of the planet, our 'cure,' is lend a helpful hand to another, to break the death grip of self-centered-ness that now holds itself within us.What did mister Rogers say? In any crisis, look for the helpers.
2
I am glad to see this article published in the New York Times. In the past the NYT has been critical of the A.A. approach - and this was a mistake - a tragic mistake. The the thousands - no, the millions who have gotten away from alcohol (and other drugs) and have gone on to lead productive lives is proven fact and a possibility for all people who continue to be crippled by alcohol abuse. A.A. meetings are everywhere today - there is no fee to attend. The help is out there. “It works if,you work it.”
5
So glad there are more SMART recovery groups cropping up. The God centric alianation of AA is palpable. Sorry AA I am not powerless, my recovery is not in the hands of God but under the control of my choices.
9
SMART Revovery...doesn’t use labels like “alcoholic”, doesn’t require you to believe in a higher power, is FREE, has online and in-person meetings. I attended A.A. meetings and all of them ended with the Lord’s Prayer. That makes it a Christian organization. SMART worked for me. I highly recommend it.
6
Having seen the success of A.A. over the last 25 years. Drunks helping other drunks in the plainest sense AA. does not charge for the support,care,and concern. Give it a try if you want to quit drinking. Give Al anon a try if you have a loved one or friend whose drinking affects you whether they quit drinking or not
3
The article has flaws galore. There are 18 embedded hyperlinks in its 19 paragraphs. In a perfect world, many of these sources would instead be tagged with footnotes and listed below the article like a high school term paper where its writer has to "show one's sources".
The title is less than true: "The Evidence Is Now In".
Um, no, it ain't.
There is not enough in the article for the reader to conclude a thing without sifting through Cochrane's 27 surveyed studies. Who has time for that? The linked "one study" in paragraph ten is from 2001. Hmm.
Do the authors know that AA's goal and promise is total abstinence? In their fifth sentence they write:
"On other measures, like drinks per day, it performs as well as approaches provided by individual therapists or doctors who don’t rely on A.A.’s peer connections."
The compliant AA member has Zero Drinks Per Day, i.e., total abstinence. AA's promise is that God will vacate both the mental obsession and the comical "physical allergy"; the abusive drinker will never again have a drop, not "fewer drinks per day". That's a flat-out AA fail.
The authors seem not to know this.
"[A]pproaches by INDIVIDUAL therapists or doctors who don't rely on A.A.'s peer connections" aren't alternate peer-group-support "treatment" received in a non-one-on-one setting. These are apples and oranges.
AA may be "better than" alternatives, but The Evidence IS NOT Now In. Hardly.
This is how AA perpetuates itself and fools an incurious public.
7
@Secular_AA_Coffeeshop What this report shows is that, comparing therapies which get people to attend AA meetings to therapies which do not, the therapies which encourage AA attendance result in a higher rate of abstinence from alcohol.
The report shows this with a high level of confidence by using only well run randomized scientific studies. Cochrane studies are considered the gold standard of meta studies.
1
It works if you work it! One day at a time.
1
What's strange about this to me is that alcohol and opiates are both drugs. Treatment of opiate users is considered most effective with Buprenorphine, yet there is no similar drug for alcohol (I believe there is a drug that makes you sick if you drink, but that isn't how Buprenorphine works for opiate users).
Why don't we have a Buprenorphine-like treatment for alcoholics? Why is the primary treatment merely an absitenence/willpower method which has a relatively low overall success rate?
I would argue our society's shame-based thinking around excessive drug and alcohol use is a big reason, which also has a lot to do with how hard it can be to find a doctor able and willing to prescribe Buprenorphine for opiate dependency. There's some notion that medication is too easy, you're just taking another drug, you're not dealing with the awful person that you actually are, etc.
It just boggles my mind that a society with centuries of history of alcohol abuse hasn't come up with a medication that tapers abusers off alcohol treats their physical addiction instead of just forcing them to quit cold turkey and then feel bad about themselves.
3
@Conch Republican because the physical part is only half of it.
Been sober for 9 years In AA and have never been happier despite some prett my heavy things in my life today. AA is not a cult, it’s just a group of ordinary humans trying to help each other live a healthy, happy way without substances. There are no requirements whatsoever except for a desire to stop drinking. Join us! We are here to help!
7
As the daughter of an alcoholic, I can't even begin to tell you how much my sisters and I wanted my mother to join AA. We begged, cried, cajoled, bribed. One sister even called Dr. Lester Grinspoon, her shrink, who ripped my sister apart and wouldn't believe his patient was an alcoholic. We went to AlAnon and found it greatly relieving and productive. Alcoholism is seductive and often conquers. Keep AlAnon in mind.
6
Well AA was a good start for me but I got bored with the meetings. I got tired of hearing people's horror stories. AA has hurt many people with some members being sexually predators preying on people in a weakened psychological state. I'm now attending SMART Recovery meetings which are more science based (CBT) and allow for a more conversational flow.
4
30 years Sober in AA and no one ever pushed anything on me. Only made suggestions and told what worked for them.
One of the slogans in AA is "Live and Let Live" Another is "Take what you want and leave the rest"
Saved My Life!
4
Higher power? Not buying it. Ever.
2
It has saved my life—twice. I first got sober in 2001, after a drinking career that gradually destroyed my professional one. I was astonished to walk into a large evening AA meeting on the Upper West Side, which turned out to be a 3-speaker meeting, where I heard a kind of rapture in their voices that was yet very grounded and full of insight. Serenity. Courage. Wisdom. The Holy Trinity for anyone who has a desire to stop drinking. I attend one or two meetings a day, every day, no matter what. I don’t drink a day at a time no matter what. And after that I don’t smoke a day at a time, nor overeat nor spend beyond my means, a day at a time. The gift of sobriety is getting over my big fat ego. E G O stands for Easing God Out.
Who taught me that? A man named Preacher Robert, a man with funny bones who lived in a cardboard box for 25 years. Rest In Peace, my first sponsor, one. If God’s humble servants who rocked my smug little world, and who taught me to put down the drink, seek God, clean house, and help others.
We have a beautiful thing going on in AA. Come see about us.
6
There is a dark side to AA that no one wants to address. I personally witnessed a group of men with 'time' in their 30's and 40's pass around a vulnerable 18 year old girl - meaning they had sex with her. She was addicted to multiple substances, depressed and broken. I have heard multiple admissions by women in recovery who have been raped by men in the rooms. One woman told me her sponsor (a woman) said she owed the man who attacked her an amend for her 'part'. I overheard one man saying his sponsor told him to 'wait until they had enough time to stop throwing up' before approaching newcomers for casual sex. This type of predatory behavior is alive and well in the rooms of AA. The excuse made for these individuals was 'some are sicker than others'. I heard it stated that this behavior is AA is rare but I have witnessed it in almost every group, in every state I've ever lived in. The very nature of AA does not allow it to police its own members. These behaviors are glossed over as part of the disease and therefore given a degree of tolerance. No wants to talk about it. When I attempted to draw attention to the situation I was criticized and told I would scare newcomers away or break anonymity. I stopped going because of this several years ago. I've developed my own coping mechanisms and I'm doing just fine without AA. Google 13th step for more information.
4
I witnessed similar behavior in AA meetings that was tolerated without question - until I said something - when a creepy older man was repeatedly hitting on a 21-year old from our group who was in sober living and quite vulnerable at the time in the middle of the meeting. I couldn’t believe that he wasn’t immediately kicked out for this. Regulars at the meeting just laughed it off as they were accustomed to his behavior. Unreal. One of numerous reasons I do not espouse AA.
2
How could it be that we are just now learning this? AA has been around forever!
3.3 MILLION deaths per year... That's more than the 2 million expected in the US from Covid-19 AND the FLU combined! WOW!
1
39 years ago I was presented with AA as a new way of living. I was never beaten over the head with this program. I saw what it was doing for others and decided to give it a try. So far, so good. I have been given a daily reprieve from the ravages of my alcohol abuse, the latest day being yesterday. I don't preach AA to anyone. If they like what they see in how I handle my sober life, decide to try it out, ask for help, and "keep on coming back," the rest will fall into place.
5
The damage caused by AA is immeasurable, and has not been measured. Court systems forcing non-religious individuals to participate in faith-based healing is a ridiculous subversion of American justice.
2
@Daniel, I went to only closed meetings that published and posted no court cards signed. Forcing anyone to come to AA is ridiculous, shows how weak the justice system is, and interferes with the true purposes of AA, which is a program of attraction. Not promotion. And certainly not coercion.
30 years sober, thanks to AA. A couple of thoughts:
1) the only requirement for membership is the desire to stop drinking. Period.
2) Mandated attendance by courts rarely have success because of - see #1
3) AA, while focusing a lot on a higher-power is non-religious. Should a member choose the coffee pot as his/her higher power, that's just fine. The point being to believe in something greater than yourself (because "yourself" has not made very good decisions)
Bottom line - You gotta want it
5
AA saved my dad, and now my dad is saving other peoples lives...as simple as this.
It sure worked for me! 46 years sober. I stopped and stayed stopped.
There is nothing like the group support of AA. You show up for people and they show up for you. You understand that you are not unique. Your background, education, ethnicity, finances might be different, but the addiction to substance is the same. The feelings of shame, embarrassment and emptiness are the same. Nobody understands an alcoholic like another alcoholic.
I am a grateful alcoholic. I thank AA for giving me a place to go, and loving, caring people to support me through my recovery. It’s nice to see studies that show it works but In my heart I always knew that.
6
"Rigorous study of programs like Alcoholics Anonymous is challenging because people self-select into them. Those who do so may be more motivated to abstain from drinking than those who don’t."
This is a really dumb statement, not by the reporter, who is only repeating the "scientific" nonsense that the "rigorously empirical" research community dishes out, but because it totally misses the point about the difference between AA, and similar social behavior oriented therapies, and, say, pharmacologically oriented therapies, where total random selection is the gold standard.
Sure, if you're testing a drug, which presumably operates by some deterministic mechanism or another completely below the level of voluntary conscious behavior, then it is appropriate to ignore something like motivation. I don't will my Lipitor to be effective. It either is or is not based on objectively determinable body chemistry.
But while conscious motivation may be pulled somewhat more, rather than less, into the orbit of inexorable chemical process, unless we really are deterministic systems au fond - which is, of course, what most of these researchers really believe - it is mixing apples and oranges, methodologically speaking, to uncritically subsume voluntary behavior, again, however fragile, under the biochemical causation model which clearly should rule in the case of interventionist drugs.
"But that makes the validation more difficult!"
Deal with it, that's part of what being human means.
@Arbitrot
It's not a dumb statement. You misunderstand. Researchers understand very well that motivation plays a huge role. The point of such studies is precisely to try to tease out what part is motivation and what part is the SPECIFIC treatment being studied. You actually agree with the researchers in this though apparently you don't understand that.
Of course people's motivation is key. But you can't (easily) test one treatment against another without at least trying to (and the point is, from the POV of study design, this is very tricky) remove that variable from the mix, in order to isolate whatever OTHER variables may distinguish one treatment from another.
My brother has been going to AA for over 30 years. He was a binge drinker When he first quit drinking he said he used to have nightmares of sitting in a bar and getting drunk. Now he says he has no more nightmares. And he is clean and sober. He swears by AA. He says abstaining from alcohol is the best choice an alcoholic can make.
2
In some ways, the 12 steps are one small aspect of cognitive behavioral therapy - as they restructure a person's negative self talk, into a more empowering message- as is the message and the practice of praying in most religions. However, the AA message can also be disempowering and misleading and it is Christian in nature. You sinned, you are powerless, and if you start to admit your sins, God will save you.
You may feel like you do not have control now, but with a good therapist, you build a relationship, and learn how you can rely on yourself and not others, and not pills, to build resiliency and manage stress in a healthier manner. A good therapist will provide you with some education and understanding of the neurobiology of addiction, about neuroplasticity, developing insight into what causes you to drink, and learn to be cognizant of triggers in your environment. Perhaps for the first time you will learn healthy coping strategies or build on ones you already have. Unfortunately the majority of people who abuse substances because of trauma, depression. anxiety, or poor self esteem, will not be helped in the long term by people who are not trained therapists, as the research indicates. Too many of my clients tell me AA sponsors overstep their bounds.
Belonging to a group clearly has benefits as you realize you're not alone.
Psychiatrists today merely write scripts, and will keep you hooked on meds for life, a complete misuse of psychiatric medication.
2
Many people I know, who tried AA meetings, said to me that the approach is great if not for the religious part.... which can be from pretty light to be based on that entirely. It works for some; but not for all...
Sober and successful for 37 years thanks to the AA fellowship. Take what you can use of the program, and leave the rest.
2
I have remained sober for 3 years by the grace of God/ the Universe/ Higher Power/ Source Energy/ the Goddess, and because I attend weekly AA meetings.
2
All that being said, AA is not for everybody. I am close to someone who could NOT get sober until they stopped going to AA. If AA is not helping you stay sober after you really put your all into it, don’t give up and do find a solution that works for you.
7
As a close observer of the fellowship, I’m delighted to know that scientific rigor has verified what millions already know: AA works.
The rigorous study of programs like Alcoholics Anonymous is challenging not only because people self-select, but also—and this is a great part of its success—because the organization does not permit canvassing, tracking, or any other kind of study of its members.
Anonymity and freedom from scrutiny are crucial elements in the success of A.A.
1
My experience is AA doesn't work for those who are not ready. Many have a false belief that it can't be effective if it's free. They're put off by meeting halls that are decrepit. God is mentioned too much. Or... you name it. Everyone's "bottom" is different and hopefully their last drink won't kill them (or they won't kill someone). Honestly, who wants to admit they're an alcoholic? Ahhh... but therein lies the path to sobriety and sanity - we admitted we were powerless over alcohol and our lives became unmanageable.
All the tools for living are baked into the Twelve Steps. Alcohol destroys families. AA and Alanon restores them to sanity. Sometimes those who are interested in AA need to check out a lot of meetings before they find "their people".
I have not had a drink since I walked into AA 27 years ago. I could not have done it without my AA peeps. We speak a language earth people do not understand. I lead a full and productive life outside of AA, but AA made it possible.
It's no secret: meeting makers make it.
2
Up until 1935, alcoholics got together to drink and get hammered. In 1935, this changed. Two alcoholics got together and in essence, said, 'Let's support each other in our desire to not drink, just for today.' Some of the energy from that momentous meeting sprinkled down on me in 1996, and I have not had a desire to have a drink or drug from that time to this day. As I so often say to newcomers, and to my AA brothers and sisters,'Let's not drink today!'
2
AA is a brilliantly designed program. It provides a community of people who understand with out words or judgement the power of addiction. It provides a community of people seeking a better way of living than living in the belly of active addict. Addiction isolates, AA is a family. Meetings provides a place to go to instead of drinking. The steps lay out a path to recovery. It begins simply. All you have to do is admit to your self and to other drunks that your life is insane and you are powerless over alcohol. The next steps (2-3) are about owning that the power of addiction is too big to do alone. These steps ask you to find something bigger than yourself (God) to help you stay sober. The word God is loosely defined. My higher power is the collective wisdom of the people in the program. It is not until all that foundation has been laid that the addict examines her behavior. And it takes four more steps of self examination (4-8) before the addict reaches out to those in her life she harmed to makes amends (9). The final steps are about continued self examination and finally, paying it forward by helping another person just like you. There is the Big Book to use as a guide. And all the powerful stories that give experience, strength and hope. Going to that first meeting can be hard. But I can promise that every person in the room understands and will support you. It's no magic cure. Staying sober takes work and vigilance. But for a free program it is one mighty good deal.
2
Much is made of "The God Thing" by the detractors of AA. Yes, the word "God" appears in the 12 Steps. Yes, the literature speaks of a Higher Power. Yes, many groups say the Lord's Prayer at the end of the meeting.
But, no, AA is not a religious program, let alone Christian. If you actually read the literature you will see there is plenty that says you do *NOT* have to believe in God. Are there individual "Christian" or "whatever" meetings which claim to be AA meetings? Undoubtedly, but they violate several of AA's 12 Traditions and our Preamble. Kicking such groups off the meeting list is the most we can do, tho.
How do I know this? I have been in AA for 31 years and have gone to thousands of meetings. I am and always have been OPENLY agnostic. Yes, I have heard individuals talk about God and sometimes even Jesus Christ, to the group or even directly to me. But never in 31 years has anyone told me that I must believe in some deity or get out. It is, "Whatever works for you."
Some people come in and see "the G word" in the Steps and leave, often resulting in the drastic consequences of alcohol and drug addiction. Some of them come back and we hear about those consequences. The best I can do is tell newcomers that belief in God is NOT required.
Agnostic or not, I *do* have a GOD. I ask my GOD for help and I get help every time I ask. What is my GOD? My GOD is a Group Of Drunks and their collective wisdom thoroughly learned in the University of Hard Knocks.
5
I view AA similarly to religion: humans using their imagination to invent a ‘solution’ to a baffling conundrum (human existence and in AA’s case addiction). There’s a long history of religion & an equally long one of quack cures - bleeding w/leeches anyone?
Humans are also social creatures by nature and wish to belong. As such, group of people in a room can convince one another just about anything is true (Scientology anyone? Noah’s Ark? Salem Witch Trials?) Anyway as w/religion, the real benefit is a community & support system. Since it is helpful to some, they assume all the dogma must be true.
All well and good. But I put my trust in science, especially in matters of human health. Also if I had a disease and heard people heralding a cure w/less than 1/3 success rate, I’d wonder why everyone was celebrating. I have problems w/any cure blaming patients the 2/3 or the time it doesn’t work, that rigidly claims to be the only real cure, makes relapse = total failure, that addicts should be allowed to ‘hit bottom’ - leading to higher suicide rates, worse relapses & fatal overdoses. And the unregulated 12-step based treatment industry - gouging desperate addicts tens of thousands for what’s supposed to be free? Btw read up on founder Bill- LSD enthusiast later in life.
Addiction is a mental health & neuroscience issue with dire consequences to physical health. Science-based treatments backed by evidence are the only route to recovery w/better odds than a blackjack table.
4
Naltrexone has been very effective for many suffering alcohol or opioid abuse. It is a drug that reduces cravings for these substances and can be administered in pill, injection, or implant forms. Some use it to aid abstinence. Others use it in conjunction with The Sinclair Method either to achieve abstinence or moderation. Naltrexone is NOT Antabuse, which is something of a last-ditch drug that makes the patient physically ill if alcohol is consumed. Naltrexone is a different class of drug and does not make the user sick at all. This article seems very thinly researched or written straight from a press release.
2
Without A.A., I would be dead. Thirty years after my last drink, I know that. Over the decades, I've watched various public disparagements of AA come and go. I've heard arguments that there is too much god-reliance in AA, which long-timers understand to be untrue. I am grateful for the day, scared and hopeless and clueless, that I walked into a room in a church basement, said 'My name is xxx and I think I might be an alcoholic'. Strangers smiled at me and nodded.
4
What is true for me is that the loneliness and isolation of addiction is reflected in the concept of I am powerless over alcohol/drugs/etc. But the nature of recovery is that we are not powerless when we get help from others or give help to others to move away from the negative of the past to the positive possibilities of the future. This does not guarantee the “happy” life that is a Capra movie. Life will be all those hard, painful, difficult, unfair, and awful things we have experienced, but working on recovery will give us a base of strength to get through this thing called life and continue to grow and work at being better in exploring our “better angels” that Lincoln spoke of in mid 1860’s. I know these "spirits" exist as I have met many in the rooms of AA as an avowed atheist who says “Grant me the serenity” without mention of any deity after every meeting. AA is an opportunity to explore oneself with the assistance of others directly or indirectly. For some it may be a religion, but each group has the range to be what it wishes and each individual has access to tools to make changes and also has the option to find another group that is more effective for them on a different day or a different time. My personal and professional experience has taught that everything works and nothing works but one truth remains through all of this is that recovery is something that one does it not something that happens to somebody.
3
I was raised in a alcoholic home. One of my relatives is on his death bed from drinking related liver disease. It is a horrible way to die. Another has been sober for almost a 30 years and still goes to an AA meeting every week without fail. I am very grateful to AA.
1
Probably some of the bigger factors in AA’s effectiveness are the price of treatment (nothing) and its public stance (no opinions on outside issues).
Just think if AA was sending out spokespeople on every issue and dispute in the news. This must drive the media and those wary of AA nuts. All the criticism of AA gets no official response from the organization itself, only those who choose to speak up in defense of ‘the program.’ It is as if the organization sits with its arms folded and just lets the evidence appear without spin. How dare they, right? That’s how it’s been for 85 years.
As to the criticism about the spiritual aspect of AA, I can only say, personally if when I came to A.A. and learned that I HAD to believe in God and it was that way or the highway ... I would’ve taken the highway. Not a chance i would have stayed in AA if it was forced upon me. I took my own path. And as of Tuesday this week 3/10/20, I celebrated 35 years clean and sober.
2
This is not written to bash AA. However, there is often a mental illness driving a person to addiction. That mental illness needs to be addressed and it won't be free. A 37% abstinence rate isn't okay. We won't be content with a 37% cure rate for the current Corona virus. We are not content with the current survival rates of heart and cancer disease.
Mental health needs as much attention as physical health. First we must accept that the state of the mind is not a moral failing. Just as the lepers of the Bible were infected not "unclean" and rejected by God, we must find the keys to unlock the mind and find the underlying causes of mental illness-not just treat their physical manifestations.
6
I just passed my decade sobriety anniversary in February and I’m 35 years old. I’ve always had a love hate relationship with AA. Mostly loving the fellowship and connection and hating the literature, lack of science, and Judeo-Christian underpinnings. I’ve have incredible experiences in AA meetings across the US and Europe - really powerful experiences. I’ve also enjoyed some of the women’s retreats but ultimately I found the pressures to conform too great. How authentic is this tribe for me if I can’t safely express myself opposing views points and question some of the bogus dogma? Ultimately I turned to secular AA and then Refuge Recovery and Recovery Dhamra.
AA would have you believe as an alcoholic something is “wrong” with you, and you belong with them. AAs greatest strength is it’s greatest weakness - the spirit of the program is for me to share my experience with you - NOT for me to tell YOU what to do. A lot of folks in AA struggle with that...
Nontheisic meditation based recovery tells you, people who struggle with addiction don’t have a franchise over the human condition. Nothing is wrong with you, your tribe is humanity. I find this message far more empowering and accurate. I miss the fellowship of AA but I had to move on to a venue where my personal experience and thoughts didn’t alienate the group.
I know some regions have more relaxed AA - and those groups benefit from being able to openly discuss their alternative perspectives (theist and non theist.
3
National Allilance on Mental Health is another "closest thing to a free lunch" in public health. Too bad the providers discourage it at every opportunity.
1
To be clear, I have nothing against AA, but I was aghast reading this article, which is the AA-centric viewpoint of addiction treatment in the United States. The study that the authors highlight is titled "Alcoholics Anonymous (AA) and other 12‐step programs for alcohol use disorder", while their own title is essentially "AA versus other approaches". The "other approaches" that AA is not compared to include medical interventions that are highly effective in combination with behavioural therapy - approaches that have been used to great success in Europe. For anyone struggling with this awful disease and looking for a scientific assessment of the spectrum of treatment approaches that they could consider, this article is at best misleading.
2
“On other measures, like drinks per day, it performs as well as approaches provided by individual therapists or doctors who don’t rely on A.A.’s peer connections.” What is the “it” in this sentence? It’s unclear if other approaches perform as well as AA or not.
Less expensive? Try free. I've told patients this for years. Still, most addicts aren't content to involve themselves with community based non profit interventions like AA. Why would they? Our addicts, just like our business people and politicians, are influenced by a culture of greed, individual self interest, and the overwhelming sense that in America nothing of value can be had without great monetary expense.
Plus AA uses the whole "god" thing. Unfortunately many addicts won't attend AA or NA because they're agnostic or atheist. Money is the true God. I've seen families bankrupt themselves paying for treatments that aren't evidence based only to lose their addicted children and their homes before the end. In their grief there is no God to assuage their suffering, for their money is gone and their god never was.
3
AA has been working great for my stepfather-in-law. More power to him. He’s more awake, more aware, more coherent, more productive, more fun.
What worries me is the religious context. The man was born in California in the late 40s. He grew up along the central coast, started a successful business in San Francisco, you get the picture. He’s as Californian as they come. He fell into depression and alcoholism while approaching retirement age. He nearly died in his sleep. He had to spend a week in the hospital, where - obviously - he was cut off cold turkey. He joined AA and has been “dry” for almost a year. He has been following their program religiously. And I use that word with purpose.
Suddenly, this died-in-the-wool Californian who was in his prime during the 60s and 70s, who has embraced the local life style all along, is getting all religious. “I needed Good in my life”. “To change your ways when you understand the higher power”. Really?
To me, this is just switching from one addiction to the next. Maybe without the chemical connections in the brain, but can we be sure?
1
@T R
A year, you said. Of course. Normal stuff. Just give him some time
Why are either persons concerned with an anonymous spiritual fit condition? How do you have evidence of a spiritual program?
I've found it invaluable in the early stages of recovery but it doesn't suit my temperament over the long haul. If it does for you, great! My only real complaint about it is that there are some zealots who insist that not only is AA effective, but that it is the ONLY effective method. That's an especially destructive message to hear especially for people in early recovery. And yes, when people tell you that, it's the very definiton of a cult and a dangerous one at that.
I am aware that such vehement insistence on itself is not exactly AA dogma, but I heard it expressed numerous times from some of the most respected members of various groups. AA was the only way, and if you slipped up, you failed, not AA. And you were doomed -- "you're gonna die!" -- if you didn't get back in the rooms and confess your sins.
While that works for many, it doesn't for me, but I wish all those well for whom it has been a lifesaver. And it has played a part in saving mine.
I know I am hardly alone among the ex-AA, still-sober contingent. Two of my best friends fit the same bill. One attends occasionally, when asked to by friends or family, and the other never ever goes. Between them they have about 20 years of sobriety and are very well-adjusted. They, and I, have taken what they needed and left the rest.
4
I wish more science reporting focused on high quality, large scale results as exemplified by Cochrane, so bravo for that!
We need to move beyond breathlessly reporting (and often overstating) the results from standalone studies that so often turn out to not replicate.
Even if a meta-analysis of studies related to alcohol abuse shows AA as the best choice, we should take these findings with a grain of salt. First, in the studies included for analysis, the demographics were not uniform with some including no female participants (the most any study included was 49%). This means the findings might hold true for men, but the same cannot be said for women who were included in much lower numbers for the analysis. Reporting on this should be cognisant of the factor sample demographics contribute to the interpretation of the results. Even if a meta-analysis of studies related to alcohol abuse shows AA as the best choice, we should take these findings with a grain of salt. First, in the studies included for analysis, the demographics were not uniform with some including no female participants (the most any study included was 49%). This means the findings might hold true for men, but the same cannot be said for women who were included in much lower numbers for the analysis. Reporting on this should be cognisant of the factor sample demographics contribute the the interpretation of the results.
4
@Stephanie In 32 years in AA I have seen just as women as men recover (gay, straight, bi, etc). You will find in the study what you intend to find in it.
People who want to be in recovery choose programs that work. Pick up a meeting list in most any community and you will find hundreds of meetings each week. Thousands of people attending. That isn't a fluke and caused by "meta" analysis hype.
1
I'm 35 years old and have been sober for over 15 years thanks to AA. Getting sober was unquestionably the best decision I've ever made and it would not have been possible without the help of AA. Walking into a meeting and hearing people share thoughts and feelings that I myself harbored but was too afraid to look at and share was a revelation. Through AA I cultivated a spiritual side, learned of the inportance of being of service, and found a fellowship of true friends that eluded me when I only socialized through drinking. Having been around the block in recovery, I am also aware of AA's shortcomings. A strict adherence to the text can be overly punitive in my opinion; the message that if you are alcoholic you are basically a sick and selfish person who will be lost without the help of God was helpful in the beginning to me as it helped me take ownership of my actions and learn about humility, but that message also reinforced negative feelings about myself acquired from childhood trauma. I've come to a more balanced approach to sobriety that works for me that involves staying close to my people in AA. Another trend I've noticed is about twice a year the Times or someone else publishes a new trendy recovery program that disavows AA, but is never heard from again after a few months. Overall, as many have noted here, real data on efficacy of AA is scant, but I can unequivocally state I've personally witnessed AA deliver people from the brink more times than I can count!
12
These articles are always interesting. The Great Debate!
The 12Steps are a good program and they’ve created that path of health and happiness for so many people.
I believe that there is no right or wrong way in recovery.
This is just another opinion that is manipulated to show the values it wanted to achieve.
Tomorrow there will be an article debunking this one.
Recovery success is a flat line number right across the board whether it’s 12Step, MAT, therapy, LifeRing or Smart, etc.
Why is it always so important for some to create this debate when the most important thing isn’t what program/method individuals choose for there recovery, it’s simply that they are doing recovery.
Do say one program/method is better is from a bias of fear.
2
I don't need a study to prove it. Now sober for 31 years. Thank you AA. You saved my life.
4
Many here have pointed out the problems with the notion of a "higher power." Some AA defenders argue that it does not specifically refer to God. Yeah? But they sure do put a lot of pressure on their members to go that direction. Also, saying that one has no power over alcohol seems really counter productive. These are the problems one encounters when turning to a bunch of amateurs for help with a medical problem. AA may work well for some, but for the reasonably intelligent it is a frustrating group filled with weak willed people who tell the rest just how weak willed they are too. No thanks.
4
@Max Deitenbeck Sorry you have got a negative impression of the twelve steps. The aspect dealing with a higher power is whatever that higher power IS to you. The most important thing is just not to think you ARE that highest power in the universe. :) Also, two of the biggest impediments to sobriety are intelligence and wealth to the extreme. Humility and an open mind help the most, but I hope just that you find one great meeting and one great chair to change your mind. Yes, some people need doctors' intervention; others do not for the most part, and the program may be just the thing that brings them back into functional life, improved. Good luck. :)
4
@Max Deitenbeck the only problem with this thinking is that there are amateurs AND professionals alike in the meetings.
AND....it takes a great deal of courage and fortitude and honesty to set aside delusion and stick to a program of any kind which makes you do hard work to save yourself and become a better and more productive person. It actually does not matter if you subscribe to everything in the program IMO so long as you contemplate earnestly what the heck got you there in the first place.
1
I'm an AntiAA and anti-prohibition activist. I think the data that might be the most relevant for the long-term success rate of AA is their own records of sobriety coins.
This also repeats the 5% or so success rate for one year with an 80% success rate for all years after that. Thus, the longer one is in AA or other 12 Step the more likely it is that that person will leave it it by the following year.
Also as a former member of AA, I experienced and saw the damage it can do. It's bizarre reliance on a Higher Power for sobriety, which can include a lightbulb, tends to create atheists. Then there is the problems with sexual predation, blaming the victim, and the increase of OD rates related to the chanting that one is "powerless" over drugs without the help of the Higher Power (lightbulb).
So, I think it was a huge waste of time and resources to have studies that say in some contexts AA seems to work. We know it doesn't work via the more direct evidence of former members and AA's own data on membership rentention.
If one wants to talk about how and when 12 Step can work, if an article wants to be more than propaganda for 12 Step, it needs to do a serious exploration of why it doesn't work and why there is a an AntiAA movement. This article does not do that.
To pretend that there isn't the data I mention is again to provide an inferior article that is not news but mere free propaganda for AA and other 12 Step.
6
@Silver Damsen I trust the numbers of a systematic review which looks at over 20 of the best medical studies of AA more than an unscientific analysis of sobriety coins.
The science on the matter (as seen in this article) is saying AA has a 22-37% success rate, which is far higher than 5%.
2
@Silver Damsen A.A. is not for everyone, and doesn’t claim to be. It’s worked for me for many years, my life is better than I could have dreamed. It’s not a religion, and certainly not a cult. It does have a spiritual aspect for most but not all people. It works on attraction, not promotion, so their will always be people who leave the AA rooms and never come back. It’s their choice to keep drinking, we’ll just keep the lights on in case they want to come back.
You talking anecdotally about people you know who quit A.A. means nothing to anyone but you or them. And the idea that AA has this magical ability to track members who never even give their last name is ludicrous. It’s entire name and single purpose is to anonymously help alcoholics stop drinking.
As for the sexual abuse allegations, it’s widely believed it is no larger in AA than in the general population. I understand why people say AA is not for them, but being anti-AA for the reasons you stated is a disservice to the people who want to try and see if it can help them
If AA doesn’t help you, I honestly hope you find what does. It’s a disease that kills people every day, so we ex-drunks need all the help we can get.
2
@Silver Damsen
"the longer one is in AA or other 12 Step the more likely it is that that person will leave it it by the following year."
What? This is a peculiar statement. Wouldn't it be true of virtually anything one did? For instance, the longer I stay at my current job, the greater the odds that I will leave it the following year. In the end this will be true of everything, because even if I don't quit or get fired, I will some day die. Absolutely everything I do takes me one step closer to not doing it anymore.
My name is James. I am a former addict. But I did it all by myself.
To those stating otherwise, let's be clear: AA is a religious cult. There is nothing wrong with a cult per se; most are benign and useful to adherents who need people to think for them. As a religious organization, as something almost always mandated in a DUI sentence, AA is in violation of the separation of church and state. There should be a way to create a program that "leaves out" religion, without leaving it up to the alcoholic, who, as an addict, is prone to taking things to an extreme. The problem is AA has made the recovery industry lazy; comparisons to other programs are useless.
America is overly religious, to a degree that is detrimental to social and scientific/educational progress. It's part of the DNA inherited from the Founders, religious fanatics. If you look at the AA format, it is clearly an adaptation of low church (i.e., Puritan, Quaker, etc.) meetings: There is a book, study of it, prayer, witnessing, commandments; God is mentioned in 7 of the steps. This is toxic to orthodox atheists like me, and while we yet make up a small percentage of the country, enlightenment is just around the corner.
Only Americans could turn drug and alcoholic addiction into a religion. Even the most optimistic success rate of 37% is hardly what anyone would call a "success" for a ubiquitous program were it not complete taboo to speak ill of America's most sacred dogma; when have you seen AA criticized on TV?
4
@James I’m glad you’ve found ways to help you stay sober, it sounds like AA is just not for you. That’s ok, whatever works for you is good enough.
An organization who’s only requirement for membership is to want to stop drinking, has no dues, asks for $1or less to cover minor expenses, and requires nothing from its members... can hardly be considered a cult though. My own group often has Christians, Jews, Muslims and Hindus all sitting together simply trying to help each other stay sober using a simple common bond of similar experiences. The idea of a higher power is always optional at any meeting, and is never required. I have numerous long-term AA member friends who are Atheist but still go to meetings every week because it helps them stay sober. If that doesn’t work for you, I truly hope you find what does.
3
I cannot tell anyone what will work them, but the most important thing is that they work for themself to find what does work for them. What is true for me is that the loneliness and isolation of addiction is reflected in the concept of I am powerless over alcohol/drugs/etc. But the nature of recovery is that we are not powerless when we get help from others or give help to others to move away from the negative of the past to the positive possibilities of the future. This does not guarantee the “happy” life that is a Capra movie. Life will be all those hard, painful, difficult, unfair, and awful things we have experienced, but working on recovery will give us a base of strength to get through this thing called life and continue to grow and work at being better in exploring our “better angels” that Lincoln spoke of in mid 1860’s. I know they exist as I have met many in the rooms of AA which can be real challenge for an avowed atheist who says “Grant me the serenity” without mention of any deity after every meeting.
4
Keep coming back.
3
I drank very heavily almost every day for 18 years, from age 29-47. And before that, I drank as much as I could when I wasn’t studying for my engineering degrees. I was a functioning alcoholic to the max; married, three kids, great job, great friends. It took me until I was in my late forties to realize how much of my life I simply lost to my love of alcohol and how much I simply wasn’t there for my kids during all the evenings I was drunk. AA didn’t work for me to become sober because too many people, at least in my experience, were there because they had to be there for legal reasons as part of a dui conviction, etc. There was not a lot of sincerity or the real desire for sobriety in my group. I’m also not one to talk about my personal problems with a lot of others. But because it didn’t work for me, I know it has worked for many. To quit, it just takes the willingness to give up that part of your life. I loved drinking, but also, I finally admitted that every bad thing that had happened to me, large or small, was due to my drinking. So, one random day, five and a half years ago, I just quit. It wasn’t easy. Walks, binge tv watching and hundreds of books were my diversion. And while I know I can’t go back and relive the time I lost while I was blacked out drunk, I can live my life the best I can for the rest of it. Quitting drinking, by whatever means, AA, rehab, counseling, or cold turkey alone like I did it, will make every aspect of life easier.
6
In "The Cross and the Switchblade" pastor David Wilkerson tells of members of a violent street gang transformed from killers and addicts into productive members of society through their relationship with "Jesus."
Jesus represents the spiritual realm. For us Jews, it is G-d; for the non-religious in AA and other 12-step programs it can be Nature or a Higher Power.
Addiction is a spiritual disease and requires a spiritual solution.
Addicts may be addicted to alcohol or drugs, or not. Many are addicted to "love" and other people, including parents and children (codependents); money; power; shopping; overeating; gambling; working out. The list goes on.
When we turn our lives over to a Higher Power, G-d, or Jesus, we accept the fact that neither we nor anyone else is God. We give up our God-like control of others and ourselves, and can end destructive or unhealthy relationships, both with people and with substances. When we have a relationship with a Higher Power, we are never alone, and thus have no need for a crutch.
Self-proclaimed atheists who have no spiritual grounding are more likely to be narcissists or addicts (spiritually sick) than those who accept that human beings are flesh and blood, and not gods.
People with a spiritual practice tend to be more humble, and more fulfilled. If we're not spirituallly fulfilled, addiction is all we've got.
12
@dga
Spirtual people tend to say self-righteous things such as atheists are more likely to be narcissists
19
@dga I am afraid that you fail the humility test with your own pronouncements right here. You are not onmiscient and it is arrogant for you to assert that "self-proclaimed atheists who have no spiritual grounding are more likely to be narcissists or addicts (spiritually sick) than those who accept that human beings are flesh and blood, and not gods."
17
The wine glass as the photo ?
You know that's a trigger for some alcoholics right?
And who is most likely to read this article? Alcoholics.
14
@linda5 this is a pro alcohol culture and triggers abound everywhere. With triggers proliferating in every aspect of our culture, anyone who identifies as an alcoholic has to learn the phrase very quickly "other people can, I can't."
If one were to succumb from an image, one could never watch television, go to a movie, drive past a billboard, or attend any kind of networking or social event - one would have to maintain total isolation - which in itself is a much more powerful trigger than any image.
14
@Megan if it were a scratch-n-sniff of a freshly popped can of miller high life, i assure i would heave the laptop across the room to get away from it. but a picture, not so much.
2
AA is about to have its first very serious test.
Epidemiologists urge that close group gatherings of all kinds be cancelled because of the Corona Virus.
AA meetings are perfect for transmission of the Virus.
Will AA suspend meetings on its own, or will it declare itself "too important"? Do authorities have the nerve to declare AA meetings a public health hazard?*
If Schools providing a vital service to the nation can be closed; if top Universities can send all their students home; if Basketball tournaments can ban crowds of 20,000 from Arenas, why should groups of 20 to 100 be exempt — especially when they all hold hands during the Prayer?
If AA meetings are prohibited, what will the consequences be?
- Will members relapse and start drinking again?
- What percentage of members will relapse? Only a few, or en masse?
- Will there be no effect, and members will remain sober without attending meetings?
Such results would provide the most conclusive data possible about AA's efficacy.
Sadly, I fear, no one will collect this data.
Perhaps the authors of this article, Austin Frakt and Aaron E. Carroll, will do it. They cite new studies which find AA to be the most effective treatment, praise them to the skies and offer them as proof — but don't bother to critique any of those studies, simply accept them.
Corona Virus could provide a perfect empirical test, if ALL AA meetings are suspended.
Which they should be.
4
@Bima AA groups also rely heavily on shared phone numbers so that members can reach out in moments of crisis to others for support. So having to cancel meetings during a pandemic is perhaps not as apocalyptic as you would like to suggest.
16
@Bima : Hey Bima: There are always meetings on line and chat rooms that can, in a pinch, take the place of an actual meeting. AA works even for those who are considered "loners" in very remote parts of the world - where it is just about staying sober on literature until they are able to be in an actual meeting. We are all very well connected whether we have an actual meeting room or not. And we will stay sober no matter what. Let's hope you do, too!
10
@Bima Not at all. You can't test the efficacy of a program when a whole country is panicking, experiencing social isolation, people are stressed out, the news is terrifying, etc. I wouldn't trust that data at all. Heck, current events are likely to make people START drinking.
I also don't agree AA meetings should be suspended. There is not yet a level of community transmission that warrants "no one interact with anyone else ever!" The CDC certainly isn't recommending such a thing.
10
AA replaces one addiction (alcohol) with another (religion). We should be able to do better than support the scams of religion.
22
@Tom Nope. AA is not a religion, and a belief in a God is not a requirement. The only requirement for membership is a desire to stop drinking. Your "higher power" that you rely on can be anything you choose. Anything.
49
@Tom AA, in fact, has little to do with religion.
39
@Tom Not true. AA is not a religion or a scam, it saves lives and asks for nothing in return.
43
Folks who run those meetings, in my limited experience, are sanctimonious jerks with no training.
8
@Max Deitenbeck People who run these meetings are not trained counselors. They are recovered and stable enough to be sponsors. They try their best and if they come across as sanctimonious, perhaps it may come from their own successes. You want professionalism for this kind of addiction, go spend the big bucks at rehab. Most of us do not have that money and the "jerks" you refer to are those only out to help.
1
@Max Deitenbeck
Now that’s a deeply rational, well thought out comment. Thanks for the insight, Max. It was a good thing you hedged a little, though, based on your limited experience. That may be just enough of a crack to let a little light in. Hang onto it.
2
No one "runs" the meetings. Those who attend participate in helping to serve their fellow alcoholics. If you don't like a meeting, just find another one or start your own. There is no one in charge of AA. That's one of the reasons it works.
2
I found it cult-like. Atheists and agnostics were rejected at meetings. While they proclaim it isn't religious, the word "god" is mentioned more than 90 times in the first 100 pages of the blue book. And then there are the multiple prayers.
The program was developed 80-90 years ago when religion was a way life more than it is today.
What also troubled me was its failure to acknowledge that addiction has real physical components, such as its affect on the brain and other organs. It is more than a moral failure. The camaraderie is great for those who grasp it unfailingly, but not so much for those who question elements. That is what I discovered.
99
You read the first 100 pages to count how many times it uses the word God, but you didn't actually read about the physical craving that it literally spends the first 40 pages covering? That alcoholics have this strange physical reaction to alcohol that makes them crave more? And in those very same pages talks about how it's NOT a moral failure to be an alcoholic -- that it's a disease and we literally have something different in our bodies...
67
@jayelle I'm sorry that was your experience and btw, nowhere does AA state that alcoholism is a moral failure. Quite the opposite. AA treats alcoholism as a disease and very much acknowledges the devastating physical affects of alcohol. My advice to you (and what worked for me) is to find a meeting you like, and take what you need and leave the rest. Been working for me for 17 years. Good luck.
57
@jayelle AA frequently discusses how unhealthy drinking is, and how hard it is on your health. Maybe you went to different meetings.
31
By all means, lets have another comment about how AA got me sober and "I have been sober for 150 years," or something. I am glad it works for those of you who enjoy belonging to a religious cult. I tried AA when I was a young man and could not stomach the cult atmosphere, the hypocrisy in the people, so many attending looking for a hook-up. Entire clubs devoted to making it possible to leave "real life" and remain in the group. Nonsense spouted, herbal fixes, comments about not having enough "God" in my life, all sorts of mumbo-jumbo that tried to toss my hard-earned ability to think rationally in an irrational society out the window. It does not take a cult to stop drinking anymore than it does to quit smoking. The development of "Sex Addicts Anonymous" was really one of the bigger jokes for me, along the way. I got sick to my stomach in a meeting one night, left, and never went back. I am 70 years old and don't need to "brag" about how long I have gone without a drink because I figured out I could not think rationally if I drank, which would also keep me out of AA and churches. It also kept me from voting for Trump. Try some real rational thinking using the scientific method to prove what the truth is and it will do wonders for you.
67
@Jim Calling it a cult is an insult to the program. I have experienced AA on three continents and many states. The term cult has prevented many from an experience that may have saved their life and is quite unfair. While the local culture may seem to promote some religious ideas it is by no means universal. There are many agnostic and atheist long time members. It always seems to be the non-alcoholic who has all the criticism. I think the majority of the comments testify to the effectiveness of Alcoholics Anonymous.
19
@Jim
Sounds like you found a way to be happy in spite of AA. Good for you.
Maybe if someone reminded you to focus on the written principles of AA and not the personalities who show up, it would have been easier for you.
8
@Jim A logical thing to do when faced with your own loneliness and unmanageable emotions is to seek out a community of people who understand what you’re going through, won’t judge you and will give you support and guidance. Another rational thing would be to believe the findings of a rigorous scientific review of 20+ studies. There is no real separation between rational and emotional; all of it is real and affects people’s lives. What works works. It’s alright that AA didn’t work for you. No need to denigrate something demonstrably good and free.
6
Except that it requires the adherent to adopt a faith-based approach to healing, which may be contradictory and mentally harmful for a person that needs help the most.
33
@dortress it doesn’t require anything but a desire to stop drinking. Period. So don’t come if you don’t want to stop, just know we’ll still be there when you do.
@dortress
Mincing words...AA encourages a belief in a higher power--to me, this is a softer, easier buy-in for some in recovery than "faith based" as you put it. The AA participant can make up your own higher power and not be part of an established faith system.
What this finding says is that a habit that can be changed through conscious thought, willful restraint, and social support, is not a disease. You can control it if you choose to.
18
But AA is not those things. If it was, we wouldn’t need it, we’d control our drinking by willpower. For alcoholics willpower was not enough, we kept drinking anyway. The 12 steps of AA removes the desire for alcohol entirely and then willpower is no longer required. I did it, and it was hard work. I still attend meetings and practice the steps and try to help other alcoholics get sober if they want my help.
It’s not a cult, AA doesn’t take your money or remove you from family and friends. You can come and go whenever you want. The only requirement for membership is a desire to stop drinking. I’m in Australia, maybe it’s a bit different here. The respectful treatment of members is taken very seriously and we try to support each other as best we can. I’ve learnt great life tools and my life has vastly improved. Lots of ups and downs, good and bad but I don’t have to drink over it anymore.
3
There is nothing in the study (much less this article--a competent, informed, and accurate 2nd-hand account of the study) that claims or argues that alcoholism is not a disease. Read it.
1
No, what this shows is the principles of AA, the 12steps, and finding a higher power work
AA is not group therapy. They should be studying the length of sobriety for those who work the 12 Steps of AA, that is the actual program of recovery.
13
I tried for years to stop smoking with no success. Finally I took a job with an alcoholic/addiction treatment facility that used AA as part of its program. That was when, at long last, I got it through my head that to stop smoking, I had to accept the fact that I could never have another cigarette as long as I lived (or at least until I was ready to die). I had to stop playing that little script in my head that said "It's been two whole WEEKS since I had a cigarette. Just one, that's all I want. I deserve it. I've earned it. Just one little cigarette never hurt anybody!" I'm 87 now and I've not had that one cigarette yet. But it took AA to show me what I had to do: stop kidding myself.
21
This has been fairly obvious to members of AA for years. It works. It works without the personal humiliation techniques ...that Betty Ford and many other 30 day in house programs rely on for success.
16
My critique is that your explanation of "other approaches" was one sentence about CBT in parentheses. Responsible reporting may also warrant a short comparison of AA's efficacy on alcohol vs. current research on AA/NA/abstinence on other substance use disorders like opioid use disorder. I can see Big Book thumpers everywhere shouting this from the mountain tops - "it works, it works!" The free lunch metaphor is apt, though.
12
Good coverage of some hard data that confirms what many knew from experience—it works if you work it.
12
"Worldwide, alcohol misuse and dependence are responsible for 3.3 million deaths per year, 10 times the number of fatalities from all illicit drugs combined."
This statement, so aptly, displays where we've been and which has often been dismissed primarily because alcohol is *legal*. One can't imagine to ponder where we'd be today without th efforts of AA and other treatment programs out there, at least, trying to get a handle on an illness that's been plague-ing mankind for centuries.
8
I am forever grateful to AA for 50 years of sobriety,, one day at a time.It has changed my life, all for the better.
31
AA is still only effective for about one in the three at best. It might be more effective if it taught moderation and self control rather than total abstinence. The all or nothing approach just raises the stakes and increases the likelihood of failure. There is something quintessentially American about an absolutist approach based on denial and self-righteousness. We might find it amusing if the stakes weren’t so high for people afflicted with various substance addiction disorders.
11
As a recovering alcoholic, I laughed when you mentioned moderation and controlled drinking. The fact that we can’t do either of those things is what defines an alcoholic, in my mind. Many of us have tried... At 23, I went to my first meeting. I felt like I was finally with my people. I am not religious in any way, tho if pressed, my God is a She. I knew a man who had a very nice tree for a higher power. It kept him sober for many years. I relapsed once early on, but have been sober since. Not everyone stays sober, but AA is a safe place to start trying. I’m glad that a study finally agrees.
5
@Larry you clearly do not know what you're talking about.
Re: Controlled drinking, mentioned in a number of comments.
In my experience, after one has been sober in AA for an extended period of time (varies for each of us), abstinence becomes a habit.
"Controlled" drinking, even if I could do it, would be misery. I don't want to worry about how much I drink, when I drink, in what environments I drink, who I drink with. I abstain instead, because it is far, far easier. Alcohol is no longer part of my life. If I may use a phrase from AA out of context, abstinence is for me the, "easier, softer way."
21
In New Hampshire, USA, when seeking help for an alcoholic, the trail often leads to providers of a system & method used by the state's justice court system. It is called Psychology of the Mind or Three Principles Psychology. Very different from AA. In this story, I did not see a comparison to that method.
5
As they say in meetings, "Take what you need and leave the rest." I found myself throwing out the baby with the bathwater in my early meetings because (probably in part because of my subconscious denial and resistance) I disagreed with some of the strangeness, egos, or things that didn't apply to me. It took some time to let the wisdom and support rise above these. A good lesson on my black and white thinking.
Along those lines, I seem to see many studies attempting to isolate factors of deciding which therapy is the "one". Combining several approaches seems more wise.
16
Geez -- let's see I have known that AA works since the 1970s when I became friends for the first time with an alcoholic. A friend was engaged to an alcoholic and she attended the support groups. I have known other people who find the support groups very helpful -- they also help with depression.
Glad to know some 50 years later that we have a definitive. answer. I wonder if similar support group programs with definite ground rules could not work for other addictions... The only problem is Is that some people are very unwilling to attend and participate.
5
These findings are not too surprising (but good to see that they are confirmed by Random Control Trials.) Similar peer group mechanisms combining mutual support and and accountability all focused on a focused goal (in this case stopping drinking) are powerful. In my field, grassroots economic development, saving in groups has a similar outcome. Once again clear objectives - amassing a useful amount of money - being part of a group of peers who save money weekly in a group with each in turn taking home the total amount collected that week until all have received their payments is a powerful mechanism for getting ahead. After 40 years promoting microfinance I found out that the virtually no cost system of peers helping each other save works better than microcredit and any individual approach.
2
Thirty years ago, as a young late stage alcoholic, AA didn't work for me simply because as a person with severe anxiety, participating in a group setting felt impossible (panic attacks were a given). After nearly dying from complications due to alcohol consumption, (youth and the ICU saved me), I got sober out of necessity. Various forms of therapy helped. So have time and medication. I have been fairly successful in my career and I have a wonderful husband and daughter. My anxiety has waxed and waned over the years, as I assume it always will. And sitting in a group and talking is still extremely stress inducing for me. Most people do not know this about me. I share this so that others with this issue know that AA is simply not for everyone, and for any number of reasons that might not be apparent to others. And you can still stop drinking.
29
@Tam I don't suffer from anxiety but I too have found that AA does not work for me. I find that there is so much discussion of drinking that it makes me want to drink again. Perhaps because I am an atheist, I can't find any support for what to me is a mythical higher power. I'm delighted that it works for many. I also tried meditation, hyonosis, other groups such as Woen for Sobriety. For me, "Just say no" seems to have been the answer.
To put it in a broader perspective, what helps one individual may not help another. I hope that a study such as this will not impede the maintenance of the other available programs and the research and development of new and potentially more effective programs.
21
@Tam
Sitting in a meeting may help but the only way to get sober in AA is to do the steps.
1
The God question made my skin crawl when I first went to a Al-Anon meeting (for friends and family of alcoholics that also uses the same 12 steps). The program clearly states, "Take what you like and leave the rest." Which made it possible for me to return, because most of what I heard spoke to my condition as the spouse of an alcoholic.
The 12 step program is not a cult. It has tools that I use how I see best for me, and has allowed me to find my way and manage my life with clarity and sanity.
23
@harpla Try Refuge Recovery, it's a similar program but is also Nontheist!
1
This article should be amended to say AA is the most effective abstinence based treatment. There are other treatments that don’t require abstinence as the end goal.
12
Correct. There is also a difference both physiologically and psychologically between someone who abuses alcohol and someone who is dependent. People who have actually altered their brain chemistry are not going to be capable of successful recovery which is not abstinence-based.
5
Does AA work for atheists? Surrender to a higher power is a key part of the AA philosophy. In the AA "Big Book" there is one page dedicated to "Our Agnostic Friends" in which non-believers are encouraged to change their minds. I get that camaraderie with other sufferers is vital. And despite some in the program telling you that your higher power doesn't have to be God, most all speak of their higher power in religious terms. I wonder if camaraderie could just as well be achieved within a secular, evidence-based world view.
23
@Jeff Scott As a confirmed atheist with 28 years of sobriety thanks to AA, I can affirm it works. It's a wonderful program for everybody. And that higher power certainly doesn't have to be a god. Every meeting group is different. I'm sure meetings in the Bible Belt tend to be quite religious. Not In London. I went to one in Tokyo which was an amazing experience. Find one you like. The camaraderie is certainly part of the magic. but mine was certainly a very secular experience.
22
There's a chapter actually called "To Agnostics" I have found after 25 years of personal involvement and 20 years of professional involvement in the field that certainly recovery can be attained and preserved for those who are willing to be open minded. Probably some AA groups in smaller rural areas are more flexible about the concept of higher power versus traditional God. But for those individuals who really feel they are perishing in the sea of addiction, I think they become less particular about what the life raft is named.
11
@Jeff Scott It worked for me and I'm as atheistic as you get. They say "Take what you like and leave the rest." I did exactly that. I used the groups and the friends I made there as my "higher power" and just got the job done instead of using "god" as a way to not get sober.
1
Why is this still a controversy?
One problem is the misunderstanding by the public and even some psychologists and psychiatrists concerning the “God question”.
Any alcoholic who is willing to accept the help A.A. offers learns that there are no other requirements for membership. The important concept is one of a power greater than oneself, which can be any source of wisdom and guidance, not any specific “religious” figure or principle.
Another idea that is misleading is that A.A. fails to address the “root cause” of alcoholism. AA does not profess to replace the need for help with actual mental or emotional disorder, but only the desire to stop drinking. Members do benefit psychologically from both group sharing and individual sponsorships and are free to seek further medical assistance.
AA saved my life over 40 years ago, but I needed to understand and address deeper issues in my personality in order to become the person I wanted to be. Without AA I cannot be sure where I would be today.
31
Congratulations Julia!
The mantra from AA which keeps me sober is, ”Keep coming back. It works if you work it, so work it ’cause you’re worth it.”
This does not really surprise me as I have long thought that if you take the 12 steps and boil them down to their essence, even removing the spiritual element, what remains is a very helpful framework.
I've never been in AA but I was in Overeaters Anonymous for 10 years. In the past few years I have heard a lot about Cognitive Behavioral Therapy for eating disorders. I bought a book by one of the leading academics in the field. I was surprised to find that CBT teaches some of the very things I learned in OA - such as identifying trigger foods, not consuming those trigger foods, and not having them in the house, for one example.
In the past few years it has been trendy to bash 12 step programs. I do think there are some problems inherent in it, such as the fact that they are not centralized, so there is no overarching authority to whom to report problems, such as sponsors taking advantage of sponsee, etc. But many of the elements of 12 step programs are very useful for recovery of all kinds.
11
How is "success" quantified? How is it verified (self reporting?)? How are failure rates determined? How are those who disappear from the program counted? What were the "other common treatments"? How were the success and failure rates of those treatments determined? Are there other treatments outside AA and these vague "other common treatments" that need to be considered? What were the success and failure rates of those who sought no treatment at all, and how would that be verified?
Without clear answers to these and other questions, the study seems to say that AA seems to work for people it seems to work for. I'm not sure that's useful information.
24
@Jacob Great questions. Some are answered in the linked publication.
@Mel The uncertainty admitted to in the study makes it difficult to take seriously about any results. Some were randomized, some not. Some at high risk for attrition bias, some not. "Our certainty in the evidence ranged from very low to high for the different outcomes. Most of the high‐certainty evidence was based on the results from studies with reliable study designs (randomized controlled trials) and good measurement methods." Which makes one wonder why studies without randomized control trials and poor measurement methods were used at all?
1
I feel like this fails to make the essential distinction that AA critics are trying to make. It's as though you had a supply of granola bars in plastic wrappers and you proved by randomized trial that eating granola bars with plastic wrappers is an effective treatment for malnutrition.
It doesn't really address whether forcing people to eat plastic is a good idea. Group therapy without the cult indoctrination would work just as well.
18
Yes, exactly this. The support group is the most effective aspect of AA. Support groups without the cult-like aspects of AA would be preferable for many reasons.
2
AA has done a lot of good for a lot of people. As far as being causal to the positive outcomes noted, I believe a problem in the analysis is that not all variables are controlled for. Natural Recovery is a big one. Sometimes called Spontaneous Recovery, it is highlighted by a great deal of research that shows that some people who fit the DSM diagnostic criteria for dependence for a year or more stopped drinking without AA, medications, therapy or other treatment. I think that we view alcoholism as unitary concept, much the same way we once did cancer. But there is too much documented lived experience to show that what we have been calling alcoholism or alcohol dependence has variable origins, intensities and resolutions. Like the ranges of distress found in other disorders, it appears that some people experience a less intense period of alcohol use and less intense physiological consequences. All while meeting diagnostic criteria for dependence. We just don't know enough yet to fully comprehend what the full spectrum of alcohol abuse is and the range of interventions that could prove useful at different points on that spectrum.
16
I have seen it work for a number of friends... It is an amazing organization: it works in many countries,with little in the way of centralized leadership or bureaucracy. It is virtually free so that anyone can afford it. And it welcomes and joins people from every socioeconomic, religious and ethnic background. What other practice or organization can say that?
17
@Nick Defabrizio
Well, to be fair, it's not that welcoming to people who don't subscribe to the "higher power" idea.
I'm a pain and trauma psychologist. I've treated many people who have been active in AA or other 12-step programs for years. Generally speaking, they come to therapy with effective and robust coping skills learned in AA, along with a reliable social network. I view it AA as valuable and easily accessible scaffolding for people trying to build a healthier self.
AA also saved my sister.
45
Thirty six years ago I walked into an Alcoholics Anonymous meeting thinking that 'those people' would show me how to drink normally since my normal consumption at that time was around 750ml a day. I was shocked to hear that it was a program of abstinence; this must be a cult! Needless to say I didn't stay long, but as my health and quality of life continued to spiral downward I found myself attending meetings. I still didn't buy into the twelve step concept especially when it came to a belief in a God. Even if it was one of my understanding. Then a day came in spring of 1989 when I quit fighting and surrendered and accepted what 'those people' had freely offered me. I discovered the problem wasn't the alcohol, but the problem was me. I have been sober since then.
46
@Beorn
Wonderful story and congratulations!
9
AA saved my life 17 years ago. I also met some of my best friends in the world. The fellowship has been amazing. Do I like everyone? No. I am also Jewish and have problems with the prayers but I use what makes sense and have stayed sober. Its the fellowship and the steps.
23
I’m not an alcoholic. I’m...other things. So I’m now a triple winner as I’m in OA(eating disorder), DA (chronic fear around money and work) and ACOA (grew up in a chaotic home). My life is completely different than it was ten years ago in every possible way—dream career, meaningful friendships, a sense of purpose, grand adventures and I spend most days relaxed and I sleep like a rock.
12 step recovery does not work for everyone. And many need additional help. But it’s free, welcoming, ongoing and free of controversy and politics.
19
I was a run of the mill active alcoholic, tried therapy and it did not work. I also tried AA, attending meetings regularly for several years, also going to a therapist who was a recovering alcoholic, not drinking for weeks at a time, but relapsing until I finally got it. I also went to a psychiatrist who prescribed Naltroxene, and have not had the urge to drink for over 2 years. I enjoy my sobriety and still attend AA meetings, because I value the introspection of people with similar issues and recovery. Certainly, the lessons of AA, the support of a fellowship was instrumental to my recovery, but there is no question that my various therapies were helpful as well. AA does provide lessons in better living, "accepting life and life's terms." for which I am grateful. I do not look at it as either or, but rather that AA is effective and has helped many, but it often works best in conjunction with other methods. There may be other paths of recovery, but I do know that this one worked for me.
18
It sounds like Naltroxene is what really worked for your alcohol abuse, whereas AA is something you enjoy for the camaraderie and other support group benefits. That's valid, and support groups are great, but let's be clear that it was modern medicine that did the trick.
1
AA saved my life. I have been sober now for over 26 years, and I owe it all to this wonderful program. My sobriety is a miracle because I drank alcoholically for 30 years and after attending my first meeting, have not had a drink since.
It may not work for everyone but it provides the best opportunity to get sober and live a happy, healthy life.
My 2 daughters are eternally grateful that they have a father, who would have died a long time ago without the miracle of the AA program.
It works if you work it.
15
It is important to take a moment and reflect on what AA doesn't have... spokespeople and real estate.
The Anonymous, or second A, means that AA won't become attached to a cult of personality and personalities eventually fall from grace. And by meeting in church basements and community centers, AA can focus on the mission and not paying the bills for an office building or treatment center.
AA endures but never dominates the recovery seen. All newcomers are told, "take what you like and leave the rest." Perhaps dropping the obsession with celebrity spokespeople and real estate could be applied to other health programs.
34
About a third of people it helps - this has been known for awhile. Naltrexone or antabuse has a higher than 80% success rate. AA is good fellowship, is free and helps many people, but it is in the end the best of 1930s technology.
12
Technology isn’t what addicts need to recover. What’s the long term recovery rate of happiness, joy and emotional freedom of the other solutions you mentioned?
AA isn’t for everyone, but it being a Lo-fi solution isn’t even adjacent to being a reason why.
12
@David Anderson
If getting sick from drinking (antabuse) would help a person stop, they are not an alcoholic. By the time most get into the rooms of AA they have been sick 24/7 for a long while.
IDK what Naltrexone is supposed to do but it won't stop an alcoholic from drinking that is certain.
Ok, so I skimmed but it seems this rates success as being completely abstinent? So other approaches focused on responsible drinking rather than an all or nothing approach are fails then?
5
When you are an alcoholic only abstinence works.
1
@Jel Yep!
An important criticism of AA is that it doesn’t address the trauma that is the root cause of some substance abuse.
9
@Laume The fellowship's sole purpose is to help members stop using alcohol/drugs. And then to achieve a better life while maintaining sobriety.
For many people, that will mean seeking treatment for emotional and mental issues. But that is up to each individual.
Other trauma—which many do suffer from—must be dealt with via medical practitioners. AA is not a medical program, and doesn't give psychiatric advice or treatment.
When I speak with people, I always recommend speaking with a doctor, psychiatrist, and/or therapist.
AA can't—and shouldn't—handle every issue facing its members. The group would become unfocused and less successful and likely would not even exist 80 years later if they had expanded beyond the prime goal of helping alcoholics and addicts to maintain sobriety.
5
@Laume
It does in that the big book encourages you to seek medical care for all things medical.
1
That’s what therapy is for. AA encourages outside help.
After getting drunk every single day for 25 years, I could no longer continue. I went to a doctor and psychiatrist and they suggested detox (to ensure I didn't die from withdrawal) and AA.
Just celebrated three years sober yesterday.
I go to to 5-6 meetings a week and get to see and hear about miracles at every one.
32
@Tom F Congratulations, Tom! Keep going back! You’re one of the ‘miracles’ that comes from surrender and saying “yes’ to life as opposed to slowicide!
I am clean and sober almost 31 years thanks to Alcoholics Anonymous, but I got so much more from AA than just sobriety. The 12 steps gave me a path to living a happy and productive life. My alcoholic father terrorized the family, all because he was unwilling to admit that he had a problem. However, my daughter has never, ever had to put up with a drunken father. Priceless.
36
As a psychotherapist, I am extremely sad that with all the research now available in the field of neurobiology, and epigenetics, and the myriad of healthy coping strategies, and successful psychotherapeutic treatments we know work, that we are still stuck in the AA disease model of substance abuse.
That we still don't look at substance abuse with its etiology in our sick and corrupted culture that makes demands on people they can't manage for various reasons, both personal (trauma), or cultural.
Our drug culture, and lack of affordable and good mental health care, the exploitation of workers, contributes to Americans being one of the most drugged out and unhappy people on the planet between alcohol, caffeine, anti depressants and anti anxiety meds. The richest country on the planet and we have a raging obesity epidemic, a record number of people suffering diabetes and heart condition.
(simplified)...substance abuse and misuse of drugs is caused by maladaptive behaviors that become encoded in the brain and are very challenging to change. But change is possible. There is literature out there to help, as well as less doctrinaire support groups.
Most important - we need drug, health insurance, medical devices, psychiatrists and rehab companies to stop lobbying politicians, so we can let science dictate and not $.
It's all connected.
21
@Sara Excellent
Less doctrinaire? There are no rules in AA. Individual groups may institute rules to remove a drunk and disruptive person, but AA as a whole says only that you shouldn’t reveal your AA attendance in the media. If you do, however, there will be no consequence beyond individuals suggesting you don’t do it again.
You are a member of AA if you say you are. If you want to go out and drink, you will be welcomed back.
What on earth is less doctrinaire?
2
@Sara And yet you object to a solution that is free?
2
The TV show "Mom" does an excellent job of presenting AA, although I've never been to an AA meeting.
3
I enjoy this television show as well! The writers do a great job of portraying the behaviors of recovering alcoholics. I strongly suspect that at least one of the writers is in recovery.
Excellent! However, those who have faced the abuse and addiction to alcohol know that the cost of 3.3 million deaths/year worldwide is a very small part of this disease. The alcoholic's negative repercussions on family members and friends compounds it’s terrible impact.
Fortunately, there is free help for family members and friends of alcoholics offered by Al-Anon. Al-Anon is a recovery program for family and friends since it is recognized that alcoholism is a family disease. Al-Anon meetings are found throughout the country and world-wide. Most meetings are face-to-face meetings but online groups are also available. To support these meetings, Al-Anon makes available an extensive selection of recovery literature usually found in local libraries or ordered from Al-Anon service centers.
Al-Anon adapts the 12 Steps of AA, and believes "that in Al-Anon we discover that no situation is really hopeless and that it is possible for us to find contentment and even happiness, whether the alcoholic is still drinking or not." (excerpt from Suggested Al-Anon Welcome...).
I can attest that, like AA, this program offers hope, and can be effective in providing family members a healthy way for living with and confronting disease of alcoholism in loved ones.
8
This article is dangerously misleading on several fronts.
Firstly, for individuals who are physiologically dependent on alcohol, attending ‘just AA meetings’, without seeking medical consultation is both unwise and potentially life-threatening. In order for one to even consider making AA the core component of his or her ongoing treatment plan, safe detoxification from alcohol in an essential first-step. Self-detox from alcohol may assume a number of severe medical risks, including seizures and hallucinations- responses that can be properly attended to in secure medical environments.
Secondly, while the author does acknowledge that that these findings are with regard to recovery from alcohol, given the current state of the opioid epidemic, it is remiss/dangerous to not emphasize and clarify that such findings should not be generalized to recovery from alternative substances. For example, individuals who are seeking support for opioid use disorder often require interventions that NA alone could not provide. Specifically, patients who
choose to utilize Medication-Assisted Treatment (MAT), which include medications such as Vivitrol, are 50% less likely to experience an overdose. We can all agree that staying alive is clearly a prerequisite to ‘working the steps’.
11
@Aryeh Barris, Psy.D I appreciate and respect your qualified opinion, and it is important to recognize the critical component of just living through detox. But I also think you miss some important points about AA.
First, even an AA member with almost no experience can likely tell you where the closest detox center is from anywhere in the city they live. Never would one of us would discourage that, it’s quite the opposite. I would say confidently that millions of people’s lives have been saved precisely because of AA members and the actions they take. Helping procure a bed in detox or a treatment center is something we do everyday.
And even more to that point, after detox we actively encourage each other to seek whatever other medical or mental help they need. Clinical depression, PTSD, bi-polar disorder, schizophrenia, etc. are way over our heads. Our scope is very limited compared to yours , but nothing seems to help an typical alcoholic stay sober as well as talking to another alcoholic about how they got sober and stay sober.
AA helped me a lot. It gave me tools that have helped me quite a lot in my sober life. I am grateful for the things I learned there, but it does have some major drawbacks. AA was created by and for men and does not cater to the needs of women. As a women I felt that it wasn't a good fit for me in the long run and stopped going to meetings. I also discovered that I wasn't any protected or warned about the sexual predators in AA (there are a lot). It is also bible based and that is incredibly off putting to people of different faiths and atheists. AA has good points, but it also has terrible points and is in desperate need of modernization. Again I am grateful for the tools I learned there, they helped me get and stay sober, but I do have major issues with how the organization is run.
15
@CowgirlEd OK, you are generalizing your experience as a woman to all women. I'm a woman in AA, and I'm a lifelong feminist too. AA was NOT created "for men", it has no more sexual predators than the population at large (and I would argue that it has less of them), and for heaven's sake, it is not "bible based". It's true that the "Big Book" was written in the 1930s, by a man, and does reflect the usual position of women in society at that time. But people who can understand that and overlook a few sexist assumptions, the Big Book is pure gold for any alcoholic of either sex. And AA has a variety of other more modern literature that is NOT sexist at all.
Finally, when you say you "have major issues with how the organization is run", it reveals that you really know very little about AA. AA is run by all of its members. It has bottom-up governance. There is no president or governing hierarchy in AA. To say that you have "major issues" with "how it is run" can be only to acknowledge that society at large also has major issues that need to be dealt with, because the problems in AA are simply the problems of society at large.
1
@CowgirlEd AA is not an organization that is run by anyone.
AA is not Bible-based—to address only one misconception in your post. AA speaks of a “higher power”, which can be whatever you choose, as long as you don’t choose yourself. When it speaks of God, AA uses the term “God, as you understand him”, which is found nowhere in the Bible. Yes, there are a lot of people who believe in God, but there is no insistence on any particular version. If you want to make your dog (who may represent to you love and caring) your higher power, you are welcome to do so.
Please don’t mistake the opinions or beliefs of individual members for anything but that. You are free to believe what you want.
I congratulate the number of poster's here who attained sobriety through the AA program, but as a long time member of AA and having seen countless individuals pass through AA's doors, I seriously doubt your assertion of a success rate between 22-37%.
JMO, but I believe AA's greatest contribution was the creation of "support groups," and as you stated, these "support groups" are free.
8
Opine all you want. This article is about Scientific Research, not beliefs. In our world, this is what we widely accept to be “Proof”.
The comments on this thread look a lot like a bunch of regular folks sharing on a topic that’s not always openly discussed, and stating out loud “where they are at”. People listen and identify, and learn. That’s kind of what happens in The Rooms of AA.
The healing and powerful results that come from things that can’t be quantified —Community, peer support, not being Alone as you do the hardest thing you have ever done in your life...that is a power of something Higher. Call it Love, call it a doorknob. But It Works. And it works BETTER than anything else we’ve got.
News Flash: based on this article, that’s a Fact.
At the end of the day, AA is about one person helping another who is struggling. That’s it. One human being helping another get through today. And it doesn’t cost $1000 a day, like rehab, or $200 an hour, like therapy. With thousands dying daily from opiate addiction and no government entity or strategy making a dent in it, we need a sober Community with an open door now more than ever.
If it is now shown by research, declared by brilliant minds at Harvard and Stanford, and published in the New York Times that AA Works...if that fact helps to bring one person through the door of a meeting for help that may save their life...that is enough.
Grateful for the Report and for this article.
...Thank you for letting me share.
21
@Nancy M. If you click on the link to the actual study, I see at least three major problems with the study (the study freely admits them). I'm not sure this study alone qualifies as a "Fact".
8
@Nancy M. I am glad to hear that you are doing well and the this research supports your experience. As a clinician I think it a life-saver for many people. However it is a common misunderstanding that research proves things. In fact the object of research is to find evidence that either supports or does not support an hypothesis. Although journalists & readers often think of research findings as proof, conclusions are really only statements that a theory is supported by current evidence at a particular confidence level. Evidence can change. Studies can have flawed designs. Sadly, when research is looked at as proof, it gives science a bad name as soon as conclusions change.
3
@Nancy M. And thank YOU for sharing!
The Towns Hospital in NYC was a place that helped the founders of AA to learn the true nature of the disease of alcoholism. The desperate alcoholic and the caring fellow alcoholics found they could understand eachother's maladies as no one else could. I am sober today because of these founders. The true nature of the disease. My life blood to this day. My refuge. Thank you for 17 years of sobriety. It works.
8
I see the stories of those who have a drinking problem, attend AA meetings, and find AA’s collection of time-consuming meetings, sophomoric sayings, and spiritual efforts as not suited to their life situation. That’s fine. AA is a program of attraction, not promotion.
The issue is the efficacy of treatment. People expect most treatment to alleviate the cause of the condition. That cannot happen here. It’s alcoholism, not alcohol was’m. AA treatment does not focus on the cause. Only by addressing my character defects today that I am able to not drink today. That is a tough thing to do. What the study demonstrates is the AA approach works better than previously thought. Just because I’m sober right now doesn’t mean I’m not an alcoholic.
Not everyone finds the wherewithal to achieve daily sobriety. There are such unfortunates. AA will be there to help when they are ready. I’m grateful for my sobriety, which started today at 6:47am today. Just like the 11,379 preceding days.
11
What I think no one is factoring in is that folks don't want to disappoint their god, which would suggest to me that we've not developed a criteria that supports the individual as the highest power. No one is going to like me saying that weak-minded people need an imaginary friend to control them, but I just have. This is just another example of the lack of education we have in this country.
6
Did any of these studies examine the use of medication? We are constantly told that the gold standard in opioid addiction treatment is medication assisted therapy, yet it is rarely used in the treatment of alcoholism, which, IMHO, is malpractice.
Someone I care about wanted to (and needed to) stop drinking, attended therapy and AA but was constantly white knuckling his way through life and falling off the wagon. A few months on a medication to alleviate cravings allowed him to embrace the sobriety he wanted. Notably, he had to push his psychiatrist to prescribe it, it wasn't offered to him.
This must change. We should be offering evidence-based solutions to alcoholics, not having them rely solely on a treatment plan that is only 30 percent effective. (and btw, Weight Watchers offers better cognitive behavior therapy than the 12 steps, many of which require you to believe in a supernatural being, do).
7
I worked as a public defender in a drug court program. The people who did best in recovery were those that religiously attended their AA meetings.
10
AA's insistence on believing in a "higher power" gives it a pseudo-religious flavor. Some people are reluctant to attend because certain groups turn the gatherings into revival meetings.
4
So find another group. There are thousands.
@BodhiBoy There are many kinds of meetings.You find one that works for you. Reluctant to attend means not ready to give up drinking.
The data has been there for decades. And it's free!
2
32 years in AA has saved my life, helped me help others. Love AA.
I did get therapy and other treatment. I still get therapy when I need it.
It's a constantly changing recovery experience. Right now, haven't been physically going to meetings because of the coronavirus but will do meetings online.
Any way a person can get sober is great. Keep trying til you get the method that works and stay open to new ideas for keeping your sobriety fresh.
Don't listen to anybody that tells you they have the one right way to get sober. The only thing that matters is for a wet alcoholic to keep trying. Never give up.
12
7/5/89. First day of my life after 20 years hard drinking, drug use, and general wildness. I had my first drink (cheap whiskey from the bottle at age 12 on July 4, 1989, along with smoking some hash) This went on in various ways for the next 20 years until my last drink on July 4, 1989. I got up today at around 7AM. if you’re sober and got up earlier, you’re sober longer than me. Peace and love.
7
I myself gave up alcohol more than twenty years ago. I aged out. Meaning, it was harder to get up and get going after a night of drinking. Even moderately. I have also had friends who drank themselves to death. Their families put them through every known intervention and treatment to no avail. They had a booze bottle on Their back and it eventually crushed them to death. To me Booze is insidious. As insidious as opioids. We as a society promote booze as a way to manage our stress. What a farce. We set examples for our teenagers to binge drink and have no clue we are doing so.
There are those who need AA. And thankfully there is one just about everywhere. But one of the most frequent complaints I hear about those I know who have gone and then stopped going was the religious push that takes place. Christian by most accounts.
Still, I am a friend of Bill Wilson. He is someone who should be included in high school civics classes. When we received our drivers licenses in the sixties we were made to watch gruesome movies beforehand like signal 30 or death on a highway. How about all sixteen year olds listening with the whole school to a person who destroyed every meaningful relationship and led his family down the path of financial ruin. All because of a bottle of booze. Could not hurt
8
This retired psychiatrist and recovered alcoholic/addict thinks of my 12-step mtg's. as a wonderfully, free, widely available group therapy program that supports abstinence from alcohol and other non-prescribed mood altering drugs, especially when times are hard and we used to drink/drug over them. The "spiritual" basis is soft pedaled so as not to offend anyone and welcome all faiths. How unusual in this day and age? Stress R Us
9
Actually, it offends many of us atheists. Deeply offends our core values, as a matter of fact.
1
As a former long time member of AA and watching countless individuals pass through AA's doors, I find your assertion that AA has a success rate of between 22 and 37% fails to hold water, especially given the fact that anonymity being a core principle of the program would lead one to believe the test you cite is riddled with confirmation bias.
6
@Jim I see you actually address "confirmation bias" in your article. My Bad.
What is AA being compared to? From what I've read the Sinclair method is much better. And at $.78 per dose the Naltrexone used is pretty cheap.
6
I grew up in a family that drank a lot. Many of us were alcoholics. I quit drinking because I was ashamed of how I behaved. 12 years later I found my way into AA. My life story suggest there is an enormous difference between abstinence and recovery. Just by stopping drinking I was not addressing my alcoholism. I was still angry. self centered and dishonest. Once I began the steps in AA with a sponsor's guidance I began to accept all that and try to change. My life now is much better. I am respected and loved by many and am able to love and respect them and myself.
Patrick H.
Minneapolis, Minnesota
9
I had a serious, chronic drinking problem for close to 2 decades. I was in and out of AA for almost ten years before I was truly ready to surrender and was helped by someone who was adamant about taking the 12 steps as thoroughly and quickly as possible. Especially the first one. Once I conceded to my innermost self that I was powerless and no human power could relieve my alcoholism my whole life change. The miracle of AA happened for me which is I was placed in a position of neutrality when it came to alcohol. I have been sober since September 1, 2017. I thank God for AA, the Steps and my sobriety every day. Glad to see it's worked for so many other too.
5
Can we assume that these two published findings (the journal Addiction and the review published by the Cochrane Collaboration) are peer-reviewed?
2
The 12-step fail rate (horrible phrase, that) is 3-4 out of 5. So let's hold off on the parade and the fireworks for now.
The higher power quasi-religious aspect of 12-step doesn't work for many millions of us.
For any given individual, the efficacy of any single treatment varies widely. The basis of addictions, including alcohol and drugs often has a lot to do with OCD and family history.
If it works for you or your loved one, great.
But if not, don't fret. There may be a different, better road for you out there - it's highly individualized. One size doesn't fit all.
Oh - and keep fighting the good fight. We're rooting for you.
7
AA simply goes to prove that none of us is an island. We not only need others to get from one place to another, but we also need others to keep our spiritual lives strong enough so that we are able to defeat the power of an earthly substance that is powerful enough to defeat our very souls
5
I always say “if you’re an alcoholic like me.” I have a family member who quit drinking because he wanted to quit before it became a problem. He doesn’t seem unhappy at all and doesn’t struggle with his decision. He’s not like me and I’m not like him. I couldn’t quit on my own and AA gave me a chance in 1988 at age 19 to have the freedom to choose whether to die miserable, or learn to live life on life’s terms with grace, dignity and compassion. 31+ years later I’ve never felt the need to second guess that decision.
I can’t say I’ve never looked at an unwilling newcomer and thought they were kidding themselves...but I try not to. If we’re different types of alcoholics, I hope that they find something that works for them as well as AA has for me, because it’s given me more than I ever would’ve thought to ask for.
5
I recently had a conversation with a new friend about our childhoods. Mine was miserable, with both parents being profound alcoholics and my mother being a malignant narcissist. I have had a lifelong struggle with depression and survived a sudden and very bitter divorce, with an estrangement from one of my children. She asked me how I turned out to be such a "lovely person". I told her it was because of my time in AA. AA is about so much more than stopping drinking. It is about embracing life on life's terms without alcohol. And, you get out of it what you put into it.
9
Yes, it's wonderful for those alcoholics who will actually go!
Many patients cannot accept the basic premise: the "higher power" and G-d or Christian elements.
there are also other approaches, such as "Smart Recovery" (secular) and Refuge Recovery, a Buddhist AA model that are gaining ground.
4
As the article itself states, people joining AA are more motivated that those that don’t. I’m sure that if you could possibly compare people who are equally motivated but not inAA to those that are, the difference in effectiveness will diminish.
3
@Warren
The authors acknowledge your criticism, but then point to a random assignment study that found that AA participants did better than those assigned to another treatment.
You can’t just choose which study you’ll attend to.
2
@Alex
But that random assignment study was not measuring what's called intention-to-treat. It was still biased by selection effects because participants who were assigned treatment could decline. Therefore the study only included people who were assigned treatment, then complied. That group is systematically different from those assigned treatment who do not comply.
4
There's incredibly wide treatment heterogeneity for AA. In other words, the impact varies widely per person based on other factors. There's evidence that for many types of people the impact is small or moves in the opposite direction, i.e., AA could make certain people more likely to binge drink than if they had never done AA.
There are probably systematic patterns in this treatment heterogeneity, but this study did not address those patterns. For example, my hunch is that there could be wider variation in how AA works for atheists or Jewish people, since so much of the rhetoric is based in Christianity. We don't know for sure whether that's true since it hasn't been definitively studied, but we do know there's a lot of variation in the impact. Similarly, the experience of AA varies widely in the different types of meetings, and we don't know if there are systematic patterns in how the impact differs between those types of meetings.
As pure social science this meta analysis is ok, but as policy relevant research it should not be used to inform decisions because there are still too many unanswered questions. If courts start using this to justify mandating AA as a one size fits all solution, that would be a real step backward.
6
@Chrissy What is the "rhetoric based in Christianity" that you claim is in AA?
There isn't any. None.
The courts already give many offenders a choice between jail and attending AA meetings.
@Chrissy I am with you 100%. Right off Step 1, a nonbeliever, gets turned off. It almost is an admittance that one, per se, cannot do anything to stamp out this "evil". Only god can do that.
If one looks at alcoholism as a disease, and not as a moral issue, the whole AA scaffold falls apart. Judges need to stop prescribing AA and punishing people for not attending. They are infringing on people's rights. Choices need to be made available. The hung-up is that people who are poor, may be stuck with AA.
1
AA might not work for everyone, but it worked for me 30 years ago. Using the 12 Step program for a period of suicidal depression also worked and I owe my life to this program. It is not perfect, and it does not work for everyone, but I applaud the good that it does for those who can find its serenity and peace. God bless Bil Wilson and Dr. Bob Smith!
16
What is not mentioned or measured is the harm caused by AA when used by the courts as a dubious “scared straight” diversion tactic for juvenile offenders.
My college freshman daughter was caught drinking under age at a college party in a college town. She was charged and mandated to 1) pay a $500 fine, 2) perform 25 hours of community service and 3) attend 20 AA sessions at a specific facility which hosted only criminal offenders also mandated to attend as a part of their diversion programs.
The forced sense of “community” and being shamed into submission resulted in her being “befriended” (stalked) by a 30 year old career criminal who was also addicted to heroin and tried to groom her to become a mule for his drug dealing.
Meeting facilitators are not professionally trained to recognize potential manipulation and these court endorsed and mandated diversion sentences bestow unofficial authority on people of very dubious character. I had to challenge the court to allow her to attend a different meeting to avoid her stalker. Also as a non Christian she was forced to recite their mantras that are Jesus based.
I’m glad it helps some but these research finding will embolden the courts to rely on it even more with no discussion of the harm and unintended consequences.
18
@JAS
It really saddens me to hear this. I've never been to AA, but have had a number of friends over the years that were greatly helped by it.
Thing is, as far as I understand it, one of the foundations of the program - and in fact one of the primary keys to its success - is its voluntary nature. People commonly start there when they've hit rock bottom (often even a single event), when some internal switch got flipped where they decide they have to change, and need help doing so.
I can see how a community of people in a room who are all there because they made the inner decision to fight their alcoholism could form a powerful platform upon which they can not only change, but sustain the change over time.
Maybe someone with AA experience will correct me if I'm wrong, but it seems to me that involuntary, forced participation would actually shatter the very foundation, the social milieu, upon which the steps work.
And forcing a college teenager into a group containing hardened drug addicts, frankly, sounds really abusive.
11
@JRC People talk about being forced to attend AA when in reality they are given a choice between straight jail time and attending AA.
AA saved my life; I now have 35 years of sobriety (DOS:7.17.84) and a good life. While the LONG TERM success is likely closer to 10%, it is the best game in town . . .and costs $1 per meeting! Certainly at least as good as so-called intensive treatment programs that cost many thousands of dollars. Thanks to Bill Wilson and all those in the program who helped me along the way.
19
So this study is a study of studies, some of which are randomized trials of unspecified design, studies performed by a community that is generally disposed to favor AA.
Any meaningful study will have to include people who successfully quit *without* AA or without any treatment at all. People like me.
The only treatment I had -- four years ago -- was two weeks in a hospital detox clinic to get me through the seizures. A bottle of bourbon a day makes a demanding master.
I went to AA. For me it was an unpleasant experience. The idea of sitting in a room of people obsessing over their addiction, with many making a virtue of it, was not going to work for me.
19
My mother remained sober the last 40+ years of her life by regularly attending AA meeting. I also have three alcoholic siblings and all of them had different outcomes from AA. One is sober and active in AA, one is sober by substituting marijuana for alcohol. The third drank himself to death. For the pot smoker and the deceased, AA was of little help. The surviving two live very stable, fruitful lives and their diverse methods have sustained them for over 20 years. The point is that what works for one does not necessarily work for another. My late brother was admitted to over 30 rehabilitation facilities or hospitals in the last three years of his life all endorsing AA's 12-step program. Each time it failed to help him the next facility would again prescribe the same treatment! With any other disease a different treatment would be prescribed if the current treatment fails. It's time for members of AA and public health workers to start thinking with an open mind. AA is not the end all and be all of addiction treatment. Few alcoholics I've met are even aware of pharmaceuticals that may help and psychiatrists who are board-certified in addiction treatment. My brother died thinking AA was his only option.
13
@Jeff Gewert You're right that pharmaceuticals have shown some promise. But AA actually acknowledges, right in the original "Big Book", that those in AA "know only a little", and that if someone can learn to drink responsibly again, "our hats are off to him".
To claim that AA is the only way is to ignore AA's own Big Book. Some AA members forget that, and some clinicians do too.
2
@Tam R Well expressed, Tam R. I wish more people thought that way. My brother might still be with us.
@Tam R
I got a PDF copy of the Big Book and searched for "know only a little" and it came up empty. Tried many variations, as well.
I'm honored that so many of you are willing to share your stories--your hardship and your success. Both the anecdotes and the research show that AA is effective. This is wonderful news for society!
To those of you still struggling, especially those who feel that AA has failed you, I see you too. And I hope that you can find a program, a doctor, a friend, a system, a mindset, a life that leads to sobriety.
15
It is inappropriate to contrast a free "treatment" modality with ones that cost money, or to lump treatments together. There are other free or insurance covered treatments. Also, many people are legally mandated to go to treatment, and do not self select.
6
Interesting review, but please check the Cochrane article, there are important details and caveats. The evidence used is mixed, from high quality to low quality. A better summary in my opinion is that "AA works for some people and it's cheap." But the specifics of who it works for, where it fits in the spectrum or series of therapies, etc is not there. There isn't information on the mechanism by which AA's work is effective. The research does not make the case for AA instead of other therapies, or other therapies instead of AA.
So, the information, while useful, is of limited value when making therapy choices for a very difficult problem, alcohol addiction.
11
Maybe AA is the 'better approach' and blessings to all who have found a way out from addiction through any method. I never had the problem but know people who did. Some went to AA / NA and it helped a couple of them. Sadly, not most did not succeed.
Still find it hard to understand how any program with a success rate of approximately 1/3 can be lauded as an answer. Seems to me that there are far more answers to this problem that have not been explored.
Would we be satisfied with 85 years of cancer research that only yielded a success rate of 22- 37%?
11
@jar I hear you but the truth is that the rates of recovery for ALL methods is relatively low. The "indictment" of AA that I heard for years, before this research was published, is that AA worked "no better" than any other method. That is to say, they were all terrible. But this research shows that AA is in fact better than the others. Not perfect, but man oh man, addiction is a tough thing to beat.
1
I was never in AA but I was in Al Anon. It seems strange not to mention the spiritual aspect of the program, because it is certainly striking at least to an atheist (as I was at the time). Groups vary—I went to one that was overtly Christian and that freaked me out—but I always wondered if partly it worked because it very gently presented an ecumenical spiritual system; obviously spiritual beliefs correlate with a lot of good health outcomes (whether those beliefs are true or false).
In any event, I have also been in various support groups for other things over the years, and Al Anon was, again, strikingly special in its shared seriousness, purpose, and moral vision.
8
The authors appear to have read only the concluding summary of the Cochrane Review. In fact, the review states that:
Manualized counseling combined with AA was more likely to produce continuous abstinence than other treatments in 2 studies. It did not produce a higher percentage of days abstinent, longer duration of abstinence, or less intense drinking. Without the careful manualized counseling, AA may (1 small study) produce a higher percentage of days abstinent, but was at best equal to alternatives on the other three measures. The main advantage of AA-based treatment is its lower cost - though all major approaches studied led to reduced health care costs. The bottom line, as Lester Luborsky put it long ago, is the Dodo Bird Verdict: "all have won, and all must have prizes."
3
More great reporting by the New York Times.
Two eye popping, fantastic facts, in this important piece:
1. AA is free. I've known numerous wealthy families over the years who spent big money at high end alcohol rehab clinics for family members, of course, with mixed results. AA has a higher success rate(by as much as 12%)
and is located pretty much everywhere. Some people are turned off by the religion aspect, but nothing is perfect. It is available, it's free, and it works for a lot of people - as we see from many glowing testimonials here.
2. This is "the lightning in a bottle" for me - the key to the success is people being coaxed by their peers - not some recent PHD from Harvard medical school. Just get real with people, because you have been through it and empathize with them. This reminds me of another story in the Times a couple of years ago advocating women talking to other women suffering from depression, and helping them just by being concerned and talking. It works to improve the women in many cases.
My own brother went off the deep end with alcohol, but didn't respond to any kind of therapy. He was an agnostic and couldn't get past the God thing with AA. Despite a lot effort to help him, he is dead.
Congrats to AA for a practical, free, readily available program, that works for a lot of people.
9
I think this incredibly inspiring comment section is evidence enough that AA has helped countless people turn their lives around. Every sober person I know has relied on AA. They worked the steps and leaned on the community they built in and out of meetings. It is an extraordinary thing to witness. Two of my favorite pieces of advice I've received from sober friends are "what doesn't serve you weighs you down," and "take what works for you; leave the rest." I remind myself of them daily.
10
Freedom isnt free
1
AA IS cognitive behavioral they just don't realize it.
15
Addiction and dependence are pretty complicated. Another, innovative way is "Hello Sunday Morning" which had its start in Australia which has a very big drinking culture:
https://www.hellosundaymorning.org/
1
So even with AA, the rate of continued drinking is still 63-78%? That's a strong overlap with the 75-85% of other, presumably smaller and less well-known programs. So the moral is that we still don't know how to get people to become and stay sober.
12
@Griffin
Let's be clear: the moral is that we still don't know how to get people to become and stay sober....in a society that embraces alcohol, and, put bluntly, really despises to hold a person responsible for his or her behavior unless really, really out of bounds, and even then, what does one do with the chronic DUI offender?
It is a far, far more complex issue than any of us care to admit.
2
10 Years ago I ended up in hospital because of my drinking. It was impossible for me to stop drinking, the addiction demanded 24/7 upkeep. It very nearly killed me. It took about 4 years to recover physically. All those difficult first years of abstinence I could not have managed without the 12 step program. I recently celebrated 9 years clean and sober.
20
@Thon H. it took five years for me to heal cognitively. I attended meetings daily.it saved my life. Peer leadership and support are incredibly helpful. The bonds developed there are like none I have ever known. The early years I stayed sober for the AA people who helped me . I celebrated 32 years recently. I try to carry the message of recovery to any person suffering this dreadful disorder.
3
I went to my first AA meeting on July 16, 1986-I haven't had a drink since. I went to AA because I couldn't stop drinking on my own. For the last 6 years before getting sober, I enjoyed the social aspect of drinking alone. All through my daily drinking, I was functional and maintained a full-time job. I am grateful.
18
I have seen the ravages of alcoholism on society, families, individuals. 30 years ago when my sister-in-law's high-functioning (professor) alcoholic father took several drinks and committed suicide, she realized she had inherited the addiction gene, got herself to AA, has worked the program ever since and never touched another drop of alcohol. She also stopped smoking, and leads other people into sobriety. As a licensed counselor, I have referred clients to AA with great success. Do it. AA works if you want it to.
10
@Anne Russell -So if we say that people should pray to a rock, as a counselor, you're supportive of that. Sure they get sober, but at what cost? Now they have an imaginary friend and will seek to impose those false (Freedom of Religion) values on others across the board. Me, I'd rather have them drunk than voting Republican.
I spent 45 days in two separate inpatient treatment programs in 1985 and 1986, yet it was AA that ultimately helped me to get and stay sober in 1987. Although I have not attended and AA meeting in many years, I still remember many of the faces and names at the regular meetings I attended in oh-so-many church basements and meeting rooms. And more importantly, I remember what happens if I forget that I am an alcoholic, and think I am more powerful than that first drink. Happily sober for 32+ years.
6
As a current mental health therapist and for substance abuse counselor at all levels of care, I find this article just a bit misleading. This paragraph in particular "One study found that compared with Alcoholics Anonymous participants, those who received cognitive behavioral treatments had about twice as many outpatient visits — as well as more inpatient care — that cost just over $7,000 per year more in 2018 dollars. (Cognitive behavioral treatments help people analyze, understand and modify their drinking behavior and its context.)" makes it appear as if AA is a better option than outpatient cognitive behavioral treatment. I STRONGLY advocate for AA or SMART Recovery as additions to, not substitutes for, overall outpatient recovery. Every single substance abuse setting I worked in, I always told my clients/patients/residents to seek mental health counseling IN ADDITION TO an outpatient substance abuse support group to the root cause(s) of why they started substance abusing in the first place. AA/SMART Recovery combined with mental health counseling is truly much more effective than just AA on it's own.
17
The article is only misleading if it misrepresents the findings from the systematic review study. I don’t believe it does that.
truly one of the greatest movements of the 20th century. this is one movement that is being overlooked by the addiction medical specialists that are diverting all addicts and many alcoholics to get on opiate replacement therapies for fear of opioid overdose. we should try to use the 12-step programs more because narcotics anonymous also works.as a physician, I see what's happening all around me and I see that this wisdom is being overlooked.
10
“The closest thing to a free lunch in public health”. I am proud to be a sober member of AA for 23 years. It saved my life. But he those words, “free lunch” have already made it to the ears of the insurance industry. I can foresee a way for them to postpone or eliminate rehab payments for the sick and suffering with the caveat that they try AA first. In reality, many people come to AA after rehab and based on my personal observations, it is still much more difficult for people with drug dependence to get clean and stay clean with only a 12 step program. AA groups will always reach out to help whoever needs it, that is the basis of an unparalleled program. But don’t let the insurance companies take advantage of this.
15
Take note that the most effective program is free and completely without government interference.
10
@joe Hall
I’m also so glad there won’t be government interference in the Coronavirus response!
@Bach Apples and Oranges. Bigly.
I think the underlying issue is more that AA depends on being in some sense voluntary and personal and has an organization that is not bureaucratic. A pandemic is another animal entirely. That takes massive organization.
1
@joe Hall
"free and completely without government interference."
Isn't beautiful!
It seems to me AA is often misjudged as a cure per se rather than an incredibly valuable support system for those who want to stop drinking. Coming from the other side, I can say the unconditional support I found at Al-Anon saved my sanity.
23
@Peter Elsworth Go on you, Mate. I had a friend in crisis call yesterday, following a death in his family, and his AA buddies were the only thing he had to hold onto, and he stayed sober for another day. Keep going, it works!
If only our society put as much emphasis on preventing addiction as curing addiction. But there’s no money to be made in addiction prevention.
8
Where else can you meet and bond with people where alcohol is not served. Living in NYC, it is a rare social gathering where a glass of wine is not shoved at you as you enter the door and the open bar beckons. It is difficult to navigate these social events for a non- drinker. Many people have become alcoholics due to being very socially active. For these people AA is a lifeline.
7
@Regina Expand your horizons! People meet plenty of places without alcohol being the focal point! Sports events, music/cultural events, museums/galleries, playing team sports, going for walks, meetups, etc! People need to get more creative and imaginative.
1
" AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive."
So apparently, this is not quite the breakthrough the article suggests.
"The available experimental studies did not demonstrate the effectiveness of AA or other 12‐step approaches in reducing alcohol use and achieving abstinence compared with other treatments"
Click on the link and discover that essentially, AA is NOT the best there is.
13
@uwteacher Sorry, this comment is suspicious of denial and veiled interest. Noboby has enough facts to make an incontrovertile general statement about the validity of a path of treatment for a so serious and variable problem as substance abuse. I question what is the goal of people who come to public discussion only to stamp suspicion on 12-step programs, or even outright bash them, picturing them as outmoded -- against the much more numerous personal statements about AA saving lives and relationships, even here in this comments box. You need not change your beliefs about the matter, just leave it at peace that AA works, albeit not for yourself.
2
@uwteacher: "There is high quality evidence that manualized AA/TSF interventions are more effective than other established treatments, such as CBT, for increasing abstinence. Non‐manualized AA/TSF may perform as well as these other established treatments." (From the main article.) Which link are you recommending? I tried several and was hard-pressed to locate the quotes you cite in your letter.
@uwteacher Seems like maybe have a personal agenda. Why do you want AA to be ineffective?
AA saved my Dad. As a result his last 15 years were filled with love and family.
His weekly meetings kept him on track. He made friends with the other AA members and they supported each other.
He knew he could talk to and lean on people who knew his struggles.
AA is wonderful.
27
The AA program encompasses the wisdom of the ages.
Much of what the AA program teaches is antithetical to our popular culture. In some profound ways it is a cure for our culture of self-centeredness and always trying to be in control and the suffering that comes from that stance in one's life.
The AA program encourages care for others, reverence for all things, charity, honesty and keeping an open mind. It is not surprising that these beleifs cure many ills including substance abuse.
In know this for a fact ... sober 41 years and still practicing the principals taught in AA meetings - the wisdom of the ages.
28
By not incorporating data from the treatment run by the "Native American Church," the study invalidates itself. In a community most severely afflicted, the results are significant. Cultural bias still plays too large a part in deciding on the best way to healing.
10
In 1972 some very good friends of mine guilted me into going an AA Meeting after having witnessed one of my very sloppy drinking episodes, which I usually managed to hide much better. I went just to get them off my back. I was 25 years old. I never had another drink. It made everything that came after possible. To this day I am profoundly grateful that this organization exists.
As for that ‘God’ business, I was and still am, an atheist. There was a man there, many years ago, who decided that the word God stood for Good Orderly Direction and that’s how he understood that. Made sense to me and that’s how I dealt with since then. No need to believe in any god to stay sober.
It’s been many years since I’ve been to a meeting. But the message of that organization stays with me to this day. I’m 73 years old and can unequivocally say that, for me, that organization saved my life.
46
@A M Boy do I wish I had the friends you had. It took until age 39, but AA helped give me my life back.
22
If you read the 12 steps that AA uses to help people, they all require belief in a higher power. For those who are non-religious, it can be a real challenge to try and admit these things.
I'm an atheist, and if I were an alcoholic I could never join AA - even if it would help me - because I don't believe in god.
20
@Ben- This is one of the great misconceptions about AA- that it's a religious program. I am an atheist who has been sober, attending meetings of, and using the principles of, AA for more than 11 years. The steps require that one find a "power greater than ourselves" but there is no explicit requirement that such a power be religious in nature. I put my trust in the greater wisdom of the group and the proven track record of the people who've stayed sober for decades before me. The program also explicitly teaches that each member is free to "choose your own conception of god" - I choose that there isn't one.
45
@Ben
That's why it's called a higher power, If you hear people call it god, that is their choice. I know this is difficult, but speaking as a member of Al-Anon (for the people affected by the alcoholic) it is important not to feel alone and have to make decisions in a vacuum. A higher power can be one's own better thoughts, conscience, or a useful friend or book. I used to discuss this with my atheist brother, and I feel that the higher power concept is misunderstood. It does not take away from one's independence but rather increases resources. It does not have to engender passivity.
28
@Ben AA is a spiritual program and not a religious one. Spirituality is the belief in the existence of a higher power. Religion is all the rules that humans make to define our relationship with that higher power. Most people (not saying this applies to atheists) have problems with religion, not God. Discussion of religion is very strongly discouraged in AA.
Don't let AA's mention of high power discourage you or anyone with a drinking problem from checking them out. What do you have to lose, finding out there is a God after all? Isn't this worth the price so you can wake up in your own home instead of jail or the hospital; having a loving family instead of alienating them; being a contributing rather than destructive member of society; looking at yourself in the mirror with love instead of loathing?
If alcoholism is mostly about trauma, and the greatest trauma is being cast out and abandoned by family and culture, then AA and its ability, at least for some, to recast daily life as about belonging and people noticing and caring we exist, is essential.
I define God as spirit, that which is generated by a common people on a common journey, and my experience of life is that most of life's disasters come from losing that spirit. Of course, we sicken and die when dysfunctional families, military, overly competitive schools toss us to the curb.
Imagine a culture where all have a home, a sense of belonging, where we are of God, of that spirit. I suspect we evolved from thousands of years of small tribal groups where all were needed and had a place.
I was raised in an alcoholic family, and saw AA help when nothing else could. Of course, broken hearts often cannot be healed because they faced a reality that would destroy most people, but that doesn't mean the pain cannot be born and the day be cherished. I always saw AA as, more than anything, a gathering of the terrible traumatized and lost.
16
No one else has been turned off by the "I'm [insert name], and I'm an alcoholic"?
Why define yourself by that? I'm a musician, a professional, a daughter, a sister, a girlfriend -- who has had alcohol misuse issues in the past.
The cult-like mentality and tiresome "drunkalogues" of "old-timers" were repeated turn-offs for me.
I'm glad AA helps people. It didn't help me -- nor did the mantra "it works if you work it".
Meditation, better nutrition, exercise, focus on what I want to do for myself and for others, and renewed connections with loved ones -- and by extension, the broader world -- seem to have done the trick: no depressing church basement required.
36
@minkairship
You are not defining yourself by that label. You are copping to its applicability to you and your life. Bully for you for finding your own path. Too bad it’s made you so condescending and judge mental towards the paths others take.
4
@Deborah The quickness to condemn those who get help -- or help themselves -- in a different way was a huge turn-off for me, as far as AA. Thanks for illustrating the point.
Anything that helps people, including AA, I'm all for. There are as many paths to progress as there are individuals!
2
@minkairship
Funny - to me, a die-hard atheist with terrible memories of church and passionate feelings against religion in general - church basements are, nevertheless, comforting, not depressing.
I am still alive but for the grace of God, my sponsor, my family and the Fellowship of AA and its literature.
It took nearly 35 years to finally "get it" and now I am a responsible member by sticking out my hand when someone is in need. One Alcoholic helping another. Same way Bill and Dr. Bob did it 85 years ago.
19
It would be interesting if one could go backwards in time and see those results from the very beginning until to now. There weren't a lot of options in the early years regarding Alcoholism.
Today's AA is somewhat different from the past. Each generation makes a few tiny adjustments.
The first things one learns in AA (in the 60's at least): Realize you have a problem, Get a Sponsor--some one you can call 24 hours a day for help.
At one time the saying was "a meeting every night for a year" will clear your thinking. After that you can start working on healing...including healing relationships.
Those are the things that saved my parents; Recognition, Sponsor, Meetings. After the first year, you might be allowed to make coffee...
I can't remember exactly how it was worded, but at one time there was a card for a wallet:
"I am Responsible . . . Anyone, Anywhere, Reaches Out For Help, I want the hand of AA to always be there."
23
AA works for me, and for many friends and relatives, as I approach 34 years of freedom from alcohol and drugs. A day at a time. It's a simple program. Don't drink (or use), ask for help, go to a meeting. It's the greatest thing in my life and has made everything possible. As they say in AA, it's not for those who need it but for those who want it. Come on along and join us. We're there for you.
35
As a loved one of an alcoholic I have seen and experienced the benefits of AA. There have been slips and it has been hard to hang in but I'm still trying. I have also attended alanon which is for family and friends or those living with an alcoholic or addict (which means almost everyone). I'm sure it has helped me to deal with all the problems that come from loving an alcoholic.
One thing I kept reading in these comments was some people having a problem with faith or belief in god. I myself have been completely turned off to organized religion since my youth. I find that in alanon I can express my belief and thanks to God as I understand him without any obligation to a religion. I'm thankful for being able to do this without feeling guilt .
I wish the government who is profiting from all the taxes on the vices of alcohol ,tobacco and now pot would be forced to spend all the money to address the problems these addictions cause.
20
The studies cited show that AA gets a favorable result in about one-third of cases. That leaves a lot of people needing an alternative. The article names only one. Another, which helped my spouse quit and stay sober after 40 years of heavy drinking, is a drug called naltrexone. It's cheap, has no apparent side effects and is widely used to treat alcoholism in Finland. If AA hasn't worked, find a doctor who will write you a prescription.
36
@Alcoholic's spouse or do both as I do. Naltrexone has been an amazing help for me as has AA one day at a time. One does not exclude the other.
22
@Alcoholic's spouse
Better yet, get the naltrexone and also attend AA meetings.
Your loved one did not become addicted to alcohol overnight, has developed poor coping mechanisms and will not be cured by a drug absent other intervention.
@Alcoholic's spouse Fascinating about that drug. Most of my friends who have alcohol issues have several over indulgent sort of issues. For example, one alcoholic gal shops like a lunatic and another one got heavily into Jesus. My BIL stopped drinking but keeps up his gambling and is now obese. Does this drug address these mental health issues that alcoholics seem to have? There must be an "over indulgent" part of their brains.
I remember being at a meeting once where a member whose pattern was to stay sober of 3-6 months and then go drink (called a "slip" in AA) After a bad long weekend, he dragged himself back to meetings. He was surrounded by some very long-term members when it came to his turn to talk. He said that despite his slip, he felt good being around about 117 years of contiguous sobriety. Everyone laughed because they got the joke. The key to long term sobriety was sticking around. Sooner or later, the program will get you...only then will you actually get the program.
20
I’ve had many alcoholic patients over the years (I’ve been a psychiatrist for 25 years). A good number of them adamantly opposed AA, usually because it was a ‘cult’, ‘had to do with G-d’, ‘wasn’t for me’, ‘just replaces one addiction with another,’ and so forth.
Not one of those individuals ever achieved long term sobriety.
Most people who refuse AA aren’t ready to quit drinking.
It can happen. I’ve just almost never seen it.
56
@rob Have you tried referring such patients to a similar, yet secular, group like Smart Recovery that incorporates the communal aspects of AA without the preachy, religious undertones? Most people struggling with addiction are already fighting multiple impulses or excuses not to seek help: removing the excuse of AA's dogmatic, churchlike feel would probably help those patients that are non-religious. AA's benefit is not necessarily in its program or beliefs as much as the community of like-minded people looking to change.
31
@AS as an AA member I have not seen the preachiness, but I had to go to many different meetings to find one that fit well. Now I build my schedule around that meeting.
28
@AS
The people who were supported in their participation succeeded because that direct human contact affects you in ways that reading a book, even the Big Blue one, can rarely achieve. People really do need people.
2
I agree AA is useful. I know a couple of people who were almost goners but then they went to detox, treatment and did AA for a while (not more than a year) and then they've been clean and sober for more than 20 years. In one case, the person went back to the way they were before they started drinking.
I think comprehending the reason to stop is important and that one needs to treat alcohol like an anti-medicine for a chronic condition - taking it increases the risk of starting the addiction cycle is key.
Still, the failure rate of all these approaches is high (65% or higher). I think a big mistake people make is thinking that it has anything to do with will power...
11
Actually, AA is not strictly self selective. Courts and treatment centers have been pushing people into AA/NA, etc. for a very long time. Anecdotally, having attended a few meetings over several decades (including my first one which was mandated by a court in 1980), well over half of AA members do not self select. In fact, if you just counted self selected individuals, I have no doubt that the success of 12 step programs would be even higher.
The article is also correct to note that other methods will, for some people, be more effective. The truth that AA recognized is that alone an addict stands virtually no chance at all, and that is the challenge for an exhausted addict; what kind of help is best for me?
14
@Steve G Actually, because of the "higher power" step, forced attendance at AA meetings has been found unConstitutional in many, many juridictions.
@Naomi Yep, and I agree with that. The way courts get around this (and, incidentally, the law on this is actually very mixed) is to turn it over to treatment centers that mandate it. You have the right to seek a different provider, but your choices might be very limited. And if you don't get tx you are in violation of your probation. I work for a tx center and we do not mandate 12 step programs, we encourage building support systems. However, Wa state does mandate, in the RCW, that deferred prosecutions for DUI must attend 2 12 step meetings a week for 2 years. I eagerly await a challenge to that law. I believe it is a violation of ones rights. I also attend AA, but I'm an atheist and I do get the objection, spurious as it may be.
A challenge for AA now is the availability of space for meetings. Many churches can no longer offer free/inexpensive rooms in the evenings or on weekends for lack of staff to open an close the facilities. It’s harder to have lunchtime meetings in office buildings because of security. Landlords don’t always want to devote the space for free or reduced rent.
Even municipal buildings are unwilling to make space available.
With addiction at such a high rate, this should be a priority for all public buildings. Not just AA, but other 12 step programs as well.
20
@Park Bench For a while the church I attended had AA meetings. I thought it was great.
The church stopped allowing the meetings when the group began having meetings using candles, and dark rooms.... Some left the matches on the Sunday School Material. They didn't help their cause.
I have, and will always advocate for the churches I am a part of to allow AA meetings. But when for some bizarre reason, the meetings take on a very odd style, the battle is lost.
Trust is a big issue in churches that have had negative experiences with meetings. Finding a church that has an onsite 24-hour caretaker is the best...or has a portable building where a set of keys can be offered.
3
As a member of Anonymous programs (AA and NA) I can say it works- if you do the work. It gives way to remission only, not a cure. That said, I can honestly share that the 12 steps saved me from insanity and death.
38
Indeed. I had 20 years with drugs and alcohol. I entered AA several times. Finally, I was able to do it. It isn’t easy. It is not a simple little pill. It’s not there to work FOR you. It’s there with answers and to work WITH you. You have to do the steps. I do not believe in a god and my higher power is “the group.” I don’t typically associate with the cult-like members or the people smitten with the concept of “god keeps me sober.” I work my butt off to stay sober. Nobody does the work for me. All my dreams - except two, ha! - have been worked out. I bought a house, a car, finished my graduate degree, traveled through the entire country of India, as well as China, SE Asia, and Nepal. Got married. Relapsed. Had a kid. Got sober again- through AA. I left AA, and now I’m back in AA, with 9 years of sobriety. You can work the program however you like. Ignore AA bullies who tell you you “have” to do this or that. It’s not true. The program is complex and is not for lazy people. It’s hard work at first but it gets easier and the pay check is joy and freedom.
3
Yes! It works if you go to meetings and work the steps.
Good news! AA works and so cheap! Compared to what was not clear. The lack of options in the field is breath taking. There’s AA or in or out patient programs which usually include AA, so not really a different option. Or cognitive therapy. One on one with a drug counselor? One Whose main qualifications might be not much beyond his own addiction and sobriety experience? Or someone with an advanced degree? What we are cheering as success—not impressive. These claims of effectiveness are nearly meaningless.
Mental health study i hope is in its infancy. Antidepressants are blunt instruments and AA is another crude instrument meant to lessen the predations of alcohol dependence. This field cries out for study , for new ideas, and for more effective treatments, so we have better and more scientific options or even a cure.
16
@Susan Debevec
Oceans of research have been done. Alcoholism is a very dangerous disease that involves the mind, body, and spirit. To call AA a blunt instrument is demeaning to a program that has saved millions of alcoholics and allowed them to lead to happy and productive lives. Give it a break. It’s free!
Early in my professional career I had a mentor who used to say "The only employment statistic I care about is the number of jobs I have: one or none." Today, years later, I'm a longtime member of AA and have worked with many newcomers to the program. And I would say the same sort of thing to anyone struggling with addiction.
The only recovery statistic that matters is yours: clean and happy or not. AA (or NA) can take you there IF you sincerely work the program. Not like an automaton but like the highly capable human you're meant to be -- taking the 12 steps to heart, even if they seem odd at first, and applying them creatively in your life.
As the article says, you can also use the steps in conjunction with other processes that may be helpful. Or, who knows, another approach entirely might be best for you. But whatever you do, do it now, and don't give up. An astounding new life awaits.
37
I was raised in an alcoholic family (mother, sister) who were not sober, and married to an alcoholic who struggled and became sober. I am not alcoholic. I wish my mother and sister had sought treatment. My experience without all the studies says AA works! I often attended meetings with my husband and got insight into him and myself as an alanon. I believe AA could help many who are alcoholic and homeless too. Maybe L.A. and San Francisco should try utilizing AA as well. Worth a try! It’s free, it works , and it’s a proven treatment program that’s already established!
28
It seems like a lot of people are not paying attention when they go to an AA meeting or maybe are showing up after they got going? Just sitting in an AA meeting is very unlikely to help anyone.
If you go to AA meetings that is only the beginning. That is where you find the help. The next part as is instructed or should be at the beginning of each meeting, is that you stay after the meeting and talk to people who identified themselves as willing to help newcomers.
The point of an AA meeting is to allow you to make connections with people whom have got sober using the AA method. All of it is printed in official AA lit.
You want to try a lot of different meetings, they suggest 90 in 90 days to get good idea of what is in your area and who the people who are actually sober are. The camaraderie helps some too.
Buy the Big Book at some point in those 90 days. You don't have to be that faithful to 90/90 but some find it does help. Find someone with a few years sobriety at least, that you would respect enough to be your sponsor and ask.
Then you will begin the process of reading the book alone and then together and discussing what it means and how it works. Leading up to doing the steps.
If you don't do the steps you never tried AA. You just went to meetings.
26
@magicisnotreal Imagine what the success rate would be if the majority of AA recovery was centered in the 12 steps and not meeting attendance.
2
@Robert You are exactly right! The AA Philosophy has worked for me for over 45 years. Both here and abroad I've had to go to meetings wherever I can find them, and sometimes I've had to go without for long periods. The 12 & 12 has been my constant companion and has born fantastic results. So bring on the virus, the Master will have it's way.
9
@Robert I'm not sure what you are claiming here, but the real secret to AA, and the thing that got both Bill and Bob sober, is the fellowship. Having both the Big Book and the Fellowship is best, but if either had to be sacrificed it's the book (I know of people who got sober pretty much with the book alone, but those are the excepti9ns that just prove the rule).
38 years sober in AA. i go to 2 or 3 meetings a week, have a home group, always had a sponsor and in more recent years a few good sober friends to ask for advice. As others have said, AA works. I would not stop going and would not want to stop going. It is an exceptional program for people who are born with or develop this malady. If you have a drinking problem, try it, it works.
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@John What advice do people have for my friends in AA who depend on in-person meetings? I know of one meeting that's substituted locking elbows instead of holding hands when the meeting concludes with the Serenity Prayer. But that conflicts with advice from the head of WHO who just said a couple days ago not to rub elbows as a greeting.
A lot of people in AA have sponsors, so they have phone support. But it seems crazy, though incredibly cruel, that people for whom AA is a lifeline and attend to save their lives are now risking their lives and others' by having to go to in-person meetings to stay sober. I'd be grateful for any suggestions I can share with my alcoholic loved ones (and I have read some online guidance by AA and also that AA in San Francisco has stopped in-person meetings). Thanks very much.
2
@IowaCityIA I am 13 years sober. This may shock you, but our recovery from alcoholism actually depends on our daily spiritual fitness and the willingness to practice a spiritual way of life — NOT attendance in meetings. I maintain my spiritual fitness through prayer, meditation and being of service to other people. I have found that I can go anywhere in the world - with or without access to regular meetings - and carry this program and way of life with me. Seeing people in person or regular attendance at meetings is not my lifeline. I do still attend meetings so that I can meet newly sober people and carry this message and help them recover, but this work can be done over the phone, FaceTime, Skype, through letter writing (for those incarcerated), etc. My hope is that those whose sobriety is dependent upon attending meetings, one day walk through the process as outlined in the Big Book and find real freedom. I hope that doesn’t sound condescending - many people in AA just don’t read the book or practice the original message of AA and get locked into this dependence upon “support” from sponsors and meetings. It’s all about God.
4
@Gina
It is not all about God; there is an alternate concept of a higher power. The higher power can simply be AA and its membership. AA does not require that members believe in God. I write this as an agnostic who found long term sobriety and friendships in AA. There is a real sense of spirituality and kindness in AA; that can be practiced without a belief in God. I haven't read the Big Book in years, all of which have been sober. AA is not a private club; a belief in God is a required fee.
Hopefully, if anyone is reading this and wants to join AA, but not be forced into a religious belief system, go to meetings. Find a sponsor who doesn't preach. It works.
5
Cognitive behavioral treatments help people understand and modify their drinking behavior? What exactly do alcoholics need to understand about their drinking? I've been sober for 15 years. I started try to quit drinking 20 years ago. After 5 miserable years of trying to quit on my own I put myself in detox. I then committed to attending 90 AA meetings in 90 days. I did the 90 meetings then decided to stay sober on my own. I still believe in the fundamental principals of the AA program. I am powerless over alcohol if I use it; alcohol is powerless over me if I don't. Yet, before I could accept my powerlessness I had to exhaust all of the ideas I could think of to control my drinking. Everything I tried failed. Cognitive behavioral treatment would have only been one more idea to try before I quit. Addiction is not complicated and AA understands that. AA also understands that part of the process of becoming sober is repeatedly failing to quit drinking. It's no wonder that measuring the success of the AA program is so difficult to quantify.
18
@Mark Yes, "Cognitive behavioral treatments" absolutely do "help people understand and modify their drinking behavior." CBT is not incompatible w/ 12 Step. And AA recognized a number of components of CBT before there was even a term "CBT."
CBT simply addresses how your thoughts, feelings, and situations affect your behavior. Sounds a little similar to "people, places, and things" doesn't it?
If you get sober, your problems don't disappear. This is why almost all rehab centers and outpatient programs apply CBT training.
In a nutshell, it's a method that teaches you how to identify and respond to distorted thinking. Doesn't that sound similar to the old AA cliche of "stinkin' thinkin'?"
You would be amazed at how significant it is for addicts to grasp CBT in therapy programs outside of AA. Like many IOP programs. Yes, we addicts are powerless over our addictions if we are using, but once addicts learn they are NOT powerless over their ability to control their behavior in relation to their emotions, it's very much the "light bulb moment."
It's really the other side of the coin when it comes to "surrendering" as AA puts it. It's not in competition. We can't control our drinking. So, yes, don't pick up. Period. But when our addict brain starts playing tricks on us, so to speak, that's where CBT is vital. "Doing your 4th Step" is not going to help you in front of a liquor store. CBT skills will.
You use your CBT, don't buy a bottle.
And then you go to a meeting.
2
@Mark
A lot of people are not aware of the distinction between "problem drinker" and alcoholic.
@Mark Almost all of addiction science is about giving allowances for failed tries. So it's really the "final" try that matters. For the purposes of these quantifications that's what matters also. Your trying to quite for five years was as much helpful in stopping as the final AA experience but you'd be counted as an AA success story (likewise someone who did AA and then relapsed again and stopped via CBT would credit CBT but it was just the last stop on their journey).
1
32 years sober in April. It takes work, but boy does it work. I can't believe what a great life I have had since getting sober and working the 12 steps.
Kind of like the gym. You can hang out at the gym, get to know people, and be impressed by what they can do and how helpful they are.
But if you don't do any of the exercises, you will not get stronger yourself, no matter how often you go.
I wonder whether anyone has thought about studying whether the gym is effective at getting physically strong and healthy...
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@Renegator Love it!, Thanks!!
Reading some of the comments here reminds me of the five years I did putting in twice monthly at the AA telephone helpline service for a large English city.
At least 1/3 of the calls were from people who wanted to talk about how AA did NOT work for them. Many of these folk were daily callers - often over years - some of them called HOURLY.
AA works for the people it works for. Plenty of them. AA makes no special promises (if you want what we have...') and, sorry to say this, feels no particular weight of responsibility for alcoholics that don't want it.
19
@nolongeradoc It sounds like you were dealing with mental health issues rather that just alcohol. It only works if taken seriously and with a sponsor to take your calls - not the AA helpline.
This is interesting, but I don't get what AA is being compared to. A study last year showed that AA, LifeRing, and Women for Sobriety and SMART Recovery all had about equal results. AA is an excellent adjunct to treatment or treatment itself for many people. It is important to look at alternative to 12 step programs for those for whom AA does just not fit. Those meetings are also free and fairly widespread, though not as widely as 12 step programs.
22
@Wendy - AA is being compared to "other treatments", typically treatments one would get from the health care system. It's kind of cool that a community of peers, helping each other, shows more success on average than working with a professional!
13
Yes, we have to guess what the other methods were but the ones you mention must be the bulk of them. The writer is comparing apples with non-apples; or, a full abstinence program, with “other methods, a lot of which are not abstinence programs but harm reduction programs. The only measure that the writer is measuring effectiveness by is length and rates of abstinence. It goes without saying that if you use abstinence as measure, AA will compare favorably to a harm reduction model. On other measures, such as drinks per day, it is only equal. The rest of the text is just filling column inches based on that fundamental error of logic.
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@Oliver Hornsey If AA attendees drink less than alcoholics using other treatment programs, I suppose that's a good thing, but by AA's logic, those AA members drinking less are still "failing."
Any study relating to drug abuse / drug addiction has to have some basic constraints in it's development. Is complete abstinence the goal (and thus measuring stick)? Or is the barometer simply an improved quality of life due to less consumption?
1
A good article and good information.
For anyone as desperate as I was and as desperate as the countless people I've met in AA over the past almost 20 years, who cares if it looks like a religion (its not) or a cult (its not), what matters is it works.
But, for most, its not a one shot cure all. It's a very well documented program of recovery, and like any program, it works only if you work it.
And, as many commenters, noted, the drinking is just part of the problem. Of the 12 Steps of AA, alcohol is only mentioned in Step 1, the remainder of the program, The other 11 Steps, help us to become better, sober, human beings.
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32 years sober. Thank you, my friends at AA for getting me off to a good start. I attended a wonderful small group in a mountain town in North Carolina that helped me get my head on straight. It was like family but in a good way :-)
I get it with the posters who say that AA wasn’t for them.
I found the larger meetings when I move to the East Coast more challenging, less supporting, but as I look back I think the right people were there I just didn’t connecting with them as I did with the advantage of a more intimate group.
My lifesaver was my sponsor, a human connection during a very lonely time with someone who had been through it.
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@Jean I also had great experiences in one of those
North Carolina mountain towns. Great folks whom I still communicate with.
Also agree that a sponsor is one of the most valuable parts of the recovery program.
4
Good share Jean. I'll pick up my 33 year chip in May by the grace of God and the power of the AA program.
1
I've been sober since 1/21/2007 and am an active member of the 12 step community. I follow the program as it is suggested and it works. I want no other way of life today. The joy of passing on the gift of sobriety is a privilege and the one of the most satisfying parts of my daily life. There are other ways to stay sober, and as mentioned by another, AA has no opinion on the others. However plenty of people seem to have negative opinions or experiences about AA which they love to share. Too bad they didn't stick around to find the positive truth and joy of living by the principles of the program. It's always there if we work for it. Each of us is responsible for our own sobriety, however we maintain it, why put a method down if it doesn't work for you? Live and let live. The 12 steps worked for me and I will gladly share my experience, strength and hope with the newcomer walking in the door. You are always welcome.
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I can’t believe I read this: “It may go without saying, but we’ll say it: It would be unethical to prevent people in a control group from attending Alcoholics Anonymous if they wanted to.” If you were testing a medication you would never allow people in the control group to also take the medication if they wanted to. Doing so would completely ruin the trial. This statement by the authors exposes their bias toward A.A.: they assume from the start that it’s an (the?) effective, life-saving treatment for addiction.
How odd, also, that they don’t mention that A.A. is a faith-based program, which renders it quite problematic (and often ineffective and, frankly, insulting) for nonreligious folks who now make up slightly more than a quarter of the U.S. population, with 9% identifying as atheist or agnostic. As an atheist looking for help for alcohol use disorder in the ’90s, I can attest to the problem of A.A. dominance. Since A.A. was (and, largely, still is) the only game in town, the message to me was clear: There is no help for you! Fortunately, there are now some secular self-help groups like SMART recovery and SOS scattered across the landscape, but they are still few and far between.
The medical community’s continued embrace of A.A. is nothing less than a scandal. We would never accept religion as a legitimate (not to mention, primary) medical treatment for cancer, diabetes, depression, or any other illness. We shouldn’t accept it for addiction.
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@Matt I'm surprised you've forgotten our preamble: A.A. is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.
It does require a belief in a higher power than ourselves - Allah, God, AA, mother nature, other AAs, spirit that lives in our interconnectedness, Good Orderly Direction or even Group Of Drunks. The big book even has a the letter to the agnostic. I know many sober AAs who don't believe in a deity,
If AA doesn't work for you, and you've tried other AA groups and sponsors, then by all means, good luck & goddess bless. Take what you can use, and leave the rest. It works for me, it works for many I love, but it's hard to explain why. Meetings help tremendously, as does a good sponsor (I'm on my 4th in nearly 5 years of cross-addicted sobriety). But working the steps is what keeps me emotionally sober.
I don't frankly care if doctors approve or disapprove. It works for me. I'm sorry it didn't for you, but I'm glad you found something that does. To others, if you have the gift of desperation - give us a call. All we want to do is help others in their journey toward sobriety. No expectations, no rules. Just come, listen, and see if it works for you. Or not.
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@Matt No, you're wrong about clinical trials: there are many trials where people in the control group are removed and put back on a drug as soon as there's some evidence of the drug working esp. for indications where it is a matter of life and death (and people in the control group have 100% choice in this matter too - no one is a prisoner to the control group!---if you come across a trial like this, you should avoid it like the plague - usually you can tell in the informed consent documents but I find it hard to believe it is even legal to do what you say and some IRB signing off on it).
That is exactly why the authors made the statement.
4
@Matt I firmly believe a large part of AA's popularity is that municipalities and insurance companies don't have to pay for it.
I'd have to know a lot more about these studies to know what to think of them, but if the people involved knew they were part of a study on the effectiveness of AA or even of anti-drinking programs in general, that contaminates the data. People who know they are being observed like that are far more likely to stick with it than someone who doesn't have that external pressure on them.
The whole point of the second A makes it impossible to know how many people the program failed.
4
Whatever works for you. I needed a year in an outpatient program then a month in rehab and then I rejoined my outpatient program just to be safe.
I've been to probably less than a dozen AA meetings, mostly for friends celebrating anniversaries or early on for myself several times. If you feel the need, AA is always there - at least in NYC it is widespread.
If you want to get straight, keep at it and you'll get it.
10
Whatever works. My husband went to two meetings many years ago and decided that the relentless focus on drinking and mea culpas was exactly what he didn't need. He focused instead on the good things he wanted in life and although it wasn't easy he managed to give it up on his own.
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Do you know what works? Whatever works, that's what. 10/10/13 I went to an AA meeting and have been sober since. I haven't been to a meeting in over 5 years. Don't need it, don't want it. But if someone came to me wanting help I'd bring them to a meeting, or at least offer it.
29
As gratifying as it is to have the blessing of science, this is hardly news. The genius of AA is that it considers findings like this to be "outside issues". The traditions of the program keep AA from engaging in any debate, controversy, advocacy or proselytizing even on the matter of its own efficacy. The Public Relations policy is Attraction not Promotion. Imagine if other entities relied on this approach.
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@Buzzscan I am not bashing it or saying it does not work for people-clearly it can. But in our society AA seems to be the only option that is offered. The courts push people towards it that have DUI’s. There just needs to be more education available as to options for people. Doctors aren’t aware of Naltrexone and many will not prescribe it. Yet there are thousands around the world who have stopped drinking using this method.
23
@Lisa I agree. AA is not for everyone. A large section of the AA Big Book focuses on separating the alcoholic from the non alcoholic/heavy drinker. Based on the description of the alcoholic put forth by the founders of AA, if someone could stop on their own human power they were not powerless over alcohol and therefore do not qualify for AA. If you have lost the power of choice in drink then AA is for you. Referrals to AA from the courts and elsewhere have often not benefitted the individual or AA as a whole.
2
@Robert AA does not promote or agree with court based attendees, but tolerates them. The program is based on "attraction not promotion."
Sober and clean since 1988. Participation in AA has been the key to that abstinence. However, AA is more than an abstinence program. It offers a way of living that stresses passing on the gift of recovery grounded in the 12 steps that are a roadmap to successful living. AA is the greatest self help movement of the 20th Century and millions have directly and indirectly benefited.
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@deathless horsie Beautifully said. Thank you.
@deathless horsie Well said!
I’ve been working the AA program since 1988 and have remained sober since my first meeting
I think I’ll keep coming back
Great article
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AA and Alanon saved our family’s lives.
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I was very disappointed to see this article did not mention the Sinclair method, a science based practice that incorporates the medicine Naltrexone. It has close to an 80% success rate and does not require a lifetime commitment for meetings. The rate of success for AA cannot be measured as the group is anonymous, and even the stats mentioned in this article are comparatively low.
AA is great for the support it can offer to those who find it useful, but to me it was not a solution. I found the literature to be super outdated and was disappointed to hear about some of the history of the creator of the group. And going around the room where everyone labeled themselves an alcoholic never felt right to me. But again, if it helps people abstain from behavior that was ruining their lives than I am grateful for it’s existence.
The Sinclair method is not well known, which is a disservice to the overall health of our country. It offers a great alternative for those who are not cut out of the AA cloth-website is
https://cthreefoundation.org/the-sinclair-method
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@Lisa
AA does not require a lifetime commitment for meetings by any means.
I walked up a flight of stairs in Tupelo, MS, almost 26 years ago and attended my first AA meeting. I attended 2 additional meetings, the following day and one 3 days later. Long story short, I'm a stubborn guy and like to do things my own way, but to be honest, in 3 meetings I received enough acknowledgement (of me, of the problem), enough support and understanding, and enough love and eye-opening to realize that I could stay sober.
So, I am still sober, and while I have the utmost respect for AA, and am very aware that it is there, virtually everywhere, would I need it, I have not attended since then.
Alcoholism is problem of the individual, and the individual must realize that control is the issue, lack thereof in respect to alcohol. Rarely, I would surmise, is alcohol the actual issue; something is always underlying, and that is what needs addressing.
It is true, though, that not all AA meetings, groups, etc., are the same. Some are really big on a fairly Christian focused aspect, but others are pretty much open to "whatever you call spirit".
But no shoe fits everyone, so one who has fallen far enough and is looking for help should consider AA, Sinclair method, or whatever to simply be a beginning to sobriety. One must get used to trying and trying again. Accepting failure is part of it too.
But AA is by no means a commitment. Sobriety is.
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@Lisa I agree that Naltrexone and other similar drugs are amazing "pill type" solutions.
AA doesn't need to be lifetime as people have said. I know people who've lost their cravings entirely after anywhere from a few weeks to a year even after two+ decades.
All what many of these solutions do (including suboxone for opiod addicts) is give enough time for the brain to heal a bit so the organ you use to make choices can find its footing. The attitude after your mind clears up is key I think to permanent recovery or a temporary one.
3
@DKM I am glad you found it
I think it's vital to understand what is going on in your brain, body and spirit, and to talk with other people. There are many paths to doing these things.
I found the most effective help on YouTube. No kidding. Find the guy who calls alcohol "attractively packaged poison" and the transplant from the UK who makes daily videos while hiking in Spain. One channel has the word "drinking" in its title, and the other, "alcohol".
Persist! And, good luck.
13
I find that with weed being legal in most places, I am drinking a whole lot less. One little edible (10mg) is enough to enjoy the late afternoon, without getting all zonked out. Plus, weed wears off after a while, without a morning headache. Alcohol...nah, don't need it much anymore.
14
@Pb of DC ~ Good on you. And you'll have a healthy liver with cannabis, definitely not with alcohol.
SMART Recovery, Women for Sobriety, Dharma Recovery, Rational Recovery and SOS Recovery — all secular — were not even mentioned. Shame on shoddy reporting.
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@Lori
AA is secular.. your "Higher power" can be anything you want it to be.. I always likened it to "The Force" in Star Wars.
The story was about AA’s efficacy, not all recovery programs.
@Lori
Thank you! AA is not the only solution.
2
Let's talk English: It's not "alcohol use disorder". It is alcoholism. Or, they are drunks.
15
@Jonathan Katz Just to clarify, the article is using the correct, current professional terminology. "Alcoholism" is a colloquial, often more stigmatizing, term. The DSM-V (Diagnostic and Statistical Manual of Mental Disorders) was updated several years ago, replacing the terms "Alcohol Abuse" and "Alcohol Dependence" with the single diagnostic term "Alcohol Use Disorder."
1
@Jonathan Katz That refers to the DSM V. Its the official diagnostic term, I believe.
@Jonathan Katz The alcoholic who drinks is a "drunk." The alcoholic who abstains is "recovering." Only my opinion.
The 12 steps changed my life. Its so liberating to truly see that my own self-centeredness is at the root of most of my problems. I don't care for meetings and I dont pray. I have found Buddhism more to my liking.
19
AA plus treatment has worked for me for 30 years and 4 days as of now. My expectation is that I am good for the next 24 hours as well. You can never go to too many meetings, but you can start slacking off after a decade or so. I went to college for a decade or so and became a cognitive behavioral therapist. I was not successful as a Clinical Substance Abuse Counselor unless AA or NA was also part of the treatment plan. It is always on the individual in all cases, but nothing says motivation like positive action.
27
@Milt well done
Grand- Daughter x2, daughter and sister x2 of friends of Bill
My sister follows your path.
13
I am struck by the relatively poor results for all of these treatments. It shows how devastating addiction is and how we need to stop addiction before it begins. A lifetime of treatment that fails between 2/3 and 80% of the time is a terrible alternative to not being addicted in the first place
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@Chris No, actually, a treatment that works 1/3 of the time is far preferable to the alternative. Just imagine that alcoholism was Corona Virus and the death rate was 66%.
16
@Chris
You might have to monkey around a bit with genetics to avoid addiction in the first place.
1
My brothers and I grew up in a military family where the cocktail hour and happy hour at the officers’ club were traditions. My parents loved dry martinis. When I entered the diplomatic corps and had to entertain during overseas assignments, gin and tonics and whisky became standard beverages.
While on my first assignment in Iran, my wife and I participated in a course given by the guidance counselor at the Tehran American International School where our older children went. This was a “parent effectiveness training” course that was very instructive and enlightening. Bottom line, I saw that I had a drinking problem because I was emulating my parents’ behavior. By the time we got to India, I had begun to abstain from alcoholic drinks and it was more difficult to obtain booze. We also became largely vegetarian. By the time we left, we did not drink alcohol at all. I had kicked my parents’ habit. I didn’t miss the booze.
We benefited greatly from our parent effectiveness training. Of course, American culture is different. Alcoholic beverages have long been a part of certain segments of our society. I watched my parents decline while they continued to enjoy booze and I knew that it was not something I wanted to do. I have now lived longer than both of them and enjoy an occasional glass of wine or sherry. I think that one’s experience counts for a lot in dealing with alcoholism. I was very fortunate.
30
As someone grew up with parents in the program I can tell you AA may keep them from using but it doesn't make them mentally healthy or help them to fix the emotional damage they may have caused. Sadly, sometimes being sober didn't make people anything but 'dry drunks'. But I will admit; I'm bias.
39
@j.j.
Thank, J.J. I appreciate the comment. I think that the personal work that comes from recovery is separate from trying to stay on the wagon. People will have to decide whether they can do the personal work or not--which presumes therapy, etc. Sometimes the steps can help one to get there---but sometimes, people refuse to see their own issues. The alcohol was a convenient mask for something else---often percolating underneath. I have seen that countless times.
36
@Henry Dickens
Yes, alcoholism is often co-morbid with other mental health conditions.
Nonetheless, I've seen AA nudge members towards professional help.
I was married to an alcoholic almost twenty years. For ten of them he was in AA. He relapsed, and we divorced. He moved overseas, re-married twice.
At 65, he dropped dead running in a park. A stranger found him.
My former spouse needed AA as well as psychiatric and/or psychological treatment. Our marriage needed to end, but he could have -- with other supports -- lived longer and better. He could have maintained a relationship with our children.
I highly recommend Alanon, a self-help and recovery program for families and friends of alcoholics.
20
@Cary K. I have neve seen AA "Nudge" people to seek professional assistance, in fact I have seen the opposite in some groups, and that is if you were "taking" any medications for underlying medical conditions you were not truly sober.
Granted, these are just my observation, and I have spoken privately with other members, who I also considered friends and they suggested additional medical assistance, but any AA group should never make any medical suggestions.
9
Almost every expensive alcohol and drug treatment facility includes the 12 step program because it works. Almost 45 years clean and sober and I am grateful that the only choices when I needed help were AA or death. I’ll insert here that I lost a lot of friends and lovers. The thing about addiction is you have to get that what your mind is telling you should be questioned. Think, think, then think again, preferably among people who get your problem. The ego is your enemy.
27
There is so much great support in the Anonymous programs. You can never get that level of support from a paid ‘detox’ program.
27
This is a great article about Alcoholics Anonymous, with input from Mr. Fraft and Mr. Carroll and information from the Cochrane Collaboration that explains and codifies that
AA Works if You Work It ---
I heard this somewhere before....
27
Perhaps I'm an outlier. I found no help whatsoever through AA. Sitting around listening to war stories of drinking didn't do it for me. It only made me want to drink more.
I did finally break the cycle, but AA had nothing to do with it. At some point and after numerous DUI convictions I decided that jail and/or prison just wasn't for me. It was either give it up or end up likely dead in a prison cell. I opted to give it up.
I might add that year of treatment for heroin addiction had a huge influence on me. Booze and methadone don't mix well. Neither taste very good anymore, but alcohol tasted extra nasty with methadone. After almost 10 years of my daily drink of methadone I pretty much forgot about drinking and now, if I do drink, which is very infrequent the hangovers are just unbearable so I'm done with it.
13
I drank for 20 years. quit at 35, no aa. Retired at 65. With help from my doctor became addicted the benzos. collapsed after five years. recovered in hospital. Joined aa which saved my life and am drug and alcohol free. aa saved my life. i attend each day. free at last, at 83. 13 years clean. never give up.
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@stan Best wishes.
@stan Yes ... it works .. 41 years clean, sober, and sane for me. Congratulations
1
My dad failed at 2 hospital rehab programs but stuck to A.A. for years anywhere he lived. The group meetings were like religion for him.
15
I guess the question is how you do this without the religious overtones?
6
@E Campbell
I am an atheist it works fine. If you are hanging up on "the religion" then that is coming from within yourself, not from the program.
The program is what is printed in the big book not what people tell you.
16
@E Campbell AA is not a religion, and a belief in a God is not a requirement. The only requirement for membership is a desire to stop drinking. Your "higher power" that you rely on can be anything you choose. Anything.
18
@E Campbell easily. Take it from me.
9
Alcoholics Anonymous isn't treatment. It is peer support. One person helping another. Treatment would require a therapist and a patient, that is not AA.
People who attend AA meetings for support may receive treatment from therapists and the support from peers is no doubt encouraging and helpful, but it's not treatment.
There is such a thing as 12 Step Facilitation Therapy which is in fact therapy. The patient is treated by a therapist and encouraged to attend AA meetings for support.
It's an important distinction, support vs. treatment. They are not one and the same.
26
@John Sheldon
Thanks, John. There is this strange assumption that AA should be a "cure-all". It is not. But it does help to have people to talk to and engage over one's issues. And that peer support can be important---and as many have stated, life-saving. Isn't that worth naming?
It may not work for all---but the article stipulates it has worked for many. That's all we need to acknowledge.
17
@John Sheldon
In line with this, I’ve often, not without a little levity, called A.A. the small claims court of psychiatry.
1
It certainly worked for me! 38 years of sobriety. I come from an alcoholic family and other family members have also gotten sane and sober with AA. The common complaint that it is "religious" has never bothered me. Higher power is something we all have. It is our better self, also providing us with other survival skills. And it is based on community, which is something we are largely losing in our society. Having a sponsor - or mentor - is of great benefit. I think if everyone lived by the 12 steps we would all be better citizens and profoundly happier.
73
@ckstaples44
I agree. The 12 steps would benefit everyone, Especially with trust and honesty being central principles.
A.A. embraced many I cherish and helped them find freedom and joy in sobriety. I’m sure other programs may work as well but why recreate the wheel?
19
@Schimsa Right, the objective of this study was to measure the effectiveness of Twelve Step Facilitation Therapy, which is indeed helpful. This was not a study of AA, which doesn't keep any sort of statistics because it isn't in the business of providing treatment.
The article would be more accurately titled, "12 Step Facilitation Therapy found more effective over other approaches"
6
Groups like AA work much better for extroverts than for introverts. And some people (like me) might find the focus on "making amends" for past wrongs a little overbearing. Of course it makes sense to come to terms with those around us right now. However, I don't have time or energy to track down and contact every person I have ever offended in my life and "make amends" via an apology or some other action.
10
“Tracking down” all former friends/family/former lovers or past employers isn’t what making amends requires nor what the program encourages.
26
@Martha Goff
What did you do that you don't want to face?
5
@magicisnotreal For trauma/abuse survivors, as well as criminal offenders, this can be more complicated than it seems. Even Steps 4-7 can. That’s not me saying no one should work the steps, just that some have a simpler path than others.
3
I'm almost 4 years clean and sober and I tried AA, never resonated with me. I have been able to stay in recovery without it.
13
@Dana Licko
If you never got a sponsor and did the steps you did not "try AA".
5
@Dana Licko Four years in, God bless you. When I was four years in, I was still having nightmares of holding a drink in my hand. If not for AA, and knowing it is out there, I would be dead. And I haven't wrecked a sportscar since then!
1
@Dana Licko Good luck. My story was the same but I started drinking after 3 years. Drank for 7 horrible years. Forced myself to try AA again. It was the last place I wanted to be. Happily, almost 20 years sober. Thanks to AA and the support and friends I've made I have no regrets and a life I'd never dreamed I'd have.
I know that my comment is not based on scientific evidence only personal experience. On Feb 29th I celebrated 40 years of continuous sobriety starting when I was 25 years old. I had just moved back to the town where I had attempted to go to Nursing School but chose drinking and drugging instead. For money I got my old job back at the Stagger Inn, at that point I knew that I wouldn't be celebrating my 30th birthday. At rock bottom I decided to go to AA. I was the only women in the group of what then seem to be old men. We had 3 meeting a week, it was hard to relate to their stories and they were bossy too. One gentleman always asked me at the end of the meeting what step I was on and why wasn't working the program. I finally gave up and started slowly working the steps. The big change came 2 years later when guys in my age group came in. Tony G exclaimed to the group, "If Bridgie can stay sober anybody can stay sober!" There was absolutely no 13th Stepping, better know as sex in the regular world. Our little group did everything together movie night, going to meetings in other towns, helping each other thru difficult times. In Sept 1981, heading into my last quarter of Nursing School I met a man & ended up pregnant. The rules then were very different-if you worked you couldn't get any medical assistance. I had to stop being a substitute teacher. A month before my due date those old men, my buddies & 3 WOMEN had a baby shower for me. Caring--the key to my 40 years of sobriety!
119
@Bridgie - OMG. I had a very similar experience in 1974. Old men who smoked! And, drank lots of coffee. I was 27 and often the only woman in the room. Sometimes there were women but they were decades older than I was. After my first meeting, they took me to a coffee shop and made me eat a hot fudge sundae. They said it was to replace the sugar in my body that I was used to from drinking. I never felt such concern and care in my whole life. Thank God I found that meeting.
3
Eleven years clean and sober in Boston. AA works, when other methods fail. At the beginning it was dieting. Trying to control my food intake, I found white wine. I found amphetamines next, and opioids, to calm down. At the end it was white wine by the case, amphetamines to wake up, opioids to go to bed AND the chocolate cake. A daily AA meeting takes care of EVERYTHING! I'm clean and sober, stable in a healthy body weight, not hungry, grateful beyond words.
49
AA worked for me. It gave me my life back. I don’t know what my life would have been like without it. I entered A.A. thirty-one years ago and never looked back.
42
I’m a 60-year-old man who got sober when I was 25 in AA in Florida. I drank for 10 years and did a lot of drugs. I am very grateful for AA and the people who helped me and showed me how to live a sober way of life. 35 years later I am still a member of the fellowship and go to meetings regularly. AA is more than just going to meetings. There is a recovery program based on the 12 steps and this is suggested for all members, but it is strongly suggested. There must be inner change and personal growth that goes along with not drinking one day at a time. AA is not for everyone, but it works for many many people all over the world who try to apply themselves to it. It’s a grassroots organization, and it is not perfect because it has people in it. Human beings in various stages of growth. Please don’t let negative experiences or opinions of people deter you from giving it a try yourself.
56
The only thing I know is that from my professional training is that addiction to substances is a withdrawal and disconnection that grows to the point where there is only you and the substance. Recovery is the process of reconnecting to the people and world by journeying inward to the self that seems to consist of guilt, shame, self-hate, fear, loneliness, and almost complete negative sense of being. Hearing others talk about your life and experience of all of that when they are just sharing their story is the magic that allows one a chance to begin to move back toward feeling like a part of something and finding something within oneself of value. Through the practice of service in such simple ways as helping to set up chairs, make coffee, and help others one can begin examining the whole many-angled thing that is their life. The one thing for me both personally and professionally is the understanding that substance abuse/addiction is very individualized. In the rooms there is always a lot of similar but never exactly the same experience of the condition. This also means that every recovery will have a lot of similar but will not be exactly the same. Though you may have some who will tell you “exactly” what you need to do you will still have to find your own way to recovery. The reason for some of this is that this program is based on words which unlike numbers are not the same to all people and the range of interpretation and response to them reflects that challenge.
40
Nicely explained, thank you!
5
@Maverick - Rich insights, beautifully said.
8
I started drinking at age 10 while doing chores for mom. My drinking was intermittent but problematic. I kept on until I was 37 and the mother of a young baby. I was so upset with myself that I showed up at an AA meeting. I've never drank or taken any intoxicants since then. It will be 26 years on May 23. I still attend AA meetings every week. Great design for living.
29
What a timely article. Just when politics (chiefly #42), the coronavirus, and stock market dive could possibly weaken me, along comes an optimistic article with upbeat comments and reminders. Thank you!
25
@Jan T.
Oops. #45!
3
I sure wish my friend had gone to an AA meeting, or any kind of meeting. I tried to help him, but I failed. He was one of the most intelligent people I have ever met, but he always refused to admit he had a problem. He lost his wife, medical practice, office building, retirement plan, medical license, everything. Earlier this spring he finally drank himself to death. A sort three years from a heavy drinker to living for the bottle. Some people hit bottom, fall in a hole, and keep on going. AA has saved a lot of lives, he could have been one.
33
You didn’t fail. You didn’t cause it, you couldn’t cure it, and you couldn’t control it. Some people just don’t make it. Don’t be so hard on yourself. 
23
@Harry Siegel my brief time in Al-Anon has opened my eyes regarding loved ones of drinkers try to control the situation which causes an imbalance in the controllers life. Listening to other peoples stories helps me to change my behavior, which in turn, hopefully helps the drinker. My wife is 103 days sober today and I am so very thankful.
17
Associated organizations for the families and intimates who are affected by someone’s alcoholism or suspected alcoholism are:
Al Anon
Al Ateen
21
@Gracie ACA (Adult Children Anonymous) is another one
9
@Jonahh
Thank you Jonah.
What they don't tell you about A.A:
You must be able to survive the predators, grifters and bullies that inhabit the rooms of A.A. cloaked and protected by 'The A.A. Traditions', and where virtually no 'A.A. Meeting' bears the responsibility or preparation of regulating such abuse.
41
@Susanna Thank you!
6
@Susanna Just like you must be able to survive the predators, grifters and bullies that inhabit the whole world. Get a good sponsor and let them help you. There really aren't more creeps at an AA meeting than you would find anywhere people gather. I no longer attend meetings, but 40 years ago I couldn't have gotten sober without them. Didn't take me long to figure out who was full of it and who could help me.
22
So sorry that was your experience, I hope you didn’t let it stop you from ultimately getting the help you needed.
4
Except it’s not “treatment” and should not be used or portrayed as such.
16
@Evelyn Zak
AA quite clearly states that it is a NON-therapeutic program.
3
While AA is great for awhile, it ultimately disempowers people and allows them to 'do bad things' because they can just play victim if caught - they never take true responsibility. I've seen this time and time again with friends in AA and other groups.
Likewise, if you're smoking or suddenly finding religion in lieu of drinking, you're still an addict - the only true empowerment comes from inside.
8
@Jonahh Good points. I've met many A.A. adherents that continually victimize themselves. It's also common for A.A. adherents to just replace their alcohol addiction with cigarette addiction - which is also a killer and not a healthy outcome.
7
@Gabriel I won't argue that tobacco is a poison to the human body in almost any form, and of course smoking cigarettes (or vaping tobacco) will likely lead to serious illness for many in their later years.
Nevertheless, even if you view this as a matter of 'replacement', this is still a greatly reduced disease-state for the individual. Many active alcoholics and addicts (drugs) will end up dead long before a nicotine addiction would have killed them if they were sober and had a tobacco dependence.
And, sober, they have a better chance of waking up and stopping the nicotine as well. It is a matter of time, and harm-reduction.
And that is a 'lesser outcome' scenario. Many people come into the fellowship as smokers and stop within 1-5 years (after life-long smoking and drinking etc). Some start smoking, and then work through enough of their issues (outside of the fellowship) that they can stop smoking.
The important thing is that being clear-headed, rational, and drug/alcohol-free people have a much better chance at living a successful and fulfilling life.
But, in all cases, that is the individual's choice.
7
@Jonahh
I'm pretty sure you've never actually been to an AA meeting.
Alcoholism is a sickness of mind, body and soul which distorts people's moral judgement so that they often do bad, illegal, immoral things.
But AA NEVER says alcoholism absolves you from RESPONSIBILITY. The phrase "I'm not to blame but I am responsible for my actions" is often heard.
One of the most important of the '12 Steps' is admission, confession and acceptance of past misdeeds, wrongs and crimes. And accepting, gratefully, whatever consequences those confessions produce.
Nobody ever wiped their slate clean by beginning 'it wasn't my fault...'
Addiction is inherently isolating and kills the soul. Connecting with others, gaining support and trust and, in many cases acceptance and friendship, is what happens when people struggling with addiction allow themselves to participate in AA or other Anonymous groups. AA helps bring addicts back to a healthier end of the living spectrum.... back to the living.
19
I hope this article goes some way to muting AA's critics and encourages victims of alcohol to try it. I'm bittert, having just lost a friend to alcohol-induced liver failure at age 65, a brilliant musician/composer, loved by everyone who knew him, whose life was disrupted and derailed by the poison.
It's difficult in our culture to escape it. In the late 80s advertising distilled spirits on radio and TV was banned. K Street alcohol lobbyists have overturned the ban, an example of the industry's power over government and society. Fat chance of ever eliminating slick beer advertising that pays for televised football, sending the message that joy of sport, masculinity and sexual success results from drinking beer.
When young I drank more than my share of booze, finally quitting in my late 40s after the ordeal of quitting smoking. Nicotine is an even more addictive drug being promoted today to young people using candy-flavored vaporizers (matched by the alcohol industry's promotion of candy-flavored sparkling drinks, basically soda pop with added alcohol.
I now see alcohol as poison, as I watch friends and acquaintances deteriorate and die from its use. I've been alcohol-free for over 20 years. My name is Peter. I'm an alcoholic.
So are you. The point of that statement is that any human (or other animal) is a potential alcohol addict, given a certain amount of exposure over time. And you don't stop being an alcoholic if you stop drinking. Good luck to all.
22
@Blandino It's clear that A.A. works, but I'm more interested in the secular and atheist versions of addiction recovery. As an atheist and secular humanist, I take issue with the religiosity of A.A. If they are going to trot out 'studies' showing the efficacy of A.A., then its apparent that the other 'non-religious' platforms need to be considered, as well.
2
Really enjoying the comments, like going to a meeting. I was lonely and isolated at my bottom. Wanted to quit but thought I could figure it out on my own. When I finally asked for help a friend came over and talked and took me to a meeting (NA) the next day. I found out later that he was thinking of suicide when I called. .We've both been clean and sober for 33 years. I found I needed other people, their experience, strength and hope. I still go to about 5 or 6 meetings a week and credit AA with most of the good things in my life. One of the many genius concepts of AA is helping each other as equals. What a blessing
41
@Kyle
These comments are helpful and remind me of early meetings in ‘88. Congratulations on your 33!
7
I'm not an AA member but an Alanon. I lived with my older brother, an abusive alcholic, for years at a young age. I left before him because of his abuse. AA has been a life-saver for him. I think people often get turned off by the Higher Power concept in AA. For me, it can mean anything that will help someone -- Nature is fine enough. Sponsors I have known have been so generous. With AA, take what you want, leave what you don't want. But my experience is that it works, but it may take a few go-arounds. Nothing to be embarrassed about there. One day at a time ... that's all we have.
23
Who am I to argue with the science, but for many who are not into the tightly structured, albeit peer led, prayer-like incantations, dull workbooks on a grade school level, dogged insistence on dogmatic creeds (the first relapse into any use will without question will result in "death, jail" or something equally dire which I can't specifically recall).
Then, the ritual of clean time, how many years, months, days and sometimes hours that the half of the participants who are abstinent. The "perdition" stories of the clean time folks about the inept or evil things they'd done while they were addicted and their "rock bottom" testimony.
Then maybe some workbook on the steps. Make a list of all the people you've wronged with your use and what you can do to make "anends", say, if you're working on the later steps. Then time for attendees to "participate" and be called upon to say something.
The cultish environment of the "meeting" pretty strongly encouraged statements worthy of a Chinese Communist "self criticism" meeting.
Then one more prayer or two, and it's over. Longest 90 min ever.
Usually depressing surroundings (church basement flourescent lights, bad coffee, lots of smoking breaks outside (cigs are OK, meetings are stressful to smokers).
Maybe that's equivalent to treatment in an accredited clinic with real professionals, but I feel this experience was not valid, ethical therapy.
Wasn't my cup of tea. Private sessions with a certified therapist worked better.
13
how long are u sober?
2
@Jackl That's all well and good, but maybe you didn't read the article. AA gets better results.
5
Gosh, that sounds terrible. I’ve been going for a while & am happy I’ve never encountered the kind of meeting you described. Glad you found a helpful alternative.
P.S. There is no conference approved literature that could be described as a workbook. Sounds like someone in your area was mixing apples & oranges.
13
One of the unforseen aspects of the pandemic's group and crowd contact control measures is the possible limitation to Twelve Step gatherings. I hope we may be able to 'figure something out' at meetings.
5
@Jane Vavra Jolly,
Very important point! Videoconferencing and teleconferencing can help fill that gap until the pandemic passes.
It's possible that experience with using these vehicles will be a good rehearsal for even more disruptive events in the future. COVID-19 may be only the first...
5
@Jane Vavra Jolly Well, I'll still be going to one or two meetings a week.
I just won't be holding anyone's hand, or doing the smooch on the cheek to say hello to friends; and otherwise, not getting too physically close to anyone.
Then I'll practice the recommended hand-cleaning and touch-avoidance one's face, mouth, nose, eyes precautions. It does take conscious effort not to touch our faces frequently for some primal reason.
I'm not ready to shut myself away entirely in my apartment just yet! :)
I was struck by the phrase "alcohol use disorder". Is this the politically correct replacement for the word "alcoholic"? Many of the commenters describe themselves as alcoholics or drunks, so why use a fancy phrase that may conceal more than it reveals?
9
Good question - My experience with alcohol was that I didn’t experience physical dependence, and could go for weeks drinking in moderation. However, triggers such as social anxiety, stress, depression, etc. could easily lead to “going off the rails” and binge drinking to excess. I eventually realized that it was easier/healthier/safer to stop drinking entirely. Calling myself an “alcoholic” or “drunk” feels like a loaded term implying I can’t be in a bar or talk about alcohol without being in danger of waking up drunk in a dumpster the next morning. Alcohol use disorder feels like a more accurate reflection of my relationship to alcohol. I think the word also opens up a more holistic conversation about how and why we use alcohol without putting people on the defensive or having them tune out of the conversation because they don’t relate to the word “alcoholic” as portrayed in popular culture.
12
Old labels tie people to stock portrayals, stereotypes and blanket assumptions even for those who refer to themselves as such. “Substance/alcohol use disorder” defines the malaise not the person. 
6
I think it’s because the word “alcoholic” is not a recognized medical term.
5
If you’re an alcoholic, there’s no *right* way to drink.
If you want to recover, there’s no *wrong* way to get there.
AA has worked for me for 34 years, with help from mental help professionals for other aspects of my problems.
Happy to see this research showing what many of us have seen over the years-a fair share of people do stay sober in AA.
Try lots of groups when you come in, look for stories with which you can identify.
Keep coming back.
32
“Often the cure for addiction is community” AA has plenty of it at a wonderful price
15
I have not had a drink for 2 years while attending AA meetings and have worked for the past 9 years as a counselor in methadone treatment. So in my mid-60’s, I have had quite the experience of addiction/recovery/AA/12 Step/MAT. On the personal level, I never was addicted to ETOH but was gathering steam for a strong run at it until a couple of years ago when an incident resulted in me confronting (with the assistance of my family) the role of ETOH in my life. I began attending AA meeting 5-6 times per week for about 12-14 months but due to the demands of my work, that has been reduced to 2 times a week at a 0700 meeting on Saturday and Sunday. I am also an avowed atheist who realized he did not believe in the traditional “higher power” while attending a church camp in high school. Many of those with whom I work as a counselor shared their AA experiences. I had also attended a week-long training at the Betty Ford Center while working in another field where I witnessed the 12-step program first-hand and was even given a copy of the Big Book which I did read. When I began attending meetings, I felt that I was an imposter based on what so many others there had experienced and overcome in their work toward sobriety. But the human connection was so strong that I stayed. The people in the “rooms” are the program. The quotes and sayings from the all the literature provide interesting connections across so many demographics as well as almost endless variations on recovery.
14
Just so everyone knows, there is a 12 step program for food addiction as well, called Overeaters Anonymous. I weighed 335 pounds (give to take 20) for most of my adult life. I found Overeaters Anonymous 10 and a half years ago, lost over 100 pounds and kept it off...so far. The 12 step approach does require a commitment and continuing treatment in the form of meetings and personal work, but I have breakfast each Sunday with over a dozen men who have lost over 100 pounds and kept it off with guys from 25 to 70 in our ranks. If you know someone with serious food issues, they might want to look into OA. In my experience, it works.
19
An attractive part of AA is their reluctance to make any outlandish claims that the 12 Steps are the only way for an alcoholic to get sober. Though there is deference given to members with long term sobriety, there is no rank or authority that comes with much accumulated time without a drink or drug; as is often, all each sober has is today. The joke in some groups is that the person with the most sobriety is the one who got out of bed first. I'll further convey another cliche from the rooms , which is that AA works the best for those who do it the most, a notion that jibes well with some of the findings described in the article. It may well be that the last gaspers who make to AA are convinced to their own satisfaction of their powerlessness over booze and are very well motivated to pick up the simple tools that the Fellowship provides.
15
Since at least the 90s, in many areas aa is really aa/na. I hope the many cross-addicted folks keep this mind. There are always seats available, I hear.
12
Did this include medication treatment of addiction?! Because those treatments are also very effective.
8
Given that AA is 100% free, why wouldn't someone try this approach first? I am close to someone who tried it. They went to the meetings, got a sponsor, did what their sponsor told them and they have never had another drink since. Grand total price for this was a few hundred dollars in gas to and from meetings over the years and $1 in the donation basket at meetings. Plus they made a lot of new friends. Sure beats spending tens of thousands of dollars for a few weeks in a treatment center and then being turned loose with little to no support network afterwards. To be clear: sometimes treatment centers are the answer, especially if you have a physical addiction that could harm you if you if you stopped using suddenly without proper treatment. You know what though? Even most treatment centers tell their clients to attend AA or NA meetings, both during and after their stay in the treatment center. I could say a lot more but will stop now. Don't listen to the naysayers before giving it a shot. It's free folks.
47
@Marc Bossiere good looking out Mark. I got sober in a non AA program in Tucson over 30 years ago and did just what you said...continued w AA and some other “A’s” there. Still keep going to offer hope to the newcomers to this day and because I still have a desire to not drink, use drugs, or go back to prison. Those newbies that show up need to see that change is possible and those of us that are still changing have the responsibility to freely...key word free-ly pass this message on. Always say it’s much harder to get 30 days than it is to get 30 years. Appreciate your feedback and comment...whatever works...work it.
I chose abstinence in 1991 without AA and am fortunately now totally comfortable with abstinence, so have no good reason to try moderate drinking.
A major point of newer evidence based treatments is that a sizeable portion of people with alcohol use disorder don't have to abstain to successfully moderate their drinking.
While AA is to be congratulated for their long term success, it's important to realize their stance that total abstinence is the only way to go ain't necessarily so.
A majority of college students qualify as alcoholics under AA standards, and a good portion of them are able to choose moderation when they enter the "real world".
8
@Kevin Banker A major point of newer evidence based treatments is that a sizeable portion of people with alcohol use disorder don't have to abstain to successfully moderate their drinking.
Unsupported citation just serves to further the myth that alcoholics can learn to be moderate drinkers. People who drink too much and are not alcoholics can do so. True alcoholics cannot.
18
@Kevin Banker
"A majority of college students qualify as alcoholics under AA standards, and a good portion of them are able to choose moderation when they enter the "real world"."
That is literally the reverse of what AA defines alcoholism as. If you can moderate for whatever reason you are not an alcoholic, period.
5
@magicisnotreal
No one mentioned that during the 1 AA meeting I attended as a guest of a family member who was helped, when I had been sober for 2 years.
It seemed that anyone who introduced themself as an alcoholic was accepted as one.
AA is the gold standard of dealing with addiction.
Perhaps much of the opposition comes from the simple fact that it is free and no one makes a dime from it.
I recommend patients with substance abuse issues use 12 step programs of which AA is the original.
I especially like that at its basis it is people supporting others with common problems.
49
If nothing else, it provides people with support, community, and makes people claim responsibility for their choices and actions.
32
There is little info here about what the comparison treatment was. I have seen evidence that medication-based treatments and treatments that do not require total abstinence, such as the Finnish Sinclair are more effective than AA in helping people.
8
I am a physician and a colleague who was an expert in drug abuse told me once that there were two ways for alcoholics to stop drinking: attend AA or hope for a miracle.
And there are many self help groups to treat a variety of problems. AA is one of the rare ones that has never sought to make a buck off of its name so it has never had any conflict in choosing whom it was trying to help.
65
@Steve I applaud your colleague. I suspect a more complete answer might be: [for the [motivated] alcoholic to] attend a competent, professional, medically based treatment program for a month or so, and THEN- in order to STAY STOPPED- go to AA as a matter of course and happiness.I realize that the financial aspects of medical treatment in the initial phases of recovery, preclude this ideal method. Hence the [again-motivated] alcoholic CAN make it with AA alone, and has for many years. Thank You
2
I’m an alky, sober almost 14 years. Man, A.A. would have made me run the other way! That said, my best friend, now sober 9 years, surely would have died were it not for A.A. — and for that, I’m forever grateful.
Different folks! Different strokes!
(PS — ask any recovering alky about the best day of their lives!)
20
Last Friday was 29 years to the day when I walked into my first meeting --
When I walked in - they quoted Bette Davis and told me - "Fasten you seat belts, it's going to be a bumpy night" --
And they were right --
It has been a bumpy night (ride) - with lots of ups and downs along the way - but it's certainly been real learning how to deal with and accept life on life's terms --
The great lesson I learned in ameeting one day was - "It's not what you drink - or how much of it you drink - it's WHY you drink" --
I think that's what makes people any uncomfortable about facing their own drinking issues --
And -
As far as having problems with certain elements of the meetings - an old-timer once gave me a bit of good AA wisdom -
He said - "If you like everyone you know in AA, it means you're not going to enough meetings" --
And I would like to add my voice to the other commenters so far who have expressed their gratitude for AA -
Like they said - AA saved my life...
52
With all due respect to the authors of the article, and to those who have worked so hard conducting the studies, I could have saved you all some time!
AA saved my life. I've seen it save so many others. That's all I need to know. Are you having trouble with alcohol? Go to a meeting - you'll see for yourself!
If you really want to get the full effect, try going to 90 meetings in 90 days. If you want to stop, that's the place to do it.
33
It was good to see this article on the efficacy of AA. But as you say, 'one size does not fit all.' Many alcoholics and addicts achiever sobriety without AA. Maybe your headline should have noted this. Kinds and numbers of 'bottoms' is another variable that should be quantified if possible.
There is a cost related to attaining and maintaining sobriety in AA, albeit not a monetary one. Journeying through the 12 Steps with others is a 'one day at a time' commitment to 'work the program' to the best of our ability and the language in the 'Big Book', (AA's basic text) bears this out. The BB is full of phrases such as, 'thoroughly followed our path,' 'go to any lengths,' 'let go absolutely,' etc., and it indicates the cost is a human one: time, such as going to lots of meetings; reading the literature; learning and practicing honesty and trust; willingness and openness to bond with others; applying the 12 Steps to all areas of our life, and many more. If one follows this, one day at a time, we have a good chance of not picking up that first drink or drug.
When I first walked in the doors of AA, these were incomprehensible. Over time and after continued relapses, I felt I had no choice, stopped arguing and followed suggestions. The application of the guidance in AA bore me great fruit: sobriety and tools for a better way of life.
20
@Malachy and Fenix Grange Many alcoholics get dry without AA. They don't get sober.
5
As a recovered alcoholic who's been to AA I can say that it is only better than doing nothing or trying to quit drinking on your own.
AA does absolutely nothing to help treat the underlying psychological issues that cause alcoholism. Rehab isn't the answer either. Addicts need real psychological treatment with psychiatrists and psychologists but most people's insurance doesn't adequately cover those costs.
My experience is that AA is just another crutch that leaves its cult-like followers as 12-step zombies without the life skills they desperately need.
25
@Liam
As a therapist I agree w you about the value to understand the psychological drivers of alcohol abuse.
AA supports people’s daily life effort to be alcohol free.
As humans w depth and complexity, knowing one’s vulnerabilities which increase the chance to abuse alcohol, opens many new doors to living w increased confidence across all life areas.
This is the enhancement to AA which therapy offers.
8
@Liam It doesn't claim to do ANY of that. Literally the only thing it claims to do is help someone stop drinking if they follow the steps as laid out. Literally all it says or promises. They also don't give you a new car there, or a new house. That's another thing that's bad about it...
8
@Liam I reckon that you missed the point when you were in AA. Almost anyone can stop drinking, at least temporarily. It's staying stopped, despite the wreckage that alcohol wreaks on our lives, that is the challenge. And millions of us sober people did that by learning a new way of life, based on the principles of AA. These include honesty, integrity, responsibility, and humility. You're quite wrong to say that AA does nothing to help with the underlying issues that cause alcoholism. It is true that some people need additional outside help, and AA does not discourage that (AA has no opinion on outside issues). But it certainly has helped many many people with the underlying issues that caused their alcoholism.
8
The article’s title is misleading. Its claim is in regard to abstinence from alcoholic beverages. Which is an important goal, when and if that is the targeted goal.
A more recent goal, since the AIDS/HiV epidemic is the more generic goal of “harm reduction.״ To self. To others. To ones’s neighborhood and community. Reducing and preventing types of harm. Medical-physical; which limits the spread of infection. The current pandemic, for example, also focuses on reducing harm. Sterile needle exchanges all too often “ represented” this approach, as many substance users continued their drug use for the range of functions which it met.Harm reduction can be, and is, much more complex, nuanced and multidimensional than just getting sterile needles in exchange for “ dirty” needles.
A more general goal is that of wellbeing, which is a code for a
 person recovering types levels and qualities of healthy coping adaptation and functioning in their range of identities, roles, behaviors In diverse environments, settings, networks outcomes, etc. Abstaining, using or harming self and others, or not, is part of who and what they are. Aren’t. May never BE. Are yet to become. Wellbeing, a description of a word, term, outcome needs ongoing delineation.
One can be abstinent, 12 stepper, or not, and still harm self and others, as well as not achieving any level of actual and experienced wellbeing. One can decrease/cease harm to self and others and also not experience wellbeing. The goal?
3
If you sit through a few AA meetings you realize that what you are seeing, when it is stripped to its essentials, is group therapy.
Group therapy is used in psych units because it works. It isn't and should not be the only thing used, but it does work. Hearing some perfect stranger telling you what is happening to him, and seeing that it is the same thing happening to you can be quite an eye opener.
There are a lot of mental issues involved in alcoholism, though from what I have seen the most common seems to be some form of long-standing depression. Get a grip on that and your chances of staying off the sauce improve immensely.
As for the God talk, make your Higher Power whatever you like. I never did like the Cult of the Sky God much, myself.
And as for One Day At A Time, carve out time chunks you can handle. One hour at a time, if that is what it takes. The idea is to break the problem up into manageable chunks - don't worry about tomorrow, we aren't there yet. Yesterday is history, it can't be changed. Just worry about today.
There are well characterized patterns in adult children of alcoholics - if you are an ACOA you aren't unique. And you don't have to suffer alone. You will never get a normal life (but then, what is normal?) but you can heal and you can have some fun in this world.
Good luck, stay sober today, worry about tomorrow when it happens, and remember - we have all been there. You are not alone.
20
It's dogma also teaches people to admit they are powerless and must acknowledge some higher power if they are to succeed. Thanks, but no thanks
8
@Topher S Powerless OVER ALCOHOL. That's a big difference. On a deeper level, "surrender" refers to accepting the randomness and unpredictability of life itself. A tough lesson to learn for many people; it goes against everything we learn in growing up ("be a man", "do it yourself", etc), but is a powerful insight.
18
@Topher S
I know the powerlessness thing is very objectionable for many people, but to be fair, "surrender to a higher power" is a core principle of all world religions and mature spiritual practices. It was certainly not invented by AA, nor is it a "dogma." AA is only interested in what works and has no interest in ideology in and of itself. If surrender didn't work, they would have tried something else in the early days.
9
@Topher S Hugher power can be the group or a mountain or literally anything you and your sponsor decide on. It DOES NOT have to be something supernatural.
5
Alcoholics Anonymous saved my life as a young girl ready to go off my 10th floor terrace due to alcohol withdrawal. I had no idea I was in alcohol withdrawal or anything else about the physical or mental consequences I was experiencing after a "big party night." I picked up the phone and asked the operator to connect me to Alcoholics Anonymous while lying on the bathroom floor. A woman answered the phone and after a few questions said to me, "Look, honey, if you want to drink, that's your business ...if you want to quit, that's ours. So what's it gonna be?" Lying on my bathroom floor in alcohol withdrawal, I had to think about that for a few minutes and then said very meekly, "OK, tell me where the meeting is and somebody can take me." In December, I celebrated 41 years of recovery one day at a time with deepest gratitude. If someone is abusing alcohol and drugs, I don't care how they stop, I just know for myself that only through AA have I stayed stopped and am fortunate to have a life I never could have imagined for myself - and a ton of laughs along the way. If someone is finding fault with the "God" aspect of AA - the person will find fault with any form recovery because that person, underneath it all - still wants to drink and use - which is their perogative and frankly, none of my business. AA is a program of attraction - not promotion. The only requirement for membership is a desire to stop drinking. Period.
32
Sixteen years sober now, thanks to AA. The program is not for those who “need” help, it’s only there for those who “want” it. That might be the most lasting takeaway from my years at AA. I learned more about life and more about my own inner issues than from all the schools and churches I ever belonged to. I was never judged, never criticized, but always listened to with patience and kindness that was my experience. If you want help with your alcoholism, just reach out.
20
I think it's amusing and silly how aggressively people are against AA, when AA makes no effort to promote itself or force itself on others. It's not like AA is out there sending spam emails, doing robocalls or TV ads, or anywhere else. If you don't want to do AA, don't. It's as simple as that. And if you go and then decide it's not for you, no one will hunt you down to drag you back - because unlike almost everything else in this world today, no phone number, address, email address, or name are required to go.
It seems those treatment centers with just as high, or higher, relapse rates - but charging $30K+/month - should be the object of people's ire, not a free program that makes no effort to force itself on anyone.
32
@Kas
One reason people are against it is because they are mandated to be there.
As it says in the article, a lot of those who are successful in aa choose to be there- which will always influence the efficacy. So while aa itself doesn’t advertise etc, there are still folks who don’t want to go, but have to.
8
@Kas
Judges do plenty of promoting of AA
5
@Kevin Banker
I'm pretty sure you have to get arrested for an alcohol-related crime like a DUI for a judge to 'promote' AA
I know plenty of folks who chose being 'mandated' to AA over 90 days in jail - it's not like the legal system is scooping up random citizens at the grocery store checkout and forcing them to go to AA.
7
Clean and sober for 31 years. Meetings reinforce the habit of sobriety, the steps are a practice of constant self-discovery, and the traditions are guidelines for interacting with the rest of the world. Some people get hung up on the higher power thing. For me, G.O.D. represents Good Orderly Direction and the experience, strength and hope of my fellow drunks.
13
@Partly Sunny. The "acronym" G.O.D. can also be Group Of Drunks, Great Out Doors, and Gift Of Desperation.
In AA, we get to have our own concept of a higher power. No one has to go to a church, temple, or mosque. It isn't even suggested.
7
@Tam R
That may be a concept too far for people who have a limited view of what god is.
We agree that important aspects of all "the people" who are getting help or would get help from AA are ignored in this article. In my small community and many others, those who feel most comfortable attending AA meetings on a regular basis are straight white cisgender men (in percentages far greater than the demographics of the neighborhood). Where are all the African-American drunks in our town? Why are attendees often forced to choose seating based on outdated binary gender profiles? Any level of ignorance, prejudice, exclusion that exists in a community will also appear in meetings of Alcoholics Anonymous. That is not to mention the literature, which is treated as gospel and maintains all the greatest hits of bias and inequality from the 1930's, 40's and 50's. Having said that, AA meetings do provide a sort of laboratory where you can practice dealing with the same attitudes you find in the street but with lower stakes, like a dress rehearsal for real life.
6
@LD All you need to start your own meeting is a couple of other people who want to have a meeting too. And of course the coffee pot and a "resentment" are actually optional. If your area doesn't have meetings you like, start one of your own. And do remember that although the "Big Book"s first 164 pages have not been updated since it was first published, the stories in the back certainly have, and are more inclusive. AA also has a wide variety of supplemental literature (pamphlets, etc.) that are definitely tailored to people other than "straight white cisgender men".
I don't go to any meetings where men and women "are forced to choose seating based on outdated binary gender profiles", nor any where it is even customary. There are definitely meetings for the LGTBQ community.
5
@LD I'm the only straight white cisgender man in my home Al-Anon group. The other male is a 31-year white gay man, the remainder white women. I don't know why there aren't any black or Hispanic people attending as the city that our meeting takes place is diverse. All I know is when I finally decided to get help I sought the group that was the most convenient to attend based on my work/home schedule. All I have ever hear is member's experiences in dealing with an alcoholic friend or loved one.
3
I drank for about twenty-five or more years. Nothing helped and I hated AA. I was diagnosed with bi-polar, medicated, and just like that , I stopped drinking. I simply don’t want it and never think about it. How many more out there are like me—suffering with a undiagnosed mental illness?
19
This saved a family member's life- that's enough for me.
9
It is true- this fellowship works. It is not a cult- there are people here that care and understand. Doctors don’t work; psychiatrists don’t; meds don’t. These fellowship do
5
@BEB please stop perpetuating this dogma. Getting sober and staying sober often requires therapeutic work combined with support through various recovery groups, safe family, friends, and sometimes medication
AA does not, and will never, take the place of professional & medical help.
AA for me is simple.
Don’t drink and go to meetings.
Everything else will be what it will be.
9
Though not a member I know some who are and if they find a “good” group (one that has members to whom the participant can relate), success can be achieved. In addition many throw their own sober parties at times when people generally celebrate (Halloween, New Year’s Eve, Super Bowl to name a few).
3
"Alcohol use disorder" is an awful euphemism. Why do we barbarize our language in this way?
2
Ask the American Psychiatric Association. It replaced the terms alcohol dependence and alcohol abuse which suggested a dichotomy and seemed to ignore the fact there is a continuum or spectrum.
4
@Mark
Alcoholism is the standard word. There is no sense in replacing it.
1
It is quite disturbing that an approach designed by two alcoholics almost 80 years ago cannot be improved upon by current experts.
7
@Travelers Actually I would say that it is a testament to how thoroughly Bill W and Dr Bob understood a problem that has plagued humanity since the year dot.
5
The 12-steps work for those in Al-Anon, as well, even for atheists, like me. "God" is shorthand for a mental construct that allows me to let go of the illusion that I can control anything other than my own behavior. I'm not the center of the universe and that's *freeing*. It isn't all up to me. By focusing on myself and managing my emotional sobriety, I can leave all the drama and false responsibility for others behind.
15
Thank you for this. AA has worked for me for 30 years of continuous sobriety. I never bought in to the higher power part beyond the way I might see a guitar teacher as one: she knows how to play, I don't. She tells me where to put my fingers, I practice. My fingers toughen, it gets easier – Voilà! I'm playing Little Wing almost as well as Jimi (doesn't have to be perfect).
That's the spiritual experience. (Change "how do I play guitar?" to "how do I stay sober?"....) To keep it all I have to do is teach anybody else who asks me for guidance. For free. We don't know each other's last names at meetings, yet we can safely examine and jettison the darkest parts of our suffering. If you don't dig it, leave anytime, nobody chases you down. I'd change the name to Almost Anarchy. I'd be dead without it.
15
We need a similar treatment approach for todays self-harming/suicidal youth. I have a program Id like to propose but I dont know where to take it.
2
@Nate it exists, it’s called ACA adultchildren.org
2
@Nate I don't have a suggestion for you, but that's a great idea. Persist, and good luck with it.
1
AA almost killed me. I found myself involved with an anti-psychiatry group that shunned me when I sought medical treatment for PTSD and depression. I cannot, I’m good faith, recommend the program to anybody.
More research needs to be done into the Pacific Group and the Atlantic Group. Both have been described as cultish.
Likewise, sexual abuse and harassment is endemic in AA. It’s not safe for LGBTQ people (like myself) or women, in general.
I guess it’s easier to characterize it as “effective” because it’s free than actually provide a real critique of this outdated, Christian, patriarchal organization. Tells you far more about our society than it does AA.
Stay away from AA.
13
@Steve So sorry you had such terrible experiences in AA. I attend Al-anon meetings, and one of the things we read aloud each week at the start of each meeting is a reminder that we don't give each other advice. It goes without saying that we don't judge. The members of my group embrace the idea that people make various choices in dealing with addicted family members; what's right for me may not be right for another family. I would hope AA meetings share a similar philosophy; it's sad that yours did not.
6
@Steve im so sorry to hear this.
It’s not a safe place for all. I have multiple friends who were stalked and sexually assaulted by “old timers”. The lack of authority is problematic, as is the way old timers are seen as infallible.
6
@Steve I'm sorry too that you feel this way. The truth is that AA is an organization where ordinary alcoholics help each other. We aren't professional alcoholism counselors with industry-regulated standards of conduct. You don't have to be a perfect person to attend. So to the extent that social and other problems exist outside of AA, they are going to exist in AA. AA membership must, by definition, reflect society as a whole to some extent. There are single sex meetings, there are groups for LGBTQ members, there are groups for speakers of languages other than English, and you are free to start your own AA group if you aren't comfortable in any of the groups you've already tried. In my experience as a sober woman, sexual abuse and harassment is no more "endemic" in AA than anywhere else; in fact I would say that it is less so in AA than in the wider community.
As for your experience with an AA group where the members shunned psychiatry, I would, if I were there, challenge that very strongly, because from the beginning, AA has asserted that it has no opinion on outside issues, including psych meds or talk therapy, and it definitely publishes guidance saying that you should do what your doctor says is a sound treatment. AA members and groups that say otherwise are not in alignment with AA as a whole.
Also, I think there are many AA members who share your dislike for the direction that the Pacific and Atlantic groups have taken.
7
Reading this article just confirms what most of us in AA knew all along, it works if you work it. And for anyone considering AA but isn't really sure - if you don't believe what you hear, believe what you see.
8
I can only offer this: AA and its hard-working members gave me back a family member.
8
deb, alcoholic/addict - thanks to aa, i'll be 30 years sober on 3.17.20 ...
15
Read the Allen Carr book. I've been to therapy and AA. Read the Allen Carr book.
2
@A. R.
Humm, I thought the Carr book was only for smokers
Alcohol is responsible worldwide for 10x the number of deaths of all illicit drugs combined? That’s a crisis! Why is alcohol abuse not covered extensively in the media with a stat like that? That’s unbelievable! What a devastating drug.
6
@Parker because it makes so much money for corporations and governments through taxes.
2
@Parker Well we already tried prohibition and--old news bulletin!--it was a flop. Alcohol is, sadly, deeply ingrained in nearly every society on Earth.
2
AS a dedicated AA member celebrating 32 years of happy sobriety this week all I can offer is "It works if you work at it"
9
As an atheist it wasn’t for me. I just couldn’t sit in a church and thumb my nose at peoples beliefs. One day at a time works great.
11
AA is a simple program. Follow the old timers in the room, have a long list of phone numbers, find a sponsor and for the first 6 months do nothing but listen. Keep the cotton out of your ears and in your mouth. Took me 6 months to raise my hand and ID myself as an alcoholic.
It works if you work it.
15
@Sarah thank you for sharing.
hi, my name is fred and i am an alcoholic..one who has been sober for nearly thirty-four years and who found AA something akin to useless...i entered rehab in 1986 and they rendered a service i could not provide myself...a disruption of the cycle of withdrawal and use...credit where it is due...i attended thirteen AA meetings while at rehab and was disturbed by their insistence i admit i was "powerless over alcohol"...nonsense... i am sober because i did the difficult work of turning my addictive personality against the addiction...a change of habit that took two years, had some white knuckle moments, and provided the knowledge that overcoming an addiction is not a communal effort...it is in the hands of the addict and their hands alone...AA, therapists, psychoanalysts...none of them have answers...those are interior landscapes...if AA works for you by all means use it...anything that works is useful in this...i found it an impediment...self-cures are all there is.
3
Glad to see this research that supports my experience. I sobered up at 20 with the help of AA. Thirty years later I still attend and have known hundreds of people who've recovered the same way. I belong to a meeting for agnostics. Most our members are powerhouse women. The program isn't perfect but it's flexible, free, and much more customizable than you might think.
7
Sure AA doesn't guarantee recovery, but the knowledge it gives you does guarantee to make your next drink unenjoyable.
10
sober 42 years...AA works.
AA is in more countries than the United Nations.
It has a Big Book that has been translated in 75 different languages...because it is filled with "great truths that mankind has known for ages"...it also has no loopholes for the alcoholic.
In AA "you will find a fellowship you crave". May you join us as you tread the journey to a "Happy destiny"
8
As a bit of an aside, try to find more riveting tales of debauchery for a paltry few dollars. You can't!
10
I despise AA. It is a cult. Joining a cult should not be a recommended way of stopping excessive drinking. "That one is God, may you find Him now!" still rings in my ears even as I read this article. "God?" The simplest answer in all of this is that it is simply the extensive network of meetings available in every city, town, burg and church basement in the country, which, if it removed the "God" nonsense, would still work, and not turn off so many people who try it but do not like it. I see a fundamental problem with using fact based thinking and decision making in the face of a required belief in a supernatural, invisible, imaginary friend, which is the required belief system in AA. No matter how you want to rationalize it, AA is a religious cult and I resist using it for anything anymore than I would a meeting of witch doctors from the Congo who tried to cure me using rattles, drums, and mystic chants, much like the Catholic Church and all of the organized religions do. AA ties itself in knots to overcome any resistance to its thinking by making the member feel bad for not accepting the cult's religious beliefs. I despise AA. It will never stop.
5
@Jim You seem to have missed the part where, in AA, we get to define what our higher power is, and it need not be called "God". That word, "God", is definitely shorthand for whatever your higher power might be, whether it is the AA group itself, or "love energy", or some other power that you choose to believe in the goodness of. There is no requirement to believe in a deity. None. And it is at best, ill-informed, but at worst, dishonest, of you to assert that AA requires a belief in God. "The only requirement for membership is a desire to stop drinking". That is a central tenet of AA.
5
AA is THE HUMAN CONNECTION! Thanks!
4
The twelve traditions protecting AA from itself are equally as miraculous as the 12 steps. Paraphrasing:
The only purpose is to help other alcoholics.
It is not a religious program.
You are a member if you say you are.
“God” is whatever you think it is.
There are no rules, only suggestions.
There are no leaders or spokespersons.
There is no accumulation of money.
Nobody gets paid for service.
There are no ads or endorsement deals.
Only you can disclose your own membership.
I use the free “meeting guide” app to locate meetings.
17
Alcoholics Anonymous combines the confessional and the psychological and binds with community and simple universal rules.
4
AA works if you are ready to quit. Really ready to quit. Ready to do anything to get your life back. If your not at that point, nothing will work.
12
There is an unwholesome religious element in AA. It tries to foster dependence on a loosely-defined notion of God instead of fostering self-awareness and self-control.
An AA program without the pseudo-religious element might be more effective.
4
@AynRant It would appear that, for alcoholics, their own self-awareness and self-control did not work. AA does foster self-awareness, and self control, in company with others. If one wants AA to be a "religious" program, it certainly can be; if not, AA won't be. AA is as religious or not as the individual attending AA wants it to be. Though I am not religious by any stretch of the imagination, I would not necessarily define what you describe as a religious element as unwholesome.
7
@AynRant You're welcome to start one. All it takes is a coffee pot, and even that is optional.
4
Assuming that abstinence based recovery is the gold standard by which success should be measured is misguided at best and damaging and dismissive at worst. By not looking at other forms of recovery including harm reduction, moderation management, as well as other, science based support groups such as SMART recovery, this study has shown that it clearly has no understanding of what recovery actually means.
Coercing people into attending AA meetings as part of their treatment and presenting it as the only option for people looking for support with their substance use will, of course, lead to a higher number of people engaging with it and potentially finding success. What should be noted is that only up to 37% of people involved with AA engage in abstinence based recovery. Once clinicians, researchers, and others recognize that abstinence based recovery is not the only, or even best, option, only then can the remaining 63% of people who do not find AA beneficial begin to find the support that works best for them.
It's also unfortunate that this article and study fail to discuss the sexism, misogyny, and coercion that take place within AA meetings as well as the forced spirituality that is pushed onto people.
For people who find AA beneficial, that's great, and it's time to start looking beyond this recovery model as the only way to find success and to stop defining success in addressing substance use as abstinence.
6
Although I consider myself a border line alcoholic, my primary disease is overeating. In 1995 I joined Overeaters Anonymous and it changed my life. Following the "12 Steps" gave me a clear and easy to follow path. I seldom formally "make amends" now when I transgress, which I still sometimes do, but I do my best to follow the right path. My present goal is to learn to love myself. It is a lifelong quest which I will never fully achieve, but it is definitely a path worth pursuing. My sponsor was an alcoholic and he became one of my closest friends. God Bless You, Sam.
11
Study supports what has been known for a long time by family members and people in the employee assistance and treatment community. That said we still need outpatient and in-house social model programs, recovery communities and cognitive behavioral therapy as long as they support and expect AA commitment. Those in recovery can use all the help they can get as well as their loved ones.
5
Most clinicians have known the efficacy of AA over medicalized interventions. It is also true that there are some people for whom AA is not a good fit- who stop drinking after a personal experience (including but not always 'hitting bottom'). Threats to an important relationship can be a big motivator as well as positive enticements.
Motivational Interviewing has grown popular in MD-patient encounters where destructive behaviors compromise health. This is surely better than the old school use of dire warnings & bullying.
More complex is the nuance of who stays sober vs who relapses. It seems likely for there to be more than one effort to stop- and this includes smoking, porn, gambling and other compulsive or addictive activities.
Like a doula for child birth, a sponsor for alcoholism does save costs while improving outcome.
6
Two comments:
1. The review did not include any studies comparing AA to naltrexone, only other forms of non-medical treatments. There is some reason to think naltrexone might be better than anything at helping alcoholics keep their drinking within bounds.
2. By making duration of complete abstinence the measure of success, the authors accepted AA’s own definition of success and possibly introduced a bias in favor of AA. What if there were a treatment - e.g. naltrexone - that allowed alcoholics to live healthy, productive lives while continuing to consume moderate amounts of alcohol? According to the outcome measures examined in this review, AA would be more “successful” than such a treatment without necessarily doing a better job of improving alcoholics’ lives.
25
@Aaron Walton Why is it so important to keep on drinking at all? I'm all for meds that help relieve craving but it seems like the mental obsession with bottles may be deeper than the physical stuff. I just don't get it.
10
@Aaron Walton
An alcoholic by definition cannot drink any amount of alcohol without bad outcome. Thus regardless of how you do it if you can adjust your behavior and change how you drink you are not an alcoholic. That assumes the adjustment is comfortable and easy. If it is just as much of a struggle as drinking was.....
3
There's too much money to be made in the addiction treatment system to embrace options that actually work. One of those with a phenomenal success rate is the Sinclair method. My best friend at my consistent urging finally tried the Sinclair method over a year and a half ago. It was transformative. Not only did his binge drinking vanish, he actually drinks in moderation like a non-alchoholic. There is plenty of information on this from multiple sources. So do you or someone you love want to get better permanently?
3
@Karl Yuhas
There is a difference between binge drinking and being an alcoholic. Alcoholics have a craving. A binge drinker might only have alcohol once a week or 2 weeks..
@Karl Yuhas I should like a follow-up on your "best friend", say 3, 5, 10 years- to see how his 'moderation' program is going. "Cheers"
1
Not surprising. What will be surprising is if the medical-industrial complex will agree and stop their high priced less effective treatments.
Not very likely in our for-profit medical industry.
8
I'm guessing other 12-step programs like Narcotics Anonymous and Overeaters Anonymous are equally effective. You don't need to be religious or believe in a higher power for it to work since it is the support of other people which makes these programs effective. The bottom line is that people need people and we're stronger together than apart.
20
Another meaning of AA is 'absolute abstinence', one day at a time. It is, as I and many others see it, common sense that addicts fare poorly so long as they continue to use problematic substances to any extent at all.
The peer-support and character-(re)building aspects of this program provide a structure, and ordered guideline for personal rebirth, in the context of self, family, employer, community.
There are surely other roads, but this is one open to all.
19
AA works but I suspect it would help lots more people if AA would lose the "God" part of the program.
I got sober in AA 21 years ago and I owe my life since then to AA and, to me, it's most important founding principle: When all else fails, one alcoholic helping another works. There are other critical parts to the AA formula for success outlined in the 12 steps, including a higher power.
Yeah, you can pick a doorknob if you want, but most AAs chuckle about that. Most believe a Supreme Being is taking their craving away, and, although you can find groups that are less dogmatic, it's based on religion. AA founders Bill and Bob were Christians.
Anyway, after 911 when the "praise the lord and pass the ammunition" crowd started to feel their oats in and out of AA rooms, I exited.
I stayed sober by continuing to connect often enough with a Group Of Drunks (G.O.D.) who work an honest, humble program minus any hint of religion. I'm still sober -- though I do fall off the Ben & Jerry's wagon now and again.
33
@Tony Bickert I know several AA people who aren't believers but for whom this is not a problem.
3
@John , So do I, John. I'm just not one of them. :)
3
As the son of a "functional" alcoholic I lived with the consequences. My father never went to A.A. Meetings, after all his episodes were at home, in hid den, and on holidays when he didn't have to work. He did get up and go to work and managed to stay off-the-booze when necessary. He could not accept the basic premise that "HE" was an alcoholic.
I was up close and personal dealing with addictive behavior and I don't drink alcohol because I know the damage it can do.
From my perspective the problem with the alternates to A.A. is that they seem to promise a "cure" which tends to promote the idea that you become "normal" and can be just like everyone else and have those social alcoholic beverages.
My father didn't like A.A. for two reasons - he would have to admit that he has a problem and accept that there is no cure for the addictive behavior only self-management that requires a life-long commitment to sobriety. Perhaps if he could have committed I might be able to answer the medical question that is always asked: "What was your father's health when he was your age?" My response, at 72 years old is: "He was already dead for 20 years." That wasn't the worst, the worst was watching my mother and sister enabling his addiction by ignoring and justifying it. That is why I don't drink and divorced my family when I was 30.
15
I say whatever works! I had been a daily drinker for the last five years, and have drank regularly my entire adult life. I quit for January this year. Am 49 and I have never felt better. Healthier, sleeping better, looking better (skin and eyes), lost 8 pounds so far. My outlook changed for the better. I think all the money in alcohol is involved in keeping us addicted. I am taking it one step at a time, and as of now hope and plan to never drink again. It poisoned my body and affected my brain, all of that is now very clear to me. I don't trust even small amounts to affect my health.
24
@Sadie
Go! You go, Sadie!
7
@Sadie
Good luck!
2
@Sadie :
best of luck to you!!!
2
I've known people who have had good results over a period of years attending AA meetings. Other people have not. It depends a great deal on whether you can accept or work around the religious connotation of turning your life over to a "Higher Power". Some people have said they regard AA itself, rather than a supreme being, as the higher power, although that seems to stretch the point a bit.
4
@gesneri I don't think it's such a stretch. AA, that is the group, may very well be the higher power. Any one who took Sociology 101 is familiar with the idea that a group is more than the sum of the individuals it it.
17
I just celebrated 15 years of sobriety on Mar 9. I am grateful to AA for its structure and its practicality. I have been in meetings in the Northeast, in the wealthiest communities of Silicon Valley, in the deep Bible Belt conservative south and in the suburbs of the nation's capital. The friendships and support from the meetings have changed my life for the better. There is no need to fight its principals or "prove" its effectiveness. Please use AA if it works for you, if not , grace to you as you seek alternatives. Peace to all. One Day at a Time.
45
@Richard F
Salud!
2
Years ago, a man I knew tried AA and found it "boring". His doctor sent him to a psychiatrist, who prescribed Antabuse. He wore a medic alert bracelet that said alcohol could be life-threatening, and I never saw him drink again. But he sure went through a lot of Cokes.
6
Thank you Mr. Frakt and Mr. Carroll. And once again, thank you NYT. I am not surprised by the report of the Cochrane Collaboration.
I am an alumni of Alanon, AA's sister/brother program for the family and friends of the alcoholic. We are every bit as much a victim of alcoholism as our alcoholic friends and relatives. For all intent and purposes the Alanon program is the same as the AA program, except it has a different audience.
My testimony is that Alanon saved my life. I was on the same death march as my alcoholic, addicted, relative except I didn't realize it and I didn't drink.
All I can say is THANK YOU Alanon and indirectly thank you AA.
18
@Walt Lersch
Glad to see this here! Grateful member.
2
AA works for so many and that's life giving no matter what - no criticism here. But why aren't there more transparent studies and solid reportage about how Big Alcohol targets their marketing towards women and low income developing countries? Alcohol is toxic to every body. It's poison. It's only matter of time before it has its tobacco moment, a time that undoubtedly the alcohol industry will do its utmost to forestall, by any means necessary.
7
@Alice - I couldn't agree more. Interestingly, as the wife of a dead to rights alcoholic -- I justified my own issues with alcohol by comparing myself to him -- and thinking "I'm as bad as he is" - it wasn't until I started reading and educating myself that I realized that alcohol is bad for everyone -- and it's a little crazy to blame the person -- rather than the substance. I'm not in favor of prohibition - it didn't work the first time -- lol -- but I think more people need to realize the toll alcohol takes -- even if they don't think they are a problem drinker. Totally think it's the next big Tobacco
2
This drunk got sober on St. Patrick's Day, 1995 so I'm coming up on 25 years. AA saved my life, gave me a family of soulmates to help and just basically let me rant and rave until I was ready to heal. It worked for me but I know folks for whom it didn't and doesn't. My husband got sober through individual therapy. I also needed lots of outside help: doctors, church, therapy, etc. I would love to see studies that take in those other supports and how they impact recovery. In addition, I also know that there are people who are deeply traumatized or otherwise marginalized for whom the message that they are "powerless" is not one that helps. But AA is a step forward for millions, including myself.
17
AA philosophy is based on simple conclusions: you are not 'responsible' for your addiction, it is a disease. You cannot win against alcoholism alone; you need the support of your group(s) and the belief in a higher power (not necessarily a God) that will give you access to the strength to combat alcoholism. And lastly, it is an on-going struggle as there is no cure. Hence, the notion of meetings. My sponsor has been sober 37 years and attends faithfully. I have been sober for three years after over 60 years of uncontrolled drinking.
It is not an easy path but it is simple. Keep showing up for meetings, keep an open mind, and help others achieve sobriety.
Works for me, thank God.
22
The most important word in a 12-step meeting is the word that forms the foundation of abstinence and recovery.
It is "WE".
The second most important word is "HOPE".
The third most important word is "SURRENDER".
3
For years the medical establishment has thrown shade on AA, because they can't stand not being able to get their greedy hands on the dollars AA people save by voluntarily going to this entirely admirable organization.
8
Ignatz
I disagree with what you write about the medical community. I have been part of that community as a nurse and a nurse practitioner for years. We have always recommended AA and AlAnon to people with alcohol problems. Always.
16
@Ignatz Farquad AA has commitees that meet on a local level with the medical and professional personnel to help in understanding of the common problem. The medical community (unrelated to drug companies, etc) has always been tremendously supportive of AA from its very beginnings, and continues in that support to this day.
3
It took me years to learn something simple: Don't tangle with an opponent that beats you EVERY time. Surrender. I learned that in AA. Signed a grateful recovering alcoholic.
11
I hope the people who have been campaigning against 12-step programs like AA and NA have the good grace to retract their misinformed criticism now that the research is clear.
Ideally, public figures like Penn & Teller--who profited from denigrating AA--will now use their influence to support 12 step programs, assisting people who struggle with the disorder instead of helping sustain their misery.
7
This is really great news. People should start to realize that the substance abuse community is seldom the right answer. Substance abuse is a tremendously difficult problem and dollars will seldom buy an abuser freedom.
1
One thing I've noticed about the AA meetings over the years is huge gender imbalance. I don't see anything about a male bias in this article and am curious if is considered in this study or if it is ignored and the results of this study are only relevant for males.
6
@Rob I think there could be a few reasons for that. It is only recently (in the last decade or so) that alcohol consumption has increased dramatically in women. And this is just observational, but women try to minimize their drinking our of guilt, shame or denial, whereas men are inclined to be more open about it (“got wasted last night” ) Historically, men have been the drinkers - again until recently- and even in deep drinking are less inclined to hide it, so when it becomes unmanageable there is greater acknowledgment. (Often encouraged or forced by the women in the lives.) Having said that, I’ve seen more and more women in AA, and expect there will be more as female alcohol consumption continues to escalate. No drinker escapes that moment when they know it’s a problem. My relationships with women colleagues and friends reveal that women are less honest with themselves and others about it. Maybe societal pressure to avoid being labeled a drunk, or maybe the pressures of modern life that have made booze-fueled girls night out, or “wine o’clock” de rigeur.
2
@Suite 710 @Rob Great comments. Thank you. I think one piece of it that doesn’t get acknowledged often enough is that steps 4-8 can re-traumatize people who have been taught that things like abuse, mental health issues, sexual assault were “their fault.” (Also, women are often far too aware that they are “self-centered.”) Women are more likely to have experienced these traumas, so I strongly believe that this influences who makes it through the steps. There are a few things that could be updated that I think could transform the membership.
Looking at the study, there seems to be no demonstration of an advantage in outcomes to AA. The evidence leans that way but is not conclusive.
AA does offer lower out-of-pocket costs. Hard to say what the outcome would be if all costs, personal and social were considered, including the treatment periods, opportunity and travel costs,
All-in-all, there is a lot of room left for sub-population variability in outcomes and in social costs.
It appears that more research is needed. Also a new headline.
5
Was the SMART Recovery program included in the study? It's a community-based program, free and based on Cognitive Behavioral principles, and doesn't integrate overtly spiritual/Higher Power language. It also offers family and friends support that's analogous to programs that AA offers.
Another difference is that SMART programs allow participant cross talk so that people share their experiences of responses and strategies in facilitated conversation. Also, the narrative of "alcoholic" or addict is contextualized with the basics of cognitive behavior therapy principles, emphasizing agency and techniques for challenging irrational beliefs and non-constructive habits of thinking and response.
The phrase "other treatment programs" doesn't indicate that the SMART Recovery program was considered as a distinct approach-- it differs significantly from group therapy based on CBT, and is distinctive in how it organizes, facilitates, and supports community-based groups (it offfers, for example, publications and workbooks as well as trained facilitators).
Both AA and SMART Recovery are valuable, free, well-resourced programs to engage and support people who've decided to challenge addictive behavior. I'm just curious about what this study revealed about the efficacy of SMART Recovery for people who may be looking for an alternative to AA (if its data allowed for this extrapolation of its comparative analysis).
17
@Tadidino I like the SMART program better, it's more evidence based, scientific and intellectual, AA is good for people that don't care for science and prefer a never ending bunch of mumbo-jumbo, to each their own.
2
@Tadidino Yes. An interesting thing about SMART is that almost everyone there has tried AA (not just stopped into a couple of meetings, but worked the steps with a sponsor, participated for years sometimes). Ultimately, they are in SMART because AA did not fully meet their needs or was a profound philosophical disconnect (and sometimes, especially in the cases of trauma survivors and those with especially severe mental health issues, was harmful). Every time a newcomer to SMART criticizes AA, they are surprised because SMART members suggest they try a different meeting, a different sponsor—don’t give up on AA so easily. This often throws the newcomers who are expecting a shared anti-12 step rant! SMART members encourage each other to work through many paths of recovery: our workbook and CBT in general are awesome, but so are different forms of therapy, medication, lifestyle changes, varieties of spiritual paths, and, yes, for some, AA. One thing SMART has in common with AA: community. I can pick up the phone and text many different people when I want support. We challenge and care for each other. In a culture drenched in alcohol, I agree that it is useful to have a place to go and people in our lives who do not use it. Community is key. For me, for whom AA was not the best option, SMART has been a beautiful thing.
@Tadidino Thank you! I've been plowing through this entire chain of replies hoping to find any mention of support groups other than AA. I know many people who are finding success with programs like SMART (smartrecovery.org) and Recovery Dharma (recoverydharma.org), not infrequently while also participating in AA and working the steps. I'll need to reread the article carefully but I'm not clear whether AA was compared to other support groups or just to more medical-type interventions. My own opinion and experience from participation in AA and other groups is that, as has been suggested in this chain, group support may be as big or bigger than the specifics of a given program for many of those trying to deal with addictive behaviors, and if elements of a given program pose challenges for you, look around - there are other options.
Is it really any more "unethical to prevent people in a control group from attending Alcoholics Anonymous if they wanted to" than it is to prevent people in a different drug study from taking other life saving medication "if they wanted to"? I don't see the difference?
1
I have no doubt that AA works for some people, and I do not want to diminish the experience of those people. However, this article failed to mention a distinguishing characteristic of AA: it is an explicitly religious program that mostly amounts to a rebranding of Christianity. Instead of "God" they say "higher power" but the program amounts to this: pray for God to fix your moral defectiveness (none of the steps have anything to do with alcohol itself, which is why all 12-step programs use the same 12 steps).
It is interesting that the survey itself seemed to shy away from mentioning that AA is a religious program, given the seemingly obvious scientific need to control for the religious background of the subjects of the various studies. That raises a few red flags for me, especially given the presentation (that this is "strong evidence" of AA's effectiveness). Another red flag is the implicit assumption that abstinence is the goal of a substance abuse program -- learning to drink in moderation is a plausible goal, and in fact is the goal of some programs for some patients, making a fair comparison somewhat complex. Again, no mention of this, which I would flag immediately if I were reviewing such a paper.
25
@Ben ... my dear friend Betty was sober for 30 years before she died. She scoffed at the idea of religion but was still an active member of AA. She is one of many people I know that attend AA and are not religious. They take the approach that the group was their higher power, not a religion. So, to say that the program is religious is incorrect.
18
@Ben
You do know, surely, that tjere are numerous agnostics and even atheists who achieved successful recovery within the fellowship of A.A.?
5
As a Buddhist (or atheist) member of Al Anon, nope. No relationship with Christianity is required.
7
This is good news for people with alcohol use disorders and alcohol misuse. But please be clear about the language used in this article. AA is a recovery support group. It is not addiction treatment. While many addiction treatment programs offer a 12-step facilitation approach (i.e. introducing people to AA and the 12-steps) AA is not, in and of itself, "treatment." This is an important distinction. Behavioral health treatment in our country is based on a Western Medical model of assessment, diagnosis, and treatment using evidence-based counseling or therapy approaches like Motivational Interviewing and Cognitive Behavioral Therapy. AA is not a counseling approach. No one in AA gets an assessment or a diagnosis. AA is a group of people who help each other recover from the ravages of addiction. It is important to have some data that demonstrates that AA is helpful to many people, but one of the reasons that it has been so helpful to so many people is because it is not treatment.
22
I used to question AA. I still question some of it. But it has worked well for my son and AL-Anon has been great for my wife and I. Try it before you bash it. It can help bring serenity and sobriety.
33
I am happy to read this. As an member of A.A. and still sober after ten years, this is great news. Those 12 steps really do work.
34
I am glad to see that A.A.'s effectiveness is now being studied. The study compared A.A. to other forms of therapy, which I assume have to be attended by appointment and which have to be paid for - whether by insurance or by the patient. Because of these apparent distinctions, the comparison is not exactly comparing like with like. Leaving that aside, there is no suggestion that the study compared the effectiveness of A.A. with the effectiveness of Medication-Assisted Treatment (MAT) for substance misuse. Effective MAT for alcohol dependence exists. FDA approved Naltrexone is one such medication. It would be interesting to see a comparison of the effectiveness of the A.A. program with the effectiveness of a MAT program. I suggest that medications to treat dependence should be the subject of discussion between any person dependent on alcohol (or other substance) and their physician. I have no doubt that A.A. helps many people - but for others, there are alternative options and these should be discussed and/or offered.
11
This study didn't address medication for alcoholism. There is some evidence that medications which block the receptors from the pleasure effects of alcohol are effective.
16
@Susan B They didn't work for me. AA did.
I stopped drinking when I was diagnosed as bi-polar. After I was medicated I lost all interest in booze and rarely even think about it. That was 10 years ago. There must be others out there who also suffer from mental illness and self-medicate.
29
Good essay, thanks for bring some more clarity and empirical data to what millions already know from first hand information; AA works well for many.
A younger, brilliant brother of mine was an addict, drugs and alcohol. At first he was a very high functioning addict; good job, wife, apartment in Greenwich Village. His was a slow spiral. Eventually he lost wife, job, friends, back teeth, health.
In his late 40's now, a judge upstate gave him a choice. Seek treatment (AA and a few paid counselings) or 30 days in jail for DWI. He went the AA route though at first he would have a few drinks before the meetings (I know). But he started to listen and then to share. He had a lot to share. He got straight and sober, had a traumatic relapse a year later, then got sober again and stayed sober for the next decade.
In that ten year period he mentored young parolees, worked full time as a counselor for mentally handicapped adults including teaching them art and arranging successful shows of their work, broke new ground taking these same folks on wilderness camping trips. Played percussion with two different bands and organized music therapy. Got remarried. At age 57, finally bought a house...
When Dean died on his 58th birthday of complications from his earlier life as an addict, a line of 300 people formed at the funeral home, waiting to say their goodbyes. Dean touched many lives in many ways. AA was a very big part of his story. Thought I would share that. RIP brother.
592
@Bill Cullen, Author :
thanks for sharing....very moving and so sad he couldn't enjoy his "new" life longer.
22
@Bill Cullen, Author: It's a beautiful thing to see someone get sober and use their recovery to help others. Thanks for sharing your brother's story.
13
@Bill Cullen,
The Hand Book of Alcoholism Treatment Approaches statistically normalized 100 studies and AA was 38th worst. Obviously AA misleads and harms a lot of people too.
A lot of people also attended L Ron Hubbard's funeral because its a cult with misleading and needy followers.
AA bashes unwarned newcomers... and so do all aa members when they read the AA preamble and recite the so called AA spiritual axioms at every meeting. AA preamble calls people dishonest when AA does not work for them. AA's core founding axioms claim that "whenever someone is disturbed, they are invariably at fault and they did something based on self will to cause them self to be abused".
The AA program aka [Bill Wilson's medically misreported belladonna hallucinations] is full of total psychological and ethical abuse! not to mention success rate lies, AA books claim 75% success which Bill always knew was a lie when he required AA hospitalization before a newcomer attended early AA meetings. After aaRehab was standard practice Bill just denied AA was legally related to AA/rehab/hospitalization. AA is massive lying malpractice.
This article's "new opinion" of testing basically says more people stay sober when they have been participating in AA for a year - duh! They just throw away people who can't stay sober a year. This same highly deceptive AA math has been opinionated in articles before - under the heavy influence of the 50billion/yr AA rehab lobby.
As an AA member for 30 years, I’ve found that its success has less to do with alcohol abstinence than working the 12 Steps. After a time—and it varies from person to person—emotional sobriety becomes the focus. This may be the reason for its ongoing effectiveness.
67
@Randy Watson
This is the basis for the saying "It's easier to get sober than it is to stay sober". Neither is easy , at all. I know this from experience. But as hard and downright taxing it is to get clean and put a day together, then another, then another, the real challenge, I've found, is showing up everyday in my own life, ready and willing to "do the next right thing". That's where my real sobriety comes from. AA offers many ways to do this, 12 o them in fact.
I've gotten clean many times. I got sober only once. Hopefully, for the last time.
16
I owe my life to AA, and my proverbial "bottom" was not even that dramatic. I simply could not stop on my own. The sense of fellowship, spirituality (not religion), and the program itself (the steps) have not only kept me sober, but have brought me peace of mind in ways that nothing else could. I cannot say enough about the 12 steps - they are something everyone should have an opportunity to experience, alcoholic or not (though most of us only get there once we've become desperate). Still, I'm grateful I got there. It's not easy, but it's all worth it.
58
Friend of Bill for 32 years. Only thing that worked for me. All it cost me was an hour of my time daily for a few years. I am forever grateful to those who showed us the way.
91
AA has been life saving for my 28 year old daughter who is an alcoholic. I am eternally grateful to the legions of members who work tirelessly to help others and who never give up on them. God bless you all.
I want to congratulate every person who wrote in to say how AA has helped them stay sober. I wish you the very best.
After my daughter went down the dark path of addiction, I started reading about the AA philosophy. I think all of us can benefit from doing the steps.
79
Great to read all the comments from Friends of Bill. I know that AA gave my father the tools he needed to spend the last 16 years of his life sober. He (and Alanon) helped me work through the issues that children of alcoholics inherit. It seems that the 12 steps are good for everyone.
108
I learned in college, getting my psych. degree, that 12-step programs are the most effective way to treat alcoholism, but that they have a roughly 50/50 success rate. I also learned that initial research into psychedelic psychotherapy indicated treatment with LSD may be more effective than AA. We learned about why AA works so well (all the factors listed in the article), why it's limited (also written in the article), and how it's being tried with other types of addiction.
Did I take that class in the future? This seems like old news to me.
4
@Andrew Roberts A college education is a wonderful thing, and not something everyone gets. Most Americans still believe addiction disorders are caused by low morals or a failure of willpower.
1
@Andrew Roberts :
the article is based on a new study which utilized a LOT of people (so many studies are far too small to be meaningful).
@Andrew Roberts This study says only a 22-37% success rate, just a bit higher than CBT and something else. I only read the free summary, but it sounds like there is still room to worry about selection bias.
2
For a lot of AA members, the spiritual side of the AA program is hard to distinguish from religion. And they say God keeps them sober.
I have never had a dramatic conversion experience. I tried praying as is often recommended, and even went to church for a while. None of that took hold. I'm still an atheist and still sober after 49 years.
For me the "active ingredients" in the program are the emotional support I get from my fellow AAs and the 12 Steps looked at in a more humanistic way. Do a search for "secular AA" or "atheist AA" and you'll find that quite a few people have revised the steps in the same way that liberal religious people use inclusive language in their prayers.
I also got professional help for depression and have used anti-depressants successfully. Combining AA with other therapy modalities is just fine.
Professional therapy can be very useful, but I really like the fact that, in AA, no one ever asked me for my medical insurance card.
208
It would be nice to see if there are heterogeneous effects (i.e. does AA work better for some types of people than others). To that end, it would be nice to see the Wager and Athey Causal Forest run on this dataset as it may be able to uncover some interesting sources of heterogeneity.
12
They don’t want to control for that because it would show that AA works best for affluent, white, heterosexual cisgender men.
2
Absolutely. Given the sexual harassment/assault I and my sponsees have been on the receiving end of, my guess is AA doesn’t work as well for women.
I have also seen outright racism, hostility toward medical-assisted recovery and sponsors requiring sponsees to get off antidepressants. All of that is why I stopped going.
Still sober, though. 18 years.
3
My husband was called a hopeless alcoholic/addicted in his mid-twenties. He is now close to 40 years sober -- successful in his career and a great family man. He stays active in A.A. and loves it. He has so many fun, kind, smart sober friends.
Families want lasting recovery for their addicted loved ones. We are not interested in the use of fewer drugs (that never lasts) or living with dry drunks (addicts). Alcoholics Anonymous is designed to rehabilitate the addicted person's character and create long-term recovery. In doing so, A.A. produces better members of families, better employees, and better citizens.
126
@lilla victoria
I dealt with a lot of long term sober people who are not "better" in any way except they are not drinking.
The 12 steps and the big Book work. People??? Not so much. You have to be lucky in that department.
5
25 years sober through the grace of AA. Since my last anniversary, I have now been sober more years than I drank.
I thank my lucky stars I found an AA group with some old-timers who knew the program inside and out, and were on to my table-whining and self-delusion. They stayed on me and helped me and hammered me until I finally got it. The program worked for me exactly like they said it would work. I'm one of the lucky ones.
Unfortunately, I have run into many groups around the country which have turned their table talks into religious fiefdoms, and even more groups which do not have anyone present who understands the Big Book or the 7 Traditions - they are flying blind. From my personal experience, the program IS the Big Book. Accept no substitutes! Do not dabble in extraneous matters - everything you need to know is in that book. (I know many people will disagree with me - all I can do is offer my experience, strength and hope.)
31
I have been in AA for 34 years and bless my good luck every day! Getting and staying sober is a journey. Why not join with others and share the way?
36
While AA is clearly labeled as help for alcoholics, its practitioners and many supporters, such as those in the legal system, often overstep the mission. Substance Use Disorder co-occurs with serious confounding mental illness, traumatic histories and unbearable life circumstances which do not remit with another round of 90 meetings in 90 days. Many of us in long term recovery who started in AA have witnessed the disservice to those who do not respond to the social structured, moral configuration of AA. Prescribing AA as a standalone treatment without a full integrated assessment dooms many to an unnecessary "failure", because "AA works", but for whom? When that research is complete, patients can be matched to a full array of supports and hopefully those promises will come true for them as well.
38
@NEOdes
What are these people doing when they get to the part of the big book that tells them about seeking medical care?
5
@magicisnotreal The fault is not in the Big Book or the Traditions. The difficulty is largely in the broad misuse of AA by organizations and individuals who miss the primary purpose or expand the primary purpose into areas it was never intended for. When people have a stand-alone issue without the complications, the practices and principles can restructure the chaos of addiction, sometimes quickly and sometimes slowly. If it isn't happening, there may be good cause to help people look for additional help, rather than trying another round of the same thing and expecting different results.
Amen. Addiction is still widely misunderstood. People almost always abuse drugs because they suffer from mental illness, significant childhood or adult trauma (sexual abuse, rape, abusive parents), and very often both. I’m advocating or disavowing it, but the evidence very clearly supports this, as the overwhelming majority of recreational drug users do not become addicts while a significance number or those with mental illness and trauma histories develop substance abuse issues. Simply put - alcohol & drugs offer temporary relief from overwhelming existential pain, the kind that leads sufferers to self-harm and even make suicide attempts.
There is still a great deal we do not understand about the human brain and mental illness. AA has exploited this vacuum and for many years there were no other options. It’s also clearly a product of our country’s Puritan & Protestant heritage, only becoming mandated by the courts bc of co-founder Bill’s campaign to a teetotaling Rockefeller senator. It’s like bleeding people with leeches back on the day - the minority who managed to get better swore it worked for them.
However more is understood every day in the fields of mental health and neuroscience, including the efficacy of drugs like Nalexone and even the potential of psychedelics in the treatment of mental illness. In fact, years after founding AA, Bill became quite a proponent later in his life - look it up.
AA works for some people, not all. Some people are just philosophically opposed to some of their ideas such as " a higher power" and "making amends" and some people cannot find a decent sponsor or cannot find a meeting where they feel comfortable with the others in attendance.
It works for people who are a good match for that particular program and who are ready to commit to it....
30
Mmmmm, I think you’re missing the point of AA. It does work, when, those precepts are followed. Just like any medication, “when taken as prescribed it is most effective”.
AA works on attraction not promotion. It wants nothing but for the individual to maintain their sobriety and to help others to achieve the same.
That again is one of the requirements, if you’re not willing to help others, you MAY not succeed. You may stay sober, but a happy life is built upon selflessness and helping others....
if you want what we have, do what we do. Sorry...there is no easier after way. Thank God.
1
Using Natrexone via Sinclair Method. It removes the craving and urge to get wasted. It works especially combined when with non AA support group. The medication is very inexpensive. Find a nurse practioner who's authorized to prescribe.
22
@Worth considering The problem is that evidence shows that managing cravings is the worst way to achieve lasting sobriety among those who are addicted to alcohol or other drugs. We need to change the routine of the addicted and that's what A.A. does beautifully. To think relapse is just a reaction to a craving is wrong. Researchers have used electrodes to the brain that make cravings anatomically impossible and the alcoholics continue to drink anyway.
5
A key point missing here is in the sentence; "For people already in treatment, if they add A.A. to it, their outcomes are superior than those who just get treatment without A.A.,”... The converse is also true, for those in A.A. alone their outcomes improve by adding other treatments. If we are to help people this point needs to be stressed.
42
I'm not an AA evangelist, and I love it whenever I hear that anyone with a problem finds a solution, whether that solution is AA or not.
But AA saved my life and has kept me sober for 35 years. It has brought friends into my life and provided support and help that I couldn't find anywhere else.
569
@Sean
Well said, Sean , and well done!
AA is also international.
It’s allied organisations of Al Anon and Al Ateen are for the families, teens, and those intimately affected by alcoholics and the disease of alcoholism.
Al Anon and Al Ateen are also international.
Wherever you are there will be a meeting somewhere you may be able to get to.
As a family member of more than 1 alcoholic, AA and Al Anon have been crucial self-help organizations in my childhood and adult life.
I have the greatest respect for my father - a 32 year veteran of AA, who lived the AA 12 steps and the Serenity Prayer, and because of that, made my life as a teen and an adult survivable.
26
I'm sincerely glad AA worked for you, but we know for a fact that it can actually be harmful for some people. One size does not fit all.
3
@Sean
32 years for me and a new life. Not bad for a drunk.
1
"The bonds formed from the shared challenge of addiction — building trust and confidence in a group setting — may be a key ingredient to help people stay on the road to recovery."
I think AA offers therapeutic benefits through the 12 steps but this to me is the more important part. Simply, knowing that you're all facing the same problem and not alone is probably the most powerful reason why AA works. And it's free.
85
I agree. The 12 steps didn't work for me. Feeling the support and fellowship of other people who have had the same life experiences as you is my "higher power".
41
I was at almost a liter of vodka a day. AA did NOT work for me.
Finally, I said to myself: "I have no higher power, I have the power. And I WILL have a drink, TOMORROW."
And tomorrow came, and I said it again. And again.
Five years passed, and I had a shot of vodka. Since then, I have maybe a glass of wine with steak (about once a month), or a shot at New Year's or a toast at a wedding.
And this has been for the last five years.
So, down from a liter a day (ten years ago), to the equivalent of two shots a month (for the past five).
47
@JT
Yes, all it takes is inner strength and discipline. Good for you! Too bad others are afraid of their own strength.
1
@JT
If you can moderate your alcohol intake on your own you are not an alcoholic. Thus AA would not work for you and is not designed for you. Though the Big Book does suggest a test to determine this if you have doubts about your being an alcoholic. The premise of that test is that you are attending meetings and have at least a sponsor if not a group of friends who know what you are doing.
6
It's essentially free, except for a few bucks in the basket at each meeting. Only the treatment centers cost -- they are good and valuable but in the end, regular attendance at meetings and working with people in AA is the best hope. for sustained recovery. I know, I've been doing it a long time.
44
@Tom J
Donating is voluntary not required.
1
@Tom J Not to disagree, but just to clarify your wording for the uninformed, there are no AA treatment centers. There are treatment centers that host AA meetings, there are treatment centers that employ AA principles or encourage AA attendance, but none of them are affiliated with AA.
3
After seeing a lot of articles that try to discredit 12-step programs and AA, it nice to see some research finally supporting what I've found to be true for myself and others, that AA works really well for long term sobriety.
186
@Brandon And millions of other recovering alcoholics KNOW this to be true as well.
8
These studied never really get to the "Causality" part, and the article was correct in that people going to these meetings are already more motivated and that social interaction in groups is probably more effective for "some" people.
Now all they have to do is make AA non-religious, and yes a program that mentions Unicorns and Pixies in four of its twelve steps, that two non-scientists pulled out of their Kiester 100 years, is religious. Your in denial if you think differently. Not to mention the elves and dragons talked about in its small book, invented by the same people.
Can you name another cure for any disease that requires the intervention of a deity and has not changed its basic precepts in a hundred years? Nope?
Sorry. All these studies, including the ones that say a particular food, or whatever, is "bad" for you, never get deep enough into causality and the multitude of other factors that persons going to religious group meetings, in this case, may have in common.
Sorry, but proves nothing.
19
@Shawn Cary
I have friends and relatives participating in in AA with great success who are atheists. One's higher power is "'time and nature' cause they're both gonna get you." I had my doubts about the programs effectiveness for a close family member who is very analytical and a tad stubborn. He made it work for him and stays strong working the steps. He has sponsored others who also don't posses traditional religious beliefs. Whether it is pixies and unicorns or human psychology, it is good to see real science performed to evaluate the process.
44
@Shawn Cary Hey Shawn, that's an interesting perspective on things. I saw your posting location and it makes me miss carne asada burritos, horchata, and Trestles. I'm not in AA and am not religious so maybe you could fill me in on this? I don't know what you mean by not getting deep enough into causality?
@Shawn Cary To the people who poo-poo the AA experience, you may be right about "causality," the non-scientific basis of of AA, and whatever objections you have to AA, but here is my truth: my daughter (mentally ill and an addict), who is uncomfortable with expressions of Jesus-loving dependency, and does not believe in unicorns, pixies, elves or dragons, has maintained sobriety for 10 years, while continuing to work on mental health issues, with the consistent support and encouragement of her AA friends. It's true that she also has the support of a psychiatrist and a therapist, but those two alone would not have provided the ongoing support that she has needed. Also, in her groups, are people who have 5, 10, 30 years of sobriety. For me, the bottom line in addressing the confounding problem of addiction is that whatever works, take it and use it. There are plenty of people who haven't found anything that works, at least not consistently and lastingly, so if one finds it, then keep it.
4
Some takeaways from my experience:
Mandated attendance does work more often than you think.
The people you meet there are the same as people you meet in bars on a bender. So don't go in wide eyed and naive. Follow the suggested rules for newcomers.
Get the Big Book as soon as you decide to try it.
If you are not talking about staying sober you are not doing AA.
Religion is not a requirement. Refer to the BB.
69
I am glad to see this article, especially since the NY Times has run a series of recent pieces critical of AA without any balance. The most recent criticism in December ("The Patriarchy of Alcoholics Anonymous") was written by a woman who didn't bother to disclose she operates a treatment business of her own (called "Hip Sobriety").
381
The patriarchy in AA is very real. Read some articles on The Fix about the Pacific Group and Clancy I.
13
@HAP
And - not only that - but I heard about this report earlier today on a news report which also said the data showed that the AA success rate was slightly higher for women than men...
5
@Steve @Hap was referring to the whole article, rather than just the headline word you mention. The article in question was a mistake by the NYT, and the NYT may not have been aware of the fact that they were being used to help promote a venture-backed, for-profit business at the expense of the AA name, women and men in AA, and those female and male alcoholics who've yet to find AA, and the families of all these people. The experience of thousands is more "very real" than anything you may have read.
16
The A.A. program confronts us with a social paradox because it seeks to cause a religious conversion in the alcoholic: a belief in God, and in many cases a direct conscious conversation with the Holy Spirit. For example, according to A.A. World Services (1981): "Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.” (p. 13)
Those of us who have been psychologically traumatized by religious cults will understand immediately how corrosive these sorts of programs can be. Worst of all, alcoholics often come under the control of religious charitable organizations. This situation is ready-made for abuse.
My personal disdain for this situation is tempered by the fact that a religious conversion seems to be necessary for abstinence. This, of course, is the social paradox presented to us by A.A.
For example, Roland H. and Bill W. of A.A. both exchanged letters with psychiatrist C.G. Jung on this matter. Jung was convinced that a spiritual aspect to the treatment program was necessary to maintain abstinence. In his reply to Bill W.'s letter dated Jan 23, 1961, Jung says: "An ordinary man, not protected by the action from above and isolated in society cannot resist the power of evil, which is called very aptly the Devil."
Cite:
A.A. World Services, Inc. Understanding Anonymity. Pamphlet, 1981.
14
@W I would recommend reading literature by George Vaillant, MD (emeritus psychiatrist, Harvard Medical school, author of A Natural History of Alcoholism, among other texts), who goes into great detail to explain how AA, as opposed to organized religion, is a safe form of spirituality, on multiple levels, including its philosophy and how it operates as a fellowship. Spiritual transformation and religious conversions are two different things.
31
@W not true. I'm an atheist and I've stayed sober for 35 years only because of AA meetings, etc.
no religious conversation necessary. My higher power is the group!
5
Thank you for saying this as an atheist. It is the power of the group love and support.
4
What was the percentage of males to females in the research? While there are a very small number of groups for women (in big cities?), I have heard many women say that AA meetings are dominated by men who sometimes hit on them, so most women do not attend coed meetings. Given those reports, I would never go to an AA meeting as a female. The article fails to mention gender.
32
@jj True, there are some men out there that prey on newcomers, but most do not. When I was new, I was taught early on to stick with the women and to stay away from 13th steppers in co-ed meetings. There are also wonderful women's meetings where those men are not allowed and newcomers are embraced into the fellowship by other sober women. In January, I celebrated 6 years of sobriety and there's absolutely no way I could have done it without the fellowship of AA (trust me, I tried). It's not the only path, but it was the only one for me.
34
I find this argument irrelevant. The anonymous programs are made up of imperfect people, just like the rest of the world. Yes, some people may have a bad experience because some men are inappropriate. Sticking to all-women’s meetings may be a good idea, declining dates from other members, and staying close to a strong female sponsor and other female members are all good ideas. But let’s not throw the baby out with the bath water. I’ve been hit on inappropriately at work, on the subway, by realtors, etc. Should I not go to work, take public transit or go to the super market?
12
@jj :
read through the comments here again. Many women have spoken about being helped by A.A. Not sure what to tell you to do if someone "hits on you"....what would you do if it happened at a bookstore or grocery store?
7
The "treatment" Alcoholics Anonymous offers is spiritual (not religious). Just as a walk in the woods or a visit to a museum can give us a sense of something larger than ourselves, AA guides people to finding a sense of connectedness and belonging that they once -- but no longer -- found in or through alcohol. Comparing AA to medical or psychiatric models of treatment misses the entire point of Alcoholics Anonymous. AA can work as a sole approach, but it can also work as an approach compatible with medical/psychiatric guidance, religious affiliation, and a wide variety of wellness practices. There need be no conflict, contradiction, competition or even comparison between recovery pathways or approaches.
69
So a 2/3 or more failure rate is considered effective. Gothcha.
10
@TD 1/3 success rate ... do you have a better option?
39
@SN AA is great for some people and it can actually harmful for others, particularly when combined with the attitude that it's the only solution. (Everything in AA is a "suggestion" but there is a pervasive attitude, conveyed in AA's literature, that "it works if you work it" and that failure is really a refusal to be honest.) I absolutely love Recovery Dharma, which takes a Buddhist approach to addiction. It's much less dogmatic and includes fellowship (sangha) and meditation. If you love AA, great, but it's not the only option.
3
@SN Put an end to the reasons people drink to make life tolerable. Make society equitable and reestablish community (without religion). End the exploitation of capitalism that drives us to seek comfort in substance because reality is too harsh to tolerate sober. To put it on religious terms "love thy neighbor".
2
Uh, Naltrexone anyone?
14
@MD
AA did not work for my brother. I wish that more medical doctors in the US were open to this form of treatment, it might have saved my brother's life.
10
@MD Yes, I'm very surprised Naltrexone and The Sinclair Method were not only not mentioned, but also not linked to as another treatment option.
4
@MD
naltrexone yes
AA yes
Smart Recovery yes
anatabuse yes
acamprosate yes
sponsor yes
exercise yes
good sleep yes
if the tool works for the job, use it, if it doesn't, put it aside for now
3
I have actively worked the AA program for over 50 years during which I have not had a drink. I personally have never seen AA fail to enable a real alcoholic to recover. The only alcoholics that I have witnessed who failed to stay sober were those who refused to consistently work the twelve steps. They are the key.
It works! It really does!
113
What do you mean, scientifically, by “real alcoholic”?
5
You are indulging in a No True Scotsman fallacy. This was used on me when I left fundamentalists Christianity - if you don’t believe now you never believed / didn’t try hard enough etc.
AA is not a treatment, it’s a support group.
7
@Mike
Apparently with your categorization of "real alcoholics" you forgot a core principle of AA and that is it's not a program for those "who need it, but for those who want it."
2
Outcomes have improved because the old AA, which was simply "Don't drink. Go to meetings" was eventually expanded to "Get professional help." If you require medications, such as lithium for manic depression, plain drunks would say, "You're just eating your booze."
Fortunately, such cruel discouragement has faded from the meetings. That former attitude proved that stopping drinking didn't prevent you from being a jerk. I knew many people who stopped going to meetings because they could not achieve serenity just by not drinking. They felt like failures so they failed. Thank God for less sober jerks at meetings.
33
@Joe Kernan
You are wrong.
Reading the first pages of the Big Book of AA would inform anyone who cares to know the truth of this. In fact the first thing suggested is that a person be medically examined to be sure of what physical/psychological ailments they might have and to get help for them before starting to work on the steps
9
@magicisnotr
He's not totally wrong.
I went to hundreds of meetings.
And was usually (not always) discouraged from mentioning other types of successful therapies, including pharmaceutical therapies. It happened all the time. It was one reason I left and found other therapies that were more helpful to me. What the Big Book says is one thing, how the meeting are run - their culture and community priorities - are totally another thing.
23
@Joe Kernan I have been a sober member of AA for the last 40 years, and I agree with you that members who seek counseling in addition to attending AA meetings often improve their chances for staying sober long term. But I do not recall, even in the early 1980's when I first started attending AA meetings, hearing members discourage other members with mental illness from taking their meds. In fact, just the opposite.
12
When an acquaintance decided to embrace sobriety, they tried AA but were put off by the religious aspects of it. While still participating in AA meetings from time to time if necessary, they ultimately succeeded with a less available peer meeting based abstinence method, Life Ring.
7
@Greg Shenaut
There is no religious aspect to AA.
If you are dealing with religion your peers are not doing AA.
17
@magicisnotreal plenty of people who have been through it think there's a decidedly religious aspect to the process. Are their feelings not valid? My parents don't feel that "in god we trust" is a religious phrase but I do. You're welcome to your opinion and you may have had a less religion oriented experience but it's clearly widely documented to be carried out in some gatherings with religious undertones.
7
@magicisnotreal
Well, YOU may not call it religion, but when most of the population here's "god" and "higher power" they do associate it with religion. And, yet again, you seem to be severly dictating what AA is and isn't. I will say (again) that god, and religion, played a huge part in my AA experiences. From my religious sponsor, to meetings being help in churches, god was everywhere and belief was encouraged.
5
The one example that is mentioned and linked is not really a very good study--the sample size isn't large and it relies on self-reported alcohol intake and attendance at AA meetings, with AA involvement as a mediator. The study doesn't seem to include other variables that might affect abstinence outside of AA. The idea of abstinence as a gold standard is another problem---it's well known that a great many people with alcohol disorder diagnoses are able to reduce their intake with "relapse" into disorder, which is completely ignored here, along with the controlled drinking literature. Finally, most people need multiple quit attempts, often using different modalities, before they have long term abstinence of clinically significant declines in alcohol intake. The treatment of alcohol disorders and the process of "recovery" is much more complicated than the simple binary offered here with its promise of a cheap cure.
9
@Rich
Maybe you don;t know this. If you can reduce your alcohol intake voluntarily, you are not an alcoholic and thus AA is not for you.
20
@Rich I would highly recommend Thinking Simply About Addiction, by Richard Sandor, MD. His clinical experience of multiple decades and several thousand patients (to his estimate) can shed some light on the mechanisms of addiction, including understanding of relapse, abstinence and other specifics.
1
@magicisnotreal
Okay. Final straw. That is not the idea the vast majority of meetings take. Again, you seem to be very limited in your view about what AA is - very literal about it. That isn't how any meeting I ever attended was run. In the hundreds of meetings I attended in many cities, no one ever mentioned anything near what you are saying. I'm sure you think your intentions are good, but that's not how the world of meetings and the culture of AA plays out.
1
If you're interested in CBT, and you aren't able to see a CBT therapist, take heart—you may not need to. There are multiple options for doing CBT without a therapist, including self-help books and Internet-based treatment. Many studies have shown that self-directed CBT can be very effective.
For example, a review of 33 studies found that self-help treatment led to significant reductions in anxiety; another review of 34 studies on depression found similar benefits of self-directed therapy, particularly when the treatments used CBT techniques. Both reviews found that, on average, the self-help treatments were moderately helpful. In other words, people who did the treatment felt substantially better—maybe not like "a new person," but a noticeably less anxious or depressed version of themselves
7
@Brandon Scott I attended a CBT-method free group "Smart Recovery" in Portland, OR. Sober 10+ years after only 6 meetings. AA was not my thing, due to the religious and some of the philosophical content. Smart fixed me, and I never looked back, after 35 years of drinking.
6
@Jill I absolutely agree with you! If memory serves me correctly, I attended less than 10 Smart meetings and have been sober for 7 1/2 years. At AA it was suggested that I think of my pet rock as my higher power, which I found to be incredibly patronizing.
1
“CBT studies” and the field of psychology in general have been blasted for non-reproducible studies. If experiment results cannot be reproduced by redoing the experiment, there is a problem with the experiment or the hypothesis is false. In other words, a massive credibility crisis fir the field.
Yes, those mandated to AA are not represented in the study and as a member of AA, I would prefer if the courts stop this practice of mandating offenders to attend. What we should focus on in this article is that if people to self select to seek out AA for their problem, their chance of recovery is better than these spin dry programs and therapist that are milking the tax payers for billions of dollars each.
11
@AA Member
Many of the mandated attendees get sober because of it.
14
@magicisnotreal
Yes, I had a close relative "self-select" with the encouragement of the state. He's got six years sober, and he's doing exceedingly well.
3
Having attended AA I have to comment on the "Self Selected" comment. The court system funnels, as for my experience, a huge amount of people into this system. Not Self Selected at all. I would predict if all theses people were not counted the "Self Selected" numbers would fall dramatically downward.
3
I never drak without getting drunk. Although I abused opiates more, I have been clean & sober for 35 years. I am not bragging or paytting myself on the back. AA and NA have many quotes. Silly and as simple as these may sound, they work. Most importantly, one has to want it for themselves. This is key. I was fortunate enough to go through a modern inpatient treatment program at the time. It was less than a month old when I went. I wanted it and was a sponge for information. As is said in AA, getting sober is far easier than staying sober. AA (or NA) help keep you clean and sober. I have friends who have successfully used other means. Some of these are religion, meditation, acupuncture, and others. Whatever works. By far, almost all of my friends (and all of my family members) are long dead. My father and brother had "issues". My sister and mother did not. They (mother and father) lived well into their 90s. I however, was the worst by a huge margin. I had over a dozen overdoses. Once I died for 2 minutes but was revived. My brother died simply from drinking beer. Tall and slim (like me), he never wanted to stop. My father did stop. The first girl I ever loved (and loved me) was breathlessly beautiful, and so smart. A friend of all flora and fauna (and vice versa). She was supremely talented; however, she simply could not get it. She died when she was 39 years old. My first wife died at age 31. I could go on but I made my point: (to repeat) You have to want it.
45
Don't know how it works, don't care what others think about it but for this alcoholic, AA saved my life. And that's not to mention the friends, community and service opportunities its offered me through these last 14 years. Toss a buck in the basket (or more) if you can. Best buck I'll ever spend in a day.
161
I'd like to address the self selection issue. That people who attend meetings are in general, more motivated to stop drinking in the first place. Many judges make DWI offenders attend A.A. meeting in exchange for not going to jail, and A.A. leaders have to sign a paper saying that they attended these meetings. Many of these offenders have said they came in with absolutely no intention to stop drinking but were doing it for a lighter sentence. Many of these people came back even after being released from the mandate by the courts because they heard something in the meetings that sparked a desire to attend and stop drinking.
What does disturb me is that some churches are against A.A. because participants are encouraged to find a higher power that suits them, instead of encouraging them to "find Jesus" as their higher power. They even think of A.A. as satanic. This is not helpful, and have caused some people to leave. I have witnessed this.
12
Thankfully AA isn't a federal program (yet). Once again, people care for themselves and each other best.
3
One of the best therapeutic tools has, at least until very recently, remained in the toolbox: it's unfortunate that LSD therapy--sanctioned by AA founder Bill Wilson--was erased from the discussion and from alcoholism research early on.
12
But that may one day change. New research in psilocybin therapy shows promise for addiction in general and alcoholism specifically. In the meantime AA is a good starting point.
4
While Bill Wilson did experiment with LSD he did not "sanction" it. To my knowledge h made no public comment about his use
4
Bill Wilson did experiment with LSD from the mid 1950's until the early to mid 1960s, before much was known about the drug or its side effects.
According to historian Ernie Kurtz, author of Not God, A History of Alcoholics Anonymous, Bill was always looking for a cure for alcoholism and spoke enthusiastically about the potential benefits alcoholics might find in LSD.
Bill also thought LSD might help some alcoholics achieve a spiritual experience, which Bill believed was vital to an alcoholic's recovery.
But neither Bill Wilson nor Alcoholics Anonymous, the organization he founded, ever "sanctioned" LSD as a treatment for alcoholism. In fact, Bill later expressed regret for the controversy his actions caused among fellow AA members.
2
The religious aspect seems to really bother some.
Can't "a higher power" just as well mean the power of solidarity and mutual support of a group of caring people? That's a heck of a power in itself.
Perhaps an A/AAA --Atheist/Agnostic Alcoholics Anonymous organization would be of benefit.
16
@The Poet McTeagle There're are all kinds of meetings. Even in my small-town area there is an Agnostics meeting—and many people use the AA group as a higher power (which it certainly is and, as you point out, not an inferior replacement, but just another expression of it). If it were just about needing "God" then no one would need meetings. We need each other. That's at the heart of it, and is why people of all kinds—agnostics, atheists, buddhists, et al— can get and stay sober in AA. It can take some wrestling with the language in the book and other literature, but as more and more people join, and many of them younger and younger, the atmosphere is changing--slowly but surely—and my prediction is that so will some of the language (to be more inclusive, current, and relatable).
17
@The Poet McTeagle There is NO “religious aspect” in A.A. That’s not a requirement.
It’s about each individual’s choice of a power greater than themselves and inviting that power into their lives.
No need to re-invent the wheel.
12
@Frank C. Although I enjoyed most of the aspects of AA, that's not how it played out in my city. Although there is no religious "requirment" - there was definitly a religious aspect. It was okay, though, no one ostracized you if you were an athiest. But the religious aspect was definitely there and encouraged.
The fellowship of Alcoholics Anonymous came into the Nevada State Prison offering us their message for free. They offered me a miracle, I followed their simple instructions, and it happened. Expect A Miracle! Keep it Simple. Go to meetings and don’t pick up that first drink. Read page 21 of the Big Book of Alcoholics Anonymous ~ you may be a Real Alcoholic too? The Best Is Yet To Come! In 1991 I was able to claim “That Sentence” on page 191. I have been cured of this terrible disease.
28
It's worth remembering that this study was NOT sponsored by AA in any way. The Cochrane Collaboration does rigorous independent evaluations of all kinds of health treatments to help doctors and other health care providers know what works and what doesn't. When they decide to take on a topic, they find independent scientists to review the strongest evidence available.
There's a good video that covers how the authors did this study here: https://vimeo.com/378364390/547a5c0a77. It also breaks down their findings.
18
Here are the three major points to remember.
First, AA's success rate over the years has been questionable. The simple reason is that AA never kept records on failures. This is a faith-based thing and, in faith-based things, the only thing that counts is success, so that's all you count. The numbers were unreliable and AA never participated in most real studies of treatment plans.
Second, the rate of success for ANY drug treatment is typically about five percent. Whatever mode of treatment is used, about five percent of the people will quit every year. That's true of talking to them, patting them on the head, and every other treatment you can imagine. The one major exception is drug substitution, where they are given another, less harmful, drug in place of their addictive drug. Methadone for heroin, for example.
Third, the clients of AA are an uniquely self-selected group. In order to join it in the first place, you have to accept and confirm within you certain ideas which are plainly religious. That was the basis of it, according to the founder. Lots of people just can't do that. Therefore, AA is useless for anyone who can't submit to those ideas.
24
@Wolf Man Also, how do you count the people for whom it was ineffective - since they simply leave - without any means to contact them to follow up on the progress.
1
@Wolf Man "Talking to them, patting them on the head" ? Not only are you wrong about AA, you seem to know nothing about addiction.
11
@Roger Perhaps these are patients sent to AA programs, rather than surveys of people at AA meetings.
I am genuinely curious how numbers can be reported as accurate from a program that is anonymous, doesn't take attendance, doesn't track members, and is self-diagnosed.
That said, I struggled for a long time to get sober. A decade before recovery gained a foothold. It happened when I stopped looking for a way other than AA. I don't know anyone who has long term sobriety who does it any other way than through a 12 step program, and, arguably more important, everyone I know who had long-term sobriety and lost it all say they relapsed because they stopped going to AA meetings.
I like to be in good shape with a relatively thin physique, and the only way to do that is to eat right and exercise, in spite of all the fad diets and apps for my phone. AA is the same. If someone has a better way, I'm all ears, but there are no shortcuts.
55
@S. Carlson
The problem with the collection of data in AA has been noted for a long time. It is a faith-based program, so only successes are counted. I have heard people claim cure rates as high as 90 percent.
3
@Wolf Man It is a spiritually based program, religion is not required.
15
@Maureen To me, there is no difference between those two words. I did enjoy AA, but, eventually, I thought, "What other disease or problem would require me to go through spiritual steps in order to get better?" Spirituality doesn't cure any disease. But community can help ease the burden, and I believe community is a great part of AA.
2
The ultimate goal of AA is to somehow end the suffering, not to make every alcoholic a 12-stepper. The AA tradition is that it has no opinion in regards to the effectiveness of AA compared to other programs. This in the hope that the research toward effective means of recovery continues and the acknowledgment that AA clearly isn’t for everyone. It may be the best hope alcoholics have but thankfully it’s never been the only hope.
25
@AG
All drug treatment programs for which there are accurate records have about the same success rate - five percent per year get clean. That's true almost no matter what the treatment method is.
The problem with AA is that they are a faith-based program and, thus, their priorities are skewed. They count successes only, not the overall pattern.
Therefore, even though they may have the same success rate as every other treatment, they don't keep accurate records of their treatment. Therefore, it is hard to know what their success rate really is and they have no way of knowing how to improve. All we have are their claims.
4
Truly. You hit the nail on the head. I have no doubt it has saved my life; but it's not for everyone with substance abuse issues (that includes alcohol). I know friends who are "treatment junkies". One is a lawyer and a surgeon. Textbook over-achiever. It makes no diferrence. This can occurs to about 1 in 10 to 20 people. They have a chemical reaction in their brain receptors which most "normal" people do not. Even though the AMA declared alcoholism a disease over 60 years ago (1957), most people think it's simply "weakness". I have long ceased caring what other people think. All I know is what works for me.
8
@Wolf Man Really reply to all posts with same points?
2
AA might be best if abstinence is your goal. Lots of people with substance abuse problems benefit from Managed Moderation, which allows them to incorporate some drinking in their lives. They obviously wouldn't be counted as successes by the abstinence metric, but not everyone agrees that abstinence is the only way to handle alcohol difficulties.
1
@Mimi Not everyone likes subscribing to the religious ideas embedded in it, either.
@Mimi If you can drink moderately, you are not an alcoholic.
1
Like anything you practice, the more you do it the better the results. AA facilitates this with daily meetings that are free. There is power in the group whatever its purpose may be. While not a monopoly AA is everywhere compared to others like smart recovery. But it was a struggle for me to attend because I am an atheist and AA, despite their rhetoric, is a quasi religion. They insist that your higher power must come from outside of yourself, ie God. I refuse to believe that any person properly motivated cannot change. We are our own higher power when we are ready and AA is hostile to that line of reasoning. I sat in most meetings quiet because to challenge AA dogma invites backlash. But I still attended because practice practice practice. Take what you want and leave the rest, but they don't make it easy. I'm 2 years alcohol free and attend meetings occasionally, quietly. AA works but they should strive to be more tolerant.
14
@Michael
Obviously you have not read the Big Book in regards to your atheism.
5
@Michael Start an Atheist/Agnostic AA meeting. They have them in a number of cities around the country.
5
@Michael
In my Al-Anon (for families and friends) meeting we tell people a higher power can be whatever you choose-- nature, Good Orderly Direction, the group as well as a traditional 'god'.
I hear my higher power as a small still voice in my heart and through the voices of others. I don't have a need to convince anyone else that what I believe is right. It works for me.
5
I am grateful that this shows progress of understating a program like AA can be successful.
I went through AA in my early 20's and reentered in my 50's and now a few years sober. AA with a sponsor and a therapist with a supportive wife keeps me hopeful for long term sobriety.
The language around addiction continues to evolve and this article is difficult to read from the lens of someone that does not believe they have a problem yet.
Our medical measurements and communication as society needs a lot of work. In the mean time I will go to meetings, work on my spiritual life, see my therapist at 11am today, hug my wife and pray for us.
Love to all that have read this article and best of luck on your personal journeys.
27
AA can be amazing and work wonders for thousands of people. I genuinely loved the variety of types of meetings and meeting places and the fact that it's free and you can walk in any time. I went to a few meetings where it was only women and I found that to be a great environment for me- especially considering that I have difficulty making friends and past experience with abandonment by female friends.
That said, even though AA is truly great, I did not enjoy the "higher power" concept. I'm an atheist and I absolutely respect others' beliefs, but I felt that in order to succeed, I was being told I had to believe in something greater than myself.
I'm still struggling with my alcohol use, but it's definitely not as bad as it used to be. I definitely owe some of my progress to my experiences with AA and having an awesome, supportive significant other.
3
@Mary I'm glad you found AA helpful in some respects!
I too am an atheist. I've been attending AA meetings for a little over 10 years, and just marked 9 years of sobriety.
I have found that some parts of AA literature are explicitly anti-atheist. I now avoid meetings where that literature is used. Even so, for the most part the literature was useful in teaching me about alcoholism . When I came in, I knew nothing.
Most of the people I've met in AA respect my religious beliefs and spiritual practices. But in the beginning some questioned whether I even knew what my beliefs were. I have stuck with people who respect my views as much as I respect theirs. I avoid others, but am pleasant to all.
Over time, almost all have come to realize that I'm there for the same reason they are - I don't want to drink today.
26
@Mary Can we quantify which was the greatest help in success, a supportive significant other, or the support of strangers?
1
As I understand AA explanation of alcoholism my body is allergic to alcohol. The symptom of that allergy is an intense physical craving for alcohol that develops after I get an ounce or two of alcohol in my stomach. I have read that the intensity of an alcoholic's craving is on par with someone suffering water deprivation.
So great, all I have to do is avoid the first drink and I am recovered.
But the catch is that alcoholism is also a mental illness. So after a period of time without a drink my mind tells me that I can have just one and it will be different than it was the last five hundred times, that this time I will be able to drink normally. Or my mentally ill mind tells me the scotch is the problem, not the alcohol, and if I switch to vodka I will be able to control my drinking - to drink like normal people. Or only drink by myself, or only on Sunday, or only at home, ad infinitum....
As I understand it AA treated my mental illness, that part of the disease that always lead me to take the first drink, thinking that this time I wouldn't drink till unconsciousness.
I still have the physical allergy; once I start drinking the physical craving for more alcohol will come back. That will never go away. But no first drink, no craving. Since the mental illness component is in remission, held there by AA's program, the physical allergy doesn't matter.
My last drink was in 1988.
AA worked for me. I have seen it work for hundreds of others. It works.
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@AmarilloMike very cogent explanation. pretty much exactly as my only sponsor explained it to me. and once a drunk can actually internalize and live it, that drunk is free, in a way that could not before be imagined. i only have to stay away from one drink, for one day, and my life gets better. i'll be sober 40 years on april 15.
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@david
Happy early AA birthday!
And that's a long time for a drunk to go without a drink.
7
All you write and this: One’s mind can’t recall with sufficient force the disaster of the last drunk to keep you from taking that drink again. I was an alcoholic the day I was born. I just didn’t know it until my first drink at 14. A drunk driver struck me standing on a corner waiting to cross the street smashing me into a traffic pole 18 months ago. It nearly killed me. Cost me my right leg above the knee, almost the left, and my career. I cancelled final interview travel arrangements for my dream job in Alaska. Now I live in HUD housing on a social security check with a wheelchair and plastic urinal to pee in. Got the driver, also an alcoholic and a veteran, seven years in prison. You’d think that would make the thought of alcohol abhorrent. It doesn’t. After 15 years sober, I returned to 12-Step recovery and have four months again. I have forgiven the driver and will write him in prison. He has to understand that knowledge of this terrible tragedy won’t keep him sober. AA will. Any alcoholic will identify with a careful reading of not all, but much of the text. I have a PhD and was a college administrator. All the knowledge in the world won’t keep you sober. Practicing the principles in all our affairs can and does.
12
I think studies would find that all 12 step programs are effective. The medical establishment is pretty ignorant of 12 step programs in general, unfortunately. Overeaters Anonymous is for anyone that struggles with compulsive food behaviors. Narcotics Anonymous is for those with drug addiction, including marijuana. There is even Clutterers Anonymous for those who have a problem with "things" or hoarding. None of these programs monetize suffering. All are welcome.
11
@Debby Leschyn AA is too focused on religion and the power of god IMO. There are other groups like Smart Recovery and LifeRing that are more secular and open to everyone.
4
Twelve step is a spiritual program in which one defines- or not- their own idea of God. This is difficult for many of us to talk about. If it doesn’t work for you, great, but to slam it as a religion is not a fair assessment.
4
AA founder Bill Wilson both used LSD & advocated its use to help alcoholics quit drinking.
Recent studies on use of psilocybin to help people with various addictions are extremely promising/successful.
13
So... apparently nothing in this article changes the 9O% to 95% failure rate of the 12-Step Program.
But at least we now know that it tends to work better than the other options available.
1
@TOBY in the article: 22 percent to 37 percent stay abstinent clearly contradicts your unreferenced failure rate.
5
@TOBY
Apparently you didn't read the article. It states that the success rate of AA runs from 22-37%. That gives it a failure rate of 78-63%. Pretty bad, except for all the other approaches. 90-95% appears to be a figure you pulled out of your hat.
4
@TOBY Where did you hear of the 90 to 95 percent failure rate?
3
There is no research. But plenty of hook ups in AA
2
@ricky "I think they called it "5th steppin.'"
1
@Roger That would be "13th Stepping". It seems to me that men and women find each other no matter where they are. The species doesn't appear to be dying out, last I checked.
1
“13th stepping” and it’s an endemic problem to that culture. Lots of older predatory men are involved in the program.
1
Too religion oriented for my taste.
14
The problem with this paper is that it doesn't compare AA to other peer-support groups like Smart Recovery, LifeRing, etc. There was a paper a few years back which compared AA and Smart Recovery that found that the greatest predictor of long-term sobriety was engagement with the group. They were found to be equally effective so long as the participants were engaged.
Some people just don't do well in AA and do do well in programs like Smart Recovery. AA isn't a panacea. It's one in a number of approaches to recovery. I just wish more people in recovery who go the AA route could appreciate that fact.
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@Hank
I totally agree with your assessment - it's the community, not the program, that leads to success. My sister-in-law was somewhere in the vicinity of 25 years sober (before lung cancer from smoking took her) and she remained connected - closely - to all who helped her and that she helped. These were not life-lines, these people were close and loving friends.
This is what is lacking in our country, Community; that sense that we are our brother/sister/other's keeper is gone.
This is not because of Trumpism, Trumpism is merely the symptom of something that started during at least the Reagan years.
8
AA isn't "less expensive". It's free. It's not for everyone, and doesn't claim to be. The value of getting help from people who have walked in your shoes and aren't getting paid to help you can't be overstated.
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@Marjorie Donnelly Absolutely. It's not only 100% free but AA is everywhere. All over the world you can find meetings and in many major cities you can even find meetings offered in different languages for travelers or expat/migrant populations. English language meetings are quite common. I've been to meetings in Seattle (USA), Vancouver (Canada), Paris (France), Tokyo, Kyoto and Osaka (Japan).
For those of us who are highly mobile and making it one a day at a time, it is an amazing resource. Just about anywhere I go in the world I can walk into a meeting, claim my chair, and relax because I am "home."
4
Time is our most valuable commodity, so in that sense AA is the most expensive of all treatments, involving decades of time devoted to meetings. Think of all the opportunity costs.
If Naltrexone and 6 months of therapy would get your drinking under control permanently, that's much cheaper long term. And doesn't involve joining a pseudo Christian cult.
1
I am sure many people will write comments bashing AA. I find that most people with the most criticism of AA either resent it because they are worried about their own drinking or know nothing about AA. I have found unconditional support and love in AA and I am not particularly religious. There is a focus on spirituality, whatever that means to you. If you want to stop drinking, give it an honest try. You don't have to call yourself an alcoholic and you are not signing up for lifetime membership. Just give it a good, solid try. It works if you work it.
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@Maureen Actually I was in AA for 3o plus years. I don't drink but I left AA because of the sexism, racism, misogyny, the individual power trips, and the people are not so great. There are no regulations. And treatment centers use the Free AA meeting to make money off their poor victims.
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@ricky AA meetings are like restaurants, my friend. Some have 2 stars on Yelp and some have 5, some have great service and some dont, but a girl's gotta eat. AA is the only program that works, I have yet to be proved wrong on this, and I've been searching for an easier softer way since the early 90s.
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@Maureen -- As an old-timer in my group used to say, "If you don't like AA you can leave any time. We will gladly refund your misery at the door."
34
Alcohol the most acceptable, addictive drug on the market today.
AA, and Al-Anon 'keep coming back because it works if you work it"
11
Attending meetings can be very reinforcing, but some people react negatively on the shame aspect of the program. People are not powerless, but make decisions very specifically to drink. I like Smart Recovery, an online program that is also free and has meetings online, lots of education and some local face to face meetings. It probably was not evaluated in the study since it is online and very private. I think going to AA can be friendly and supportive, but the steps? They are just silly.
8
@Susan Kuhlman Spoken like a person who has not attended meetings or worked the program, or who has something to gain from the paid programs, most of which don't work. Admitting you are powerless over ALCOHOL is not shaming someone, it is the truth, because the biggest problem is that most think they can monitor the drug. They can't. I was never made to feel shame. Ever. Hopefully you are not telling your family members who are in the program the steps are silly.
21
@Susan Kuhlman The motivating forces are your ego and fear, not the substance. Every impulse to drink or use comes from in your mind. The steps are effective tools, in combination, to recognize the warning signs, and to take action. How you incorporate the collective 12 step process into your daily approach is up to you. But failing to do so, and be grateful for it, and to be of service to others who need the same, you do so at your peril.
6
Pssst. Here's a clue for you all. Even if you go to rehab in the finest facilities you'll spend a good deal of time in AA meetings.
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@Rich Sohanchyk Sure. But that doesn't mean AA is effective. If AA is central to treatment centers, and treatment centers aren't all that effective...
3
"Cognitive behavioral treatments help people analyze, understand and modify their drinking behavior and its context."
For real alcoholics, that's like trying to analyze, understand and modify the relationship between gasoline and a lit match.
You'll never guess where I learned that.
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@Stephen Indeed. Like greed, alcoholism is a "spiritual disease".
9
@Stephen LOL so true. I would never engage in therapy focused on my alcoholism with someone who is not an alcoholic. CBT cannot take away the switch that gets flipped when I drink, the switch that says: another. And another. People don't understand. Context? LOL. Analyze? LOL. Real alcoholics get this.
16
@Stephen Yet some of the steps and tools of the program are similar to CBT practices - which came first, I wonder?
4
At its core AA is a guide for living. Yes it can seem at first glance very religious but in the big book it says the steps are suggested as a program of recovery and a “higher power” could be the collective wisdom from the people in the rooms. But despite all that is wrong with AA there is a horse in all the shit. At the end of this month I will be celebrating 37 years, still trudging and have found a new happiness and a new freedom.
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Congratulations!!!
11
@MJ 31 years here. And a convinced atheist all that time. In fact, there are now AA meetings all over the world for people who want AA without the religious element. Considering that about 20% of the US population is now "nones" in regard to traditional religion, this should not be surprising ---and Bill W. himself worried that the "higher power" business could be AA's weakest point.
For this recovering alcoholic, it is the group and the personal attachments that perform the "higher power" function; indeed, some of those personal attachments formed among "litter-mates" in the early stages of learning to live without drinking (the hardest part) are the strongest in my entire 80 years of life, akin to those formed in early school years or long professional association.
One thing that hearing thousands of stories over these years has taught me: everyone has baggage, everyone is crazy in one way or another --- and those who think they are totally sane are the ones who are REALLY crazy.
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@MJ It seems religious at first glance because it *is* religious.
For years, people have said, "It's spiritual, not religious," but it's basis is in fundamentalist Christianity of the Oxford Groups and most meetings here in the US close with Lord's Prayer, which is a clearly religious prayer.
Further to the point, go to any group conscience and try to explain that if AA is not allied with any sect or denomination, they why continue to use a prayer that clearly earmarks AA as religious in the Christian sense. You'll be laughed out of the room.
It may not have a cross over the door, but AA is its own religion with its own dogmas and beliefs even if more ecumenical in the modern era.
10
Bravo that we have finally wrested the exclusionary term "evidence-based" from those who would have every addict and alcoholic believe that salvation lies in the hands of Big Pharma.
15
I have 39 years sobriety thanks to AA. This is where the real men (women) go to deal with this disease. I guess I just have one of those obsessive personalities where I have to drink a whole bottle of rum and not just one social drink. At AA you listen to others and learn. Example: when you have enough time in sober, how do you handle a social gathering where everyone is drinking? Lesson: no one cares if you are drinking a soda, only what they are drinking so don't be afraid of standing out as a non drinker. The information is endless and helps. I have not been to a meeting in years (only went 2x a week for six months, then maybe 3 times in all those years) but knowing there are AA meetings going on close to you is a comfort. AA saved my life, thank you for that.
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@JBell
I have me by a year. My count is 38 years. I do think all of us who received the gift of sobriety have an obligation to go to a meeting or two per week to pass along the message to new comers. Not meant as a lecture but just food for thought. Congratulations on your years of sobriety.
6
@JBell - I go to meetings on my anniversary. If I ever got a drink signal I’d be back in the rooms so fast. I spent the early years of my recovery in a lot of meetings. I am forever grateful that there is AA. I found spirituality and love and nurturing there. I wouldn’t be typing this comment had there not been AA. I would have died way too young.
7
April 1, 2004 was the date of my last drink.
Since then?
Not one hangover.
Zero trips to the ER because of ‘accidents’
Zero times wondering how I got home last night
Zero times apologizing for things I can’t remember saying or doing.
Life can be a struggle. I am not always successful handling things but, I have one less set of things with which to struggle.
Perhaps there are other things that work for people. Go for it.
A.A. worked for me and for that, I am grateful to all of its membership.
Crazy thought. In this world so many people seem to enjoy leaving people in their misery. A.A. is one of the few places where people are genuinely happy to help me to succeed.
305
If you work the program, it works. I've personally witnessed the results of AA firsthand. It's truly a community of people who are there for and support each other through battling alcohol which is cunning, baffling, powerful, and deadly. Additionally, it's not a religious program but a spiritual one. So if you higher power is your golden retriever, that's perfectly fine. Simply put, AA saves lives.
55
@Midwest Mama It is also one of the few places (maybe the only one left) which brings together people from all the strata of society, since alcoholism is a one-size-fits-all condition. I have been at meetings where I sat between a media star and a recently released convict. Where else does that happen?
86
@jprfrog - that's exactly right! I've learned so much and gotten such great insights from so many different people.
12
@Midwest Mama So, if it doesn't work its because one didn't work the program. In that case I guess 12 step programs have a 100% success rate - for those it succeeds with.
7
This research confirms what we in AA have known anecdotally for many years: About one person in five makes it to five years sober. What surprises me is how the other treatments fare no better.
I think AA's success rate would be a higher if we were a bit more welcoming to people who have a higher power they choose *not* to call God.
16
@32 years Especially true in small towns. In big cities you can find programs of atheists and then specifically Buddhist and the like... but small town can be filled with religious zealots.
12
@32 years Ditto. Even in larger cities, it can be religious. I got sober on another continent and when I moved to the US, I was appalled at the religiosity in American AA. Try explaining to people in the South why it might not be the best idea to close with a sectarian prayer.
5
I'd like to know what AA was compared to. Compared to health care choices that people have to pay for, of course it's better. We don't have free health care in America, so a huge percentage of poor working folks will never even have that option.
And was AA rigorously compared with Buddhist recovery (i.e., Recovery Dharma), SMART recovery (or Life Ring), Women for Sobriety, and other free groups? Were modalities like ACT (Acceptance Commitment Therapy) studies?
Health care providers push AA 'cause it's free, and they don't know (or want to pay for) any better choices.
13
@Collins Flannery Take it or leave it, but I've always regarded 12-step recovery as "Buddhism for Dummies." No offense intended, I simply mean that the principles of AA and Al-Anon and the rest seem analogous to many of the principles of Buddhism, and in fact Bill W., AA's founder, readily admitted that the 12 Steps were a compilation of the wisdom of the world's great spiritual traditions. As a member of the AA family, I can attest that AA saved my life. I am forever grateful. Best to you!
33
@Collins Flannery It's not only free but readily available almost anywhere anytime. Those other groups may be good, but they're few and far between.
5
@Collins Flannery One big problem is that AA has such a lock on the recovery movement and is so heavily sponsered by recovery industry and religious groups, that it's very difficult for other programs such as Refuge Recovery, SMART, LifeRing, WFS, or even Secular AA to make a dent outside of a large urban area.
Where I live, AA (and very traditional christian AA at that) is the only thing available, without a significant commute to a city.....
6
After of more than 35 years of anecdotal evidence, I'm glad that "the numbers crunchers" now support the view that the 12 step program of AA is probably the most effective approach in recovery from alcoholism. As a treatment professional, I require my clients to attend regular meetings in addition to psychotherapy with me. The two together are the magic elixir for long term recovery.
But these two are so much more: People with long histories of alcohol (and other chemical dependencies) must not only stop using, but they must re-imagine their lives Typically, they must develop new relationships with themselves and with others in their communities. Long chemical use, particularly from an early age, stunts our psychological, emotional and spiritual growth. That's where AA and psychotherapy come in.
Many years ago, the brilliant clinician, Virginia Satir, coined the term 'people making'. It's an apt description for what the 12 step programs do for its members: I call it a thoroughgoing rehabilitation of mind, spirit and body. This journey takes years and in a society addicted to instant gratification, 12 step approaches are rarely touted. In large measure because a basic tenant of the fellowship is that it takes no stands regarding public issues. For another, the variety of 12 step (global) fellowships are humanity's best kept secret: they operate under the radar and gaze of a crazed society while providing genuine opportunities for health, well-being and serenity.
36
As a 31-year member of the Fellowship of AA, I've seen firsthand hundreds of truly miraculous recoveries, mine included. It is essential to remember, though, that there is no cure for alcoholism. AA's genius lies in offering a path and a community to help keep the disease in remission. Because alcohol is so "cunning, baffling, and powerful," it's not easy to stay on the road of sobriety, which makes measuring "success" rather difficult. For me, I'm a success today if I make it to bed sober tonight. I'll cross tomorrow when it comes.
39
AA and my Higher Power (who I chose to call "God") have kept me sober now for 33 continuous years since I first entered the rooms. I have only gratitude and happiness to report. Within AA I have learned how to calmly and capably handle all my life challenges without even the thought of drinking. I am so fortunate to be sober for 33 good years and to share this sobriety with my fellow AAers.
81
AA is a model for how to live, structure groups from the bottom up, respect others, be honest with oneself. People will absolutely take responsibility for themselves if offered a helping hand and consistent support. When you remove power and profit from the equation, people can do anything.
69
@Craig Lucas If only our world worked this wya.
6
Over the course of encountering many alcoholics during a forty plus year psychiatric career, I am convinced that AA is the most powerful approach. Got an alcoholic in the ER? Call AA and they show up. Quickly. Unobtrusively. Anonymously, and leaving phone numbers behind.
It also offers a lifetime of support through sponsors. The classic 28 day rehab programs finally are built on a financial model. Most of them include AA in any case.
I am impressed again and again by the sincerity, fervor and- yes- humor of a fellowship dealing with a dark problem realistically.
Religion is not an essential in the aspirant. Most non-deistic patients I knew simply substituted "AA" for the deity in their minds. I remember one person who would throw his shoes under his bed to get himself down on his knees.
I am glad to see this article. I have no bone to pick with rehabs or cognitive behavioral approaches, but AA is the best!
275
I went from a very heavy drinker in my 20s to a light drinker the past 10 years or so, without AA. I'm glad I did it without joining a cult that would have brainwashed me into believing I had a "disease" my whole life. Now I seldom think about alcohol one way or the other.
The way I personally did it was by going back to school and focusing on a data science career in which I need clarity of mind to function. I filled my life with that (and Rupaul's Drag Race). I also started taking a very light anti depressant in the lowest dosage. My career is my priority now, and I love it more than I ever loved partying. I did lose many party-oriented friends, but I gained new ones. All without AA.
My tips to someone struggling with heavy alcohol use: try to go dry for 2 months or so on your own to break the physical dependency. If you can't do that solo, go to a therapist for Naltrexone. Once the physical part is conquered, fill your life with something else you love, and accept that you'll drift apart from hard partying friends, but that's OK because you shared a fun part of your lives that you'll remember nostalgically. If you go out with friends, drink seltzer or one light beer or one fancy cocktail at a bar that you really savor slowly, like an expensive scotch. Fill your new free time with something else you love. Pretty soon you'll naturally stop thinking about alcohol because you're thinking about these other interesting things, without AA. Welcome to the rest of your life.
4
As drinking is a problem not only to the user but also to others who are driving on the same roads, maybe we need a national program to reduce consumption, like that which made smoking tobacco socially unacceptable and thereby saved many lives.
When we came from England to Iowa in 1958, one of the many things I liked about the Midwest was that although prohibition had ended, there was much less drinking. Faculty were not allowed to serve alcohol if students of any age were present. The only drink available in bars was 3.2% beer. The system worked.
9
For anyone who has trouble with a "higher power" or any other aspect of AA (or any 12-step program): use the tools provided and shape your sobriety to fit you and own it. Be open to change, accept that you will continue to learn and evolve (hopefully!) for the rest of your life. Nothing is "one size fits all." AA provides a tremendous framework to make change but you must do your own work. I am forever grateful.
173
@InAZ A very wise person recommended I think of my higher power as my intuiton. It was a little hard to find at the time--to find it, be able to pay attention to it and focus on it. Her visualization was a pilot light. It was like a meditation--difficult at first, but very sustaining in the long run. Go AA!
42
@InAZ I believe that AA, and its sister programs, are one of humanity's greatest achievements. If only the world (and the Church) operated in this way.
27
@InAZ
AA tradition 3 states that "The only requirement for membership is a desire to stop drinking."
I have found in my 48 years of sobriety in AA that there are many people who erroneously try to present their personal ideas as those of AA. They can be safely ignored and will usually become more accepting as they get well themselves.
Alcoholism is a chronic, fatal disease and AA offers a way out. It is a shame to stay away because somebody hurts your feelings by talking about religion.
Remember "The only requirement for membership is a desire to stop drinking."
32
This has been known a short time after the two gentlemen founded AA thru studies and personal experience and other sources.
it is very much like dieting. Don't complicate it, some form of weight watchers is far superior to the kazillion diets, methods and more extreme methods of losing weight.
27
@Paul Weight Watchers costs money... but I do like the idea of an AA style group for people that have unhealthy food relationships.
6
@Paul - Re: “dieting” — many of us are Food Addicts, just as many of us are alcoholics. For those who have food addiction, there is Food Addicts in Recovery Anonymous (FA) — https://www.foodaddicts.org/.
4
@Laura thank you for your reply. An AA type meeting for unhealthy food relationship is ok as long as you don't use it as an excuse to keep eating.
Most things cost money. I maintain my weight by using a rough form of weight watchers ie only a certain amount of calories in and if I go over, say eat a 400 unit dessert, I skip the one I am entitled too and it is free.
1
AA simply saved my life. No matter what I did I could not stop drinking on my own. I always cringe when I read articles critical of AA because it's not medically based because I know, from personal experience, that if you work this simple program you can flourish in a sober life.
326
@A Southwick And if you go to a medical facility or posh rehab you still end up going to AA meetings which tells you all you need to know.
60
@A Southwick
Well said and well done.
6
That's true for you, but that's not true for everyone. AA doesn't work for some people, and for some it is even counter productive. There's lots of evidence that because of the "one drink you're a drunk" tenet, it has pushed a minority of people into binge drinking once they fell off the wagon, worse than they would have done without AA. There are almost definitely systematic patterns in who those people are.
We need to move away from one size fits all solutions, and try to identify what treatments work best for which types of people.
6
Great to see this report. It aligns with my experience. I tried many ways to control and /or quit my drinking over a 20 year period. When I finally started to go to AA meetings and found a community of like minded people and a program of simple steps to follow, my use of alcohol ended. That was 30 years ago.
Other approaches may work for other people, but this one works for me. I don't worry about any of the emphasis on higher power stuff ... all I know is that this works and my life is infinitely better as a result.
362
@Another Canadian It is really great to read this morning how your life "is infinitely better." Thanks for a nice message. All the best.
63
@Another Canadian An Albertan here in total agreement - AA worked for me especially one of its slogans - a day at a time - celebrated 29 years of sobriety recently.
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@Another Canadian
My spouse was severely addicted for years before as was compelled into recovery. He was deeply resistant to AA, and initially felt more comfortable with Smart Recovery.
But as time went by, he began to go to AA meetings. He felt accepted and began to see great value in it.
He has needed both Vivitrol and Antabuse to aid in his recovery. And a whole lot of therapy.
Having AA in the mix has been a blessing.
26