A few simple things AA could do (but probably won’t) to make AA more of a help to alcohol abusers

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

Over the years, I’ve written a lot about AA, mostly about the negative things that are lost in the avalanche of pro-AA testimonials.

Let’s take as a given that AA’s own statistics (AA’s 1989 triennial survey) are correct: 5% of those who walk through the door are still there (and probably sober) a year later. That’s about the rate of spontaneous remission.

My very strong suspicion is that if you’d take away the million-plus people coerced into AA attendance every year in the U.S. (mostly via DUI sentencing and employee assistance programs), the percentage who recover with the help of AA would be a lot higher — that is, if you’d only count those who voluntarily come to AA for help, the recovery rate would probably be twice, maybe three times the rate indicated in AA’s summary report on the 1989 AA triennial survey. (I have to stress here that this is only my own entirely scientifically unsupported estimate, though I suspect that my friends and family who have been in AA for decades would tend to agree.)

Why would this be? Two reasons come to mind: 1) once someone has decided to change, almost any helping hand will increase their chances of recovery; 2) there’s evidence that AA works especially well for religious people, for whom AA’s religiosity isn’t a problem, and is likely an aid.

This brings up the first way that AA could be of more help to alcohol abusers and the alcohol dependent: AA should stop aiding and abetting the coercion of alcohol abusers into AA attendance. This could be easily done by having meeting secretaries stop signing attendance slips. AA’s annual general service conference could easily declare such a policy.

The second way AA could be of more help is if it (okay, the true believers at most AA meetings) would admit that there are other routes to recovery. There’s good evidence that cognitive behavioral therapy (CBT) approaches are the most effective treatment option, and CBT self-help is the foundation of the second-most common alcohol self-help group, SMART Recovery.

That leads to the third way AA could be of more help: AA has an official “take it or leave it” approach (not that this reflects real-world AA), which means that AA could help more people by referring them to SMART Recovery, Lifering, Moderation Management (and other harm-reduction groups), Secular Organizations for Sobriety, Women for Sobriety, and other non-religious recovery groups. These groups can and will help many of those repelled by the rigidity and religiosity of AA.

A fourth way AA (again, the true believers at AA meetings) could be of real help is if AA would stop repeating unscientific, destructive dogma.

Go to almost any AA meeting and you’ll hear that without AA “alcoholics” will inevitably descend into the hell of “jails, institutions, or death.” Abundant scientific research indicates that this simply is not so: most alcohol-dependent persons (not just alcohol abusers) either improve significantly or quit entirely without participation in AA or any other type of treatment program.

So, if AA (the hardcore members) would simply stop repeating the “jails, institutions, or death” mantra, it would help huge numbers of people to take the first step to taking responsibility for their own behavior and recovery (or at least improvement). AA should admit that it is possible to recover independently or simply reduce self-harm, and that doing so is possible and important.

A fifth and very significant way AA could help alcohol abusers is if it (again, the hardcore fanatics at almost every meeting) would stop insisting that “alcoholics” inevitably lose control after a single drink (“one drink, one drunk”). There’s good scientific evidence that this is a self-fulfilling prophecy, and that those having no exposure to AA are significantly less likely to binge than those exposed to AA.

Of course, when those with alcohol problems drink it’s at least to some extent Russian roulette. So, it makes sense not to drink. But pretending that even a single drink inevitably leads to a bender is a horrible, destructive, self-fulfilling prophecy.

If AA (oookay, once again the hardcore believers) would stop insisting on all this pernicious nonsense and would instead present AA honestly as a religiously based recovery program that works for some people, AA would be a real help to people with alcohol problems.

As is, AA does more harm than good. I hope AA changes so that it helps more people, but I’m not optimistic.

 

 

Alcoholics Anonymous Is Religious, Not Spiritual (revised)

A few years ago Sharp and Pointed posted “AA Is Religious Not Spiritual” in two parts. That was a bit inconvenient for readers, so here’s the text in full.

* * *

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

AA’s Religious Origins

Members of Alcoholics Anonymous (AA) routinely assert that AA is “spiritual, not religious,” though even a cursory glance at AA’s practices and official (“conference approved”) literature reveals the opposite to be true.

One of the most widespread myths about Alcoholics Anonymous (AA) is that it has existed as an independent organization from day one, from the day in 1935 that Bill Wilson met AA’s other co-founder, Bob Smith, in Akron, Ohio. When they met, Smith and Wilson were both members of a Protestant evangelical group called the Oxford Group Movement (OGM), or more simply the Oxford Groups.

The Oxford Groups — which had nothing to do with Oxford University, nor the city of Oxford; they merely traded on the name — were founded in the 1920s by the Reverend Frank N. D. Buchman, notable for his lavish lifestyle, entirely financed by his followers; his right-wing views (in 1936 he described Heinrich Himmler as “a great lad”); his virulent prudery and homophobia; and his targeting of the rich, powerful, and prominent for recruitment. Smith and Wilson evidently found all this attractive, as they were both enthusiastic OGM members.

Convinced that Oxford Group principles were the key to overcoming alcohol abuse (and all other problems in life), they devoted themselves to carrying the Oxford Group message to other alcoholics. What they called the “alcoholic squadron of the Akron Oxford Group” remained as part of the Oxford Group Movement until 1939, and the group Bill Wilson founded in New York remained part of the Oxford Group Movement until late 1937.

The reasons that AA parted ways with the Oxford Group Movement had nothing to do with differences over ideology; rather, they had to do with personality conflicts, the fear that Catholics would be forbidden to join what was to become AA as long as it was part of a Protestant organization, and, quite possibly, embarrassment over OGM founder Frank Buchman’s statements in an August 26, 1936 New York World Telegram interview in which he said, “Thank heaven for a man like Adolf Hitler,” and in which he pined for “a God-controlled Fascist dictatorship.” This was a possible contributing factor to the split of what was to become AA from the Oxford Groups, though it was over a year before the New York group severed formal ties to the OGM, and approximately three years until the Akron group did so. (It’s worth mentioning as an aside that the manner in which AA treats this interview in its “conference approved” Wilson biography, Pass It On, is blatantly dishonest.)

One reason that this link between AA and the Oxford Group Movement is not more widely known is that during the years following the adoption of the name Alcoholics Anonymous, AA never credited the Oxford Group Movement for anything — even though AA took its central beliefs, program, and practices almost unaltered from the OGM. For instance, there is not a single acknowledgment of the Oxford Groups in Alcoholics Anonymous, AA’s “Big Book.” It wasn’t until the late 1950s, in Alcoholics Anonymous Comes of Age, that Bill Wilson and AA (partially) acknowledged AA’s debt to the Oxford Groups. Even today, most AA members know little if anything about the AA/OGM connection.

The Origin of the 12 Steps

Here are the steps, the backbone of the AA “program,” taken directly from AA’s “Big Book,” Alcoholics Anonymous:

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
11. 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.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

A common myth — even within AA — is that AA co-founder Bill Wilson wrote the 12 steps entirely independently, that they were completely his own invention. A closely related myth common in AA is that Bill Wilson wrote the 12 steps directly under divine guidance. Neither myth has any but the scantiest relation to reality.

The author of AA’s 12 steps and the text portion of AA’s bible, the “Big Book” (though not the personal stories in it), Bill Wilson, was a dedicated Oxford Group member who was convinced that the principles of the Oxford Group Movement were the only route to recovery for alcoholics, and the 12 steps he included in the “Big Book” are a direct codification of those principles. Indeed, in Alcoholics Anonymous Comes of Age, Wilson directly credits the OGM as being the source of the teachings codified in the 12 steps (pp. 58-63, 160-167). Further, in a letter to former OGM American leader Rev. Sam Shoemaker, Wilson stated:

The Twelve Steps of A.A. simply represented an attempt to state in more detail, breath, and depth, what we had been taught–primarily by you [Rev. Shoemaker]. Without this, there could have been nothing–nothing at all. (quoted by Dick B. in Design for Living: The Oxford Groups contribution to Early A.A., p. 10)

Wilson also stated publicly:

Where did early A.A.’s … learn about moral inventory, amends for harm done, turning our wills and lives over to God? Where did we learn about meditation and prayer and all the rest of it? … [S]traight from Dr. Bob’s and my own early association with the Oxford Groups … (quoted in the AA publication, The Language of the Heart: Bill W.’s Grapevine Writings, p. 198)

To be more specific, the Oxford Group principles of personal powerlessness and the necessity of divine guidance are codified in steps 1, 2, 3, 6, 7, and 11. the principle of confession is embodied in steps 4, 5, and 10. The principle of restitution to those one has harmed is embodied in steps 8 and 9. And the principle of continuance is embodied in steps 10 and 12.

There is not a single original concept in the 12 steps. They all came directly from the Protestant evangelical Oxford Group Movement. (see Twelve Steps and Twelve Traditions, pp. 48 & 97)

It’s noteworthy that alcohol is mentioned only in the first step, which strongly implies that alcoholics cannot overcome their problems on their own. The remainder of the steps implore alcohol abusers to engage in religious activities (prayer, confession) and to “turn [their] lives and [their] wills over to the care of God.”

Alcoholics Anonymous and 12 Steps and 12 Traditions

Much of the rest of the “Big Book” is just as religious, if not more so, than the 12 steps. In his comments immediately preceding the steps, Bill Wilson exhorts the reader: “Remember that we deal with alcohol — cunning, baffling, powerful! Without help it is too much for us. But there is One who has all power–that one is God. May you find Him now!” (p. 58) Wilson also devotes an entire chapter (Chapter 4: “We Agnostics”) to attacking atheists and agnostics as “prejudice[d]” or crazy, and to presenting belief in God as the only way to restore “sanity.” Wilson also recommends that AA members “work” the seventh step through prayer, and even provides the wording for a prayer to “My Creator.” (p. 76) It’s also worth noting that the “Big Book” is saturated with religious terms. There are well over 200 references to God, capitalized masculine pronouns that refer to God (“He,” “Him”), or synonyms for God (“Creator,” “Father,” etc.) in its 164 pages of text — and this doesn’t even take into account such terms in the personal stories that make up the bulk of the book.

AA’s second — and second most important –book, Twelve Steps and Twelve Traditions, also written by Wilson, is just as religious as the “Big Book.” For instance, the nine pages devoted to “working” step 2 contain at least 30 references to God, synonyms for it, or capitalized masculine pronouns referring to it.

Wilson also repeatedly exhorts the reader to pray, noting in one place that “Those of us who have come to make regular use of prayer would no more do without it than we would refuse air, food, or sunshine.” (p. 97)

And in his discussion of step 4, making “a searching and fearless moral inventory,” Wilson makes a truly extraordinary recommendation: that the list of one’s “moral defects” be based on “a universally recognized list of major human failings–the Seven Deadly Sins [!] of pride, greed, lust, anger, gluttony, envy, and sloth.” (p. 48) Contrary to Wilson’s assertion, these are not “a universally recognized list of major human failings”; rather, they are a specifically Christian list of sins enumerated by Pope Gregory the Great in the sixth century. (Even ignoring its origin, one wonders why this “universally recognized list” would omit such obvious “defects” as cruelty, hypocrisy, intrusiveness, exploitation of others, and sanctimoniousness.) That Wilson would make such an extraordinary recommendation underlines the Christian origins and orientation of AA and its “program.”

Common AA Practices

As for AA’s practices, most meetings open with a prayer to God, the Serenity Prayer: “God grant me the serenity to accept the things that I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Most meetings also feature reading (and often discussion) of the 12 steps, with their exhortations to pray and to turn one’s life and will over to God. And most AA meetings close with the reading of a specifically Christian prayer, the Lord’s Prayer.

AA and the Establishment Clause

Indeed, the religious nature of AA and its “program” is so obvious that three federal courts of appeal (the 2nd, 7th, and 9th circuit courts–the next level down from the Supreme Court), two state supreme courts (Tennessee and New York), and nine federal district courts have ruled that government-coerced attendance at AA and NA (Narcotics Anonymous — a clone of AA) is unconstitutional in that it violates the Establishment Clause of the First Amendment, because AA is religious in nature. (There have been no contrary rulings on the appeal level, but unfortunately there is no national binding precedent because the Supreme Court has refused to hear appeals of any of these rulings. Without this binding precedent, government-coerced AA and NA attendance continues on a piecemeal basis across the country.)

Given all this, it seems amazing that AA members routinely and vehemently assert that AA is “spiritual, not religious.” There are two primary reasons that they do this. The first is that AA is a very anti-intellectual organization, in which honest questions and skeptical attitudes are viewed as “disease symptoms,” and in which great emphasis is placed upon unquestioning acceptance of revealed wisdom. Three of the most common AA slogans embody this anti-intellectual attitude: “Utilize, don’t analyze,” “Let go and let God,” and “Your best thinking got you here.” So, in a milieu which demands blind acceptance and denigrates critical thought, AA members hear that AA is “spiritual, not religious” and repeat it like parrots (which is unfair to parrots).

AA members who own treatment facilities or work in them have an additional incentive to repeat the “spiritual, not religious” mantra: money. In 1990, over 93 percent of treatment facilities in the United States were 12-step facilities, and treatment was a $10-billion-a-year industry. Very probably even more money is at stake today. If 12-steppers who own or work in treatment facilities would honestly admit that their approach is religious in nature, that river of government and insurance-industry cash would dry up in short order.

Ultimately, one must ask that if a program based on faith in God and on prayer to “Him” isn’t religious, what is?

AA and Spirituality

One might also ask what’s spiritual about encouraging blind acceptance? What’s spiritual about discouraging critical thinking? What’s spiritual about disparaging those who ask honest questions? What’s spiritual about encouraging people to identify with destructive past behaviors? What’s spiritual about telling people that they’re “diseased” for life? “What’s spiritual about telling people that they’re “powerless” to solve their own problems? What’s “spiritual” about inculcating dependency? What’s spiritual about issuing destructive, self-fulfilling prophecies? What’s spiritual about telling vulnerable people that their only alternatives to AA are “jails, institutions, or death”?

These are things religions do. As for AA:

• Blind acceptance? Check.
• Discouragement of critical thinking? Check.
• Ostracism of doubters (“heretics”)? Check.
• Identification of self with sins (past behaviors)? Check.
• Diseased (“sinful”) members? Check.
• Personal powerlessness? Check.
• Dependence on an institution for salvation? Check.
• Fear-mongering about an inevitable downward spiral if one abandons the institution and its teachings? Check.

 

It’s time for some honesty. It’s time for AA to admit it’s religious, not spiritual.

Related Posts

• Alcoholics Anonymous does more Harm than Good
• Alcoholics Anonymous is not Effective
• Alternatives to AA — and Why They’re Needed
• Why is Alcoholics Anonymous Sacroscanct?

The Opioid “Epidemic” — what no one is talking about

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

Chris Hedges’ series on RT, “On Contact with Chris Hedges,” has a new episode titled “The Fatal Addiction.” In it, Hedges does a fine job of presenting the human cost — the heartache, the deaths (50,000 last year in the U.S.) — caused by opioid addiction and overdoses.

While he succeeds at that, he doesn’t deal with the causes of addiction, nor with the failed, dominant approaches to curbing drug addiction, nor with better approaches. (Of course, it’s too much to expect any of this in a half-hour documentary, and one hope Hedges will deal with these matters in future episodes.)

Since “The Fatal Addiction” doesn’t tackle these issues, we will here. Please consider the following:

• The dominant view of addiction in the U.S. is that it’s both a result of moral failings and is a “disease” or “illness.” (See AA’s “Big Book.”) This is  wrong on both counts, which can be easily seen when you look at historical addiction and overdose rates. They’re not steady, but vary dramatically over time.

Opioid overdose deaths have multiplied tenfold over the last two decades in the U.S.; reported rates of alcoholism have also fluctuated considerably over the years; the rate of tobacco addiction has plummeted in recent decades; and 95% of American soldiers who were addicted to heroin in Vietnam kicked it without treatment after they came home.

If addiction was caused by moral “shortcomings” (see AA’s 12 steps), one might ask whether former tobacco addicts became more moral over the years, whether morality skyrocketed among heroin-addicted Vietnam vets after they returned home, and whether the spiking opioid addiction rate has been caused by a mass outbreak of individual depravity.

If addiction is a “disease,” not a behavior, as we’re constantly told by 12-step treatment professionals, 12-stepping celebrities, and reporters who accept that absurd assertion at face value and who haven’t done their jobs (investigating, analyzing, raising awkward questions), one might ask the following: Why would the rates of addiction to different substances vary so radically from one substance to another in the same time periods, why would the rates of addiction to single substances vary so radically over time, and what does disease “theory” predict about rates of addiction in the years ahead?

Disease “theory” advocates have no answers to these questions, because disease “theory” is a “theory” only in the popular sense of the term (a conjecture or wild guess). In a word, it’s an assertion. It is in no way a scientific theory, and hence cannot provide answers; its adherents cannot use it to generate testable (falsifiable) predictions.

The dominant 12-step view of addiction (that it results from moral shortcomings and is a “disease”) is very, very wrong.

(As for the actual roots of addiction, one can look to psychological factors — stress and hopelessness, to oversimplify — and the environmental factors contributing to stress and hopelessness. I dealt with this in a separate post, “AA, the War on Drugs, and Disastrous Misconceptions,” so I’ll leave the matter here.)

• As for AA and the treatment approaches derived from AA with its incorrect assertions about “moral” failings and “disease,” they’re every bit as ineffective as you’d expect.

Twelve-step groups such as AA and its clones (NA, CA, etc.) produce results no better than the rate of spontaneous remission, as shown by the best available studies: studies with control groups and random assignment of subjects, mass-participation longitudinal studies, and AA’s own triennial surveys. I summarized this evidence in “Alcoholics Anonymous Is Not Effective,” so again I’ll leave the matter here.

The formal (“professional”) 12-step treatment programs derived from AA are just as ineffective as AA itself. (I haven’t put up anything about this on the blog, but deal with the matter at length in Alcoholics Anonymous: Cult or Cure?)

One telling segment in Chris Hedges’ documentary is with an interviewee who mentions an addict who’s been in and out of rehab 17 times, which the interviewee says is typical. (The numerous 12-step references in the documentary [“meetings,” “sponsors,” “recovering addicts”] are equally typical.)

Clearly, the dominant American approaches to addiction aren’t working. Why, beyond faulty “moral failings” / “disease” premises?

• For one thing, we’ve been stuck with the authoritarian, worse-than-useless “war on drugs” and the criminalization of addicts and recreational drug users for decades. This has resulted in untold suffering and incredible waste of tax money (easily $1 trillion over the years, and currently a good $50 to $70 billion per year).  Criminalization has ruined countless lives to no good effect, and it’s been utterly ineffective at reducing drug use and addiction. If you doubt this, consider the number of opioid overdose deaths over the years, that hard drugs are freely available to almost anyone who wants them (see Hedges’ “The Fatal Addiction“), and have become both cheaper and more powerful as the “war on drugs” has ground on.

So, what does work? What will reduce drug use, addiction rates, and deaths from overdoses?

• On the purely personal level, the only treatment approaches with good evidence of efficacy are cognitive behavioral therapy approaches. (I deal with this in the final paragraphs of “Alcoholics Anonymous Is Not Effective.”)

I should note that methadone “treatment” merely substitutes a legal synthetic narcotic for illegal narcotics; this is substitution, not treatment — it keeps users dependent on an addictive substance.

• On the societal level, it’s obvious that the “war on drugs” and criminalization of drug users and addicts must be abandoned.

Not only has criminalization of drug users and addicts failed to reduce the rates of drug use and drug addiction, it has taken an incredible human and economic toll. It’s done nothing to reduce the availability nor the price of drugs. And it’s a major component of “big government” intrusion into the lives of individuals.

Criminalization of drugs and drug users has been an utter disaster.

(Those who profit from the enslavement of “war on drugs” prisoners might disagree.)

Criminalization of drugs and their users is in large part directly responsible for the tens of thousands of overdose deaths every year in the U.S. Why? There is no quality control with illegal drugs. Those who buy them (especially opioids) are quite literally gambling with their lives, and multitudes lose that gamble every year.

So, is legalization (or at least decriminalization) a better approach?

Yes.

In Portugal, where drug use was decriminalized in 2001, the rate of death from overdoses has plummeted, as shown in a recent Washington Post article, “Why hardly anyone dies from a drug overdose in Portugal.” The rate of opioid addiction has fallen in half. Portuguese taxpayers aren’t paying ungodly amounts of money annually to lock up drug users and drug addicts. And Big Brother isn’t intruding (or at least intruding less) into one aspect of the lives of individuals.

• Finally, here’s a question that almost no one asks, and even fewer try to answer: Why do millions of Americans feel so stressed, so hopeless that they drink themselves to death or play Russian Roulette with hard drugs?

The answer to that question has been available for decades.

A few ways to moderate your drinking

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

Here are a few time-tested ways with which people have moderated their drinking. As with almost everything else in life, there are no guarantees that these will help. But if you’re concerned about your drinking and don’t want to quit, here are a few things that might work for you. Emphasis on might. (The AA dogma that you’re powerless is simply wrong — there’s a good chance that if you work at it you can learn to control your drinking, or at least moderate the harm it causes. You are not powerless.)

For now, we’ll address only the day-to-day techniques. And please note that this is not a comprehensive list of moderate-drinking techniques. These are only a few things that I know of that have helped people who want to keep drinking but want to moderate, and who don’t want to give up their drinking friends and usual haunts:

• Alternate alcoholic drinks and nonalcoholic drinks. For example, if you’re drinking beer, have a glass of water between every beer. The water will help you avoid getting drunk, and you’ll have the reward of a beer after every glass of water.
• Keep track of how much you’re drinking — write it down. Keep a “drink diary.” In years past, this was done with a pen and  pad. Nowadays, I’d be surprised if there wasn’t an app for it.
• If you’re out drinking, keep track of how much you’re drinking and over how much time. If you do this and have any doubts at all as to whether you’re close to or over the legal limit, look up your estimated blood alcohol content (BAC). Moderation Management has BAC charts on line. Here’s the BAC chart for men, and here’s the BAC chart for women.
• To take things a step further, carry a breathalyzer with you. Key fob, battery-powered breathalyzers are available on eBay for under two dollars, shipping included, and presumably better ones are available for about ten bucks. Before relying on one of these cheap Chinese products, though, it’d probably be a good idea to have a couple of drinks at home and check the breathalyzer reading against the BAC chart.
• Allow yourself a certain number of days per week to drink. Keep track of them. Even taking one day off per week is better than drinking every day (though three or four days off per week is better than that). After having a no-alcohol day or two, you can look forward to your next drinking day.
• Avoid hard booze, wine, and medium- to high-octane beer, and stick religiously to low alcohol beer. Stick to beer with 3.5% alcohol by volume or under. Some of these beers actually taste pretty good, and will get you buzzed but (probably) not drunk. (You’d have to work at it to get drunk on 3.3% beer.)  Sticking only with the ones commonly available nationally, the best are probably Kirin Light (3.3%), Heineken Light (3.3%), and Amstel Light (3.5%); the Miller (MGD 64) and Budweiser (Bud Select 55) low-alcohol brews are considerably worse than their full-alcohol (5%) counterparts. (Bud Light, at 4.2%, is not a low alcohol beer.) If you’re drinking craft beers, stick to the blondes, which tend to be under 4.0%. And even when drinking low-alcohol beers, do alternate them with nonalcoholic drinks.

There are no guarantees that these techniques will help you moderate your drinking. But they might.

If they don’t work, you can always try an abstinence program such as AA or SMART Recovery, and more likely succeed at it because you’ve given moderation a shot.

AA, the War on Drugs, and disastrous misconceptions (revised)

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

There are direct connections between the beliefs underlying Alcoholic Anonymous and those underlying the “war on drugs.” The most fundamental is that alcohol and other drugs are “cunning, baffling, powerful!” (to quote AA’s  “Big Book”) This belief is reflected in the common “drug war” term “dangerous drugs” in reference to illegal drugs, which combined, until recently, to kill about 5% of the roughly half-million Americans killed annually by tobacco and alcohol; today, about 50,000 are killed annually by overdoses, the vast majority by opioid overdoses. In other words, alcohol (roughly 100,000 deaths) and tobacco (roughly 400,000 deaths) kill ten times as many Americans as all illegal (and misdirected pharmaceutical) drugs combined.

To put this in further perspective, “drug warriors” almost never refer to alcohol and tobacco as “dangerous drugs,” while they do routinely refer to marijuana, which has never killed a soul, as a “dangerous drug.” Some of them might actually believe that it is.

The concomitant belief, that human beings are “powerless” over “cunning, baffling, powerful!” drugs, is shared by both AA and drug prohibitionists. In AA and its clones (NA, CA, etc.) that belief is enshrined in the first of the 12 steps. It’s also part of the bedrock of the “drug war”: if people are powerless and drugs are powerful, the only way to stop the harm of drug addiction is to cut off the supply of drugs.

The other underlying “drug war” belief is based in punitive Christian morality: the belief that the only way to deal with prohibited (sinful) behavior is through punitive measures–in the case of drugs, that it’s necessary to lock people in cages for using drugs and for making drugs available to others.

Another aspect of this belief system, common to both AA and the “drug war,”  is the belief that drug use and abuse are an individual matter, that individual drug users and abusers are either victims of a “disease” (according to AA — never mind the absurdity of labeling behaviors as “diseases”) or are criminals (according to “drug warriors”). What ties these two seemingly disparate beliefs together is that they both divorce drug use and abuse from their social and economic contexts.

A moment’s reflection shows that this is an absurd approach. If drug use and abuse were entirely the result of individual immorality or individual powerlessness over drugs,  the rates of drug use and abuse would not vary drastically (if at all) from one nation to another, nor would the rates vary wildly within nations over the years. But they do. Neither “disease” advocates nor “drug warriors” can explain these variances. To explain them, you need to consider social and economic contexts.

A case in point is a study published in Proceedings of the National Academy of Sciences by Princeton researchers Anne Case and Angus Deaton on the increased mortality rate among middle-aged white, especially male, Americans aged 45 to 54 from 1998 to 2015, with the increase being .5% per year. During the previous two decades, 1978 to 1998, the mortality in that age range had been decreasing by about 2% per year–as indeed it’s continued to do so in all of the other developed countries since 1998. Why? The researchers posit that, while there’s no definitive proof, these increases are likely due to an increased suicide rate and increased drug and alcohol abuse triggered at least in part by increased financial stress.

If 12-step advocates and drug prohibitionists were correct that the use and abuse of alcohol and other drugs is a result only of individual “disease” or inherent “criminal” (sinful) tendencies, this increase in drug and alcohol abuse would not have happened. But it did. The solution advanced by 12-step advocates is treatment, and by “drug warriors” is a combination of imprisonment and treatment. In both cases, the treatment offered is almost exclusively 12-step treatment, which does not consider social or economic contexts nor social or economic solutions, but rather focuses exclusively on individual “wrongs,” “shortcomings,” and “defects of character” (respectively, steps  5, 7, and 6), with the solution to alcohol/drug abuse being “prayer” (step 11), taking a “moral inventory” (step 4), and “turn[ing] our will and our lives over to the care of God” (step 3).

As one would expect, the 12-step religious program does not work very well. As covered in  a previous post, Alcoholics Anonymous is not effective, both AA’s own statistics (“Comments on AA’s Triennial Surveys”) and controlled studies report that the recovery rate in AA is no better than the rate of spontaneous remission, about 5% annually. Controlled studies of formal 12-step treatment have been even more dismal, with some components used in such treatment, e.g. confrontational “counseling,” having negative outcomes.

So, what do AA advocates and “drug warriors” lean on for scientific support?

One of the standard studies cited — quite possibly the most commonly cited — by 12-step advocates and prohibitionists was conducted in the 1960s. It involved placing rats in Skinner boxes (small boxes with no toys or other amenities–essentially solitary confinement for rats in an ultra-deprived environment) and then giving the rats the choice of either plain water to drink or water laced with morphine. Surprise, surprise — the rats chose the water with morphine. This study was widely cited by both drug prohibitionists and the mass media as “proof” that rats, and by extension people, are powerless over irresistible drugs.

In the 1970s, researchers at Simon Fraser University conducted a similar study, but with the rats in a much larger cage filled “with things that rats like, such as platforms for climbing, tin cans for hiding in, wood chips for strewing around, and running wheels for exercise. Naturally we included lots of rats of both sexes, and naturally the place soon was teeming with babies. The rats loved it and we loved it too, so we called it ‘Rat Park.'” The results? The Rat Park experiment showed that in this rich environment the rats ignored the morphine-laced water and drank plain water instead. The initial study was published in 1978 in the scientific  journal Psychophramacology. The mass media, government, and disease-concept advocates ignored it, and AA, 12-step treatment, and the “war on drugs” rolled on, leaving millions of ruined lives in their wake.

The lessons of all this are obvious: It’s time to stop blaming those who are self-medicating, and to stop looking at drug use, abuse, and addiction as the result of individual sinfulness or “disease.” It’s time to stop locking people in cages.

It is time to start looking at, and addressing, the environmental, economic, and social reasons why millions of people find life so intolerable that they — like rats in a deprived environment — feel the need to seek solace in illegal drugs, alcohol, and misdirected pharmaceutical drugs. And it’s long past time to start doing something about the environmental, economic, and social reasons for drug use, abuse, and addiction.

* * *

For more information on Rat Park, see lead researcher Bruce K. Alexander’s 2010 book, The Globalization of Addiction: A study in poverty of the spirit. 

Related Posts

• Alternatives to AA — and Why They’re Needed
• Alcoholics Anonymous is not Effective
• Alcoholics Anonymous is Religious, not Spiritual (part 1)
• Alcoholics Anonymous is Religious, not Spiritual (part 2)
• Why is Alcoholics Anonymous Sacroscanct?
• AA does more Harm than Good

More Joy of Religion

I love writing these posts — they practically write themselves, and I chortle all the way through the writing process. I delight in the sick and grotesque, and, as you’ll see, religion really delivers the goods.

So, here it is, the best of religion since the beginning of the year.

(This post will be a bit shorter than our previous Joy of Religion post. We’ve omitted the items about religious parents killing or seriously harming their children by denying them medical care, because such items are so common and so depressing.)

Anyway, here goes. Enjoy!

• There are a lot of good atheist videos on Youtube from ex-Muslims. One that we particularly like is Things Muslims Should Know About Apostasy. About 30 seconds in, check out the crybaby Islamic judge wailing about “insults” to the prophet. Like all too many PC leftists and Christian fundamentalists, Islamic religious extremists believe that they have a right not to be offended. They don’t. It’s a binary choice:  either you have the “right” not to be offended or you have the right to free speech. As is blindingly obvious, if everyone has the “right” not to be offended, no one will have the right to free speech. And if only some have the “right” not to be offended, you end up with tyranny.
• A recent piece in The Guardian, The shelter that gives wine to alcoholics, provides yet more evidence that the religious approach to addictions enshrined in Alcoholics Anonymous is utterly useless, if not actively harmful, and that the secular harm reduction approach produces much better results. (The rate of recovery via AA is no better than the rate of spontaneous recovery.)
• The always entertaining Rev. James David Manning of ATLAH Worldwide Missionary Church has proclaimed that “God is gonna put a cancer in the butthole of every sodomite,” and that “every sodomite will have a flame coming out of his butthole,” necessitating “special ass asbestos diapers.” Do check out the video — Manning’s words only hint at the power, at the magnificence of his performance.
• If you’ve ever doubted how misogynistic Mormonism is, check out Rape victim could be punished under BYU’s ‘honor code.’
• For yet another testimony to the salutary effects of religion upon individual judgment, see Woman says rapture was coming, God told her to crash car into Walmart.
• And finally, via Florida Man, in an item which seems like it must have a religious connection, though the article doesn’t mention one, we find Florida man charged with soliciting sex with dogs on Craigslist.

Stay tuned. More to come.

Still more Interesting and Marginally Useful Internet Crap

When I saw  a news report about a campaign to ban sex robots, I laughed. I thought that the “campaign,” if it actually existed, was the result of:

1. The entire Onion staff going on a PCP binge
2. Denizens of the fetid, postmodernist swamps of academia unleashing a new mutant horror upon an unsuspecting public
3. Some pranksters doing an excellent imitation of the entire Onion staff going on a PCP binge

Then I saw another article on the campaign, and followed the link to the campaign’s web site. I still wasn’t convinced it was real, despite persuasive evidence on the site–sex robots will, somehow, “objectify” women, and (as always) must be banned for the sake of the children. You’d think that would have been enough, but no. So, I looked up both members of the “organizing committee”–all two of ’em–and they’re real academics with real jobs in academia! I’ve gotta stop being so suspicious.

The Guardian has a good article, “I was fresh meat,” on a negative aspect of AA we haven’t covered here: sexual exploitation of newcomers. As long as we’re on the topic of Alcoholics Anonymous, I’ll mention again that the best online source of information on AA is Orange Papers.

If the entirely unwarranted worship of Ronald Reagan by Republicans makes you queasy (as any type of hero worship should), check out The Intercept’s “Seven things about Ronald Reagan you won’t hear at the Reagan Library GOP debate.” It’ll provide several handy facts you can cite the next time an acquaintance shows disturbing signs of Reagan worship.

The stupidity of the right’s rhetoric about a “war on police” is revealed by the figures reporting violence committed by police and violence committed against police. According to The Guardian‘s “Counted U.S. Police Killings,” “US police kill more in days than other countries do in years.” There’s no government registry of police killings, so The Guardian‘s count of 862 citizens killed by U.S. cops so far this year is very probably low. At the same time, according to the National Law Enforcement Officers Memorial Fund, 96 cops have died in the line of duty this year. However, according to the same pro-police site, last year over half of the 117 police fatalities resulted from accidents or illness, with only 49 resulting from assault (primarily gunshots). Assuming the same holds true this year, that would mean that 39 cops have died from citizen assaults in 2015. Compare that with the 862 citizens killed by the police. That works out to a 22:1 ratio. There’s a war on all right, a war of the nation’s cops on its citizens.

The Best Source of Information about Alcoholics Anonymous

by Chaz Bufe, author Alcoholics Anonymous: Cult or Cure?

A friend mentioned the Orange Papers site to me tonight. I’d forgotten about it, as it’s been around forever, and I’m thoroughly sick of writing about AA–and reading about it, too, for that matter. (Twelve years ago, some kids torched my guest house, which was home to all of my research materials on AA and substance abuse treatment; it was almost a relief.)

Back to Orange Papers….. The site contains an amazing amount of well researched, well argued material. I’m familiar with almost all of the areas covered,, and everything I’ve seen on the site is accurate. (There’s also a lot of information on it of which I was unaware.)

It’s all there (topics in no particular order here):

• AA’s actual (in)effectiveness as opposed to its claimed effectiveness
• AA’s “spirituality” as very thinly disguised religiosity
• AA’s origin as part of a wacko evangelical group
• AA’s principles as codification of that evangelical group’s principles
• The pro-Nazi statements and actions of that evangelical group’s head and other prominent members
• The intellectual dishonesty of the AA program
• AA’s pronounced anti-intellectualism
• AA’s other cult-like aspects
• Cults that have grown out of AA
• And some good news: most people with alcohol problems overcome them on their own without any contact with AA; there’s some evidence that people exposed to AA do worse than those never exposed to it–in other words, AA is not necessary to overcoming alcohol problems, and could well be harmful

Don’t let the archaic appearance of the Orange Papers site put you off.  Its information is accurate, amazingly thorough, and up to date.

Years ago, I tried to talk the site’s author into writing a book on AA. Unfortunately, he declined. I still wish he’d do it.

For now, instead of a book, we have Orange Papers. If you’re at all interested in AA, it’s the best place on the ‘net for information.

Related articles

• Humanist Group Defends Atheist Sentenced to Attend Faith-based Substance Abuse…

Rant of the day: Why drink and take drugs?

Today’s guest post is by Ronn Spencer

There are better remedies for “substance abuse” than joining a cult hell-bent on convincing you to subordinate yourself and be dependent on them for the rest of your life–a perpetual victim whining about your deficiencies to other needy and gullible dupes who are now addicted to their specious and fatuous “cure.”

Here’s how I see it. First, one group of idiots creates the modern world and all its attendant miseries (your ruling class). Next, another group of con artists (the media, public schools the clergy, AA, etc). proclaim this lifestyle as splendid, rewarding, and, worse yet, beneficial to the human spirit. Then, the handful of us who understand that the whole thing is a soggy, decomposing wad of stinking, rotting half-truths and delusions are demonized and pilloried for trying to self-medicate our way through their nightmare.

“Hi, welcome to Bedlam, here’s your bunk. Don’t mind the rat crap and the petrified vomit on the walls–you’ll get used to it. What’s that? Didn’t apply for this? Too bad! Lay down and behave or the attendant brings the restraints. Leave? Are you kidding? You can’t leave! This is a club you never asked to join and that will never accept your resignation.”

So, we self-medicate. Booze, drugs, sex, which at least are participatory sports. Unlike America’s favorite panacea–sitting in front of the television and having your id, ego, superego, and unconscious slowly sucked out of your body by a cathode vampire.

If you’ve really decided to kick the booze, the dope, the smokes, so be it. When you cross that line where the stuff is corroding the plumbing you have no choice but to find some other coping mechanism. That’s why motivational speakers, televangelists, gurus, AA, and the rest of the charlatans are making big bucks nowadays.

My advice is to avoid these parasites with every fiber of your being and rely on stoicism, courage, resolve, and intellect. Otherwise, like the balloon-benders used to do on variety shows in the ’50s, the snake oil salesmen will twist your noodle into a cute doggie, pigeon or fat, stupid Rotarian.

12-Step Coercion — A Victory Against It

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure? and co-author, with Stanton Peele and Archie Brodsky, of the now-out-of-print Resisting 12-Step Coercion

Last week, Barry Hazle, a victim of religious coercion received a $1.95 million settlement from the institutions which first coerced him and then imprisoned him:  the WestCare corporation, a contractor which delivers 12-step treatment, and the State of California.

In 2004, Hazle was convicted of possession of methamphetamine and was placed on probation. In 2006, he was imprisoned for violating his probation by using meth, and subsequently spent a year in jail. After his release, he was ordered to attend a WestCare treatment facility in Shasta County. When he told his parole officer he was an atheist and objected to 12-step treatment–and the California Department of Corrections and Rehabilitation order mandating that inmates and parolees be given the choice of religious (12-step) or nonreligious treamtnet–his parole office ordered him to attend the WestCare facility anyway.

According to the Sacramento Bee, Hazle went, but was subsequently kicked out of the 12-step program for being  “disruptive, though in a congenial way, to the staff as well as other students.”  That almost certainly translates to  being polite but refusing to toe the 12-step line (turning one’s life and will over to God, and praying to God to remove one’s character defects). That was enough for the Westcare facility to kick Hazle out, sending him back to jail for another 100 days.

He subsequently sued, and following a jury trial (which found for him, but which awarded him no damages) and the appeals process, he reached a $1.95 million settlement with WestCare and the State of California. Revealingly, WestCare maintained during the trial and appeals process that it had never received the Department of Corrections order, which is very hard to believe, and that it didn’t understand the meaning of “alternative non-religious program,” which is astounding. WestCare is a national organization active in 17 states and worth, presumably, in the tens of millions of dollars; and it’s supposedly a professional organization.

And professionals providing addictions treatment of any kind in 2006 would certainly have been familiar with the most important academic/professional work on the topic, University of New Mexico researchers Reid Hester’s and William Miller’s encyclopedic Handbook of Alcoholism Treatment Approaches, 3rd edition (2003), which provides very detailed information on the practice and effectiveness of many types of “alternative non-religious program[s].” (It also provides detailed information on the practice and ineffectiveness of 12-step treatment.) As well, the Internet was around in 2006, and even the briefest search for “alternative non-religious addiction treatment program” would have resulted in at least several hundred thousand results. (I just googled that phrase and came up with 3,130,000 results.)

On the other hand, religious zealots masquerading as addictions professionals would feign ignorance, and maintain that they have no idea of the meaning of “alternative non-religious treatment.”

Today, coercion into 12-step groups and treatment is still routine in piecemeal form across the country, and many, many people are punished unjustly for resisting it. Despite three U.S. courts of appeal, four state supreme courts, and nine federal district courts ruling that 12-step groups and treatment are religious, and that mandates to such groups and treatment are unconstitutional because they violate the First Amendment’s “establishment clause,” there’s no national binding precedent forbidding such mandates: the Supreme Court has refused to hear any of the cases.

One can only hope that many other courageous victims of 12-step coercion will step forward and file lawsuits against their coercers.

 

 

 

 

Why is Alcoholics Anonymous sacrosanct?

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

AA is arguably America’s most sacred cow, and has been almost since it first came to public notice prior to World War II. During the more than three-quarters of a century since then, while the country was inundated in pro-AA books and newspaper and magazine articles, entire decades went by without publication of a single book critical of AA, or a single critical article in a major periodical. This has changed a bit in recent years, but public criticism of AA is still relatively rare.

Why?

AA presents alcohol abuse as an entirely personal problem, and preaches that AA always “works if you work it.” If someone goes to AA and it doesn’t work for them, they tend not to talk about it, because of the stigma attached to alcohol abuse and because they probably do believe what they heard in AA–that their problems are entirely their fault. So, they don’t talk about AA.

And there are a lot of such people: well over a million Americans are either attracted to AA or are coerced into attendance annually, and then leave almost immediately. (According to its own figures, AA’s membership has been nearly static over the last two decades, with a growth rate considerably under 1% per year.)

But you don’t hear from those repelled by AA. Rather, you hear from and about the relatively few AA successes (roughly 5% according to AA’s triennial surveys). And because AA is a “program for life,” those few successes stick around to trumpet AA as “spiritual, not religious” (though it clearly is religious, as several federal courts of appeal have ruled), and as the only approach to alcohol abuse that works (though it clearly doesn’t work–its success rate is about that of spontaneous remission).

Those AA successes also tend to be the owners/operators of almost all alcohol abuse treatment facilities in the United States. They then use their position as “experts” to promote AA and its “program.” They also found “public health” 12-step front groups, notably the National Council on Alcoholism and Drug Dependence (NCADD), to lend a scientific sheen to their promotion of AA. (The NCADD is hostile to scientifically based treatment methods with good evidence of efficacy.)

Given all this, it’s not surprising that there’s so little critical examination of AA in the corporate media. Reporters are often overworked, and sometimes lazy, so they tend to take the easy way out and report as fact the claims of 12-stepping “experts,” while doing no investigation of those claims. Beyond that, there are many 12-steppers and relatives of 12-steppers in the media who openly promote AA and attack its critics while concealing their connections to AA. (One can’t “break anonymity,” of course.)

(Even some of those from whom you’d expect better fall into this category. About fifteen years ago Bill Moyers [who has a 12-stepping son] produced Close to Home: Moyers on Addiction about alcohol abuse and alcohol treatment. It was a love letter to AA and one of the most dishonest pieces of reporting I’ve ever seen.)

So, the next time you see a glowing article on AA, or an interview with a gushing “recovering” celebrity, don’t be surprised. Just be aware that the claims of AA’s promoters are just that–claims. AA is religious, not spiritual. And its success rate is no better than the rate of spontaneous recovery–that is, AA is utterly ineffective. Not that you’ll hear much about that in the media.

Related Posts

• Alcoholics Anonymous does more Harm than Good
• Alternatives to AA — and Why They’re Needed
• Alcoholics Anonymous is not Effective
• Alcoholics Anonymous is Religious, not Spiritual

 

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Alcoholics Anonymous Is Not Effective

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

AA’s supporters commonly trumpet AA as the best, if not the only, way  to deal with alcohol problems. To back their claims, they cite anecdotal evidence and uncontrolled studies; but they ignore the best scientific evidence–the only available controlled studies of AA’s effectiveness–as well as the results of AA’s own internal surveys of its membership.

There have been only two controlled studies (with no-treatment comparison groups) of AA’s effectiveness. Both of these studies indicated that AA attendance is no better than no treatment at all.

The first of these studies was conducted in San Diego in 1964 and 1965, and its subjects were 301 “chronic drunk offenders.”(1) These individuals were assigned as a condition of probation to attend AA, to treatment at a clinic (type of treatment not specified), or to a no-treatment control group. All of the subjects were followed for at least a year after conviction, and the primary outcome measure was the number of rearrests during the year following conviction. The results were that 69% of the group assigned to AA were rearrested within a year, 68% of the clinic-treatment group were rearrested, and 56% of the no-treatment control group were rearrested. Based on these results, the authors concluded: “No statistically significant differences between the three groups were discovered in recidivism rate, in number of subsequent rearrests, or in time elapsed prior to rearrest.”(2)

(As an aside, the results of this study were very close to being “statistically significant.” This normally means–as it did in this study–that there’s a 5% or less likelihood that random chance accounts for an outcome. In the case of this study,  there was a 6% or less  likelihood that the poor results of the AA group were the result of random chance. Hence, the authors classified the result as “no[t] statistically significant.”)

The second controlled study of AA’s effectiveness was carried out in Kentucky in the mid-1970s, and its subjects were 260 clients “representative of the ‘revolving door’ alcoholic court cases in our cities.”(3) These subjects were divided into five groups:  One was assigned to AA; a second was assigned to nonprofessionally led Rational Behavior Therapy; a third was assigned to professionally led Rational Behavior Therapy; a fourth was assigned to professionally led traditional insight (Freudian) therapy; and the fifth group was the no-treatment control group. The individuals in these groups were given an outcome assessment following completion of treatment, and were then reinterviewed three, six, nine, and twelve months later.

The results of this study were as follows: AA had by far the highest dropout rate of any of the treatment groups–68%;  the lay RBT group had a 40% dropout rate; the professionally led RBT group had a 42% dropout rate; and the professionally led insight group had a 46% dropout rate.

In terms of drinking behavior, 100% of the lay RBT group reported decreased drinking at the outcome assessment; 92% of the insight group reported decreased drinking; 80% of the professionally led RBT group reported decreased drinking;  67% of the AA attendees reported decreased drinking; and only 50% of the no-treatment controls reported decreased drinking.

But in regard to bingeing behavior, the group assigned to AA did far worse than any of the other groups, including the no-treatment control group. The study’s authors reported: “The mean number of binges was significantly greater (p = .004) (4) for the AA group (2.37 in the past 3 months) in contrast to both the control (0.56) and lay-RBT group (0.26). In this analysis, AA was [over four] times [more] likely to binge than the control [group] and nine times more likely than the lay-RBT group.(5)

It seems likely that the reason for this dismal outcome for the AA group was a direct result of AA’s “one drink, one drunk” dogma, which is drummed into the heads of members at virtually every AA meeting. It seems very likely that this belief all too often becomes a self-fulfilling prophecy, as it apparently did with the AA attendees in this study. Combine this with the million-plus people coerced into AA attendance annually in the U.S., and AA’s astronomically high dropout rate (95%, according to AA’s own triennial surveys), and it’s reasonable to speculate that AA contributes to binge drinking.

The third significant piece of evidence regarding AA’s effectiveness is that provided by AA’s triennial membership surveys. In 1990 or 1991 (there’s no publication date; I obtained the report in 1991), AA produced an analysis of its previous five triennial membership surveys, “Comments on AA’s Triennial Surveys.”(6) This document revealed that 95% of those coming to AA drop out during their first year of attendance. (7) Even if all those who remain in AA stay sober (which is not the case), this is still a poor success rate, even in comparison with the rate of spontaneous remission.

There have been many studies of spontaneous remission (sometimes called spontaneous recovery), and one meta-analysis of such studies indicates that between 3.7% and 7.4% of individuals with alcohol problems “spontaneously” recover in any given year.(8) In comparison with this, AA’s annuals 5% retention rate of new attendees is not impressive. And that 5% rate might be optimistic–it was derived from surveys conducted during the 1970s and 1980s, a period of very high growth in AA membership. In contrast, since the mid-1990s, AA’s U.S. membership has been almost flat. According to AA’s own figures, two decades ago it was roughly 1.2 million, and in January 2013 it was approximately 1.3 million.(8). This works out to a minuscule growth rate of under one-half of one percent annually. Even taking into account dropouts with “time” (in this “program for life”) and mortality, this means that AA’s current annual new-member retention rate could well be under 5%.

As for AA being the only way to beat an alcohol problem, it has been known for decades that alcoholism (alcohol dependence–as contrasted with mere alcohol abuse) disappears faster than can be explained by mortality after the age of 40.(9) Also a very large Census Bureau-conducted survey in the early 1990s found that over 70% of the formerly alcohol-dependent individuals surveyed (over 4,500 in all) had recovered without participating in AA or attending treatment of any kind, and that those who had not participated in AA or attended treatment had a higher rate of recovery than those who had.(10)

As well, in contrast to AA and treatment derived from it (the dominant mode of treatment in the U.S.), there are several types of treatment that are well supported by the best available scientific evidence (studies with random assignment of subjects and no-treatment control groups, and/or comparison groups using standard 12-step treatment). Among the best-supported therapies are those known as the community reinforcement approach, social skills training, motivational enhancement, and brief intervention.(11) All of these well-supported therapies are low-cost, cognitive-behavioral approaches in which alcohol abusers are reinforced in the belief that they have power over their own actions, and are responsible for them. (This is in direct contrast to the 12-step approach, which teaches alcohol abusers that they are “powerless.”) Unfortunately, none of these proven-effective, low-cost therapies is in common use in the United States, in which the ineffective 12-step approach dominates.

Finally, over the last third of a century, a number of “alternative” (non-12 step) recovery groups have arisen in the U.S., and many, many individuals have recovered through them. Abstinence-oriented groups include SMART Recovery, Secular Organizations for Sobriety, Lifering, and Women for Sobriety. Moderation-oriented groups include Moderation Management and Harm Reduction Network. Between them, they have hundreds of meetings across the country and all provide help via the Internet.

In sum, those who trumpet AA as the best (or only) way to deal with an alcohol problem do so only by ignoring well supported alternative therapies, the widespread “alternative” self-help groups, the best available scientific evidence, and the evidence generated by AA itself.

Endnotes

1. Ditman, K.S. et al. “A controlled experiment on the use of court probation for drunk arrests.” American Journal of Psychiatry, 124(2), pp. 64-67.

2. Ibid., p. 64.

3. Brandsma, J.M. et al.  Outpatient Treatment of Alcoholism: A review and comparative study. Baltimore: University Park Press, 1980.

4.  This means there was only a 1 in 250 chance that this was the result of random chance.

5. Op. cit., Brandsma et al., p. 105.

6.  “Comments on AA’s Triennial Surveys,” no author listed. New York: Alcoholics Anonymous World Services, n.d. (This document was intended for AA’s internal use only. It’s very crudely produced–mimeographed stapled sheets bound by a staple in one corner–and is not part of AA’s official “conference approved” literature. I first found mention of this document while digging through the reference shelves at AA’s San Francisco intergroup office in 1991, and I–and subsequently other researchers–obtained it by writing to AA’s General Service Office in New York and asking for it.)

7. Ibid., p. 12.

8. http://www.aa.org/en_pdfs/smf-53_en.pdf

9. Drew, R.D. “Alcoholism as a Self-Limiting Disease.” Quarterly Journal of Studies on Alcohol, 29, pp. 956-967.

10.  Dawson, Deborah. “Correlates of past-year status among treated and untreated persons with alcohol dependence: United States, 1992. Alcoholism: Clinical and Experimental Research, Vol. 20, pp. 771-779.

11. See Handbook of Alcoholism Treatment Approaches (3rd Edition), by William Miller and Reid Hester. Pearson, 2002.

Related Posts

• Alcoholics Anonymous does more Harm than Good
• Alternatives to AA — and Why They’re Needed
• Alcoholics Anonymous is Religious, not Spiritual
• Why is Alcoholics Anonymous Sacroscanct?

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Alcoholics Anonymous Does More Harm Than Good

by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?

Alcoholics Anonymous (AA) is, arguably, America’s most sacrosanct institution. Its promoters (often AA members hiding behind “anonymity” while they promote AA) present it as an unalloyed good: effective, “spiritual not religious,” supportive, nonjudgmental, purely voluntary, based on “attraction not promotion,” and leading to personal growth (being “better than well”). Some even state that AA has no negative aspects whatsoever and that AA with it’s 12-step approach is the only effective approach to addictions problems.

All of this is wrong. The rate of recovery via AA is no greater than the rate of spontaneous remission. AA was part of a Protestant evangelical group for the first several years of its existence, and its 12-step program is blatantly religious by any reasonable definition of the word. AA is supportive — as long as you parrot its party line. It’s nonjudgmental–again, as long as you parrot the party line. AA is not purely voluntary; over a million Americans per year are coerced into attending it via court orders and employee assistance programs, as a condition of avoiding jail or keeping their jobs; and many of AA’s promoters insist that AA doesn’t promote itself, even as they do exactly that. As for AA members being “better than well,” attend any meeting and judge for yourself. And AA does have serious negative aspects, both for its members and those merely exposed to it.

Let’s first look at the harm AA does to its members, those who come to it voluntarily for help, and those who are coerced into attending it.

Even for the small percentage of attendees for whom AA “works” (approximately 5% according to AA’s own triennial surveys–roughly the same as the rate of spontaneous remission), there are negative effects. The first of these is that many AA members adopt “alcoholic” as their primary identity. They identify their very beings with a past, self-destructive behavior. They stay stuck — focused on the past. It’s both strange and sad to see someone who hasn’t drank for twenty years identify him or herself as an “alcoholic.”

(What would we think of someone who gave up cigarettes twenty years ago, yet still identifies him or herself as a “smoker”? The only reason it doesn’t strike us as equally bizarre for long-time nondrinkers to identify themselves as “alcoholics” is the constant self-referential use of that term by AA members. Endless repetition desensitizes us to the  strangeness of this very odd usage.)

Another negative aspect of AA is that it keeps members dependent upon it. According to 12-step dogma, “alcoholics” are always “recovering,” and the only way they can maintain sobriety is to attend AA for the rest of their lives. The way my late friend Vince Fox defined alcoholism and 12-step alcoholism treatment neatly encapsulates the 12-step approach: “Alcoholism is a phenomenon characterized as physical, mental, and emotional, and treated in medical settings by nonmedical personnel with a religious program in which the patient is admitted as diseased, discharged as diseased, permanently recovering, and never recovered.”

So, AA members consider themselves “diseased,” adopt the “alcoholic” label as their identity, and (at least in theory) remain dependent upon AA for life. Many “old timers,” who have been sober for twenty or thirty years, still go to several meetings per week, some daily. This, of course, is a severe time drain. The amount of time wasted by American AA members on AA meetings is probably second only to the amount of time wasted in the U.S. by Mormons — in another lifelong “program” — on LDS meetings.

Another major downside of AA for its longtime members, those who come to it for help, and those coerced into attendance, is AA’s insistence that “alcoholism” is a “progressive disease,” that drinking inevitably worsens barring abstinence, and that “alcoholics” have no control once they start drinking — that their only alternatives to AA are “jails, institutions, or death.” Leaving aside the absurdity of labeling a behavior as a disease, all of this is simply wrong. But for those who buy the assertions that drinking inevitably worsens and that they have no control, the results can be disastrous. These pernicious assertions often become a self-fulfilling prophecy. Other AA assertions — notably that, according to AA’s “Big Book,” alcohol is “cunning, baffling, powerful!” and individuals “powerless” — only exacerbate this problem. So, when AA members start to drink, they think they have no control, so they don’t even try to control their drinking — they binge.

Research seems to bear this out. What is still probably the best scientific study of AA’s effectiveness (Outpatient Treatment of Alcoholism, by Jeffrey Brandsma, Maxie Maultsby, and Richard J. Walsh, Baltimore: University Park Press, 1980) reported that those assigned to the AA group (with its “one drink, one drunk” dogma) binged more than four times as often as the no-treatment controls. (That this study is nearly four decades old matters not a whit, because in the years since it appeared AA’s “program” has changed not a whit.)

As well, since AA meetings are so unattractive that only (again according to AA’s own triennial surveys) five percent of those who “walk through the door” are there a year later, millions of people have been exposed to AA’s pernicious assertions and, at least in some cases, their drinking likely worsened as a result — and many undoubtedly don’t even try to find alternatives, because of AA members’ insistence that AA is the only thing that works.

These are only the most obvious negative effects of AA upon those exposed to it.

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