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.

 

 

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.

Our First 1,000 Posts — Best Addictions Posts

We just put up our 1,000th post —  this  is number 1,002 –a few days ago. We’re now looking through everything we’ve posted, and are putting up “best of” lists in our most popular categories.

This is the second of our first-1,000 “best of” lists. We posted the science fiction “best of” list two days ago, and will shortly be putting up other “best ofs” in several other categories, including Anarchism, Atheism, Economics, Humor, Interviews, Music, Politics, Religion, Science, and Skepticism.

Best Addictions Posts

• AA, the War on Drugs, and Disastrous Misconceptions
• Alcoholics Anonymous Does More Harm than Good
• Alcoholics Anonymous Is Not Effective
• Why Is Alcoholics Anonymous Sacrosanct?
• Alternatives to AA, and why they’re needed
• 12-Step Coercion–A Victory Against It