AA efficacy rates, for BubbaBob
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AA efficacy rates, for BubbaBob
Hi, BubbaBob,
Regarding your comment in another thread,
"...since you have stated that 12 step programs show poor efficacy in the treatment of addictions..."
Here is some information, analysis, and links you might want to look at.
Some information about AA's success rate comes from its own membership surveys. In particular, the rather famous 'Comments on AA's Triennial Surveys' document cited by Charles Bufe in Alcoholics Anonymous: Cult or Cure is AA's ID # 5M/12-90/TC, which was produced for internal purposes. It is also summarized in Vince Fox's Addiction, Change, and Choice (1993). The document is not listed in AA's 'Conference Approved Literature' but Fox was able to obtain a copy from AA.
AA's own analysis was that 50% of all those who try AA leave within 90 days, which they describe as cause for 'concern'. Their own data shows that is actually optimistic. In the 12-year period shown, 19% remain after 30 days, 10% remain after 90 days, and 5% remain after a year.
The retention rate of AA is 5% after one year.
So do we define the success rate as the retention rate? You'd have to tell me if you believe that success in AA is measured by whether people are still attending meetings.
Other observations:
60% of those surveyed were getting outside professional help. This means that any success (or failure) rate, however it is defined, can't be attributed entirely to AA.
One way to measure the success of AA would be by comparing 12-step based treatment with other treatments. A 1997 study found that 93% of American drug and alcohol treatment programs follow the 12-step model. So it would be pretty easy to tell, at least, whether 12-step programs work.
An extensive study (Hester and Miller, Handbook of alcoholism treatment approaches) shows that peer-based 12-step alcohol treatment programs do NOT have a higher success rate than no treatment at all. Facilitated 12-step treatment (trained facilitators guiding subjects through the twelve-step process) were marginally better. "The two tests of AA found it inferior to other treatments or even no treatment but were not sufficient to rank AA reliably."
Brief, non-confrontational interventions and motivational interviewing were found most effective.
If you define success as reduced drinking, absence of alcohol dependence, or a reduction in problem drinking, then you see different results. Success in AA is presumed to be total abstinence. But followup to many treatment programs finds people have done some drinking, or drink moderately (defined by the researcher, not the patient!). They would be considered failures in AA--but the behavior has changed. So if one wants to improve the statistical success rates of 12-step treatment, just broaden the definition of 'success' to include moderate drinking!
Here's psychiatrist George Vaillant, an advocate of the standard hospital and AA treatment program, reviewing his own studies of his own program in The Natural History of Alcoholism:
"It seemed perfectly clear that . . . by inexorably moving patients from dependence upon the general hospital into the treatment system of AA, I was working for the most exciting alcohol program in the world. But then came the rub. Fueled by our enthusiasm, I and the director . . . tried to prove our efficacy. Our clinic followed up our first 100 detoxification patients. . . . [and found] compelling evidence that the results of our treatment were no better than the natural history of the disease."
One interesting observation: a long-term study of over 4,500 subjects found that more treated alcoholics than untreated alcoholics had been abusing or dependent on alcohol within the previous year! It is really difficult to draw any conclusions from that bit of information!
So, is AA or 12-step treatment useful, or is it harmful?
First of all, to any individual who has succeeded at getting sober by means of AA it is successful. You are not a statistic. Your advice can be useful to someone who is thinking about quitting drinking, and nothing in any study diminishes the value of that experience.
But to generalize from your experience, and make predictions about what will happen to another person? Alcohol abuse is so variable in its nature and effect that it just isn't reasonable to do that.
And there are ways AA can be harmful.
Coerced treatment is often harmful, resulting in depression, mental illness, and increased substance abuse. Most coerced treatment in the US is into 12-step programs, and is often simply mandatory attendance at AA meetings. Failure to accept the coerced treatment results in loss of employment or prison, so the outcome is undesirable either way.
If in fact AA was as effective as no treatment at all, then AA attendance would not be harmful. But if it delays those for whom it is inappropriate from seeking alternatives which may be more effective for them, then it is harmful. If it is, in fact, less effective than other treatments or than no treatment at all, it could be harmful.
In that regard, the simple phrase 'Keep Coming Back' is harmful to someone who is not finding AA helpful.
To tell them that they are somehow responsible for the program not working is harmful.
If someone who questions the tenets of AA is told to 'take the cotton out of your ears and put it in your mouth' or to 'stop thinking, stop talking, and start listening' -- they are being harmed.
They should simply be urged to look elsewhere, not blamed because AA didn't work for them. It doesn't diminish the effectiveness of AA for you that it didn't work for someone else.
Recommending the program for someone who may have abused alcohol but is not alcohol-dependent, and who may have depression or other mental illness, is potentially very harmful. I would consider sending a depressed teenager to AA for an episode of substance abuse to be very irresponsible. A trained professional is appropriate, not a peer-based program for what may simply be an ancillary problem. Don't think it hasn't happened. Coercing teenagers into 12-step programs for simple experimentation with drugs or alcohol is not uncommon.
-------------------------------------
For more information about the success rates of AA vs. spontaneous remission:
General discussion of success rate from AA source (Lets Ask Bill W.)
http://www.silkworth.net/ask_billw/Q&A33.html
Repeats the 50 - 75% figure often cited.
Analysis from a hostile source (More Revealed: A Critical Analysis of Alcoholics Anonymous and the Twelve Steps):
http://www.morerevealed.com/books/mr/chap2.htm
Reviews two studies of referred users, Vaillant's study, and Peele's review.
An extensive scientific review from a neutral source (American Journal of Drug and Alcohol Abuse):
http://www.findarticles.com/p/articl...26/ai_65803046
Describes the problems of defining remission, and gives extensive data on remission rates.
Briefly, the rate of spontaneous (self) remission for alcohol:
Defined broadly--31.4%
Defined narrowly--24.2%
This study does have a useful description of the abstinence process from this last source:
"Stall and Biernacki proposed a three-stage model of spontaneous remission….
The initial stage of the model involves finding the resolve or motivation [from] a handful of initiating factors--medical problems, pressure from family and friends to stop using, extraordinary events, financial problems--that account for over half the reasons cited by self-remitting alcohol, tobacco, and other drug abusers….
The second stage … consists of a public pronouncement to quit. … Finding substitute activities, replacing old associations with new ones, developing nondrug recreational/leisure interests, and changing one's place of residence….
The third or maintenance stage … [is] ongoing social support, a growing sense of self-confidence and willpower, and the discovery of life meaning through religion, education, physical exercise, and identity."
I think all of us can find something to relate to in that outline.
Don S
Regarding your comment in another thread,
"...since you have stated that 12 step programs show poor efficacy in the treatment of addictions..."
Here is some information, analysis, and links you might want to look at.
Some information about AA's success rate comes from its own membership surveys. In particular, the rather famous 'Comments on AA's Triennial Surveys' document cited by Charles Bufe in Alcoholics Anonymous: Cult or Cure is AA's ID # 5M/12-90/TC, which was produced for internal purposes. It is also summarized in Vince Fox's Addiction, Change, and Choice (1993). The document is not listed in AA's 'Conference Approved Literature' but Fox was able to obtain a copy from AA.
AA's own analysis was that 50% of all those who try AA leave within 90 days, which they describe as cause for 'concern'. Their own data shows that is actually optimistic. In the 12-year period shown, 19% remain after 30 days, 10% remain after 90 days, and 5% remain after a year.
The retention rate of AA is 5% after one year.
So do we define the success rate as the retention rate? You'd have to tell me if you believe that success in AA is measured by whether people are still attending meetings.
Other observations:
60% of those surveyed were getting outside professional help. This means that any success (or failure) rate, however it is defined, can't be attributed entirely to AA.
One way to measure the success of AA would be by comparing 12-step based treatment with other treatments. A 1997 study found that 93% of American drug and alcohol treatment programs follow the 12-step model. So it would be pretty easy to tell, at least, whether 12-step programs work.
An extensive study (Hester and Miller, Handbook of alcoholism treatment approaches) shows that peer-based 12-step alcohol treatment programs do NOT have a higher success rate than no treatment at all. Facilitated 12-step treatment (trained facilitators guiding subjects through the twelve-step process) were marginally better. "The two tests of AA found it inferior to other treatments or even no treatment but were not sufficient to rank AA reliably."
Brief, non-confrontational interventions and motivational interviewing were found most effective.
If you define success as reduced drinking, absence of alcohol dependence, or a reduction in problem drinking, then you see different results. Success in AA is presumed to be total abstinence. But followup to many treatment programs finds people have done some drinking, or drink moderately (defined by the researcher, not the patient!). They would be considered failures in AA--but the behavior has changed. So if one wants to improve the statistical success rates of 12-step treatment, just broaden the definition of 'success' to include moderate drinking!
Here's psychiatrist George Vaillant, an advocate of the standard hospital and AA treatment program, reviewing his own studies of his own program in The Natural History of Alcoholism:
"It seemed perfectly clear that . . . by inexorably moving patients from dependence upon the general hospital into the treatment system of AA, I was working for the most exciting alcohol program in the world. But then came the rub. Fueled by our enthusiasm, I and the director . . . tried to prove our efficacy. Our clinic followed up our first 100 detoxification patients. . . . [and found] compelling evidence that the results of our treatment were no better than the natural history of the disease."
One interesting observation: a long-term study of over 4,500 subjects found that more treated alcoholics than untreated alcoholics had been abusing or dependent on alcohol within the previous year! It is really difficult to draw any conclusions from that bit of information!
So, is AA or 12-step treatment useful, or is it harmful?
First of all, to any individual who has succeeded at getting sober by means of AA it is successful. You are not a statistic. Your advice can be useful to someone who is thinking about quitting drinking, and nothing in any study diminishes the value of that experience.
But to generalize from your experience, and make predictions about what will happen to another person? Alcohol abuse is so variable in its nature and effect that it just isn't reasonable to do that.
And there are ways AA can be harmful.
Coerced treatment is often harmful, resulting in depression, mental illness, and increased substance abuse. Most coerced treatment in the US is into 12-step programs, and is often simply mandatory attendance at AA meetings. Failure to accept the coerced treatment results in loss of employment or prison, so the outcome is undesirable either way.
If in fact AA was as effective as no treatment at all, then AA attendance would not be harmful. But if it delays those for whom it is inappropriate from seeking alternatives which may be more effective for them, then it is harmful. If it is, in fact, less effective than other treatments or than no treatment at all, it could be harmful.
In that regard, the simple phrase 'Keep Coming Back' is harmful to someone who is not finding AA helpful.
To tell them that they are somehow responsible for the program not working is harmful.
If someone who questions the tenets of AA is told to 'take the cotton out of your ears and put it in your mouth' or to 'stop thinking, stop talking, and start listening' -- they are being harmed.
They should simply be urged to look elsewhere, not blamed because AA didn't work for them. It doesn't diminish the effectiveness of AA for you that it didn't work for someone else.
Recommending the program for someone who may have abused alcohol but is not alcohol-dependent, and who may have depression or other mental illness, is potentially very harmful. I would consider sending a depressed teenager to AA for an episode of substance abuse to be very irresponsible. A trained professional is appropriate, not a peer-based program for what may simply be an ancillary problem. Don't think it hasn't happened. Coercing teenagers into 12-step programs for simple experimentation with drugs or alcohol is not uncommon.
-------------------------------------
For more information about the success rates of AA vs. spontaneous remission:
General discussion of success rate from AA source (Lets Ask Bill W.)
http://www.silkworth.net/ask_billw/Q&A33.html
Repeats the 50 - 75% figure often cited.
Analysis from a hostile source (More Revealed: A Critical Analysis of Alcoholics Anonymous and the Twelve Steps):
http://www.morerevealed.com/books/mr/chap2.htm
Reviews two studies of referred users, Vaillant's study, and Peele's review.
An extensive scientific review from a neutral source (American Journal of Drug and Alcohol Abuse):
http://www.findarticles.com/p/articl...26/ai_65803046
Describes the problems of defining remission, and gives extensive data on remission rates.
Briefly, the rate of spontaneous (self) remission for alcohol:
Defined broadly--31.4%
Defined narrowly--24.2%
This study does have a useful description of the abstinence process from this last source:
"Stall and Biernacki proposed a three-stage model of spontaneous remission….
The initial stage of the model involves finding the resolve or motivation [from] a handful of initiating factors--medical problems, pressure from family and friends to stop using, extraordinary events, financial problems--that account for over half the reasons cited by self-remitting alcohol, tobacco, and other drug abusers….
The second stage … consists of a public pronouncement to quit. … Finding substitute activities, replacing old associations with new ones, developing nondrug recreational/leisure interests, and changing one's place of residence….
The third or maintenance stage … [is] ongoing social support, a growing sense of self-confidence and willpower, and the discovery of life meaning through religion, education, physical exercise, and identity."
I think all of us can find something to relate to in that outline.
Don S
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Join Date: Oct 2002
Location: Zion, Illinois
Posts: 3,411
Don,
Just out of curiosity, what line of work are you in? Are you a pusher for any program other than AA? I'm jesting of course, but I'm amazed at the amount of time it must take to gather up all these statistics, and then post them. This inquiring mind wants to know.
Just out of curiosity, what line of work are you in? Are you a pusher for any program other than AA? I'm jesting of course, but I'm amazed at the amount of time it must take to gather up all these statistics, and then post them. This inquiring mind wants to know.
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Join Date: May 2003
Location: El Paso, Tx
Posts: 5,862
...oh I can't wait until you see the answer Music! But seriously Don, you have amazing resources, and I scarf them up for my research...so that's a thanks for the links from me. 
Last edited by Chy; 02-06-2005 at 11:13 AM.
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Join Date: Sep 2004
Location: England
Posts: 108
Hi ,I am sure you wont mind me hijacking your thread,(!!!!!!!) but I am back to AA tomorrow, monday and I cant wait. I really am not interested in the stats, I will do whatever it takes to get and stay sober, for good. I dont think there is a right and surefast way, we all just need to find the one that works for us and that may happen through trial and error. Sometimes we get so caught up in the detail we miss the big picture, rough tho it is.
I want to stop drinking and move on, that may or may not involve AA, we will have to wait and see.
Pete
I want to stop drinking and move on, that may or may not involve AA, we will have to wait and see.
Pete
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Hey, pete, the only statistic that matters to you is your own personal success rate! I agree that there is no right and surefast way--that's my point, really. The only objection people from other recovery groups have to AA is when people imply that it's the only way, and make sweeping generalizations about the likelihood of success of it or any other approach. And sloganeering just irritates me.
Many people take principles from more than one recovery program, and there are areas of agreement among them. People who come to SMART Recovery often attend AA meetings for the group support, and I'm sure that's true of most of the other programs as well (except probably RR, since it's so hostile to other approaches).
I'm a plant professional, Music, as in green growing things. Nurseryman, landscaper, and occasional media personality. Research and writing are among my hobbies, and we all know how important having hobbies can be in achieving sobriety. You?
Don
Many people take principles from more than one recovery program, and there are areas of agreement among them. People who come to SMART Recovery often attend AA meetings for the group support, and I'm sure that's true of most of the other programs as well (except probably RR, since it's so hostile to other approaches).
I'm a plant professional, Music, as in green growing things. Nurseryman, landscaper, and occasional media personality. Research and writing are among my hobbies, and we all know how important having hobbies can be in achieving sobriety. You?
Don
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Join Date: Oct 2002
Location: Zion, Illinois
Posts: 3,411
Originally Posted by DangerousDan
I knew it.
You're really Geraldo, aren't you?
You're really Geraldo, aren't you?
Actually Don, I'm a retired navy musician, and retired retail employee and now I'm working part time in a Powerhouse Gym to which I am also a member. My hobby is wieghtlifting and exercise. I train people however, I'm not certified. Money would take away the pleasure I think.
Now I know why you have so much time Don. What else can you do while the plants are growning besides sit and watch. Got to fill your time with something.
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Join Date: Jul 2004
Location: Beaver, WA
Posts: 1,346
Well, I dealt with natural resource issues for quite a few years. Through that experience, I've seen where statistical analysis can easily be done to meet certain predetermined objectives by those paying for the analysis. When there is a pre-set agenda involved by those formulating the statistics, cashflow often sways the given results.
Even polling for statistics has it's obvious flaws. Much depends upon the wording of the questions being asked. I've met with some people who are paid high dollar to create polls for meeting preset objectives. They are often paid by Think-Tanks.
They even devise specific criteria to meet their ultimate agenda in providing their lobbyists with ammunition to lay before Congressional Sub-Committees on their pet projects. When grant funding becomes the financial funnel in certain beauracratic fields, including education, flaws are nearly always an intinsic part of the process. A flawed process can certainly provide for results to show failure rates which anyone may be purposefully seeking to begin with.
I've never seen a person fail who has thoroughly followed A.A.'s path. I know the Big Book in Chapter 5 says "rarely", but I've never seen anyone fail who thoroughly followed the path. Seen many fail who "thought" they had followed "a" path though.
Just my nickle from personal experience being a real alcoholic. My opinion is that "fellowship only" recovery numbers could easily drop the rate of success in Alcoholics Anonymous or any other 12 Step Organization immensely. Depending on the criteria used for defining success, it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective.
There's some of my experience. My Strength came from developing a relationship with my HP/God through that program of recovery. My Hope is that many will continue to awaken through the simple, but not easy, program laid out in the Big Book for many years to come.
Even polling for statistics has it's obvious flaws. Much depends upon the wording of the questions being asked. I've met with some people who are paid high dollar to create polls for meeting preset objectives. They are often paid by Think-Tanks.
They even devise specific criteria to meet their ultimate agenda in providing their lobbyists with ammunition to lay before Congressional Sub-Committees on their pet projects. When grant funding becomes the financial funnel in certain beauracratic fields, including education, flaws are nearly always an intinsic part of the process. A flawed process can certainly provide for results to show failure rates which anyone may be purposefully seeking to begin with.
AA efficacy rates, for BubbaBob
Just my nickle from personal experience being a real alcoholic. My opinion is that "fellowship only" recovery numbers could easily drop the rate of success in Alcoholics Anonymous or any other 12 Step Organization immensely. Depending on the criteria used for defining success, it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective.
There's some of my experience. My Strength came from developing a relationship with my HP/God through that program of recovery. My Hope is that many will continue to awaken through the simple, but not easy, program laid out in the Big Book for many years to come.
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Join Date: May 2003
Location: Northern CA
Posts: 1,432
Hi, 3legs,
Your point about skewing statistics is true, of course. Anyone can come up with any statistic by manipulating the questions or by providing a variable that leads to the desired conclusion.
Your own statement that
"it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective" is an excellent example. Unprovable and unsubstantiated, but when it's coupled with "I've never seen a person fail who has thoroughly followed A.A.'s path", you have an obviously subjective modifier: if it didn't work, they must have just not followed it thoroughly enough, right?
None of those I cited above has any particular agenda against showing AA's efficacy, to my knowledge, nor are they funded by anyone who does. I know of no preset agenda. The first information is from AA's own internal documents. Hester and Miller are considered to be objective researchers; had their review of studies shown AA to be effective, they would have reported that. And Vaillant was a proponent of 12-Step treatment, who actually hoped that his research would prove the efficacy.
So I guess I don't get your point here. Your oblique criticism of the sources of the information makes me wonder if it's the results you don't like. There's nothing wrong with the statistics, and they don't diminish the successful application of AA by many, many individuals. It's just not for everyone, and the success rate shouldn't be overstated.
Don S
Your point about skewing statistics is true, of course. Anyone can come up with any statistic by manipulating the questions or by providing a variable that leads to the desired conclusion.
Your own statement that
"it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective" is an excellent example. Unprovable and unsubstantiated, but when it's coupled with "I've never seen a person fail who has thoroughly followed A.A.'s path", you have an obviously subjective modifier: if it didn't work, they must have just not followed it thoroughly enough, right?
None of those I cited above has any particular agenda against showing AA's efficacy, to my knowledge, nor are they funded by anyone who does. I know of no preset agenda. The first information is from AA's own internal documents. Hester and Miller are considered to be objective researchers; had their review of studies shown AA to be effective, they would have reported that. And Vaillant was a proponent of 12-Step treatment, who actually hoped that his research would prove the efficacy.
So I guess I don't get your point here. Your oblique criticism of the sources of the information makes me wonder if it's the results you don't like. There's nothing wrong with the statistics, and they don't diminish the successful application of AA by many, many individuals. It's just not for everyone, and the success rate shouldn't be overstated.
Don S
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Join Date: May 2003
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Originally Posted by Music
More like Dan Rather. Getting the statistics right?????GET IT?
Actually Don, I'm a retired navy musician, and retired retail employee and now I'm working part time in a Powerhouse Gym
Actually Don, I'm a retired navy musician, and retired retail employee and now I'm working part time in a Powerhouse Gym
Yeah, it's probably a good idea to double check things....
What was it Mark Twain said? 'Lies, lies, and damned statistics?"
Don
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Join Date: Oct 2004
Location: Jasper, GA
Posts: 239
At least we agree on a couple of points...
...first Don, like you, I feel that forced treatment of ANY kind is ineffective at best, harmful or even deadly at worst. Like AA says about their requirements for membership ..."...the only requirement is a desire to stop drinking."
Forced treatment, through AA, RR, treatment centers, or sitting in the woods contemplating your naval, is not and never will be effective.
As I have said before, it's not enough to want to stop, or really want to stop, or even Really want to stop....you have to REALLY want to stop, or you won't. Period.
Though I believe strongly in AA and 12 step programs, that does not mean I go along with everything said in the rooms of AA. Much of what I have heard there makes me cringe, but I do as suggested and take what I can use and leave the rest.
Remember, much of what is said in AA is individuals' opinion, not AA-speak. Every time I hear a bleeding deacon say, "Take the cotton out of your ears and put it in your mouth", or "You don't have anything to say worth hearing until you have a year sober" I want to throttle the speaker (OK, I still take other's inventory and hold resentments a bit). The last time I checked, when Bill W. and Doctor Bob started talking they had only a few weeks sober themselves.
You spoke of lack of effacacy in abusive drinkers, and I agree...but you link abusive drinking and alcoholism as though they are the same thing, and they aren't.
I used to think there were social drinkers and alcoholics and that was it. Wrong. Abusive drinking is a medically recognized middle ground where one drinks to excess regularily but not compulsively. I have a friend who is drunk 3-4 times a week, but who is not alcoholic. He can abstain when and for how long as he wishes...I've seen him do so. He drinks to excess by choice.
Abusive drinkers find AA useless for two reasons. First they don't want to quit usually, and second, when they do want to quit, they just quit, no problem, because there is no compulsion.
You note:
AA's own analysis was that 50% of all those who try AA leave within 90 days, which they describe as cause for 'concern'. Their own data shows that is actually optimistic. In the 12-year period shown, 19% remain after 30 days, 10% remain after 90 days, and 5% remain after a year.
The retention rate of AA is 5% after one year.
That is a case of half truth. AA's own analysis also shows that 70% of those who leave AA in the first year eventually return, and the ultimate "success" rate approaches 45%.
You don't know it, but I see alcoholism from two different perspectives. First, I am an alcoholic and spent 32 of my 50 years as one. Until the last few years I was a "functioning alcoholic". My last two years were spent drinking a half gallon of gin a day, every day, which pretty much precludes being able to put the word "functioning" in my description.
I desparately wanted to be able to find an "easier, softer way". I wanted to be able to drink responsibly, and searched high and low for a way to do so. It simply is not there.
I am also a professional in the field. I am one of those professionals you spoke of that many in AA go to see. As one of those professionals I am guilty of having let my wishing for an easier way for myself color my professional suggestions. There are probably people, former clients of mine, that are now dead because of my desire for things like RR and Mr. Peele's methods to work. I can tell you from hard personal and professional expirience that the best way for a person who drinks compulsively, not just abusively, to quit, once they have decided to do so, it through AA or a similar 12 step program.
I'll address the other points in your post after some reading.
BubbaBob
Forced treatment, through AA, RR, treatment centers, or sitting in the woods contemplating your naval, is not and never will be effective.
As I have said before, it's not enough to want to stop, or really want to stop, or even Really want to stop....you have to REALLY want to stop, or you won't. Period.
Though I believe strongly in AA and 12 step programs, that does not mean I go along with everything said in the rooms of AA. Much of what I have heard there makes me cringe, but I do as suggested and take what I can use and leave the rest.
Remember, much of what is said in AA is individuals' opinion, not AA-speak. Every time I hear a bleeding deacon say, "Take the cotton out of your ears and put it in your mouth", or "You don't have anything to say worth hearing until you have a year sober" I want to throttle the speaker (OK, I still take other's inventory and hold resentments a bit). The last time I checked, when Bill W. and Doctor Bob started talking they had only a few weeks sober themselves.
You spoke of lack of effacacy in abusive drinkers, and I agree...but you link abusive drinking and alcoholism as though they are the same thing, and they aren't.
I used to think there were social drinkers and alcoholics and that was it. Wrong. Abusive drinking is a medically recognized middle ground where one drinks to excess regularily but not compulsively. I have a friend who is drunk 3-4 times a week, but who is not alcoholic. He can abstain when and for how long as he wishes...I've seen him do so. He drinks to excess by choice.
Abusive drinkers find AA useless for two reasons. First they don't want to quit usually, and second, when they do want to quit, they just quit, no problem, because there is no compulsion.
You note:
AA's own analysis was that 50% of all those who try AA leave within 90 days, which they describe as cause for 'concern'. Their own data shows that is actually optimistic. In the 12-year period shown, 19% remain after 30 days, 10% remain after 90 days, and 5% remain after a year.
The retention rate of AA is 5% after one year.
That is a case of half truth. AA's own analysis also shows that 70% of those who leave AA in the first year eventually return, and the ultimate "success" rate approaches 45%.
You don't know it, but I see alcoholism from two different perspectives. First, I am an alcoholic and spent 32 of my 50 years as one. Until the last few years I was a "functioning alcoholic". My last two years were spent drinking a half gallon of gin a day, every day, which pretty much precludes being able to put the word "functioning" in my description.
I desparately wanted to be able to find an "easier, softer way". I wanted to be able to drink responsibly, and searched high and low for a way to do so. It simply is not there.
I am also a professional in the field. I am one of those professionals you spoke of that many in AA go to see. As one of those professionals I am guilty of having let my wishing for an easier way for myself color my professional suggestions. There are probably people, former clients of mine, that are now dead because of my desire for things like RR and Mr. Peele's methods to work. I can tell you from hard personal and professional expirience that the best way for a person who drinks compulsively, not just abusively, to quit, once they have decided to do so, it through AA or a similar 12 step program.
I'll address the other points in your post after some reading.
BubbaBob
Member
Join Date: Jul 2004
Location: Beaver, WA
Posts: 1,346
((((((((Don S))))))))))
Subjective? Yes, my observation. "it appears to me" would hopefully show that I was being subjective as well in this case. As for them not having followed it thoroughly, what better criteria is there than interacting personally & seeing these people face to face which can be used?
Nothing was meant personal to you Don in my reply to this thread. I was not stating that the statistical links you had posted had specific agendas tied to them. It might be worth a keener look though. So thanks for the heads up and if I have the time I might research it and get back to you further as time permits. The criteria used in their analysis could take weeks to weed through, just as following the dollars of the organizations involved would.
Glad you have the time for such endeavors, but I frankly find much of it a waste of my own that could be spent helping another real alcoholic like myself face to face. Your talent at stating statistics, and leading others to them is wonderful. Please don't get me wrong there. I am only hoping folks might seek to look below the surface of the statistics provided and ask some good questions for themselves.
I am not looking for any argument here nor was I in my previous reply. I just tried my best to share some of my own personal opinions based upon my own experience, strength and hope. Hope thats alright with you.
(((((((((((Don S))))))))))))
3 Legacy
Your own statement that
"it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective" is an excellent example. Unprovable and unsubstantiated, but when it's coupled with "I've never seen a person fail who has thoroughly followed A.A.'s path", you have an obviously subjective modifier: if it didn't work, they must have just not followed it thoroughly enough, right?
"it appears to me our Program of Recovery, as laid out in the Big Book, is still pretty close to 100% effective" is an excellent example. Unprovable and unsubstantiated, but when it's coupled with "I've never seen a person fail who has thoroughly followed A.A.'s path", you have an obviously subjective modifier: if it didn't work, they must have just not followed it thoroughly enough, right?
Nothing was meant personal to you Don in my reply to this thread. I was not stating that the statistical links you had posted had specific agendas tied to them. It might be worth a keener look though. So thanks for the heads up and if I have the time I might research it and get back to you further as time permits. The criteria used in their analysis could take weeks to weed through, just as following the dollars of the organizations involved would.
Glad you have the time for such endeavors, but I frankly find much of it a waste of my own that could be spent helping another real alcoholic like myself face to face. Your talent at stating statistics, and leading others to them is wonderful. Please don't get me wrong there. I am only hoping folks might seek to look below the surface of the statistics provided and ask some good questions for themselves.
I am not looking for any argument here nor was I in my previous reply. I just tried my best to share some of my own personal opinions based upon my own experience, strength and hope. Hope thats alright with you.
(((((((((((Don S))))))))))))
3 Legacy
Member
Thread Starter
Join Date: May 2003
Location: Northern CA
Posts: 1,432
Hey, great replies from both of you. Hmm. Maybe we'd better go out for a cup of coffee one of these days. We'll meet up with Music, and drive up to visit Dan. Let's wait until the snow melts, though.
3 legs: I can understand making face to face help your priority. I found forums most useful in achieving sobriety; others like online meetings. So my focus is on putting information online, because that's what worked for me, and I think putting as much information out there as possible is useful.
I think the internet is now the place where many ambivalent people start. It was for me. Perhaps they'll walk through the doors into an AA meeting, or go to the SMART web site, or attend an online meeting after they start to learn more about substance abuse and recovery.
It can be very useful to look deeper into the statistics (if you happen to be interested in that kind of thing...). For example, one of the links I posted in the bottom section goes into some (rather mind-numbing) detail about the problems with defining remission, and that obviously raises the question of how one defines success. Stanton Peele addresses that as well.
Bob: That is a case of half truth. AA's own analysis also shows that 70% of those who leave AA in the first year eventually return, and the ultimate "success" rate approaches 45%.
I'd be interested if you have a source for that. Not because I don't believe it; I just like to have the original citation in case I pass it along. I am aware of the difficulties of coming up with any accurate figure on these things. But 45% is a lot higher than 5%! So it would be useful to know how the statistic is arrived at.
It would be very interesting if the results for 'self-selected' (i.e., non-coerced) attendees could be compared to the overall results, and if the results for those attending AA meetings only could be compared with those in generic or for-profit '12-Step programs'-- which I gather can be entirely different. But being an anonymous organization, it would obviously be difficult to get those kind of numbers.
I don't think it's reasonable to blame yourself because others failed at RR or harm reduction (which is what I assume you mean when you refer to Peele's methods). Trimpey's method appeals to, and presumably works for, a certain type of person (not me!). He presents it as the antithesis of AA, so it would be an unlikely person who would move readily from one to the other.
Peele mostly addresses larger policy issues, and doesn't really advocate any specific type of approach other than to repeat that motivational interviewing and brief interventions have been shown to have the highest rate of success. I would generalize by saying he thinks the best would be to try to tailor the approach to the individual. Or let the individual build his or her own recovery program, based on what they understand and commit to.
And Peele strongly believes people shouldn't be coerced into 12-Step programs. In fact, he has shown some evidence that it is counterproductive to do so--that we'd probably get better results just letting them go through the criminal justice system instead. Then they can face the consequences of their behavior and many will adjust their choices accordingly.
I used 'functioning alcoholic' to describe my own behavior for years, after I heard George C. Scott use the term to describe his own substance abuse. We drink heavily, but we're functioning. Sort of. I don't know where you draw the line between abusive drinking and alcoholism (gamma alcoholics?), and I believe the behavior exists on a continuum.
Obviously, I disagree that other approaches are 'easier or softer'; I'm not sure what that means, really, but it sounds faintly disparaging. Nearly everyone goes through the process of considering moderate drinking. Some accomplish it. The rest of us decide that it isn't our best choice. And it isn't advocated in RR, SMART, SOS, LifeRing, or WFS.
Since you're a professional in the field, have you looked at the other recovery options in detail, and discussed them with your clients? What would your advice be to someone who tells you they wish to leave AA, perhaps for the reasons expressed in another current thread on this forum? I don't dispute your observations, but it seems to me it would be a case of the observer, or the process of observing, affecting the outcome (I can't remember whose principle that is...).
What bothers me is your use of the term 'best' in describing one option which clearly doesn't work for many people. It doesn't matter whether you think it's because they don't work it, or do it thoroughly enough, or aren't honest with themselves, or any of the other things we hear on these forums. The other programs aren't worse if they work, and if it could be shown that they work more often then maybe they are objectively better.
Even more useful would be to get away from the rating game--this program is 'better' or that program is 'worse', because substance abuse is a very individual phenomenon. What works for you is what is best for you. That's about the only generalization that stands up to analysis.
And for those of us who prefer them for our own reasons, the use of 'best' is disparaging. It also happens to be one of those absolute terms we find annoying.
Don
3 legs: I can understand making face to face help your priority. I found forums most useful in achieving sobriety; others like online meetings. So my focus is on putting information online, because that's what worked for me, and I think putting as much information out there as possible is useful.
I think the internet is now the place where many ambivalent people start. It was for me. Perhaps they'll walk through the doors into an AA meeting, or go to the SMART web site, or attend an online meeting after they start to learn more about substance abuse and recovery.
It can be very useful to look deeper into the statistics (if you happen to be interested in that kind of thing...). For example, one of the links I posted in the bottom section goes into some (rather mind-numbing) detail about the problems with defining remission, and that obviously raises the question of how one defines success. Stanton Peele addresses that as well.
Bob: That is a case of half truth. AA's own analysis also shows that 70% of those who leave AA in the first year eventually return, and the ultimate "success" rate approaches 45%.
I'd be interested if you have a source for that. Not because I don't believe it; I just like to have the original citation in case I pass it along. I am aware of the difficulties of coming up with any accurate figure on these things. But 45% is a lot higher than 5%! So it would be useful to know how the statistic is arrived at.
It would be very interesting if the results for 'self-selected' (i.e., non-coerced) attendees could be compared to the overall results, and if the results for those attending AA meetings only could be compared with those in generic or for-profit '12-Step programs'-- which I gather can be entirely different. But being an anonymous organization, it would obviously be difficult to get those kind of numbers.
I don't think it's reasonable to blame yourself because others failed at RR or harm reduction (which is what I assume you mean when you refer to Peele's methods). Trimpey's method appeals to, and presumably works for, a certain type of person (not me!). He presents it as the antithesis of AA, so it would be an unlikely person who would move readily from one to the other.
Peele mostly addresses larger policy issues, and doesn't really advocate any specific type of approach other than to repeat that motivational interviewing and brief interventions have been shown to have the highest rate of success. I would generalize by saying he thinks the best would be to try to tailor the approach to the individual. Or let the individual build his or her own recovery program, based on what they understand and commit to.
And Peele strongly believes people shouldn't be coerced into 12-Step programs. In fact, he has shown some evidence that it is counterproductive to do so--that we'd probably get better results just letting them go through the criminal justice system instead. Then they can face the consequences of their behavior and many will adjust their choices accordingly.
I used 'functioning alcoholic' to describe my own behavior for years, after I heard George C. Scott use the term to describe his own substance abuse. We drink heavily, but we're functioning. Sort of. I don't know where you draw the line between abusive drinking and alcoholism (gamma alcoholics?), and I believe the behavior exists on a continuum.
Obviously, I disagree that other approaches are 'easier or softer'; I'm not sure what that means, really, but it sounds faintly disparaging. Nearly everyone goes through the process of considering moderate drinking. Some accomplish it. The rest of us decide that it isn't our best choice. And it isn't advocated in RR, SMART, SOS, LifeRing, or WFS.
Since you're a professional in the field, have you looked at the other recovery options in detail, and discussed them with your clients? What would your advice be to someone who tells you they wish to leave AA, perhaps for the reasons expressed in another current thread on this forum? I don't dispute your observations, but it seems to me it would be a case of the observer, or the process of observing, affecting the outcome (I can't remember whose principle that is...).
What bothers me is your use of the term 'best' in describing one option which clearly doesn't work for many people. It doesn't matter whether you think it's because they don't work it, or do it thoroughly enough, or aren't honest with themselves, or any of the other things we hear on these forums. The other programs aren't worse if they work, and if it could be shown that they work more often then maybe they are objectively better.
Even more useful would be to get away from the rating game--this program is 'better' or that program is 'worse', because substance abuse is a very individual phenomenon. What works for you is what is best for you. That's about the only generalization that stands up to analysis.
And for those of us who prefer them for our own reasons, the use of 'best' is disparaging. It also happens to be one of those absolute terms we find annoying.
Don
Member
Join Date: Oct 2004
Location: Jasper, GA
Posts: 239
Two quick points...
"We drink heavily, but we're functioning. Sort of. I don't know where you draw the line between abusive drinking and alcoholism (gamma alcoholics?), and I believe the behavior exists on a continuum."
The line between abusive drinking and alcoholism is easy. Is the drinking compulsive or not? What makes an alcoholic an alcoholic is not how much or how often one drinks, it is if one drinks due to compulsion.
As to the term "best", you have a point. Probably a poor descriptor.
BubbaBob
"We drink heavily, but we're functioning. Sort of. I don't know where you draw the line between abusive drinking and alcoholism (gamma alcoholics?), and I believe the behavior exists on a continuum."
The line between abusive drinking and alcoholism is easy. Is the drinking compulsive or not? What makes an alcoholic an alcoholic is not how much or how often one drinks, it is if one drinks due to compulsion.
As to the term "best", you have a point. Probably a poor descriptor.
BubbaBob
Member
Join Date: Apr 2004
Posts: 8,709
Originally Posted by Don S
Hey, great replies from both of you. Hmm. Maybe we'd better go out for a cup of coffee one of these days. We'll meet up with Music, and drive up to visit Dan. Let's wait until the snow melts, though.
It might ruin my rebel image being seen with Music
I gotta say that one of the things that always turned me off about AA in the past, aside from the glaring fact I wasn't done drinking yet, was the "best program" qualifier often used by some.
Alcoholism being a disease/chemical dependancy/behavior/malady (pick your flavor) that affects human beings, it always followed for me that if I accept everyone is different in their essential make up, then I can't, in all logic, asign a grade to any particular recovery assistance program.
AA for me, almost a year sober, remains an essential ingredient in my tool box. But I'd surely sabotage myself in some weird way if I limited myself to that single option. I'm grateful for the opportunities to learn about alcoholism that were not available to those who suffered before me.
Member
Join Date: Nov 2002
Location: Bristol TN/VA
Posts: 12,431
Don S, I love science and I read your information avidly, and yes, use my own mind to evaluate points made. Thank you and thank you again.
Music, you were insulting to Don S in your comment about being in landscaping leaving him too much time for useless (to you) endeavors.
Education is never a useless endeavor.
Narrow-mindedness is a terrible handicap, as is tunnel-vision.
I love working out at the gym, but I find my health and happiness is fostered more by education than by buffing up my butt. Though it does have its benefits. Goo-eyed guys give me financial discounts and it makes horseback riding a lot more pleasurable.
Music, you were insulting to Don S in your comment about being in landscaping leaving him too much time for useless (to you) endeavors.
Education is never a useless endeavor.
Narrow-mindedness is a terrible handicap, as is tunnel-vision.
I love working out at the gym, but I find my health and happiness is fostered more by education than by buffing up my butt. Though it does have its benefits. Goo-eyed guys give me financial discounts and it makes horseback riding a lot more pleasurable.
Member
Thread Starter
Join Date: May 2003
Location: Northern CA
Posts: 1,432
LOL! Don't worry, Music was joking. He is just in awe of my superior cognitive, analytic, synthetic, and polysyllabic abilities.
You get discounts for being buff?! Suddenly working out seems productive. I still prefer watching grass grow.
Lawn grass, that is.
Don S
You get discounts for being buff?! Suddenly working out seems productive. I still prefer watching grass grow.
Lawn grass, that is.
Don S
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