Delray

This popped up in my FB feed yesterday morning randomly in a parenting group I follow and I'm very intrigued by it.

The Irrationality of Alcoholics Anonymous - The Atlantic

I sent it to my husband (who hasn't had a drink in 9 days) and he really really liked it. He is a self-proclaimed agnostic and was having trouble with starting AA meetings because he thought they were going to be too religious. (he said he went to an AA meeting when he was 21 after a DUI). I don't think he's done much else for his recovery right now except avoid drinking. He says he feels fine just quitting and hasn't really been interested in drinking. I've avoided talking to him much about it because I don't want anything I say to come out resentful, shaming, or guilting. I've merely told him that I'm seeking out support through AlAnon and other options (books and SR) and that I needed to take care of himself in order to keep us and the kiddos safe.

Anyways, back to the article, I'd be very curious to hear anyone else's thoughts. I know that AA works for many many people, but I suppose a lot of the evidence is anecdotal. And my husband and I are both scientists in a way, so we look for data and evidence-based conclusions.

biminiblue

my browser freaked out when I clicked that link...I had to force close the tab...jus' sayin.

Delray

Weird - Not sure why that happened. I just tried to open it again and it worked ok.

Maybe go to The Atlantic's webpage and it's on the right side of the main page.

Florence

I read about half of it this morning, and was pretty annoyed.

The science is out there and it's growing and changing and it'a extremely important -- but for 80 years AA has purported to be nothing but a free, widely available support group for drunks, not science, not a legal aid. In my experience the purpose of AA is to give folks meaningful, clean relationships with other people who share the experience of great despair around their behavior, who want to change their lives. More often than not, addicted people trying to get clean are surrounded by well-meaning but unhelpful people who don't get it, or worse, by people who encourage the addict to continue their addictive habits, and AA is often cited as helping to develop clean relationships that are mutually supportive. If it's a good group, folks are held accountable and are able to call on those relationships during times of hardship. This is invaluable.

To me, this whole conversation is a litmus test. Folks who want to micromanage the details of what they'll do to quit the drug that's categorically ruining their life don't get it and don't really seem ready to give up drugs and alcohol. Folks who want to recover in a real and lasting way will generally try whatever treatments are available to them. AA is one tool in a big toolbox, and it's free and widely available to anyone regardless of creed, gender, religion, or wealth, whereas clinical treatment is difficult to receive and pay for.

I'm an atheist, a hard atheist, a science believer, and someone who pays attention to the science on addiction. AA, NA, and Al-Anon don't offend me, because I don't need to have every one of my beliefs validated perfectly to get value out of a support group.

Delray

Spot on. I totally agree. I think that clinical treatment should be easier to obtain... I was intrigued by how the Finnish approach alcoholism and was shocked to see their treatments are such a small percentage of what Americans pay for. I would love to read more about other countries too.

I'm quite new on this journey so I'm all about soaking up all the information out there.

anattaboy

Yup, kinda biased if you ask me and I'm one who does NOT use AA. Let's face it, we are a much wealthier world and country than 75 yrs. ago. The same % of folks who become addicted need to stop so the medical field IS going to treat symptoms if there are complaints. By far the best treatment for alcohol addiction is abstinence and will be until some serious genome manipulation becomes commonplace. My motto is "any which way we can" and many can with AA. I do agree that many can without AA and will. The competition for adherents will always be there cuz THAT is truly the american way. Some religious fanaticism is there too but that is waning as the general population becomes more tolerant.

Coldfusion

Here's some scientific evidence supporting AA:

"Some of the most important brain systems impaired in addiction are those in the prefrontal cortex that regulate social cognition, self-monitoring, moral behavior and other processes that the AA-type approach seems to target." (4 March 2009; Neuroscience: "Rethinking rehab", Jim Schnabel, Nature 458).

zoso77

I think that recovery -- whether for an alcoholic, addict, or their loved ones -- is truly a personal thing. People have the right to make the best choices for themselves. Whatever works for them work for them.

happybeingme

I am not a fan of AA either. Since there is no real structure or rules regarding who starts a group or how it is run there is a lot of confusion. The program is the steps. Nothing more nothing less. Meeting attendance is not mandatory. The whole meeting makers make it was started in rehabs. It does not appear in the big book.

There are medications that can help with abstinence they don't help you become a normal drinker. Any alcoholic will tell you the only cure is total abstinence. Moderation does not work. Don't believe it? Ask an ex smoker if they can enjoy an occasional cigarette. They will say they can't. They will be back to a pack a day habit in no time. Same with alcohol. That is what science hasnt been able to figure out. How to reset the brain to eliminate the addictive reaction to certain substances.

DesertEyes

In addition to the good posts so far, there are a lot of "Agnostic Anonymous" meetings that use the 12-step format. At the other end of the spectrum there is "Celebrate Recovery", which is 100% religious.

The whole point to these "peer support" programs, of which AA is only _one_, is flexibility. That is why there's over 200 different organizations, from "Overeaters Anonymous" to "Parents of murdered children Anonymous". That is across programs, within each program there is specialization in the meetings. I've been, within AA, to "Couples group", "PTSD group", "Young people's group", "Bikers group", etc., etc.

The general suggestion is to stick with a couple of groups until you get to know the people who have been successful with that specific version of recovery. If their version of success is not what you are looking for then try the next few groups down the list. The absolute worse that can happen is you will find half a dozen other people who feel the way you do and you can then start your own meeting. I've done that several times.

Mike

fluffyflea

I've been sober for 17 years one day at a time, continuous sobriety through Alcoholics Anonymous and the 12 Steps.

Has worked very well for me.

That's fine if other methods work for different people but why does A.A always need to be debunked.

Look at the irrationality of J.G, as soon as he read that one drink would get him drunk he could never get sober again? How ridiculous is that...

One drink WOULD get ME drunk again.

BlueChair

Thanks for sharing. I like the article because it makes a lot of good points.( I sent you a p.m ).

sauerkraut

Thank you so much, Delray. This was the sort of information I've been looking for, explaining the history behind various approaches as well as the current state of the science. Much appreciated.

Duckygirl1

Not a big AA fan, but if it works for you do it. I refuse to call myself powerless over anything. Im developing my own program and its working just fine. My problem with AA is the fact people who have no interest in getting sober are being mandated to meetings by the courts who see it as an easy out and means to free up jail cells. The anonymity gives some very sick people a place to hide out in plain sight. Many very vulnerable people seeking help have fallen prey. I know some real twisted characters who are VERY high in AA here and newbies look at them like they are gods. Just. Not. Right.

Many people seeking "clean meaningful relationships" with "understanding" members of the fellowship leave their spouses and children convinced of their terminal uniqueness and that no one outside of the group will understand and the family that stood by them are now just "triggers". Part of the reason that I was dismissed by my xabf was that I aired concerns about some of the drivel being spewed at the family night by the counselors who seemed bored silly. Shoulda just clamed up. But like I said, get help where you can how you can.

LifeRecovery

I have lived with an eating disorder most of my life (that is my addiction of choice). Part of my addiction is about getting some balance around food (not too much, but not abstaining from it entirely). Striking that balance has been a challenge for me, and though I am not grateful for the challenge/lessons it has created in my life, I am grateful for the learning that has come from it. I cannot just abstain from food as that is part of my addiction. Sometimes I feel like I have purposely choosen an addiction that I just cannot abstain from (cause that is typically easier for me) because the lesson of balance is so hard for me.

I found this article really interesting in the discussion of alternative treatment methods. What I don't like about the article is that it does this by making one alternative sound negative. An alternative that by the nature of support can/does help many people.

I have not received support from my eating disorder with OA. Mainly because there is no OA where I live. I have gotten therapy, group help, body work, more therapy, work with a dietitian etc. I have also used Al-Anon as part of my life journey has been meeting, loving and getting married to a problem drinker. Just because OA is not one of my tools in the toolbox does not give me license to say it may be a broken tool. It just is not a tool that has worked in my life.

I think what really excites me about this article though is that there is ACTUALLY some focus on addiction as a serious health problem that impacts a LOT of people, and I hope we are living in an age that will start to put some focus, research dollars and effort towards helping people.

Finally the last part that struck me (it does really regularly sometimes) is that I wish there was an article like this about the friends/family/loved ones of people that struggle with addiction. If an addict impacts at least four people's lives....that is a lot of people watching from the sidelines in a loved ones lives. An article in a prominent journal like The Atlantic might help a lot of friends/family etc not feel so alone and give them some insight into what they can do to help themselves. Though it is often not as headline grabbing, I think it could be so helpful. I think it would have helped me to take some of my own power/ownership back. (I always though the same about Intervention too....)

Thanks for posting, and the posts back to it. It opened my mind which is always a good thing.

BlueChair

Heres some more info stemming from the article. An segment on msnbc and US world news and reports

http://www.soberrecovery.com/forums/...l?#post5269849

SoloMio

I definitely believe that it's different strokes for different folks, but when my RAH left rehab, he got a prescription for naltrexone and didn't fill it. I'm not really sure why not, although he said he heard bad things about potential side effects. But for him it really wouldn't do much unless he went to counseling pretty intensively, because OK, you cut off the receptors in the brain that give you the high, but wouldn't a lot of addicted people still want to feel high? While some people may be simply addicted to the habit of drinking wine (and I can see how naltrexone would work for them), for others, habit has nothing to do with--what do you do with the compulsion to escape your feelings? That's what needs work in many cases.

I can understand people not being into AA, but I personally believe in the spiritual principles--in a non-denominational way. If you REALLY were motivated to follow the program, and REALLY did work the steps, I think a lot of people would benefit--alcoholics and non-alcoholics, too.

I think the beauty of AA is its "irrational" part. We are not JUST rational beings, at least IMHO, and for some people all the cognitive behavior therapy and rational thinking in the world can't solve their problems.

cynical one

AA is a simple program of one alcoholic helping another. It was formed for anyone who has the desire to quit drinking.

AA is a non-profit corporation.

AA does not have, nor do they endorse any rehab.

AA does not mandate anyone to the program.

AA does not conduct studies nor keep data.

AA does not respond to their critics.

Irrational, right?

sugarbear1

the article is little skewed.

CodeJob

I liked the article. AA provides a community and the 12 steps, but it is not evidence based. The organization is set up that way and the idea that it is the only game in town I think is mostly an American overlay. AA has been adopted in the US by the bulk of rehab and IOPs as a main approach to stopping an addiction. It has been used as a court ordered treatment as well which is perhaps an abuse of what AA intended for its pool of attendees. AA works best when the attendees want to be there.

I think the American puritanical culture is dubious that naltrexone and other drug treatments is a reasonable approach to arrest the cravings in an addiction. This attitude about 'true' sobriety being on no drugs or stimulants whatsoever is a common discussion point among AA members.

European cultures may be more circumspect about getting addicts functional with drugs. Yeah they may not be fully abstinent, but they mostly work and aren't hitting bottom in the traditional skid row image. They can mostly function in their relationships if they aren't constantly chasing their high. I see they are using naltrexone long term, which is not how it is used in the US from my understanding. They are not taking addicts out of the community for 28-180 days at great cost, but intervening right in the midst of a life. I think it is worth being open to. It is not a 100% pure recovery, but it may very well keep a lot of addicts functional and alive.

It is true most rehabs don't track their true long term abstinence rates. But if you are going to sink $25k or more into a treatment (recovery) - don't you want to know the long term success rate? I'm not talking the attendees being clean at day 30, but at day 180, day 240, day 364... Research shows the longer you are clean, the better your chances of a long term recovery, so this is important to consider before committing big money or your one insurance covered shot. Because rehab claims to teach addicts skills to live without their drug of choice, they should offer a heck of a lot more than some counselors who were once addicts themselves and a compressed version of AA. And AA has problems with these rehab AA people too! They come out and join the real world AA and don't always transition well.

I definitely don't know the answer, but I think insurances are going to force a lot of changes on rehabs with Obamacare due to evidence-based requirements. AA does not fit that criteria and was never meant to. AA was co-opted into legal and medical care in the U.S.