How much do you know about Alcoholics Anonymous and other 12 Step programs? It’s a support group, right? It’s safe to say it’s widely regarded as the most successful recovery program for addiction. Then again, accupuncture is widely regarded as a successful treatment for all kinds of illnesses but anyone familiar with science-based medicine knows it simply doesn’t work. So, why should 12 Step programs be treated with any less skepticism? After all, AA makes claims regarding the causes of and treatments for alcoholism. What evidence, if any, is there to support these claims?
“Undrunk: A Skeptic’s Guide to AA”, by A.J. Adams, seems anything but skeptical. That is, the word ‘skeptic’ seems to be used in the “I was skeptical, at first” kind of way…rather than referring to a person who evaluates claims based on evidence and the scientific method. Has AA escaped the attention of the science and skepticism community? Certainly, the 12 Step industry must be one of the most successful quackery organizations out there–embedding themselves into the medical industry as successfully as any alternative medicine woo–and branding themselves as secular more successfully than intelligent designers.
AA and its counterparts (there’s a 12 step program for just about any addiction) are anything but secular. Of course, any program member will tell you that atheists and agnostics are welcome…but the program is chuck-full of religion; only about four of the twelves steps make no use of god or spirituality. Dr. Harriet Hall wrote a great article over at Science-Based Medicine about AA and the lack of evidence for it’s effectiveness: AA is Faith-Based, Not Evidence-Based. Another resource I found is a blog called Stinkin Thinkin:
…[W]hat we’re doing is muckraking, in the time-honored sense of the word. AA and 12-Step is has a monopoly. Sure there are some alternatives, but none of these alternatives are offered in your general addictions treatment facility. And none of these alternatives have the power to lobby in Washington the way that AA does…to get insurance money
There is a group called SOS (Secular Organizations for Sobriety, or Save Our Selves) which provides non-religious support for alcoholism and drug addiction. I found some interesting articles about AA by browsing their site:
AA, as a doctor once told me, is “an evangelical movement about saving souls”. At its core it has a good heart – it wants to save people from their demons. But, as with the death penalty, McCarthyism, the Conquistadors and other such crusades against evil, the pious ambitions of AA make the movement blind to its own hooliganism. As disinterested in individuality as the SS, and unaccountable for its actions as the KKK, AA preaches, bullies and lies to achieve its ends, and it does so with all the righteous impunity of a secret sect. Unlike other religious cults, however, AA’s victims are those who escape from its grip and return to society, their brains so laundered by fundamentalist claptrap that a glass of beer can take on the menace of a loaded pistol. That I eluded such a fate myself is thanks to nothing but sheer good luck – those not as fortunate as I can’t tell us about it, their stools at the bars and chairs in AA inhabited by new people entirely disinterested in tales of the dead ones who went before them.
I know there’s a lot of woo for skeptics to deal with, but I think the 12 Step industry deserves more criticism from the skeptical community. AA isn’t an effective treatment, never mind the most effective treatment for alcoholism, and those suffering due to substance abuse deserve treatments which are evaluated for their safety and efficacy.
April 22nd, 2010 at 5:59 pm
Its unfortunate that there are ppl like you out there that really have no clue what AA IS about. A monopoly, an industry, hardly…AA supports itself through donations, $1 per meeting, that hardly a profitable industry. It is not a religious movement, it asks its members to find a higher power, that can be anything. I met a woman once who said trees were her higher power. Hardly evangelical. My husband has been sober 8 years, no hospitals, no detox…just AA. This SOS group that you quote sounds like the real scam. AA doesn’t care who you are, where you come from. You are not bullied into anything. This other blog you quoted is also grossly misinformed, AA stays out of politics and never lends its name to any political group or figure. It does not lobby Congress. AA does not preach that alcohol is evil, only that some people cannot handle it and cannot function with alcohol in their lives, it is trying to help those people. Of all other sober-programs, AA is the ONLY one that has endured throughout the generations, that in itself is proof of its success. The ONLY requirment to join AA is the desire to quit alcohol. Any alcoholic who is fooled into these other groups that teach you to drink responibility deserve the fate they will inevitably fall into. The alcoholic does not know and never will know how to drink responsibly. I have met dozens of people who tried sobriety their way and always went back to hard core life ruining drinking. They eventually come back to AA and that is how they stay sober, and happy, and healthy.
April 22nd, 2010 at 11:01 pm
AA and other 12 step programs are controlled by Alcoholics Anonymous World Services, Inc., the company that markets the programs and runs a business off of merchandise and the program support materials, the “Big Book” being just one publication that the corporation profits from.
If you read my other post, here, you will find that it is clear in the Big Book that the higher power it speaks of is God. Regardless, a “higher power” is invoking the supernatural, even if it is directed towards a physical object. There is no need to rely on faith healing or supernatural nonsense for any medical disorder, including addiction to alcohol.
AA spreads misinformation about addiction and its members are shielded from medical based information. The “evidence” you invoke are all based on anecdotes. Personal experience is not evidence, especially when AA rooms are filled with self-selected individuals–AA members will never hear about the vast number of people who recover from addiction without the dogma of AA or the members who leave and recover anyway, because those people aren’t at meetings. The stories in the meetings are inquivalent to cheery-picking: you’re only going to hear anecdotes about the programs success, never the huge amount of failures. This gives meeting attendees a warped perspective on the statistics: AA has a failure rate of over 90%, addiction to alcohol has a spontaneous remission rate of about 50%.
It is a fallacy to claim that the program must have proven efficacy simply because it has been around a long time.
Dr. Harriet Hall has an article here showing the medical based data on AA: http://www.sciencebasedmedicine.org/?p=490
April 23rd, 2010 at 9:52 pm
AA is NOT the only way to get sober. In fact AA encourages people to try any means to acheive sobriety.But why are there so many meetings ? Why do the courts and treatment centers send so many people to AA? Why are there so many 12 step programs? Wasn’t AA the FIRST 12 step program ? Why are there so many people that are dying from untreated cases of alcoholism? And why in the hell did they write a book on how they recovered from alcoholism? I can only assume that they wrote down precisely what they did to recover so that you could do what they did if you wanted to.But you can try other means if you like.In fact aren’t there a bunch of books about alcoholism out there besides the “Big Book”? (for sale)AA’s 12 steps are suggestive ONLY. If followed can enable the user to become happily and usefully whole. Is that so bad ? There is a bar against all information which cannot fail to keep a man in everlasting ignorrance, that bar is contempt prior to investigation.Though you may come to scoff. I hope you come to stay.
August 12th, 2010 at 3:06 am
I’ve reposted below the best explanation of the take it or leave it nature of spirituality in the rooms. It’s a difficult hump to get over and I’ve found that religious fervor varies regionally. I’ve attended meetings all over the US and in 7 countries. The most “religious” by far were in the southern states of the US. I take what I want and leave the rest. It works for me but that’s not evidence of anything other than my anecdotal success fighting addiction.
You don’t have to like the way the book is written, but your lack of true skepticism (investigation from properly conducted research and use of the scientific method) is a danger to people who may want/receive help from these programs. A bad skeptic is worse than a peddler of hokum, mainly due to the self righteousness. How many of the 12 step texts have you read thoroughly? Each program differs greatly in the description of the “spiritual” portion of the program. The NA and GA texts are vastly different from the AA text though the underlying steps are essentially the same. Additionally, the AA Big Book has not changed since the thirties; mainly due to tradition and continuity. Like Doug Stanhope says “Would you still be a Christian if they elected a new Jesus every 4 years?”
How many meetings have you attended in various fellowships to conduct observational research? All fellowships have open meetings that anyone can attend.
How do you accurately survey the success of people in an anonymous program? This has proven difficult for scientists as well as the fellowships themselves. I guess the bottom line is to do the work yourself and not just infer from internet posts what you think you know. Confirmation bias can bite a sloppy skeptic too.
As promised:
My name is ____________ and I’m an atheist.
I am addressing this to the alcoholics who have had trouble with the religious overtones in the AA program. To those who do not accept the idea of a supernatural being, let me assert that it is always people who have strengthened me when I needed help.
I have a deep belief in human morality. I believe that evil impulses can be subordinated by decent actions. AA brings out impulses for good, and this has tremendous force. In my opinion, this sum total of good actions is the “higher power.”
In the words of a Unitarian minister: “In a world that has lost, or is losing fast, any convincing concept of divine providence at work, of a personal God ordering the affairs of humanity, it is not necessary to assume that the only alternative to a human-cherishing universe is a hostile or satanic universe. There is the much more likely alternative of a neutral universe where people live, hammering out salvation without hope of heaven or dread of hell. People can find that life has value, not because a divine being so ordains, but because the achievements of good men and women, laboring together with love and self-respect, are self-validating and self-rewarding.”
I was not able to accept AA or the very real help it could give until I made a rationalistic interpretation of the program. I am still an atheist, but I am a grateful atheist.
I don’t want to change AA It works for me. I just want it to be effective in attracting rationalists. Their membership will help AA tremendously.
August 12th, 2010 at 3:31 am
“How do you accurately survey the success of people in an anonymous program? This has proven difficult for scientists as well as the fellowships themselves.”
This is a common argument against the program’s lack of proven efficacy and demonstrates a misunderstanding of what is involved in conducting a well run study. Anonymity is a key feature of double-blinded studies.
Again, as I believe I mention in the post…or rather, it is meant to be the point of the post…that arguments like the ones you present aren’t any different than the arguments used to try and defend any other pseudoscientific treatment–whether it be acupuncture, homeopathy, reiki, or faith healing (AA is simply a popular form of faith healing). These treatments simply do not have proven efficacy, lack plausibility, and do not follow any standards of evidence-based medicine.