I’ve blogged before about the religious organization Alcoholics Anonymous, which has virtually hijacked the treatment of alcohol dependency in the U.S. and promulgated a religious model (known as “12 steps” or “12 stepping”) that’s been applied to other forms of substance abuse. Its chief premise is that alcoholics are slaves to booze and can never, ever touch it, because if they do, they will definitely relapse.
The problem with this, as I’ve noted, is that neither A.A. nor the “12 step” philosophy has been shown to be effective in treating substance abuse. It is, instead, a treadmill upon which people are dumped sometimes against their will (e.g. when a judge orders a defendant into A.A.) and which they’re expected to stay on for life. All too often they’re unable to do this, which leads to the predicted relapse, and the treadmill of A.A. becomes a revolving door they continually keep going through repeatedly.
Because of this I’ve long advocated more rational treatment methods that coincide better with human nature. In an op-ed piece in the New York Times, author Gabrielle Glaser offered alternatives based not on abstinence from alcohol, but moderation (WebCite cached article):
The cold-turkey approach is deeply rooted in the United States, embraced by doctors, the multibillion-dollar treatment industry and popular culture. For nearly 80 years, our approach to drinking problems has been inspired by the 12 steps of Alcoholics Anonymous.
Developed in the 1930s by men who were “chronic inebriates,” the A.A. program offers a single path to recovery: abstinence, surrendering one’s ego and accepting one’s “powerlessness” over alcohol.
But it’s not the only way to change your drinking habits.
Bankole Johnson, an alcohol researcher and consultant to pharmaceutical companies who is also the chairman of the Department of Psychiatry at the University of Maryland School of Medicine, puts it this way: “We are wedded to the abstinence model as the goal, despite evidence that there can be many successful outcomes.”
Because of the promise of anonymity, A.A. doesn’t track its members or conduct research. Some studies have found that many members find support for healthier habits from a like-minded group of nondrinkers. But a systematic review [cached] found “no conclusive evidence to show that A.A. can help patients to achieve abstinence.”
Glaser describes an approach that combines moderation, rather than teetotaling, with the drug naltrexone, as well as a support organization called Moderation Management, and an Internet application, Moderatedrinking.Com.
What’s notable about Glaser’s essay and these other tools, is that none of them purports to be the sole answer for everyone. Glaser, Moderation Management, and Moderate Drinking all admit there are some folks who would be better off abstaining from alcohol rather than attempting moderation. This is, of course, in contrast to A.A. itself, which claims to offer the one and only valid path to sobriety for true alcoholics.
Fanbois of A.A. are sure to go after the Gray Lady for having published this piece. It’s natural they will do so. They don’t like being told they’re wrong or that their way isn’t the only way. They will also no doubt use their own personal testimonials as “proof” that A.A. works whereas nothing else does. They will no doubt accuse Glaser and the Times of imperiling people’s lives by giving them advice that’s sure to destroy them. Unfortunately for them, their testimonials are “proof” of nothing whatsoever, and their scaremongering merely a childish reaction to news they’d prefer not to read or hear.
The bottom line here is that, if A.A. works for you, wonderful! Stay with it. Just don’t deprive other people of other approaches to alcohol merely because you dislike them.
Photo credit: Wikimedia Commons.Tags: 12 step, 12 steps, aa, addict, addiction, addicts, alcoholics anonymous, gabrielle glaser, higher power, mental health, moderation, moderation management, psychiatry, SAT, substance abuse, substance abuse treatment