Alcoholics Anonymous doesn’t work better than the alternatives

A recent study by Marica Ferri and her co-workers at the Italian Agency for Public Health (hey, my compatriots actually manage to do some newsworthy research, occasionally!) have compared several so-called 12-step programs for recovery from alcoholism, including the famous (or infamous, depending on who you ask) “Alcoholics Anonymous,” which mixes group therapy with Christian prayer. The results, published in the journal The Cochrane Library, are clear: it makes no difference which program one enrolls in, one has about the same (not very high) chance of returning to sobriety for good.

The news is controversial, of course, because of AA’s religious underpinning. If Ferri et al. had simply compared the effectiveness of several drugs to treat, say, the common headache, everyone would be happy: it doesn’t matter if you take Tylenol or aspirin, but it does help if you take either one. Let the slickest TV ad make the difference between the two brands. But with AA the implicit comparison (though Ferri and colleagues wisely stayed away from it in print) is between Jesus and rehab secular therapy. Apparently, a draw ain’t good enough for Jesus.

Indeed, this is a particular example of the whole “power of prayer” scientific and theological idiocy that has occasionally surfaced even in professional medical journals (and has been thoroughly debunked). Whenever effects of prayer or other religious mumbo-jumbo have been alleged, they have easily been explained either by placebo effects or by small random statistical fluctuations (in which case they will not be repeatable in a follow-up study). It is funny, in a sad way, to see religious people haggling over issues of marginal statistical significance, because they don’t seem to realize that by engaging in such exercises they are implicitly admitting to severe limits to the power of their allegedly all-powerful god. I mean, if finding Jesus could really rescue you from alcoholism, wouldn’t the outcome be clear and indisputable? Since when miracles have a probability level so close to that of random events that a professional statistician can’t tell the difference?

AA Success Rates

6. What were the success rates? Success was measured among the pioneers as 50 percent who never drank again, and 25 per cent who drank but returned to succeed. This group is critical because it is the group as to which specific names, records, and outcomes were kept. In Cleveland, there was a ninety-three success rate based on a specific survey conducted by Clarence S. and reported in A.A. literature.

7. What about today? There are several factors which make accurate calculations virtually impossible. First, the triennial surveys by AA itself are anything but accurate, and A.A. says so. This because only groups are surveyed, and many in one group go to several other groups and meetings each week and are surveyed more than once. Most are simply never the subject of a survey and certainly not a survey conducted by statistical standards. A.A. service workers and surveys do confirm that one-third of those who come into A.A. are out of the door in ninety days; and fifty percent are out of the door in a year. Second, there are no rosters in almost any group or meeting in A.A. Third, the Tradition of anonymity makes an accounting much more difficult than when early AAs knew each other, all belonged to one group (in Akron), kept rosters with names and addresses and sobriety data, and used full names in their references. Finally, today s AA is supposedly a pure alcoholic one who is in A.A. for an alcohol problem, not a drug problem. But I personally don t think one in five hundred meet that test. Both young and old today those who come to AA have tried and often become addicted to every kind of drug imaginable: alcohol, prescription drugs, cocaine, LSD, the sex-enhancers, marijuana, heroin, after-shave, and a dozen other concoctions. These are the facts also among the men I have sponsored and also have met in thousands of meetings.

12 Step Recovery

welcome-home 

If you have a desire to stop drinking and your drinking is causing you problems — or, if you have discovered that living without alcohol is uncomfortable, and you get restless, irritable or discontented when not drinking — it is highly suggested that you find a meeting of Alcoholics Anonymous. You may discover why you feel this way.

While we stress the importance of going to AA Meetings — AA Meetings are not the Alcoholics Anonymous program of recovery.

Recovery takes place as a result of taking the 12 Steps of Alcoholics Anonymous as presented in the book Alcoholics Anonymous.

Please don’t misunderstand… Going to AA Meetings is vital for an AA Member’s recovery.

AA Meetings are a place where we can reach out to each other, support each other and practice our 12th Step. And, we need the AA Meetings, to remind us what our problem is and what the solution is!

Often, one of the first signs of a sober alcoholic’s relapse to drinking, is not going to meetings on a regular basis. It’s can also also be a sign that they have stopped doing the other things that are keeping them sober.

We hope that you find something usefull on our website and that you keep coming back. Perhaps someday, we will meet, as we trudge the road of happy destiny.

intervention recovery, alcohol rehabilitation, 30 days sober

 

Dallas B.

Is Alcoholics Anonymous for you?

I’m Lane - and I’m a (closet) alcoholic.

You want proof? Here’s a revealing snippet from my life:

My flatmate: “Lane Nichols, did you drink 3/4 of the bottle of wine that you bought me to replace the last bottle of wine you drank? I thought I’d only had about 1.5 glasses. Now it’s all gone! Do we need to call in some help for you?”

My reply: “I admit: I had a SMALL glass a few days ago but no more. I fear the mice are thirsty. I will stump up with a replacement if you’ll help me swill it.”

Her next email contained an eight-step Q&A lifted from the Alcoholics Anonymous website titled: “Is AA for you?”

And hell, maybe it is.There's nothing sadder than drinking alone

Since taking up my new position, I’ve been working some odd and kind of unsociable hours. The job is more stressful than my last and when I walk in the door around 10pm each night, I’m pretty keyed up and ready to hit the bottle.

Hence my rekindled love affair with vin de rouge.

Is it wrong to throw back the best part of a bottle each and every night - with or without drinking companions? I don’t wake up with a hangover. Years of boozing have at least given me conditioning.

Nevertheless, here are a few AA questions that have sparked a bit of soul searching for me. Be honest - how do you fare?

Have you ever decided to stop drinking for a week or so, but only lasted for a couple of days?

Yes. My misguided attempt at a month’s abstinence is old blog fodder. I bottled out miserably. Complete failure I’m afraid. Next question…

What whiskey will not cure, there is no cure for.Have you ever needed an ‘eye opener’ in the morning? Do you need a drink to get started, or to stop shaking?

No - but there have been occasions when I’ve necked a bit of neat whisky (straight from the bottle like) to steady the nerves before a particularly daunting date.

Has your drinking caused trouble at home?

Plainly - or I wouldn’t be writing this post.

Have you ever tried to blame your drinking on rodents or other pests in the house?

Again, the answer is a humiliating yes. But I suspect this question was not sourced from the official AA website and is in fact an invention of my flatmate’s cunning imagination.

Have you ever switched from one kind of drink to another in the hope that this would keep you from getting drunk?

Uh huh. I use rose and red wine interchangeably between the seasons. It’s worked okay up till now.

Have you had problems connected with drinking during the past year? Doctors say that if you have a problem with alcohol and keep on drinking, it will get worse - never better. Eventually, you will die.

What? So if I become a teetotaller I’ll be blessed with the gift of eternal life? Well, now that you mention it, there has been the odd ’situation’ - though not all in the last 12 months.

I fell over and gave myself concussion in a whisky-muddled stupor. I was young and yet to learn boundaries. I’ve grown up a lot since then.

I’ve made some terrible decisions about women while heavily under the influence - most of them short-term.

And I almost died after a night’s festivities in a water-related accident on Taranaki wharf. My partner in crime is now dead - drowned in a similar incident off Sumner pier.

So there. A couple of exposed skeletons. My closet laid bare.

But I’m starting out with a dry slate - once I knock off this cabernet merlot.

Anyone else out there concerned about their drinking?

planning intervention, alcohol treatment center, how do I stop drinking

Study Finds Treatment, AA Participation Works Best

Neither Is Substitute for the Other, Authors Say

A research study indicates that people trying to quit drinking who become involved in both Alcoholics Anonymous and professional treatment program fare much better than those who only go to treatment or only go to AA.

A study in the October 2005 issue of Alcoholism: Clinical & Experimental Research tracks individuals for 16 years who have first acknowledged their alcohol-use problems and then chosen Alcoholics Anonymous, treatment, or both. Findings indicate that people who become involved in both AA and treatment fare better than those who obtain only treatment.

“We know that self-help groups, such as AA, contribute to better alcohol-related and psychosocial outcomes,” said Rudolf H. Moos, senior research career scientist for the Department of Veterans Affairs Health Care System in Palo Alto, California, and corresponding author for the study. “For example, patients with alcohol use-disorders who participate in AA, and those who attend more meetings and/or participate for a longer time, are more likely to be abstinent and to maintain remission up to five years after an episode of professional treatment than patients who are not involved or less involved in such groups.

“Affiliation with AA also is associated with more self-efficacy and problem-solving coping skills, and better social functioning, which are linked to better alcohol-related outcomes.”

“In the current study, we wanted to find out whether individuals who participated only in AA in the first year after initiating help-seeking (and did not obtain professional treatment) achieved outcomes comparable to those of individuals who participated in AA and also obtained professional treatment. We also wanted to find out whether individuals who participated in AA in the first year achieved better long-term outcomes.”

Researchers surveyed 362 individuals (193 females, 169 males) who had initial contact with an alcoholism treatment system for their alcohol-use disorder. Study participants were asked about their subsequent participation in AA and/or treatment, as well as their alcohol-related functioning, at baseline (initial contact) and then again at one, three, eight and 16 years later.

 

Participation Is the Key

“One, individuals who enter AA relatively quickly after initiating help-seeking, either alone or in conjunction with treatment, are more likely to participate in AA in the subsequent 15 years and participate in AA more frequently and for a longer duration,” said Moos. “Two, a longer duration of participation in AA is associated with a higher likelihood of continuing remission up to 15 years later.

“Three, individuals who obtain professional treatment and participate in AA in the first year after initiating help-seeking are more likely to achieve remission for up to 15 years later than are individuals who obtain professional treatment alone. Finally, individuals who have achieved remission but who discontinue participation in AA are at increased risk for relapse; individuals who have not stopped drinking and who discontinue participation in AA are more likely to continue drinking.”

 

Better Long-Term Outcomes

“These findings are consistent with previous studies of AA,” said William R. Miller, Distinguished Professor of psychology and psychiatry at the University of New Mexico. “As we already knew, drop-out from AA is high. Nevertheless, involvement in AA during, and in the few years after, treatment is associated with better long-term outcomes.

“An additional 10 to 20 percent were in remission, which is a large and clinically meaningful difference. Of those who do not attend AA during treatment, many don’t [ever] go, and if they do, [their] delayed entry to AA is associated with less benefit. In sum, there are good reasons to encourage people to get involved with AA while they are still in treatment.”

 

Self-Action Improves Recovery

“These findings emphasize that initial and subsequent episodes of participation in AA can have long-term effects on the likelihood of remission of alcohol-related problems,” said Moos. “They also emphasize that counselors in information and referral centers and clinicians in substance use treatment settings should make every reasonable effort to enable individuals with alcohol-related problems to enter and continue to participate in self-help groups such as AA.”

“Are these better outcomes due specifically to AA?” asked Miller. “We can’t be sure. In general, the more actions people take toward their own recovery the better they do, whether it is attending treatment, going to AA, or faithfully taking medication. It is an impressively consistent finding, however, that people who go to AA during treatment have better outcomes.

intervention recovery, alcohol treatment center, substance abuse treatment

Just How Does AA Work?

 they asked Bill W. this question - “Just how does AA work?” Part of what he said;

 

“I cannot fully answer that question.

How often the doctors and clergymen throw up their hands when, after exhaustive treatment or exhortation, the alcoholic still insists, ‘But you don’t understand me. You never did any serious drinking yourself, so how can you? Neither can you show me many who have recovered.’

Now, when one alcoholic who has got well talks to another who hasn’t, such objections seldom arise, for the new man sees in a few minutes that he is talking to a kindred spirit, one who understands. Neither can the recovered A.A. member be deceived, for he knows every trick, every rationalization of the drinking game. So the usual barriers go down with a crash. Mutual confidence, that indispensable of all therapy, follows as surely as day does night. And if this absolutely necessary rapport is not forthcoming at once it is almost certain to develop when the new man has met other A. A.s. Someone will, as we say, ‘click with him.’”

wonderland sober living, alcohol rehabilitation, newly sober

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