| Alcohol and drug dependence appears to be an | | | | narrow sighted definition of success. |
| epidemic in the United States. Alcohol consumption is a | | | | Many people that end up seeking help for substance |
| social norm and legal and illegal drugs alike are | | | | abuse issues have not reached a point where entire, |
| incredibly easy to access. As a result of the enjoyable | | | | lifelong, abstinence is the only viable option. For folks |
| mind altering effect and the easy acquisition of | | | | like this, there are many different markers for success. |
| substances such as these, abuse and dependence | | | | Learning how to moderate alcohol consumption, |
| are more commonplace than one might expect. | | | | reduced frequency and quantity, executing planned |
| So, the question is, where does one go for help if | | | | periods of abstinence, or setting up and staying within |
| substance abuse has become an issue? The large | | | | a set of self-defined guidelines and parameters for |
| majority of the professional mental and physical health | | | | their alcohol consumption can all act as rules of |
| community has become accustomed to shipping every | | | | success. |
| alcohol or drug abuser off to a 12-step meeting. How | | | | For those that are not able to moderate their alcohol |
| effective is the 12-step methodology as a 1 size fits all | | | | consumption, then abstinence should be their goal. |
| alcoholism treatment program, though? | | | | However, there are many different ways to achieve |
| Statistical research on 12-step programs is hard to | | | | abstinence without committing themselves to a group |
| come by; primarily because the 12-step programs do | | | | of people and a belief system for the remainder of |
| not regularly keep track of their own success or failure | | | | their lives. |
| rates. However, the little bit of research that has been | | | | 3. The Disease Model |
| executed suggests that programs like AA have | | | | Although Addiction is recognized as a medical disease |
| somewhere between a 5-15% success rate. This | | | | by the AMA and many mental and physical healthcare |
| means that of those who attend a 12-step program as | | | | professionals, there are many people that feel this |
| a solution to their substance abuse issues, only 5-15% | | | | proposition is absurd, including me. |
| of them will stick with it and stay sober for more than 1 | | | | Drinking alcohol and using drugs is a choice that an |
| year. | | | | individual makes. It is not the same thing as cancer |
| Speculative theory will suggest many different reasons | | | | where the host does not have any choice in the |
| for the low success rates of alcohol treatment | | | | matter. |
| programs like AA. I personally feel that there are a | | | | Even when people get sober through a 12-step |
| few primary components that contribute to such low | | | | program and subscribe to the tenants of the disease |
| success rates: | | | | model, they fail to realize that, ultimately, they had to |
| 1. Religious/cult like tenants | | | | make a decision to stop using drugs and alcohol in |
| AA spawned from a movement known as the | | | | order to get well. If you can make a choice to alter the |
| Oxford Group which was popular in the early 1900's. | | | | effects of a certain behavior, it's not a disease. |
| The Oxford Group was an evangelical Christian | | | | I personally feel that the disease model and the theory |
| organization that specialized in healing people's vices | | | | of powerlessness contribute to more failure than |
| through "Christ". | | | | success. It gives many folks a justification and excuse |
| While allowing its members to choose a "god of their | | | | to continue destructive behavior because they can |
| own understanding", the 12-step program still revolves | | | | always use the oh-so-famous tag line "I'm sick. I can't |
| around the idea that only a spiritual awakening through | | | | control it. It's not my fault". |
| god is sufficient to cure an addiction and remains | | | | Successful alternative treatment methods promote the |
| spiritual in nature. This rules out the success of anyone | | | | idea that addiction is the result of choices and can only |
| that holds an Atheist or Agnostic viewpoint and also | | | | be cured by making new, healthier choices. This tends |
| deters others that really have no opinion on the matter | | | | to work for those that can't find a place in 12-step |
| but definitely do not believe that "god" is going to heal | | | | programs and don't believe in the disease model. |
| them. | | | | I would like to make it clear that I am not in opposition |
| 12-step programs also maintain some eerily cult-like | | | | to AA or related 12-step programs. For the small |
| tenants. They mandate lifelong membership, ritualistic | | | | percentage of people that find success there, I would |
| practices (meetings, prayers, etc.), renunciation of one's | | | | never want to discredit or take that away from them. I |
| ability to govern or fix their own life, semi-devotion | | | | do however feel that there should be more |
| obedience to a "sponsor", and harsh criticism for | | | | widespread awareness to alternative alcoholism |
| pursuing other avenues of success or questioning the | | | | treatment program methodologies such as harm |
| effectiveness of the 12-steps. | | | | reduction, moderation, abstinence, etc. |
| 2. Definition of Success | | | | In my humble opinion, an alcoholism treatment program |
| The only definition of success in 12-step programs is | | | | should define success by the overall improvement of |
| entire, lifelong, abstinence from any mind altering | | | | the patient's quality of life; not by some preconceived |
| substances what-so-ever. This is, in my opinion, a fairly | | | | idea that abstinence through god as the only way. |