Is Alcoholics Anonymous Effective? Finally, Get the Real Facts Here FIRST Before Making ANY Treatment Plans for Yourself or Loved One

“Keep coming back, it works if you workexpects individuals to fail, and fail again until such time
it!” This is what is chanted at the end of everythat rock bottom has been reached. It is often said that
meeting, but what if you have “worked it”once an individual has reached rock bottom that there
and you still keep going back and getting drunk oris only one way to go, UP. The problem with that
loaded? Now, most people in the program will sayphilosophy is that for many people, the ultimate rock
things like, “Well, you must not have really donebottom is death. (Vacovsky, Executive Director,
the steps right,” or “You didn’t goAmerican Council on Alcoholism, May 12, 2005).
to enough meetings,” or “You didn’tVacovsky goes on to write:
pray to your Higher Power,” or “You“Many, (if not indeed most) alcohol dependent
know you did something wrong or else you would stillindividuals have lost faith in themselves, and more
be sober!” But what if the truth was that you didimportantly hope for the future. It is common for such
nothing “wrong,” that in reality you did notindividuals to have numerous attempts at sobriety,
fail the Program, but rather the Program was just notmost often using 12-step methods. They have been
a right fit for you, and in fact, it fails for most people?programmed to accept themselves as hopeless and
Hopefully even this little bit of knowledge would start topowerless, with their chance for recovery being slim to
alleviate some of the guilt and shame that many carrynone… It is up to the individual to determine what
due to numerous relapses and going in and out 12-stepthe most appropriate treatment is. It is up to the
programs for many years.treatment community to provide options that set up
Since what you are told from your very first 12-stepindividuals to succeed, rather than be expected to
meeting is, “Your only options are to get soberfail."
using our Program, or it’s jails, institutions orSadly, Americans are largely unaware that such
death,” you tend to stop thinking for yourself,options even exist. At least, the general public is. While
(since it was your “best thinking that got youthe public is being told that “turning your will and
here“), stop questioning, and just follow whatlife over to the care of God as you understand
other’s tell you to do. This would be fine if this isHim,” as AA suggests, is the only treatment for
what worked… but unfortunately, evidence istheir illness, scientifically based research has been
proving otherwise.going on for decades. Results of this research are
The 12-step success rate is showing to bethreefold:
approximately 3 percent. Yes, that’s right…1. We now have options for treatment that are based
only 3 percent! (Brown,Treatment Doesn’ton science rather than fundamentalist religion;<br>
Work, 1991). Here are some more startling statistics2. Gives back choice and a sense of control to the
(Based on Alcoholics Anonymous World Services'individual, which is proving to be extremely important
own statistics).:and<br>
*45% of the people who attend Alcoholics3. We now have evidence that is in direct contradiction
Anonymous meetings never return after their firstto the traditional view of problem drinking.
meeting.What, exactly, is the research finding? Here is what
*81% of AA attendees are gone after one monthsome of the experts in the addiction field have found:
*90% are gone after three months- Well-designed research conducted over more than
*93% are gone (7% remain) after 6 monthsthree decades has conclusively demonstrated that
*95% never return after the first year.problem drinking will not inevitably get progressively
So there is a 5% retention rate for the first year. Noteworse, and that this is one attribute of being a
that the claimed five percent of A.A. newcomers who“disease” of alcoholism is simply wrong.
are still coming back after one year (and sober, weSome problem drinkers “progress,” but
hope) is exactly the same number as the normal ratethe vast majority don’t.<br>
of spontaneous remission among alcoholics. A number- What most Americans believe about drinking
of studies have found that a small percentage ofproblems and their treatment is substantially
alcoholics improve to the point of remission ofinaccurate.<br>
problems associated with alcohol consumption, and we- Drinking problems do not occur as a result of a
call this spontaneous remission. The preponderance ofdisease. It is a learned behavior, and additional learning
studies suggests that a spontaneous remission ratecan therefore modify behavior.<br>
for alcoholism of at least one-year duration is about- For no other “disease” do so many
4-18 percent. Successful treatment would, therefore,physicians, psychologists and counselors themselves
have to produce rates of improvement significantlybelieve in the non-research-based myths of problem
above this probable range of spontaneous remission.drinking, ignoring the research of their own peers in
Alcoholics Anonymous comes nowhere neardeveloping their treatment plans.<br>
exceeding a 4 to 18 percent per year recovery rate.- “Problem drinkers in the United States are
Harvard Medical Schoolreported that in the long run,faced with a daunting dilemma when they seek help.
the rate of spontaneous remission in alcoholics isThey can either accept the prevailing myth that
slightly over 50 percent. That would put the annual rateabstinence is the only effective means to resolve a
of spontaneous remission to be around 5 percent. Yetdrinking problem, or they can be accused of being
the claimed success rate of Alcoholics Anonymous“in denial…”<br>
does not even exceed that much lower rate.- Insistence by treatment programs to only offer
If we subtract the usual spontaneous remission rateabstinence has been shown to deter many problem
from A.A.'s claimed success rate, we get zerodrinkers from seeking treatment.<br>
percent for A.A.'s actual effective cure rate. A.A. didn't- Individualizing treatment is crucial.<br>
make anybody quit drinking — those who quit- Chronic “relapsers” can actually be
were the ones who were going to quit anyway. Theyharmed by the 12-step model view that once a slip
would have quit anyway, no matter what treatmenthas started, you are powerless to stop; the stronger
they were receiving, or even no treatment at all! So, anone’s belief in this is the longer and more
alcoholism treatment program that seems to have adamaging the relapses are.<br>
5% success rate probably really has a zero percent- The confrontation and treating alcoholics and addicts
success rate, and it is just taking credit for thelike children commonly thought necessary to help them
spontaneous remission that is happening anyway. Andactually often hinders any change.<br>
a program that has less than a five percent success- Many providers deliberately resist change because
rate, like four or three, may really have a negativethey have too much of an attachment to their own
success rate — it is actually keeping someideas of what should work, claiming, “I know
people from succeeding in getting clean and sober.what worked for me, and I’m sure that it can
Any success rate that is less than the usual rate ofwork for everyone else as long as they just do what I
spontaneous remission indicates a program that is asay.”<br>
real disaster and is hurting the participants.- The only way to resolve a problem with alcohol is to
Yet even with all of this research, 93-97% ofabstain for life is wrong for the majority of people. A
conventional drug rehabs and alcohol treatmentsubstantial proportion becomes moderate drinkers
centers are still 12-step or AA based, so those whoeven when achieving abstinence is the primary focus
leave AA to look elsewhere, such as conventionalof treatment.<br>
alcohol and drug treatment for solutions, are essentially- Dr. Patricia Owen, Director of Research of the
rejoining AA!Hazelden Foundation, who was a long-time supporter
AA hardly sounds like a “proven method,”of abstinence-only treatment, referred to these
let alone one that works for most people. So, if onlyindividuals as “in recovery without
about 5% of the people are getting the help that theyabstinence” and acknowledged their presence in
need, what about the 95% of the people who are notlarge numbers among a sample of Hazelden
being helped? That is the purpose of this article…graduates.
to provide much needed awareness to individuals,Of course, not even all scientists agree on the nature
rehabilitation centers, hospitals, sober livings, and evenof and best treatments for alcohol abuse. But this is
12-step programs themselves so that people withthe twenty-first century, and no one would disagree
substance abuse problems can actually start bethat all patients suffering with an alcohol or drug
helped. The bottom line is this… is the goal to getproblem have a right, just like any other patient
alcoholics and addicts into AA or NA or CA, or is it tosuffering with any other problem, to be fully informed
actually get them some help?of the available options, the risks or areas of
Professor (and Doctor) George E. Vaillant of Harvarduncertainty, and, after reviewing the relevant
University is an enthusiastic advocate of Twelve-Stepinformation, in consultation with one or more providers,
treatment, and is currently a non-alcoholic member ofchoose a course of action. This is simply good, ethical
the Alcoholics Anonymous World Services, Inc.medicine. Should people struggling with substance
(AAWS) Board of Trustees. So he really wanted toabuse issues accept anything less?
prove the effectiveness of AA. To study theIt is also important to acknowledge that recovery
effectiveness of various methods of treatingprograms are not necessary to discover how to quit
alcoholism, Vaillant compiled forty years of clinicaland stay quit. The following is from the Harvard
studies. Vaillant and the director William Clark alsoMedical School’s Mental Health Letter, the
conducted an eight-year longitudinal study of their ownAugust/September 1996 issue:
where Vaillant reported having followed 100 patientsMost recovery from alcoholism is not the result of
who had undergone twelve-step treatment. Hetreatment. Only 20% of alcohol abusers are ever
compared those people to a group of several hundredtreated… Alcohol addicts, like heroin addicts, have
other untreated alcohol abusers. The treated patientsa tendency to mature out of their addiction…
did no better than the untreated alcoholics. Fully 95%In a group of self-treated alcoholics, more than half
of the treated patients relapsed sometime during thesaid that they had simply thought it over and decided
eight-year period that Vaillant followed them.that alcohol was bad for them. Another group said
After initial discharge, only five patients in the clinichealth problems and frightening experiences such as
sample never relapsed to alcoholic drinking, and thereaccidents and blackouts persuaded them to quit…
is compelling evidence that the results of theirOthers have recovered by changing their
treatment were no better than the natural history ofcircumstances with the help of a new job or a new
the disease (spontaneous remission). What Professorlove or under the threat of a legal crisis or the breakup
Vaillant, a Trustee of Alcoholics Anonymous Worldof a family. Support from a husband or wife was
Services, Inc. — in other words, one of theimportant in sustaining the resolution.
highest-ranking A.A. leaders — is candidly, clearlyStudy results from addiction researchers, Doctors
describing is a zero-percent success rate for hisLinda and Mark Sobell, confirm Harvard’s 20%
A.A.-based treatment program. And it was eventreatment statistic:
worse than no help: The A.A.-treated group, with theSurveys found that over 77 percent of those who had
death rate of 29%, had the highest death rate of anyovercome an alcohol problem had done so without
kind of program, significantly higher than all of the othertreatment. In an earlier study… a sizable majority
programs. And those five people out of the hundred inof alcohol abusers, 82 percent, recovered on their
the A.A.-treated clinic sample who successfully stayedown.
sober for 8 years are just the result of that same oldHowever, even though it is possible to recover on your
five percent spontaneous remission rate at work,own, you may want a recovery program, or at least a
again.licensed professional for support. The good news is
Remember that these terrible numbers were reportedthat many more treatment programs are starting to
by a Trustee of Alcoholics Anonymous Worldprovide more evidence-based options beyond just the
Services, Inc., by a real true believer in A.A., bytraditional 12-step approach, and this list is growing
someone who loves A.A. and was trying hard toeveryday. You can find a complete, comprehensive
make it look good, not by some harsh critic of A.A.directory of over 100 professionals and drug and
who might be suspected of bias, or of fudging thealcohol programs all over the U.S. and abroad that will
numbers to make A.A. look bad.provide you with many options in Melanie Solomon's
Let me mention that I think 12-step programs are greatnewly released 2nd Edition of "AA Not the Only
for those individuals who it does work for, (or at leastWay; Your One Stop Resource Guide to 12-Step
seems to work for—again, it might just be theAlternatives."
work of spontaneous remission rather than theLeading U.S. addiction expert Dr. Marc Kern states,
program itself that is working). I have seen it change“I have long awaited this directory of addiction
many lives for the better, including my dad, who hastreatment alternatives. It represents what I believe to
now had 15 years of continuous sobriety, maintainingbe the future of the field. It is a pioneering effort to
his sobriety from his very first meeting. It is also aorganize this unique body of knowledge. A directory of
great fellowship to share experiences, strength andthis type was never available before.”
hope. So, in no way am I anti-AA. However, it hasDr. Frederick Rotgers, another leading addiction expert
become clear to me that substance abuse is not aexplains, “The problem is finding treatment
“one size fits all” problem, and therefore,providers who provide these alternative,
there can not be a "one-size-fits-all" solution.evidence-based approaches. Melanie Solomon has
The National Institute of Drug Abuse, NIDA, has eventaken a wonderful step toward making that process,
gone on record to emphasize that no single addictionof identifying alternatives to traditional treatments,
treatment method is right for everyone. They claimeasier.”
that matching treatment services to eachIt is finally time to stop living in the dark ages of
individual’s specific needs is critical to success. Inrecovery, educate people about all of their choices and
addition, research studies indicate that even the mostalternatives that are out there and maybe start making
severely addicted individuals can participate actively ina dent in the alcohol and drug use problem that millions
their own treatment, and that active participation isare facing each day instead of continuing to
essential for good outcomes. According to the NIDA,perpetuate it. If you are one of those people who still
counseling, either individual or group, and otherbelieve that the 12-steps are the “only
behavioral therapies are critical components ofway” to recover, I implore you to have an open
effective treatment for addiction. It’s interestingmind. In fact, Bill W., one of the co-founders of AA said,
to note that participation in a 12-step program was"It would be a product of false pride to claim that
never mentioned anywhere in this research basedA.A. is a cure-all, even for alcoholism." Bill W.
guide which discussed the principles of effectiverepeatedly said that "our hats are off to you if
treatment.you can find a better way" and "If [those
Reliance on outdated and ineffective treatmentseeking a different cure] can do better by other
methods has created an environment that fullymeans, we are glad.