I was invited to the UK and Denmark to speak by harm reduction activists who are worried about the impact of AA and the 12 steps in their countries. Both Patrick O'Hare, who founded in Liverpool the organization now called Harm Reduction International, and Nanna Gotfredsen, founder and director of Copenhagen's Street Lawyers, who run a clean needle program and other services for drug users and addicts, watch with alarm as the gains they have made dealing with addicts over previous decades erode. You see, both the British and the Danish governments are increasingly buying into the AA line that abstinence is the best and most achievable goal, both for individual addicts and for their nations.
Oddly, in Denmark, the newly-elected socialists are most susceptible to AA's abstinence uber alles message, while in Britain it is David Cameron's conservatives who seem to be swallowing the AA message hook, line and sinker. Politicians of all stripes tend to like magic bullet solutions, especially ones that hold out the promise that their constituents will stop taking drugs. Drinking is a thornier matter, since politicians and public health savants themselves drink, and the issue there is obviously over-drinking. (Of course, in reality, drugs present the same problem.)
Here are four reasons AA is harmful and will hurt their societies.
AA denies reality. I present data generated by the American government's own research showing that each age cohort after the 18-25 age group has a substantially lower percentage of problematic drinkers and drug users -- including alcoholics and addicts. Yet, the large majority of former abusers do not enter treatment or join AA -- they have simply "matured out." Since the 12-step mantra is that substance use problems only grow worse without their intervention, AA members must deny this reality ("All the youthful drug users have died!"). I then ask how many members of the audience have quit smoking -- which they acknowledge to be the hardest drug addiction to quit. Of the large number who raise their hands, I then ask how many did so due to medical treatment (e.g., nicotine gums and patches) or support groups. If 1 in 10 former smoking addicts present raise their hands, it's a lot.
AA overemphasizes its own success. As these sorts of interactions reveal, AA-ers always overestimate their own role in recovery, both its pervasiveness (only their members quit) and their success rates. Although, in the latter case, not really. If you ask what percentage of people who attend AA stick with the program, AA-ers themselves will usually guess the correct 5-10 percent figure. Their argument is that those who depart are bound to fail altogether, since theirs is the only road to recovery. Within AA groups themselves, people who leave the program are ostracized by their former "soul mates" who predict -- some might even say they hope for -- the prodigals' failure and demise. That is, unless they return to the fold.
AA rules out other, often more effective, approaches. AA is a jealous lover. A body of research has grown that investigates the efficacy of alcoholism and addiction therapies with names like motivational interviewing, life skills training, community reinforcement, brief interventions, harm reduction, etc. These therapies share a number of general characteristics relative to AA and its 12 steps: They are more pragmatic and impact addicts' functioning and life situations, they often permit reduced or less unhealthy use in addition to abstinence, they tap into users' personal value systems rather than imposing their own, and they don't rely on a "higher power." And they generally demonstrate greater success than AA (no clinical study of AA has ever found it superior to any alternative offered to randomly selected alcoholics). And how do AA-ers feel about such alternatives? Disinterest is probably too positive a way to describe their reaction.
AA's underlying temperance message actually creates alcoholism and addiction. The American temperance movement anticipated every aspect of the 12-step approach (keep this in mind when reviewing Ken Burns' documentary on Prohibition). These include the claims that drinking problems inevitably progress to death or other forms of self-destruction, the permanence and irreversibility of human substance abuse problems (which in turn leads to the fixation on abstinence and disbelief in moderation), the need for divine intervention and the reliance on God and a higher power, etc.
But this type of black-and-white thinking is actually associated with the greatest drinking problems -- think Irish-style versus Italian-style drinking. (Pat O'Hare, with his Irish and Liverpool background, says with amazement, "In my 12 years in Rome, I never saw a drunk person -- not even a tipsy one.") In other words, the cultural outlook underlying the 12-step model is the one likely to lead to the most excessive drinking/alcoholism/addiction. This is particularly true when, in the same society -- as is true in contemporary America -- people are ubiquitously exposed to the very intoxicants whose use they are taught that they are incapable of controlling. Consider that a higher percentage of American youth disapprove of those 18 and older having 1-2 drinks daily than disapprove of weekend binge drinking.
The ascendance of AA and the 12 steps in the UK, Denmark and elsewhere in the world won't be associated with greater abstinence or relief from addictive problems (has it had that effect in the U.S.?). It is a self-fulfilling philosophy -- that is, its own failures feed its claims for its own necessity (ask someone in AA if the rate of alcohol and other substance use problems has declined or increased in America since AA was formed in 1935). Most important of all, the 12-steps deprive people -- societies -- of the belief in their own ability to manage substance use. And this loss of personal efficacy is not likely to be a good thing in the coming century.
Follow Stanton Peele on Twitter: www.twitter.com/speele5
Shaun Francis: Harm Reduction Good, But Private Health Care Bad?
RARELY HAVE we seen a person fail who has thoroughly followed our path.Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.There are such unfortunates.They are not at fault; they seem to have been born that way.They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average.There are those,too,who suffer from grave emotional and mental disorders,but many of them do recover if they have the capacity to be honest.
Our stories disclose in a general way what we used to be like,what happened,and what we are like now.If you have decided that you want what we have and are willing to go to any length to get it-then you are ready to take certain steps.
At some of these we balked.We thought that we could find an easier,softer way.But we could not. With all earnestness at our command,we beg of you to be fearless and thorough from the very start.Some of us have tried to hold on to our old ideas and the result was nil until we let go absolutely.
Remember that we deal with alcohol-cunning,baffling,powerful! Without help it is too much for us. But there is One who has all power-that One is God.May you find him now.
It is difficult to listen to anyone who wasn't in the same position. How can they understand? Walking into a room of people who all have the same, if not similar story is a relief. And then to find out that you will not only be able to live without drinking but become a person who is comfortable with yourself? That's a miracle.
No two AA meetings are alike and they differ across the country. And no two people have the same 'program' for themselves -- everyone's different. Many of us are also in therapy, see psychiatrists and seek religious counsel. Some do none of the above. Because what is important is not just stopping drinking, its healing and becoming a whole person again -- that's what is meant by the term 'recovery'.
Step 2 - Came to believe that a Power greater than ourselves could restore us to sanity
Step 3 - Made a decision to turn our will and our lives over to the care of God as we understood God
Step 4 - Made a searching and fearless moral inventory of ourselves
Step 5 - Admitted to God, to ourselves and to another human being the exact nature of our wrongs
Step 6 - Were entirely ready to have God remove all these defects of character
Step 7 - Humbly asked God to remove our shortcomings
Except for Step 4, NO!
When you are battling any type of addiction, the most crucial moment is one of personal choice. Addiction forms from the thought "I can't help myself." You have to first believe that you CAN help yourself and then you have to take action on that belief.
AA philosophy is an exercise in powerlessness which is exactly the opposite of what an addict needs to learn to grow and improve as a person. Self esteem grows from believing in ourselves and handing over all our power to a higher being is not the answer. The power has to be within us, not something external.
Mr. Peele is right in questioning AA.
The only powerlessness an AA admits is to alcohol (a substance which changes the workings of his brain and takes it out of his control). In AA and Al-Anon, people often give thanks for the dawning knowledge that they are not "God." Knowing that they can't control circumstances or other people frees them to concentrate on what they can control, their own attitudes and behavior. They do that by letting go of the desire to control the world and make it do their bidding, by admitting and dealing with old bad ideas and habits, and by opening themselves to reality and their own inner direction (aka "listening to their higher power") in order to live in a healthy manner. It's really rather Taoist.
1.We admitted we were powerless over alcohol—that our lives had become unmanageable.
2.Came to believe that a Power greater than ourselves could restore us to sanity.
3.Made a decision to turn our will and our lives over to the care of God as we understood Him.
4.Made a searching and fearless moral inventory of ourselves.
5.Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6.Were entirely ready to have God remove all these defects of character.
7.Humbly asked Him to remove our shortcomings.
8.Made a list of all persons we had harmed, and became willing to make amends to them all.
9.Made direct amends to such people wherever possible, except when to do so would injure them or others.
10.Continued to take personal inventory and when we were wrong promptly admitted it.
11.Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12.Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs
Do not let dogma nor "me-too" testimonials stand in the way of others, nor science (medical) find something other 1930's AA as a cure.
Most importantly AA members are supposed NOT PROMOTE, but to attract. Writing as these and calling people trolls like someone else here are great DETRACTORS from promote more drinking...so cut it out it's hypocritical. Why can't AA's see how when they write such things as his they do more harm to the AA...hypocritical to the extreme which only further provides that 12-step social support groups have got to go away.
Like you, the group has been a great source of comfort for him. It has helped a lot minimize the isolation factor.
However, I think Stanton has a point in the dis-empowerment, not sure AA helps people become really responsible for their actions.
I do believe the group support is something necessary, also, people seem to benefit from not being judged.
Like you, he has told me a number of times that, if it weren't for AA, he would be dead by now.
Most of AA is good, but I don't see progress in the addiction question, it's like he's always at square zero, trying to recover, relapsing, then starting all over again.
If anything, AA and NA are more helpful than harmful.
The best of luck to you in your recovery.
I realize it might be a difficult for most Huffpost readers to wrap their heads around this simple conservative principle, but here it goes: Everything has been tried before. What's passed down by history is usually our best option because (you got it!) everything has been tried before. Millions of people have experimented with different solutions and failed. AA is here and it's everywhere because it works, and you're probably not going to randomly invent a better treatment system.
The Nov 2002 Grapevine (AA's magazine) reported that over 60% of newcomers arrive under mandates from the courts, government agencies, and employee assistance programs. That's not counting the ones who are mandated by families and loved ones.
Everything has not been tried before, many new alcohol treatments have come into being because of AA's miserable success rate. Some are known as 'evidence-based practices', methods that have proved to have better outcomes that no treatment or AA.
I guess I'm his 12th step.
"...Stanton Peele’s third argument against AA is its apparent refusal to accept other approaches of recovery from alcoholism. If Peele had taken the time to read the basic text of Alcoholics Anonymous he might find that our literature does not wish to hammer opinions into anyone’s head and even says in Chapter Three that “if any alcoholic can do the right about face and control his drinking than our hats are off to him”. The AA program also believes in seeking outside help from doctors and therapists if it will help us with our recovery. Our literature emphasizes and reemphasizes our separation from radical zealous thinking. All we wish to offer is experience, strength and hope."
To read article in it's entirety visit: http://www.treatment4addiction.com/blog/treatment/rebut-to-addiction-experts-rant-on-aa/
#1 The NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions interviewed over 43,000 people. Using the criteria for alcohol dependence found in the DSM-IV, they found:
* Twenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery; more than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence.
* About 75 percent of persons who recover from alcohol dependence do so without seeking any kind of help, including specialty alcohol (rehab) programs and AA. Only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment.
#2 AA does not improve on the rate of natural recovery while raising the mortality rate, that was found by George Vaillant, former Harvard professor. researcher, and AA Trustee. He set out to prove that AA works, ran the largest study of his day. He said of his findings: "Not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling."
“Unless each A.A. member follows to the best of his ability our suggested Twelve Steps to recovery, he almost certainly signs his own death warrant.
Twelve and Twelve, pg 174)
The AA member has to conform to the principles of recovery. His life
actually depends upon obedience to spiritual principles. If he deviates
too far, the penalty is sure and swift; he sickens and dies. At first
he goes along because he must, but later he discovers a way of life he
really wants to live. Moreover, he finds he cannot keep this priceless
gift unless he gives it away. Neither he nor anybody else can survive
unless he carries the AA message." (Twelve and Twelve, Tradition One,
pg. 130)
Those are pretty definite statements. And it's not just the literature, any talk of other methods, including methods shown to have better success rates are loudly dismissed by AA members.
#4 Again see the finding of the NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions. The word 'alcoholic' has been claimed by AA to mean only what AA wants it to mean, the term "alcohol dependent" is much clearer, with an actual definition.
-My father picks up the phone when i call him
-I am able to hold a job
-I smile and look people in the eye
-I go to sleep most nights proud of what I did that day
-I don't depend on chemicals to fill a void in my life
-I reach my hand out to others and care about other humans who walk this earth
-I have wonderful friends who love me
None of things were a part of my life until i found AA.
My only disagreement is with this line: "AA overemphasizes its own success."
Actually, A.A. lies like a rug. The don't just "overemphasize". The normal rate of spontaneous remission in alcoholics — that is, the cure rate of alcoholics who quit all on their own, without any help or treatment or "support group" — is around 5% per year. The cure rate of A.A. is around 5% per year. That means that A.A. is producing a zero-percent improvement in sobriety.
It's hard to "overemphasize" a zero-percent improvement. A.A. merely steals credit for recoveries that they did not cause.
Worse, yet, A.A. participation increases the rates of binge drinking, and rearrests, and costs of hospitalization of alcoholics, and also suicides and divorce... That is not good.
For more on the effectiveness of 12-Step treatment, see:
http://www.orange-papers.org/orange-effectiveness.html
And have a good day now.
== Orange
If AA does it either from intent or being so evangelical...it causes and promotes the idea that AA is the best and only way to rid oneself of the obsessive compulsive behavior of addiction.
AA/NA has been a major obstruction in scientific and medical research whether the members themselves know it or acknowledge it. In the group meetings people are not at all encouraged to help others by reaching out to the medical communities other than to recruit more members. If AA/NA were not so "gung-ho" on he idea of spiritual (religious) illness only god and aa can cure then we'd have been that much close to a solution....
Please please please AA/NA members if you don't have something to add to research then stop this hateful "me-too" testimonials and anti-anything else-but-aa stance is wrong stance. it's hypocritical and dishonest.
Over 60% of new people arrive under mandates. When the choice is jail or AA, it isn't a real choice.
Have you ever been to an AA meeting? Have you read AA literature? Keep in mind that AA meetings are communities of people, and within every community of people there are zealots and crazy people. To say that the group or purpose of the program as a whole is dangerous it just ignorant. I will not argue with your view on addiction, because everyone is entitled to their own opinion but I will say that you seem to be jumping to a lot of conclusions. I also find it funny that an organization which costs no money, has no rules or regulations, no leader, and carries a message of love and tolerance, a program that aids those in recovery to mend relationships that alcoholics have destroyed ---is the thing that's "ruining the world".
As for your comment about alcoholism not declining since 1935, that was never AA's intention. We are not trying to defeat the problem all together, we are simply trying to show others how we have recovered. If you don't like AA, I suggest maybe you don't go. And I will never judge anyone for that. Nobody in AA should, its none of our business. Have you thought of talking to people that have recovered from AA?
But they're not usually in charge as in AA.
"love and tolerance"?
As an atheist, I got zero support, plenty of verbal abuse and occasional threats of physical abuse for asking how I could work the program.
In the recovery industry there is a fallacy promoted that the addict and alcoholic the person with a substance problem, have only one path to take, and this concept was created by the author Bill Wilson the inventor of Alcoholics Anonymous, he told his fellowship there was “no middle of the road solution.” What Bill created in recovery was “extremism.” We know extremism only creates fanatics and victims. The failed philosophies of “only the worse” reach for help and you have to hit what they called a bottom, the worse you are the better the chances of adopting his extreme ideas. Then Bill converts to being an evangelical stating that alcoholism is something that only a spiritual experience solves, since he bracketed alcoholism as a spiritual disease, not a medical condition, and that is extreme, and then we have the mainstream, the middle of the road, the rest of the world.
Before I start, if I sound angry I am and I hope you are too. And don’t worry about being angry, it is a normal human emotion not a defect of character. Recovery should not be based in "urban legend" and now it the time to stand up and say NO MORE.
The bottom line for me is that AA allows a huge amount of leeway in how I want to get sober and stay that way. Unfortunately, as Stanton Peele knows, a lot of AAers push their own overtly religious version of AA and this turns a lot of people away. I would encourage anybody who gets turned off by something like this to look for alternative viewpoints within AA (most cities have Agnostic or Atheist meetings that tend not to stress the importance of Higher Powers, God, etc.). Ultimately, though, if AA is not for you and you still think you need help, please seek it out (SMART Recovery, SOS, and LifeRing are great alternatives). You may just "mature out" as Dr. Peele notes, but if everything in your life is turning to garbage because you can't stop drinking/using, try to find the help (within or without AA) you need.
When politicians are forced to decide whether to spend money on buying needles to help keep addicts from getting HIV and other diseases or to spend money on abstinence-oriented treatment programs, the question is no longer personal. No one's trying to force their beliefs on anyone else. But if the government is spending money, they need to spend it in the wisest fashion, and the overwhelming scientific and medical consensus is that abstinence is the best treatment for alcoholism and addiction.
Wrong - It's Bill Wilson and the Big Book's way.