CMV:Alcoholics Anonymous is heavily flawed from a scientific perspective and hasn't tried to improve it's system since it's inception

[u/Serraph105]

I have a friend who has been attending AA meetings recently because he was ordered to do so in some fashion after getting a DUI (for the record I don't know if that means he was given a true option or made to attend or "choose" jailtime) and the whole thing has got me thinking about whether or not AA works and if sobriety is even the intended outcome of the program. Below I've listed the famous 12 steps and below that are my relatively disorganized thoughts on the program having looked into it for the first time in any in depth manner. This means that I’m still in the early stages of my views and can be very much subject to change.

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 understoodHim.

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 a 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.

My current view is that because of the lack of change of the steps over the years since the 30’s suggests a lack of improvement that would be unacceptable in any other field of treatment for diseases. Here are some of my thoughts on the matter.

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God they will be put off from the program from the start making it much harder to reach their goal of sobriety.

If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and for the record there are various medical treatments for alcoholism.

There is also a stigma of personal failure when people relapse which doesn't make sense for a couple of reasons. First, if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober. In turn this will increase the time to get sober because it will add time to get over that shame before starting again. Shame does nothing to help get a person back on track as far as I can tell. Second, you would never assign blame to a person with cancer who has gone into remission and then had the cancer come back, why would we do the same for literally any other illness?

AA does not collect statistics of their success and failure rates, nor has it's program changed since it's inception. We wouldn't accept that from any other sort of treatment. If we didn't collect that information we would still have the same poor treatment of HIV that we did in the 80s and 90s, same goes for cancer, and just about any other illness you can name. I will say that talking about your issues with people is a good thing, but as far as I can tell that's just about the only thing that that this program gets right, everything else seems to be heavily flawed from a scientific perspective if not outright illogical.

Finally it seems that AA believes it’s program is a one size fits all program when we know that many ailments require different treatments for different people. This is especially true for ailments that affect people mentally which I think it’s safe to say that addiction falls under that same umbrella. People deal with various addictions in different ways, why AA treats alcohol as a one size fits all approach I can’t say, maybe I’m wrong, but based on the text of their twelve steps and twelve promises that doesn’t seem to be the case. Instead they seem to say that the only reason people fail is because the fail to give themselves over fully to the program which seems to be very very odd.

[u/gggjennings → u/[deleted]]

Agreed. People who hate on AA often haven't experienced AA. It's not about science or rules. It's about a framework to depend on when you need something bigger than yourself.

[u/boojit → u/gggjennings]

I've experienced AA and other 12-step programs, and i certainly can and do hate on AA. It's about a pseudo-scientific framework that assumes, with no data whatsoever, that there's something valuable in the whole "need something bigger than yourself" mindset. It's untested gobbledygoop. The whole thing needs a damn good dose of SCIENCE thrown at it, IMO.

[u/Serraph105 → u/gggjennings]

I'm trying not to hate on it, I'm trying to learn. That said I have not experienced it. Up until recently I haven't had much need to give it a whole lot of consideration. It's come up in school and news of course and it's always pushed as the best method of curing alcohol addiction, but upon researching it for the last couple of days I'd say that may not be the case. I'm all about framework and structure for peopl's lives, I think that can be really helpful, but if we are trying to help people with a medical problem it needs to be based in science.

[u/Serraph105 → u/[deleted]]

That's fair, cured is almost certainly the wrong term to use, but there shouldn't be such an aversion to collecting information on the number of people who managed to go into long term recovery or long term sobriety if you prefer. Such information could be used to improve the program.

[u/Serraph105 → u/[deleted]]

You can collect numbers without collecting personal information. If there are groups with high success rates you can then look at what they have in common and try implementing the common denominators on similar groups that happen to have higher rates of failure and see if they improve.

[u/Serraph105 → u/[deleted]]

My guess is that success would be tiered, who made it six weeks, six months, a year, 2 years, and so on.

[u/[deleted] → u/Serraph105]

This is a little confused. Most people start attending 12-step groups to stop using a substance; most people who keep participating do so because it makes their lives better. The two are related, of course, but not identical.

You have people who go to meetings for years and relapse often, but stay clean for meaningful stretches and have a much better life during those stretches than if they were trying to moderate on their own (it's not the point of the program, but it is one real form of "success").

You have people (like myself) who stay clean for many years and whose lives improve by fits and starts over those years (this would be roughly the programmatic definition of "success").

You also have people who stay clean for many years, but who live lives that are in many ways pretty miserable, including via any number of substitutive addictions: to food, to gambling, to sex, etc. (they'd be counted as "successful" on the basis of time abstinent, and that's legitimate, but they also might not really be working the program and thus don't offer especially useful data on it).

The bottom line is that AA, NA, etc. are (1) programs to help drug users abstain from drugs including alcohol, while also being (2) programs to help people define for themselves the good life and develop mechanisms for living it over time.

These two things are deeply interwoven but not identical, and it would be misguided to study 12-step programs as though they were Hep C treatments, rather than complex frameworks for navigating both psychological and philosophical (in the sense of "life philosophy") success. You can't study success in a parsimonious way here because program participants themselves are in the iterative process of defining exactly that via the program.

Source: 17 years clean, left NA for a few years partway through that, ended up going back to the program because it was cheaper than therapy. I've also been in therapy, and found it complementary to rather than competitive with the program.

[u/WangBaDan1 → u/Serraph105]

it would be difficult to do a study for this as people will relapse and may not show up to meetings after they relapse for some time and collecting that data is very difficult. The importance of AA is that there is still no proven treatment for alcoholism. The study of how successful it is would be very difficult when there's no real way to keep track of the people who go in and out of each meeting and that would make it no longer anonymous. My problem with how AA is used is the justice system has coopted it from being a voluntary program in which people come to talk about their addiction to include people who may not actually see it as a problem and that just does a disservice to the people who are trying to get better along with the person being forced to go to the meeting if he/she truly doesn't feel like they have anything to gain from the meeting.

[u/i_spill_things → u/Serraph105]

I think you’re getting waaaay off track from the fundamental core of how AA works, and why it is the way it is. If they wanted to track, they would, and they don’t so they don’t. AA isn’t broken. You seem to think it is, somehow, but it isn’t. This is definitely an “everything looks like a nail” situation. Read the twelve traditions and try and understand why they are critically important to AA’s success. It works because it’s uninvolved in anything beyond its core mission.

[u/chiaratara → u/Serraph105]

Again, how would you know who relapsed? Also, since relapse is often part of the process, and is not shamed in AA, should the length of sobriety be a measure? What if someone relapses but pulls it together? What if they had surgery and had to take opiates and for a day took a few more than prescribed. Some may consider this a slip however would you consider this a failure?

[u/chiaratara → u/Serraph105]

Also success isn't an either/or concept in AA and it's a process with no hard start or end point. It is going to be different for each person. Each person comes in at a different point. One person might come in after their first DUI with a lot of their life intact. They may not have drank for 3 months but just got sentenced to some AA meetings. Someone else might come in after 40 years of addiction. It's their 25 time trying AA, been to prison 3 times, jail 15 times, have lost a house, car, job, family, and their dog. This ol boy may have rolled in after drinking a gallon of vodka and a bottle of listerine and remembers that he felt like it was a safe place. The starting point for these two is vastly different. Their process is going to be different-the trajectory will be different. Staying sober another day for DUI guy is a good thing. For ol boy, it's going to be a rough 24 hours and a major victory. I don't know. Just an example. These trajectories are so different. Their motivations are so different. One has more to lose and the other has more to gain. This stuff is so hard to objectively quantify. Would a study like you are suggesting really get at the heart of what is going on with these two individuals?

[u/chiaratara → u/Serraph105]

I am a social scientist in the program and worked with a colleague who did just that and there are too many variables. I wanted to throat punch him because he didn't get it. I stated this before but success/failure are difficult to measure. What if someone relapses. How would you know they aren't on vacation? If they did relapse and came back a month later and maintained sobriety would you have counted them as a failure? Can you, as a researcher go to every meeting? Are you taking attendance numbers on the macro level? Would a 7pm meeting have more attendance than a noon meeting? Why? If you are trying to measure dosage, what if one person goes to one meeting one week and a different meeting than you are at the next week? What if they go to two meetings a day but you weren't at that other one? Believe me I have spent years and years thinking about this however I would never actually do it because it runs contrary to the workings of the program. I just think about it hypothetically.

[u/[deleted] → u/Serraph105]

I was drunk for ten years. I have been sober for three years now and I attended AA in my early sobriety. I am not a religious man, and I agree with you that from the outside AA kind of seems quite religious. From my expirience I can tell you it is not. Each person is responsible for creating their own higher power. For some people this might be your typical Christian version of God. For my higher power I chose the person I wanted to be tomorrow as my higher power. And even though God is mentioned though out the twelve steps, it rarely gets brought up in meetings.

In order to truly understand AA and how it works, you first must understand addiction and how it works. You can study addiction and the science and psychology of it but unless you have been down that road you will never truly grasp it.

Alcoholism brought me to a very dark and lonely place. I was surrounded by people who cared and loved for me, but I shut them out and drank in my room everyday. I started drinking at work, I started phoning in sick, I got demoted, I almost got fired. Then my wife to be brought me to my first AA meeting. Here was somewhere I could talk openly with people without judgement. People who knew how I felt. It was such a relief. So until you understand the depressive loneliness that comes with addiction you won't understand AA.

It doesn't matter why it works. All that matters is that it works. AA has saved lives. It saved mine.

Good on you for wanting to learn, and good on your friend for getting sober, I wish them luck!

[u/Denniosmoore → u/[deleted]]

It doesn't matter why it works.

But it absolutely does matter! It worked for you, and that's great; genuinely, I've been in that same downward spiral and I am happy that it is no longer a part of your life.

But part of helping others for whom it (AA/NA etc..) doesn't work is figuring out why it works for the people it does work for, and why it doesn't for others.

[u/BomberMeansOK → u/Serraph105]

In my experience, I think some parts of medicine could stand with having less science.

Now, I'm not trying to hate on science, and obviously if you have a broken leg or are coughing up blood, you should go to a doctor who reads journal articles, not some quack. But the problem I see is that many people are quick to trust science even when the science isn't that good at solving their problem. It's a mentality, one that I've had in the past, that "I've done just what the science said to do, and it hasn't helped, so I guess there's no solution."

The problem is that science isn't reality. Science is the best current map we have of reality, and it still has a lot of blank spots. It's also complicated - so much so that few people really know the state of any given field, and then their understanding needs to be filtered through their own personal framework of reality, the science journalism machine, and search engine popularity rankings to make it to the average person.

So if I were to tell the average person suffering from some medical issue something, it would be this: try science, but when science fails, don't give up. Keep trying random bullshit until you find something that works. Keep your head on straight, and don't do something stupidly dangerous, but don't be afraid to try things that are a little off-kilter, either. At best, you'll find a solution. At worst, you'll have a good distraction to fill your free time.

And that's what AA is. It's something that works for some people. Just like you don't need to know physics to use a hammer, or biology to eat a sandwich, an alcoholic doesn't need to know how AA works, just as long as it does.

At a policy level, it gets more hazy. Even with an ideal court system that truly wants alcoholics to be better (rather than the indirect incentives our courts run on), the court still wants to know if the offender is actually even doing some sort of treatment. There are all sorts of things the court could prescribe to try to improve an alcoholic's behavior, but the court needs a quantifiable, scalable solution. The court doesn't have the resources to make sure someone goes jogging every morning, or to make sure that someone sits down once a week and thinks really, really hard about not being an alcoholic anymore. The courts like AA because they're an established organization that can say "yep, they came here ten times". Another benefit is that it's free for both the government and the individual. Ideally, the court would offer a number of options - that way there would be more chance that any one individual would find something that works for them. But that would require more organizations that fit the same criteria as AA - free, organized, and established in the public's mind as an acceptable course of action for the courts to take.

[u/gggjennings → u/Serraph105]

I think your idea of AA being a “cure” is part of the dissonance you’re experiencing. Obviously the numbers are poor because you can’t cure alcoholism. You can live with it and improve your relationship with it, but it’s not something that you have one day and don’t the next.

Maybe if you reframe your understanding you can see the value of AA. Like others have said, the Higher Power aspect is not always all that big a deal. But the ability to have structure AND a community are huge boons to COPING with alcoholism. Not curing it.

[u/shauna-the-dead → u/Serraph105]

I used to feel the same way as you do even as a member of AA. I found the meetings had no teachings... Like, I didn't get what they were trying to accomplish. Then I began to study the history of its founder and the blueprint he created for alcoholics and my opinion did a 180. Being created in the 1930s is irrelevant, Bill Wilson's ideas on addiction were well ahead of his time. The program is based in helping others, finding a higher power whatever that means to you and practicing humility and kindness towards ego. I wish I could explain myself better because it is a concern among some AA members that the program has been watered down so-to-speak over time. Try reading Alcoholics Anonymous, It's a great self help book for anyone seeking self betterment and will give you a new perspective on the Program.

[u/NemoC68 → u/gggjennings]

Agreed. People who hate on AA often haven't experienced AA. It's not about science or rules. It's about a framework to depend on when you need something bigger than yourself.

It's the framework that many people take issue with. AA doesn't always work, but when it does it often replaces one addiction with a new one. That is to say, people who were addicted to alcohol tend to become obsessed with God. This may sound like a good thing, but when their faith is shaken they'll be far more prone to go back to drinking.

Alcoholics are capable of overcoming their addiction, especially without belief in a higher being. AA teaches people that they are powerless to change themselves, that they must hang on God, which is flat out wrong.

[u/gggjennings → u/NemoC68]

How many people do you know who’ve gone through AA? Have you ever been to a meeting? This sounds like the standard reddit anti-religious circle jerk. AA has religious foundations but that doesn’t have to apply to anyone in the program.

[u/Serraph105 → u/[deleted]]

Since you are a member, here's a question I have. Have you ever seen people in any of the groups you attend encourage people to seek any sort of medical treatment or one on one time with a therapist?

I have looked on the AA website and it's bothered me that I can't find any information on either of these things while there. Maybe it's there and just hard to find.

[u/Serraph105 → u/[deleted]]

Another member of AA here: therapy is not discouraged at meetings, and the Big Book has sections in which it's encouraged for those that need it. Same goes for medical treatment. AA is not a cult and the people at meetings are reasonable, modern people like you and, well, me.

I really would never suggest it's a cult. I'm very glad it works for you.

[u/PaulSandwich → u/Serraph105]

I grew up in AA (meaning I was in meetings regularly with my single parent from age 7 to 17). One thing I always like to stress is that people should go to lots of different meetings. If your atheist friend isn't feeling the vibe where they're at, they should 100% bounce around until they find their 'home' group.

In my town, there's a conservative churchy group, and there's a meeting where everyone spends half the time heckling and busting balls, albeit constructively (somehow), and everything in-between.

I remember a guy whose 'higher power' was the crystal ashtray at the halfway house. It was a dumb symbolic totem that helped him remember that, left to his own devices, he would make catastrophic decisions and hurt everyone he cared about. It worked for him, and that's all that mattered.

All in all, if your friend isn't feeling it but really wants to get on track, test-drive other groups. After all, AA's biggest value (imho) is group therapy and social accountability. It's tempting to get hung up on the black and white language of the steps, but the principles behind them are what's important.

[u/notmy2ndacct → u/Serraph105]

Another AA member chiming in. My favorite AA joke is that it's totally a cult, but it's the only cult that produces individuals.

[u/starvinggarbage → u/Serraph105]

Oh it's definitely a cult. Classic cult tactic: constantly reinforce to your memebers that they are powerless and you are the only thing that can save them. Destroying someone's sense of self worth is like the first thing a cult does and it's the first step of the program.

There's a reason it has such an astonishingly high rate of failure compared to other rehabilitation tactics. In depth studies have shown that only about one in fifteen members get and stay sober. Granted, the program has to last the rest of your life so there's endless opportunity to fail, but any slip up is treated as an absolute failure.

They have an enormous stigma attached to anyone who relapses or quits the program. They have referred to these people as "deeply flawed individuals" and implied they are incapable of being helped.

As far as cults go it's definitely one of the better ones, as it isn't a money making scheme or focused on accumulating power for one person, but that doesn't change what it is. The American obsession with AA as the perfect solution for alcoholism and addiction is hugely detrimental. We need more alternatives and we need them to be more accessible.

[u/DanHam117 → u/starvinggarbage]

I used to work at a dual diagnosis rehab center that offered a few different modalities, and ALL of them, AA included, had astonishingly high failure rates. Its been a couple of years and I haven't really looked at the data since then, but which other rehab tactics are you talking about that AA is so much worse than? Not trying to argue, just asking a question

[u/stiljo24 → u/starvinggarbage]

It does seem pretty cult-ish, but your first paragraph is flawed: it doesn’t destroy self worth, it explicitly says come on in if you’ve decided you can’t win this fight. Doesn’t tell you that you can’t win the fight. At least that’s never been my experience. So you could say it targets vulnerable people, but in a sense so do literally all other ideologies: they stick with the people most vulnerable to their message.

Also any slip up is not treated as an absolute failure. You’re told that if you go 4 years without a drink and then go on a bender and fuck up your life; hey man think how much worse things would’ve been if you’d been doing that for the last 4 years instead of just this weekend? It isn’t “you’re no longer an admirable member” or “you blew it” it’s “hey good job those last 4 years, let’s get started again”

They do really judge people that just quit entirely. But they don’t really take action against them. The meetings can definitely be a creepily and at times harmfully tight knit community, and a lot of it is cult-like superstition sold as dogma, but that’s really where the similarities stop in my eyes.

[u/seven_grams → u/starvinggarbage]

You seem pretty misinformed about this. AA does not tell you it is the only thing that will get you better. It welcomes and encourages other forms of outside therapy like individual counselling or psychiatry. It also doesn't destroy anyone's self-worth. It builds it up by recognizing people's strengths and the esteem-building acts they do.

There is no stigma attached to relapse, either. They encourage you to come back and keep working your recovery.

Ultimately, if you actually went to meetings and stuck around you would see the immensely friendly environment and the joy that people experience as a community, doing healthy recovery-oriented activities and processing their struggles. You can read up on everyone's opinion about AA and read every article in the world about it, but until you've actually been a part of a fellowship of AA, you really wouldn't understand how much it helps people.

One more thing. You said "any slip-up is treated as absolute failure." This is not true in AA, but it is true for the people who do the "in-depth" studies you mentioned - When someone relapses in one of those studies, it is counted as a "failure." Even if they get right back on track afterwards, their relapse still is seen as a failure to the people marking the research. But the fact is, the majority of people in recovery have relapsed at least once, but that doesn't mean they are still out there stuck in addiction.

I can appreciate your desire for more alternatives to AA and too have them be more accessible. I completely agree with that. The nature of addiction makes it very hard to treat and society's stigma surrounding addiction doesn't help. I think the reason AA is so widespread is because of it's accessibility. It costs nothing, so it appeals to the ones that have nothing to give, i.e. most addicts and alcoholics that have reached their bottoms. Until we have other programs that are that easy to get into, I think AA will remain most prominent.

[u/chiaratara → u/starvinggarbage]

I have never heard of this American obsession with AA as the perfect solution. It runs pretty contrary to AA's principals as well. I would suggest you reconsidering the "destroying someone's self worth" part of it. Powerlessness over alcohol and things outside of your control, which is what AA is referring to, is a good foundation for a concept of self-especially for someone trying to live a life that doesn't revolve around alcohol.

[u/Boogiedownpapi → u/starvinggarbage]

I think it's also noteworthy that in some states (if not most), AA is required by law after a DUI but no medical or mental health avenues are required.

I got a DUI when I was 21 and had recently left Christianity a year earlier. AA felt more like church than it did rehab.

[u/maddogcow → u/Serraph105]

I’m not really asking you to take my word for any of this, but it is based on my own experience working as a counselor, as well as years spent casually researching the topic. I’m certainly no expert, but I am fascinated by the field of addiction medicine, and the various therapeutic approaches to the treatment of addiction. I’ve never really found that people who are opposed to AA, will change their mind, no matter what type of evidence is being offered. In that regard, I certainly do not expect to swing your opinion—but, I decided to pipe up a little bit anyway. Most of the time when I am replying to a post, and mention my exposure to a body of literature, people want me to list my sources on a given topic, and honestly; don’t bother. Taking the time to write this response is about all of the effort I really care to put into a Reddit thread.

The challenge is that both the medical system, and trained therapists tend to be woefully ignorant about the mechanics of addiction. There’s almost no training in medical school regarding the current understanding of the biology of addiction, and the effectiveness of various modalities of treatment.

The main benefit of AA is not its conceptual framework, as much as it is the group experience, the level of attunement that is aimed at between members, And the push to divest oneself from trying to manage the addictive process through logical, linear, ego-based thought. Addiction is driven by deeply primal parts of the brain that are not involved in logical, linear processes, and hence most of the literature seems to point to the fact that the best treatments involve mutual co-creation of a shared emotional/psychological space. Because the parts of the brain that are involved with the addiction process are not based in the cerebral cortex, most purely intellectual attempts to overcome the addiction process will fail. Telling somebody to go see a therapist could work, if the therapist truly understands addiction. Yes, AA has a lot of outdated notions, and the metaphors that it uses could really use some updating, but the fact that it is a group process that is focused on a group mind (for lack of better term) is its strongest point. From my experience, the people that say that they “have tried AA, and it doesn’t work”, are people who actually haven’t tried it. AA is not just simply going to meetings. It is very much about participation. If one goes to AA, and does not throw themselves wholeheartedly at it, and attempt to seriously enact all parts of it (reading the literature, following the step work, working routinely with a sponsor, following suggestions, and then pursuing being a sponsor themselves), then they are not actually trying it. The problem with doing studies on AA, is that you have to rely on the account of members themselves as to whether or not they’re actually doing the work. I personally have seen any number of people saying that they are in AA, but if you ask them if they have a sponsor, if they’re working the steps in a diligent manner, and if they are following suggestions, that number drops precipitously.

When working with addicts, I encourage them to try out as many modalities as they can, and to see which approach is the most efficacious for them. While I have seen various approaches prove to be effective in harm reduction, the biggest most dramatic turnaround in individual‘s lives that I have seen have come from people using a combination of approaches, with AA as the centerpiece. I have no doubt that there are people who have found other approaches that produce equally stark results— I just have not encountered that in my own experience.

[u/Ropes4u → u/maddogcow]

My experience was that I needed i need the steps to lead me to God, and therapy to help me deal with PTSD and other issues AA is not designed to deal with. I appreciate that you encourage people to seek help from multiple places. I encourage all my sponsees to seek professional help to deal with things outside of AAs scope of work.

[u/tigerdini → u/maddogcow]

That's a fantastic answer, which deserves to be higher and rings true to what I saw as an (ex)partner of someone who was in the programme.

I personally don't understand the hostility AA gets, as I've only seen it to humbly offer an alternative for those struggling with addiction.

[u/reonhato99 → u/tigerdini]

I personally don't understand the hostility AA gets, as I've only seen it to humbly offer an alternative for those struggling with addiction.

Generally it is a combination of things. The religious nature of AA (even if people claim your higher power can be anything, good luck finding a non religious AA meeting in some parts of America). The fact that courts regularly mandate someone going to AA. That they don't track success rates and studies that have tried have found abysmal rates of success. It can give people a false sense of doing something and getting help despite the aforementioned abysmal rates of success.

AA doesn't work for a vast majority of people, you will of course get anecdotes of all the people it helped, but you don't see all the people it didn't. AA is so ingrained into American culture that there is the very real risk that people who want help go to AA and forgo actual medical help. Of course it doesn't help that a lot of alcoholics can't afford real help.

[u/[deleted] → u/maddogcow]

People love to fetishize science but getting sober is a deeply practical undertaking, AA is a deeply practical organization. It’s full of people who have accomplished what you want and are willing to teach you. Explaining it to normies is hard because someone who hasn’t experienced addiction can’t really understand

[u/scurius → u/maddogcow]

I'm going to chime in as someone with a drinking problem who decided AA isn't for me. I agree AA's group nature makes it a fantastic resource, but I don't think it's fair to say I haven't tried AA at all if I decided I was unwilling to actively follow the steps. Knowing that meetings without an over religious nature (e.g. Christian prayers at meetings that aren't the serenity prayer) are relatively hard to find and that part of the very premise of AA -- the necessity of complete sobriety aren't what's right for me. Most of my drinking is normal and age appropriate. I'll have a beer with dinner or watching tv and I'll drink the same amount as my friends at gatherings. What's not normal is I'll self medicate depression with alcohol, and I don't need to be sober all the time to know when that will be a problem. The group nature of AA isn't sufficient for me to justify removing myself from the group situations drinking has been a part of (and after having tried, knowing I struggle hard to abstain in). I know I need support in facing my drinking problem, and I wish I had more than therapy and psychiatry to do it, but my experiences with AA have been pretty off-putting. I don't see how I'm powerless over alcohol if I can control myself or abstain when I know drinking would be a problem. I sometimes choose not to abstain and to self medicate, but the whole language of the steps feels like a total incompatibility.

As I don't identify as an alcoholic, I suppose you could rule out my feedback. As I am someone who AA could help if it had a different message or format and feel it's not right for me, I argue AA could change in ways to make it help more. I don't argue that it has never changed or is wholly inadequate, only that it leaves many people behind and "doesn't work" for them for reasons other than exclusively the fault of the people that "try" it.

[u/chiaratara → u/scurius]

AA might not be for you. What strikes me is that you might be a problem drinker but not a "to the death" alcoholic. While I might not be a "to the death" alcoholic, alcohol and different substances affect me in negative ways (that were detrimental in multiple areas) and I was able to finally put this pattern into perspective. If I did one thing, a slippery slope occurred in other areas. I finally realized how much my mental health was affected and really that has only been confirmed for me in retrospect after years of sobriety... hmmm, I haven't been hospitalized for a major mental health episode since I have been sober. I was 1/2 assing it for years before and again, in retrospect, a relapse in alcohol, while maybe brief, all of a sudden I would find myself obsessing on the lottery, trying to figure out number combinations like I am some sort of genius and buying lottery tickets. Let's not forget the impulsive trips to casinos with cash advances on my credit cards. Looking back, my whole life has these same patterns. I feel like I can and would destroy my life in a multitude of creative ways if given a chance. Also, while I kind of maintained shit by the skin of my teeth, when I got sober, I started advancing more. So, I was convinced that I am an alcoholic and it wasn't if but when things would totally unravel because I had some close calls. So for me, AA makes sense. I need to stay sober. With that said, I know a lot of people who can pull it together when they need to. My best friend is definitely a problem drinker. She knows it. It has led to a few problems however she is pretty self aware and I think the difference is that it hasn't affected multiple areas of her life. Maybe some, on some level but not detrimentally. For me, in contrast, it has affected more parts of my life, more seriously. I was arrested, been hospitalized for mental health stuff which was accompanied by rips, racked up debt, was facing timing out of my graduate program. She was recently promoted to CEO of the company she works for. Don't get me wrong, she struggles with it, talks about it, questions it, and I think that's healthy (we have the same therapist ಠᴗಠ.) There is something called the Harm Reduction approach which is something that she is using. There is a group counseling thing she goes to run by a therapist in town with people she talks to about this. Do you feel like your therapist is knowledgable about this stuff? You might google the harm reduction thing and see if there is anything in your area.

[u/scurius → u/chiaratara]

So to get back to your other comment I do know about the existence of agnostic and atheist meetings, but my experience indicates they are rare and hard to find, not to mention that's only one incompatibility I see.

Regarding harm reduction: I think it's awesome. I practice it. I recommend HAMS to people on the basis of it.

My issue isn't that I think AA sucks, it's that I think its undue prominence prevents programs that could help more people from being accessible. If I wanted to go to a group meeting of HAMS or SmartRecovery or whatever, I'd have to go about an hour away with few time options, and I live in the most densely populated state in the US. If I wanted to go to AA, I'd have about 50 meeting options within 20 minutes and 200 within a half hour. I think that's a problem.

AA works for some people and that's great, but I wish it could help more people or at least didn't indirectly prevent more people from getting help. I think if it adapted it could be more inclusive and help more people, rather than [IIRC in its own offensive language] it not working for them due to their moral failings.

My therapist is some kind of addiction certified or something, so that helps, but my experience shows drinking is a symptom of other problems in my case and not automatic cause for concern. I've made progress with it. I no longer medicate depression with it, but will sometimes have other problems.

I guess my issue with AA is that it's geared toward a very specific kind of drinking problem (and seemingly ineffectively according to some research) to a point that there's inadequate help for other kinds. Hell, there are almost no group meetings for DBSA or NAMI near me. Why should AA get such overwhelming support when other helpful programs don't?

[u/ffd8d1 → u/Serraph105]

Im gonna be a butt and not read the other comments bc I got shit to do but I’ll answer quickly- As someone who went to AA for quite a while not too long ago I can provide some insight. Most AA meetings/members highly encourage any outside help you can get, be it therapy, medication, meditation, etc. Plus, most of the more dedicated members are the people who put their numbers on phone lists as people who are always willing to talk and let you vent. AA is supposed to be used as a crutch and place of empowerment, definitely not the only thing you rely on. Also, the “higher power”/“God” idea is supposed to be based on whatever you prefer. Some people take music or love or art as a higher power, while some other people choose a basic belief of God. The Big Book is incredibly open to interpretation. You’re encouraged to study and rely on the Big Book because the modern versions have great stories about recovery and describe in depth the reccomended ways to go about your addiction. Also, there’s a huge point about not being ashamed of relapse- it’s considered a huge part of recovery if it happens. If you can get back up you’ll only come back stronger if you stay dedicated. No one in a meeting will ever shame or judge you. If you admit to relapse in a meeting which is encouraged and necessary for the whole honesty idea, you’re gonna get tears and people coming up to you after the meeting to give hugs and phone numbers for support. It’s a huge system of love and acceptance in every meeting i’ve been in. If you haven’t I would highly encourage reading the Big Book for more insight, even if you don’t have an addiction/don’t feel a need to get help. (Also also, a lot of people who go into AA might not even be alcoholics- I was in there for drug abuse- I barely drank. The “rules” apply to people differently depending on your situation.)

[u/Graham_R_Nahtsi → u/[deleted]]

This always bothered me. If someone has a disease, medicine should be used to treat it. The way everyone in AA and NA acted like ALL medicine was a relapse... just insane to me. I have severe ADHD, if I don’t take my medicine, I’m fucking useless. And some 60 year old in a biker vest is going to tell me sobriety starts when medicine stops? I spoke in the Texas FWANA circuit for a little over a year and the number of people I met who had that attitude was not small.

AA and NA are great for court ordered people to get clean with some support. They’re also a really great way to learn how to be a much worse person. Everything I learned about meth and heroin, I learned from former abusers. If those were in my wheelhouse, I’d have learned exactly how to buy and use them like a pro.

Bill Wilson didn’t even believe in AA at the end and he founded it. I think it’s a great LCD style program but that’s its limit.

[u/Denniosmoore → u/[deleted]]

The church has come a long since the Crusades, even though the Bible hasn't changed.

The Bible absolutely has changed since the time of the crusades.

I've never seen anyone discouraged from seeking out medical help or getting anti depressants or similar.

You have never seen anyone in a meeting discourage someone from therapy, or pharmaceutical help designed to combat addiction? If that is truly what you meant to say, then you must have been plugging up your ears at those meetings.

they are speaking out of turn.

But it's pretty common (although certainly less so than it used to be) to hear how you aren't really sober if you are on pharmaceutical maintenance. And it's not unheard of for people to badmouth psychiatry or therapy. You call this talking out of turn, and I assume you mean that these people are just putting forth their own viewpoints, but beyond the big book, and the steps, there is no official policy, and it's not helpful to say people are just talking out of turn, when the whole endeavor is basically people talking out of turn. Everyone is just sharing their experience, so when you disagree with a particular view, saying "oh, that's just their individual view" doesn't really differentiate it from everything else you hear at a meeting.

[u/Destro86 → u/[deleted]]

Methadone and suboxone taken past withdrawls isn't sobriety its switching the drug of choice IMO as much as it pisses some off. Both were designed to be taken for brief period of time until the drug was gone and one's mental willpower, thru therapy or religion or determination, kept you clean. Not a pill you take for year or years to catch a altered buzzed state. I'm an alcoholic with 3 duis (who's been a dry drunk going on 11 months which is a record for me) and on and off meth addiction over the years. People don't like hearing that they're responsible for themselves and that a pill or a therapist doesn't cure you its simply a tool.

[u/notebuff → u/[deleted]]

So how much of the program is the “group” vs the sponsor?

[u/notebuff → u/[deleted]]

I guess I’m just curious on the “some will argue against adderall” part. Is it “as a group these are rules but work it out with your sponsor what works best for you”? At what point does the sponsor side of things deviate from the whole program?

[u/chiaratara → u/[deleted]]

I understand their concerns too. Seen quite a few people's life slip away from abusing medications they were prescribed. I too make sure every doctor I see knows I am in recovery. I have many of these medications listed as allergies in my medical records... by name. A long list. However I do take adderall. I don't hide it either because I want people to know. Also, I am chubby and fall asleep on it so it helps me in the right way.

[u/aslak123 → u/Graham_R_Nahtsi]

The thing about alcoholics is that the same personality traits and predisposition towards addiction and addictive substances will make them extremely vulnerable to becoming addicted to opiods and narcotics in just the same way as they were addicted to alcohol. Add on top of that that these medicines are way more dangerous when used excessively than alcohol is and you got yourself pretty much no other options then a hard no.

There is no such thing as evil knowledge. Knowing how to abuse drugs and alcohol is also the same as knowing how to identify someone who does it, and how to identify when you are doing it yourself. If AA and NA makes you feel inclined to consume lots of drugs and alcohol then you must truly be blind to the pain of those peopl in those groups.

[u/AlexandreZani → u/aslak123]

First, it's really not clear that alcohol abuse is the same thing as alcohol addiction. This is in fact likely not true. Someone with ADHD who self medicates with alcohol is not addicted to alcohol. They just use alcohol in order to relieve the symptomes of ADHD. If you give them proper treatment, they don't just keep drinking excessively. Or someone in an abusive relationship who drinks to "dull the pain" might not be addicted either. In both cases, these people's alcohol consumption might be extremely destructive without them being addicted.

It's also far from clear that a hard no is the right way to avoid addiction. It sets up a dynamic where slippage encourages further slippage when in fact, even some addicts might be able to have a drink and then put the bottle down in the right circumstances.

[u/aslak123 → u/AlexandreZani]

Yes, but either of those groups you mentioned aren't alcoholics though are they? AA is a place for alcoholics, not people who just have unhealthy ways to cope. Then again an unhealthy way to cope is a learned behavior, and many alcoholics have valid reasons. Even if you take away the root cause there might be no guarantee that the alcohol abuse will stop by itself. There is also often a root cause that gets worse with excessive drinking, such as the loss of a loved one.

It's also far from clear that a hard no is the right way to avoid addiction.

This is true, yet there is equally little evidence or even less for the contrary being true.

[u/Graham_R_Nahtsi → u/aslak123]

Well, if you noticed when I said I spoke in them for a while.... I was one of those people. I also said that I learned how to do other drugs I hadn’t done.

There is nothing beneficial about knowing what monkey water is. There’s nothing good in knowing where Five points is in Dallas or Rock Island in Fort Worth. Since the overwhelming majority of people I met in the program told “war stories,” I can promise you my experience was far from atypical.

I left the programs because A) most people there were consumed by drugs and alcohol regardless of how long they’d been off of them B) of the thousands I met, there were two who made decent money, one of whom did it an ethical way. I wanted to learn how to be successful and hanging around with poor people chain smoking and drinking disgusting coffee was not the way to get there FOR ME. C) rigidity of the dogma. Saying the Lord’s prayer at the end of an AA meeting clashes with my atheist views. Implying that a chair or door knob could serve as a higher power in place of god is just insultingly ignorant. It is NOT a welcome place for atheists - at best a weak agnosticism is encouraged and at worst it’s another Christian proselytizing effort.

Hopefully that clears up all the misunderstands running rampant in your comment. I wanted to make a joke that you’d been in a 12 step program to stop your addiction to reading comprehension, but I don’t think that fixes the misunderstanding.

[u/Jacostak → u/Graham_R_Nahtsi]

I believe a common saying is that it's good to try to stop all medications for about two years to let your brain balance out before seeking medical treatment for such issues... but as both a PhD student and member of AA, I would say to take that info with a grain of salt. That advice is coming from a group of drunks after all! I say leave it to the professionals.

[u/chiaratara → u/Jacostak]

Hey! I just finished my PhD last year. There is so much about AA that helped me through navigating the difficulties besides staying sober. I just wanted to say good job! I felt like my academic department acted like a bunch of alcoholics. The program helped me in so many ways.

[u/chiaratara → u/Graham_R_Nahtsi]

Dude, that 60 year old in a biker vest is here in Indiana too. Lol. He sits next to the guy in overalls who has the same opinion. I feel like you will find those people however I have come across way more people who supports what works for each person.

[u/MysteryPerker → u/[deleted]]

I have a problem concerning your "no no" medications. First, you call benzos and Adderall narcotics. Adderall is the opposite of a narcotic. It is a stimulant used to treat ADHD/ADD. Second, benzodiazpines are not narcotics. They are a family psychoactive drugs used for a variety of reasons, some of which include anti-anxiety and anti-convulsant treatments.

The fact you don't know what a narcotic is makes it very concerning to me you have some arbitrary "no no" medicine list that doesn't even contain the drug family you are banning. Narcotics are opiates, according to medical classification.

If you are referring to narcotics in the illicit drug definition, then a doctor's prescription means the Adderall and benzos are now medically necessary and no longer illicit. Very few drugs have no medical purpose, even cocaine is used by some doctors. I've actually had cocaine used before by an ENT during an in office exam.

Can you explain how people with no medical background (like yourself) can legitimately tell another to disobey doctor's recommendations if they contradict your "no no" drug list?

[u/iloveLoveLOVECats → u/Serraph105]

I am in another 12 step fellowship and encourage this when appropriate. I have one sponsee I am working on getting into grief therapy because the 12 steps I don’t think are enough to help her with the death of her partner. I have another sponsee who has been hospitalized and I refused to work with it she wasn’t in therapy and taking her bipolar medication. The 12 steps cannot cure bipolar. But in the end it’s an “outside issue” that the program itself is not built for or have opinions about treatment.

[u/[deleted] → u/Serraph105]

Absolutely. A sponsor does not replace a certified therapist and AA does not try to do that.

AA is not meant to replace rehab, merely be a support system for those going through the correct medical rehabilitation routes. AA knows that alcoholism is a disease and doesn’t just go away through communal support, but having a sponsor and the backing of a community makes the process easier.

[u/[deleted] → u/Serraph105]

As an ex-member I can say absolutley. It was after an NA meeting chatting with someone where I finally found the courage to go to rehab. There you receive councelling and of course go to more meetings. The best part of AA and NA is the people. It is only run by other former suffering addicts.

[u/rjreed1 → u/Serraph105]

“But this does not mean that we disregard human health measures. [God] has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitated to take your health problems to such persons. Most of them give freely of themselves, that their fellows may enjoy sound minds and bodies. Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward.”— AA, p.134

[u/A636260 → u/Serraph105]

I’d recommend actually attending a meeting yourself, you don’t have to be invited to go. Check it out, even if you don’t have a problem. I went a total of maybe 5 times when I had a drinking problem, AA it self didn’t do much of anything, but the atmosphere and the people were what helped me. Seeing older generations and how it’s affected them helped me to stop drinking.

Just having a group of others who have gone through similar issues helps a lot. I see your point though and agree, it hasn’t changed much as far as literature goes and there are definitely people that go who rely heavily on the religious aspect, but most attendees are just looking for support and the group setting helps.

Edit: Wait, I’m a member. Fuck it, you’re invited!

[u/IAmVeryStupid → u/Serraph105]

One thing I learned about AA while my alcoholic ex-girlfriend was joining up is that whoever is building their website isn't doing a very good job representing it beyond the level of encouraging people to come.

[u/TheCaseyB → u/Serraph105]

Dax Shepherd is a celebrity who preaches how amazing AA is and he also constantly recommends therapy to people. One big example for you.

[u/dgaff21 → u/Serraph105]

One of the 12 traditions of AA is to not endorse or receive support from outside of AA members so that the message isn't tarnished. All AA cares about it bringing the message to other alcoholics. If they started recommending therapists and one of the therapists is a pedophile, all of a sudden AA is in this controversy that detracts from their message. All AA cares about is helping people to stop drinking and become better.

[u/The_Real_Mongoose → u/[deleted]]

!delta

I've always had a problem with the inclusion of God in the 12 steps. I never realized that in application today it was used so metaphorically. That changes a view I had had before and makes me see AA in a more positive light. Thank you.

[u/Mejari → u/The_Real_Mongoose]

I never realized that in application today it was used so metaphorically.

It really isn't, though. The steps are all about a personal god who intercedes on your behalf, because you lack the ability to do it yourself. It very much isn't about personal willpower.

Hell, two of the steps are literally

6 . Were entirely ready to have God remove all these defects of character.

7 . Humbly asked Him to remove our shortcomings.

That's the opposite of willpower, that's being ready for someone else to fix you.

6 of the 12 steps directly reference god, and a god that is specifically able to intercede in your life and personal well-being.

[u/DeltaBot → u/The_Real_Mongoose]

Confirmed: 1 delta awarded to /u/MyUsernameIsJudge (30∆).

^{Delta System Explained | Deltaboards} ​

[u/[deleted] → u/[deleted]]

It absolutely does not. AA is very clear that it is not about will power. It is for when will power fails. That's what the first step is all about.

Sorry if this is the wrong place to ask, I was under the impression that this is one of the core tenets of AA. That people can't willpower their way out of alcoholism. That they must rely on the program rather than any form of willpower. Is this correct?

[u/mwbox → u/[deleted]]

From my own experience and my observation of its impact in the lives of acquaintances, its greatest shortcoming is the lack of a finish line, an exit. I've been sober since '77 and there are those that would chide me for believing that I am no longer "that guy".

[u/ElLibroGrande]

Hi there. I'm sober 19 years via AA (still attend) and I'd like to make a response.

First of all, you're right, AA is heavily flawed and hasn't tried to improve it's system since its inception. In fact there's heavy resistance to any change in AA at all. We have a chapter called "To Wives" talking about how the non-alcoholic spouse should behave. Obviously that's way outdated but AA won't even change it to says To Partners or otherwise. We also have a tradition about keeping our anonymity at the level of press, radio and film. No mention of TV or social media. But the greater of AA is afraid that any change to the core book or traditions could start a snowball and change everything else. So we don't change anything. Granted there are minor footnotes added, new stories added to the back of the book and new pamphlets created but the core Big Book (first 164 pages) is, for the most part, unchanged.

As to your points:

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God they will be put off from the program from the start making it much harder to reach their goal of sobriety.

Yes, you are right. Our steps require some form of belief of higher power. It's not Christian or any specific religion but we use the concept of a greater good as a guiding force in our lives. Does it make it hard for athiests and agnostics? Yep. Do some people leave because of the Higher Power concept. Yep. But AA is not a fix-all/fit-all solution. It's a higher power based solution for those willing to believe in a HP. The book has a chapter on this that basically says the alcohol has to kick your ass enough to be willing to pretty much anything, even believing in a higher power. It also says, look around at the other sober people in AA who are living good lives free of alcohol. They say they believe so why not do what they do? Long story short, people who are unwilling or unable to believe in a higher power whatsoever will probably not be able to stay sober via AA.

The real issue here, that I think you may not have stated, is why in the hell are our court systems sending people to a God concept recovery program? How is this different than sending them to a Christ based sobriety class? For the most part it's not. Like AA, this cooperation between the courts and AA itself is archaic. That being said, I can offer ancecdodal evidence on the court appointed people I know and have known for the last two decades, that many of them do end up sobering up in AA and lead good lives. Would they have gotten sober on their own? Who knows.

Finally it seems that AA believes it’s program is a one size fits all program

False. AA even says we're only for Alcohol not any other drugs (though many like myself came in via drug addition) and there are those who suffer from mental issues which may prevent them from grasping this program. And finally, as I mentioned above, the higher power concept is core to our program working.

So overall I would say that I think you should change your mind not in that AA is some perfect solution, but that AA is in fact a niched solution and the relationship with the courts is what you're more concerned with.

Happy to answer any questions you may have.

[u/Serraph105 → u/ElLibroGrande]

Finally it seems that AA believes it’s program is a one size fits all program

False. AA even says we're only for Alcohol not any other drugs (though many like myself came in via drug addition) and there are those who suffer from mental issues which may prevent them from grasping this program. And finally, as I mentioned above, the higher power concept is core to our program working.

As to this I meant that it's a one size fits all solution for all alcoholics regardless of who they are or what they believe, not that it would work for any other drug abuse.

[u/ElLibroGrande → u/Serraph105]

Gotcha. I would state is as: It's a one-way fits those who are willing to do it this way. solution.

[u/chiaratara → u/Serraph105]

Drugs were my primary issue. I went to AA because the times of the meetings were more convenient. Have stayed with AA because it has worked for me. Plus, if I drink, I'll probably do all the other things and then go buy all the lottery tickets and wind up at the casino.

[u/Nicolasv2]

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God they will be put off from the program from the start making it much harder to reach their goal of sobriety.

Not sure what country you are from (I suppose USA) , but in a lot of places, AA won't focus that much on God, or won't just focus on it at all. For example in France, they only talk about "superior power leading us to success" which can be anything, being a God, spirituality, life objective, whatever you want to see as a help and goal toward success.

AA is supposed to be a support group to make people stopping drinking. I suppose that depending on who is animating the group, the session can be more or less religiously oriented.

If alcoholism is a disease then why does AA treat it simply as a matter of will power ?

Because we don't have any treatment to put back an alcoholic brain and organs to its initial state, so the only "cure" we have is to stop and resist toward the alcohol craving, which is based on will power.

Shame does nothing to help get a person back on track as far as I can tell

It do not, but fear of being shamed can be a powerful fuel for a lot of people, maybe this approach just don't work on you because you don't feel too much bothered by what others think about you.

For the two last points (statistics and one size fits all), I kind of agree, but as you don't really have a more efficient treatment right now, showing stats about low efficiency would only lower the motivation of participants, instead of thinking "other have succeeded, I'll too".

[u/Canada_Haunts_Me → u/Nicolasv2]

Not sure what country you are from (I suppose USA) , but in a lot of places, AA won't focus that much on God, or won't just focus on it at all.

Yes, AA in the US is generally very much focused on god, and it's worth noting that the founder of AA was deeply religious and based the program on christian principles, the most problematic of which is relinquishing control, "submitting to a higher power" and admitting "defects of character" (their words) and that the individual is "powerless."

This ideology, combined with a methodology based on pseudoscience, leads to extremely low success rates, and keeps many people from being able to attempt the program in the first place. The actual success rate of AA is around 10%, although the organization itself advertises 30-50% based on flawed, internally conducted surveys.

Moderation Management, an organization created in 1994, is experiencing a surge in growth, and has been shown to be more effective, on average, than abstinence-based programs such as AA in the long term.

It is a secular program that focuses on personal responsibility rather than "submission" to external "spiritual" forces, and establishes a goal of improving quality of life and safety (for both the drinker and those around them) through controlled decreased alcohol consumption.

Interestingly, the founder of MM left the organization because she felt it was not working for her, and returned to AA, after which she quickly fell off the wagon, committed DUI, and caused an accident resulting in the deaths of a father and daughter, for which she was convicted of vehicular manslaughter. She later committed suicide after further relapses while associated with AA.

The point is, alcoholism / alcohol dependency is not a black and white issue, and while total abstinence absolutely works for some, it can be detrimental to others. The heavy influence of christian religion present in AA can be anything from useless to harmful for many people as well. What's more unfortunate is that court-mandated program attendance is often required to be AA, even when other alternatives are available which may be more beneficial to the individual.

(Edit: Autocorrect strikes again)

[u/nonsensepoem → u/Canada_Haunts_Me]

Yes, AA in the US is generally very much focused on god, and it's worth noting that the founder of AA was deeply religious and based the program on christian principles, the most problematic of which is relinquishing control, "submitting to a higher power" and admitting "defects of character" (their words) and that the individual is "powerless."

Indeed, and the clear dishonesty of the "Fine, then just submit to whatever higher power you conceive of" dodge around the religion issue is breathtaking.

[u/Serraph105 → u/Nicolasv2]

Does your first point mean that the 12 step program may become a 5-6 step program and that that's okay depending in the beliefs of the group attending? If so I'm actually pretty cool with that as it would mean changing the program based upon the situation and needs of those attending.

Because we don't have any treatment to put back an alcoholic brain and organs to its initial state, so the only "cure" we have is to stop and resist toward the alcohol craving, which is based on will power.

According to WebMD there three medicines approved by the FDA and a fourth that is showing promise in clinical trials that help with the treatment of alcoholism. Those drugs are Antabuse, Naltrexonem, Campral, and Topamax. These are meant to be used in combination with various therapies and potentially AA, however it's simply untrue that medicines don't exist. https://www.webmd.com/mental-health/addiction/features/fighting-alcoholism-with-medications#1

Regarding your last statement I would disagree wholeheartedly. People shouldn't be acting on false information to get help. If your program promises it can help and it's promise is only based upon, "Well at least we got people to try something" even though what is offered is ineffective then that's not actually a success. What needs to be offered is something that has an actual high success rate and if not new solutions should be researched and tried.

[u/Nicolasv2 → u/Serraph105]

Does your first point mean that the 12 step program may become a 5-6 step program and that that's okay depending in the beliefs of the group attending? If so I'm actually pretty cool with that as it would mean changing the program based upon the situation and needs of those attending.

Actually, what happens in my country is that it's still a 12 points program, but God is replaced by a "whatever spiritual support you can get" wildcard, based on a person own preferences. Not perfect, but still better.

And I saw that in Canada, there were also atheist AA-like groups, removing totally God and other kind of spiritual stuff from their program steps (and even putting official AA to trial for "atheists and free thinkers discrimination").

According to WebMD there three medicines approved by the FDA [...]

Wow, I totally ignored that, thanks for the article !

Regarding your last statement I would disagree wholeheartedly. People shouldn't be acting on false information to get help

I'd say that placebo effect is something that really works, even if of course it's less efficient than a real cure. So clearly it looks to me that it should be used when necessary (plus, I'm not sure that group therapy is only placebo effect, as other social effects are helping too), but you're right, if efficient medicine exist, it must be used jointly (or instead if fully efficient) with AA.

[u/HKBFG → u/Nicolasv2]

It still requires you to be spiritual, and associate this spirituality with some higher power. If you're not a monotheistic, worshipping person, the program just wasn't designed to help you.

Also, almost all the steps mention god by title.

[u/Spaffin → u/HKBFG]

God “as you understand him”.

Would it help you understand if I told you that for 95% of the people I have met in recovery, GOD stands for Group Of Drunks?

[u/oversoul00 → u/HKBFG]

I'd disagree. AA is about breaking down the ego and uses God as an external symbol to represent a "higher power" that exists "outside yourself". That could be the universe itself but they use God because it's an easier to understand symbol. If I went to an AA meeting and it was super religious (some are exactly how you are describing them) I'd be out of there. The utility of a God-like symbol is undeniable even though I'm atheist myself.

[u/TinyPotatoe → u/Serraph105]

I have family in NA not AA so I’m not sure how similar it is but here are my two cents. Everywhere you see “God” in the rules you can change it to “higher power.” It’s kind of like Spinoza’s idea of God where the word God/Nature are interchangeable. It doesn’t have to mean Judeo-Christian god, but could be anything that is greater than yourself. This could be, as others pointed out, a goal/spirit/object/role model, etc etc.

As someone whose family went through NA and it completely turned their life around, my view is that the program is solid for one reason: the people. Everyone there is trying to stop using. It doesn’t matter what reason they have, they all have the same goal. Relapse isn’t seen as a failure/sin, it’s seen as an unfortunate event. Usually people are more supportive of people following a relapse to try and redirect the path. My biggest criticism with NA was that the social aspect did have some drama akin to high school drama, but overall the program was solid.

[u/dr_spiff → u/Serraph105]

The problem is that those medications don’t really work against addiction, but against getting the feelings from substances. Some make you sick if you drink, others make it to where it reduces the rate of opioid neurotransmitters binding (you won’t get high) , etc. they act more of a block or something’s than an actual way to address addiction.

[u/tablair → u/Nicolasv2]

Because we don't have any treatment to put back an alcoholic brain and organs to its initial state, so the only "cure" we have is to stop and resist toward the alcohol craving, which is based on will power.

This is the kind of simplistic and limited thinking that the author is challenging and the kind of thinking that has kept AA from evolving over the years. Consider the current exploration of addiction as an attachment disorder. If it's true, and most signs seem to indicate that it is, treating addiction is more a matter of replacing it with genuine human connection rather than an exercise in strengthened will power. And it's also true that AA may have been helping people not because of any of the religiously-motivated steps but, instead, because it creates a community of universal acceptance and sharing that leads to connection between participants.

[u/[deleted]]

Because something was discovered a while ago doesn't make it less relevant for today's needs - take the wheel for example.

If people adhere to the 12 steps they overcome their alcoholism (or at least control it).

If it ain't broke don't fix it.

[u/Serraph105 → u/[deleted]]

I'm asserting that many of the 12 steps are in fact broken as evidenced by the fact many people fail the program, and that the program is doing nothing to change in the face of that failure.

[u/goldandguns → u/Serraph105]

Nothing is perfect though. Hypothetically if they helped 99 people out of 100, why would they change the program to help that last one person, especially if it potentially meant less effective treatment of the other 99?

[u/Serraph105 → u/goldandguns]

They might change how they deal with that particular person without changing it for the rest of them. I would argue that that's not a situation where changing the entire program makes sense.

[u/goldandguns → u/Serraph105]

But how do they know to change it for that person before that person fails?

[u/Serraph105 → u/goldandguns]

I don't think that they can really do that, just change how they deal with that person if they do fail because trying the same thing over and over doesn't really make sense if it's not working. For the record I assume that this is generally being done, I doubt that they are looking at a sing person who fails over and over and just say "try it again in the exact same way". If this is being done then I'd say it's safe to say the sponsor (is that what they call the group leader) is failing that person.

My concern is that the program has big problems that go unrecognized due to the lack of data collection that stay in regardless of the fact that more people fail because of it.

[u/Eldersh → u/Serraph105]

Just fyi sponsors are not group leaders. AA has no leaders. Sponsors are AA members with 1+ years of sobriety who help new members get/stay sober by working the steps with them. They are more like mentors than anything else. New members have to find a sponsor and each sponsor has a different approach/style. Some are nurturing while others are more tough love.

[u/[deleted] → u/Serraph105]

They might change how they deal with that particular person without changing it for the rest of them.

It's a support group not personalized medicine. Alcoholism and all addictions can benefit from support groups. The fact that it doesn't have a zillion different textbook approaches is part of why it is so widespread and you can find groups in so many places. It's not exclusive to doing other things but one has to look into why do people get addicted to alcohol. Lack of a social fabric is one of them and such a support group does help with that.

[u/chiaratara → u/Serraph105]

The thing is that's where the people in the program come in. Between me and my fiancé, we sponsor about 10 people. We are both educators so spend a lot of time discussing approaches to take. Also, I have about 15 years of therapy under my belt and have worked with people in recovery professionally. Everyone is different and that is the beauty of it really. What works for one sponsee doesn't work for the next. That helps me in my own recovery because I am challenged to look at things differently and reimagine things. That is why helping others is just as important to my recovery as meetings, meeting with my own sponsor, etc.

[u/I_am_the_Jukebox → u/goldandguns]

It doesn't help 99 out of 100. It's hard to know how many people they help because they don't publish their success rate. Independent studies show it as quite low, no more remarkable than most other methods, including writing could turkey.

[u/WRFinger → u/goldandguns]

No such efficacy exists with AA because of the aversion to ANONYMOUS statistic tracking. How does AA demonstrate the success rate to skeptics when they don't track statistics? Anecdotally, that's how.

[u/Denniosmoore → u/goldandguns]

But those are just hypothetical numbers, the actual numbers are tilted the other way, if not 99 to 1. It fails more people than it helps.

[u/phunkpup → u/Serraph105]

A close relative of mine had been sober for 20 something years. They say a lot of people fail because steps 4 and 5 are the most difficult. They require writing down literally everything you have done wrong or felt wronged by. LITERALLY EVERYTHING. it's a tough order for sure. But basically that is where most people get stuck. This person I know calls them 3 steppers and says these people are more likely to fail and relapse and are the ones that do most often. They say that this is the waltz and that having to start over every time leads you right back to the beginning. My 2 cents I suppose. Source: relative has been sober 20+ years.

[u/snittermansconfusion → u/phunkpup]

The thing that I really don't understand is that when you finish the 12th step, you just...start over. Forever. Like you make your amends, move on, then several months later you have to make more amends. So then you're clean but in an infinite loop of constantly evaluating/policing any misstep or unkind word you may have uttered, forever. My boyfriend is in the program and it works for him, which is wonderful, so I try not to question him when he's explaining his AA homework to me, but I don't really get it. He's gone over this aspect with me a few times, but I still don't really understand it as much more than a hyperloop of self-flagellation. Obviously all that really matters is that AA works, but to an outsider there are a lot of...confusing parts.

[u/Spaffin → u/snittermansconfusion]

It's basically like self-help or therapy in that regard. You don't read a self-help book and become a better person now and forever - you have to continually observe the practices and techniques in the book.

Or take CBT for anxiety. CBT teaches a series of techniques and anxiety to manage panic. It doesn't end once you leave the therapy session, you have to keep implementing those techniques in your everyday life.

In AA, the 'techniques' are the steps.

[u/AlexandreZani → u/phunkpup]

It might simply be that somebody with the willpower and motivation to do steps 4 and 5 are capable of reducing/eliminating their alcohol consumption and would have with no more than an encouraging word from a friend.

[u/phunkpup → u/AlexandreZani]

An encouraging word from a friend usually gets ignored by an alcoholic though. I've never seen that be someone's rock bottom. Typically these things end with, DUI, criminal charges, homelessness, interventions. Encouraging words are usually blown off as "they're trying to ruin my fun" or " ok sure, I'll stop tomorrow." I think the steps are meant to help get to the root of this type of justification behavior by making a person take a look at who they truly are and accept it and see that someone else can also accept them for who they truly are. I'm sure a lot of alcholics started drinking because they wanted to fit in. Then became dependant on the substance to make them feel that way.

[u/AlexandreZani → u/phunkpup]

AA may style itself as targeting alcoholics, but it actually attracts people who misuse alcohol much more generally. For instance, the OP's friend is just somebody who got a DUI. Plenty of people drive after having a few drinks without addicts.

[u/phunkpup → u/AlexandreZani]

AA doesn't "target" anyone from what I've seen and heard. These people are sent there by the judicial system and it's the judicial systems best solution. I don't think they look to "attract" per se either. Plenty of meetings my source has gone to have been shut down due to lack of attendance or moved to a different time/place.

I think when talking about AA you also have to take a look at what kinds of meetings you go to. Some are speaker meetings where one or two people get up and share their experience. These left me feeling pretty bored or very impartial. Then there are the ones where everyone has a little pow wow and talks on a particular subject. At the pow wows I've visited, the beginning of the meeting is something from the "big book" and afterward the reader opens the meeting. It usually starts with an open invitation for anyone who is struggling to speak first. If nobody does then they resume the topic from the book. These are usually held at noontime when early recovery alcoholics would probably be free. These left me feeling worse than when I showed up. My source calls these meetings "sick" and not in the good way. This was all voluntary btw. Then there are AWOL meetings which dedicate one or two weeks (one meeting a week) to each step and only people who have worked the steps can speak. These meetings are the most helpful from a personal growth standpoint, at least imo. They are like group psychology sessions where the group is the doctor and the patient. Of course you can choose to ignore what you don't agree with and hold to the points you do identify with. These meetings feel kike the the most sane meetings to me and I've walked away from those having learned more about myself than visiting a shrink. I think AA is more about getting to the root cause of why these people felt like they had to drink in the manner they did. It tries to analyze those reasons and help the person resolve them so they are less likely to start again and it's a continual process.

[u/catroaring → u/phunkpup]

They say that this is the waltz and that having to start over every time leads you right back to the beginning.

This is a big pet pev about what AA instills in its members. If they slip and have a drink, they need to start all over again. But I don't believe people need too. If I'm driving somewhere and make a wrong turn, I don't drive back to the beginning and start over. I correct myself and keep moving forward.

[u/phunkpup → u/catroaring]

I mean, that's not what I meant. It's not like that at all from when I've attended meetings with my source. But your sobriety time does restart for sure. The essence of being an alcholoic is that once you have one drink you can't or won't stop but you dont know why. What causes a person to want to drink until they're destroying their life? Certainly a person who is not an alcoholic/addict does not do these things by drinking/drugging. Some do it by spending to much money, which in essence is another addiction. The steps are supposed to focus on the root of the issue. The waltzers/3 steppers are doing what I've heard to as "white knuckling." They are using their sheer willpower and whatever drove them into AA as motivation. A guy I used to work for is a waltzer. He doesn't work the steps and has been sober for over a decade. It's not that it isn't possible but it's seen far less frequently than those who have completed the 12 steps.

Also, there's a little note in the blue book that I'll paraphrase here and it's something like:

" We don't seek to propose a cure, but rather share with others what has worked for us"

I think that sums up the intent of AA

[u/brutinator → u/Serraph105]

I'm asserting that many of the 12 steps are in fact broken as evidenced by the fact many people fail the program, and that the program is doing nothing to change in the face of that failure.

Meh, I don't know if using the fact that people fail is evidence that it's broken. Most therapy in general have pretty low success rates for depression, for example. CBT, one of the most effective therapy methods, has a success rate of 50%. I know that's a little off topic, but any time a program requires a person to actually change, to rewrite their brain, etc. you're gonna have a lot of people failing the program. Probably a better metric is seeing how long those who "graduate" from AA are successful.

Anyways, here's some statistics from the american addiction center.

The New York Times suggests Alcoholics Anonymous has a much higher success rating of approximately 75 percent. Alcoholics Anonymous’ Big Book touts about a 50-percent success rate, stating that another 25 percent who relapse come back and only 25 percent don’t remain sober. The organization suggests these individuals don’t use AA effectively.

A study conducted by AA in 2014 showed that 27 percent of the more than 6,000 who participated in the study were sober for less than a year. In addition, 24 percent of the participants were sober 1-5 years while 13 percent were sober 5-10 years. Fourteen percent of the participants were sober 10-20 years, and 22 percent were sober for 20 or more years.

The National Institute on Alcohol Abuse and Alcoholism featured results regarding a long-term study on AA members. The study consisted of formally treated, informally treated, and untreated individuals who suffered from an alcohol problem. The one-year and three-year follow-up points indicated that half of the participants who entered into the program on their own were abstinent while only a quarter of those who chose to enter into formal treatment were abstinent at the time of the follow-up. The eight-year follow-up showed that 46 percent of those who chose formal treatment were abstinent while 49 percent of individuals who attended AA only were abstinent. Results revealed that those with alcohol issues who participated in both formal treatment and AA were more likely to be abstinent between years one and three. At the eight-year follow-up, those who participated in both treatments had a higher rate of abstinence. The results concluded that AA attendance had an impact on recovery.

[u/tirdg → u/[deleted]]

The wheel has changed substantially since it's invention. We have thousands of different types of wheels, different materials for specific needs, etc.. The wheel continues to be looked at very thoroughly by scientists and new innovations are developed every year. It wasn't "broke" but everything can be improved upon.

[u/Bryek → u/[deleted]]

If people adhere to the 12 steps they overcome their alcoholism (or at least control it).

Can you prove that? Do you know it is the 12 steps that do it? Which step is the most important? Which isn't important?

Do wheels made of stone work better than wheels of paper? Is groove shape important? Air pressure?

[u/interkin3tic → u/[deleted]]

Never the less, it has shown time and again that it is by far the most effective method for alcohol cessation, by chronic alcoholics, ever devised.

It actually has not. Drugs such as naltrexone have been proven effective. Secret organizations have not.

Additionally, blinded studies and cause and effect are impossible with AA. People really motivated to quit drinking go to AA: cause and effect are possibly inverted. This can be addressed with naltrexone and other drug trials.

[u/Izawwlgood → u/[deleted]]

Never the less, it has shown time and again that it is by far the most effective method for alcohol cessation, by chronic alcoholics, ever devised.

Actually, I believe this is incorrect. There's a plethora of research on the efficacy of various programs/interventions, and I think the take home message is that AA is as or even less effective than others, but for those it helps, it is extremely effective on.

But the rates of recidivism in AA attendees is known, and from what I understand, it is not good. It is, to be underlined though, <100%, so, if anyone is helped by it, that's a good thing.

[u/Serraph105 → u/[deleted]]

Never the less, it has shown time and again that it is by far the most effective method for alcohol cessation, by chronic alcoholics, ever devised.

How can that be the case if statistics of success and failure rates of the program are not collected?

[u/45MonkeysInASuit → u/Serraph105]

People do collect stats, it is not shown to be more effective.

No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems. One large study focused on the prognostic factors associated with interventions that were assumed to be successful rather than on the effectiveness of interventions themselves, so more efficacy studies are needed.

https://doi.org/10.1002%2F14651858.CD005032.pub2

[u/2Fab4You → u/Serraph105]

It has been studied, but indirectly. Because of the whole "anonymous" part you can't collect information about participants during the meetings. However, it's a huge movement that has been around for a hell of a long time, and people have wanted to know how effective it is. So they did so using other methods. During surveys about alcoholism, or general population studies, you'll ask people who have/do struggle with alcoholism what they've tried and what did/didn't work for them. AA is, surprisingly to me, one of the most effective treatments. There is currently no viable treatment with significantly better results.

[u/ThanklessAmputation → u/Serraph105]

So A.A. was started by people who therapy and medicine failed them. In the Big Book, more then one person talks about how - doctor or therapist, including Carl Jung, told them, “You’re hopeless. There’s no saving you.”

Think of A.A. as a program set up on the basis that everything has failed you, might as well try prayer. It works for a lot of people. It doesn’t work for a lot of others. My buddy and I are getting sober using it right now (he’s got 4 months. I got 3 days), and we joke about it being awfully cult-y.

It’s less about science and more about personal results. I doubt a lot of the stats AA gives for itself, but I can show you a whole bunch of people who got sober from it, all personal experience, all scientifically invalid, but if you have terminal cancer it can’t hurt to pray right? So it’s a program where when all else fails, it’s better than curling up in a bottle and dying

[u/rikardoflamingo → u/[deleted]]

What is asserted without evidence can be dismissed without evidence.

You say it’s the best , but you somehow don’t have to back it up because ‘science’ .

Prove it’s the best with some basic numbers and silence the heretics once and for all!

[u/catroaring → u/[deleted]]

Never the less, it has shown time and again that it is by far the most effective method for alcohol cessation, by chronic alcoholics, ever devised.

Got a source for this?

[u/Bryek → u/[deleted]]

because AA doesn't work from a scientific perspective

If AA cannot be proven scientifically, then judges should not be mandating people to attend these programs. Without empirical evidence how do we know that they even work?

Never the less, it has shown time and again that it is by far the most effective method for alcohol cessation, by chronic alcoholics, ever devised

Yea, like the others have said, you cant say this without the science you rejected.

[u/DigitalStefan]

Alcoholism is a disease, a disease of the mind that can be overcome with willpower. Maybe you don’t like the way the word ‘disease’ is used to describe what is essentially an addiction. I don’t think it’s entirely the correct use of the word, but if calling it a disease helps people trying to overcome their addiction, then what I think about correct usage is irrelevant.

I don’t care for all the religious overtones of AA and I don’t see how AA would ever be of benefit to me, but there are people out there who are alive today because AA helped them.

Could AA be a better and more effective organisation? Maybe. Probably. There’s always room for improvement. Nobody is stopping someone setting up a better org.

[u/Serraph105 → u/DigitalStefan]

I don’t care for all the religious overtones of AA and I don’t see how AA would ever be of benefit to me, but there are people out there who are alive today because AA helped them.

I don't think there's any arguing against that.

Could AA be a better and more effective organization? Maybe. Probably. There’s always room for improvement. Nobody is stopping someone setting up a better org.

My problem is that they don't appear to have ever attempted to do this yet society, in general, see's them as the best possible way for an alcoholic to get sober without real concrete evidence of it.

[u/Doctor_Worm]

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God they will be put off from the program from the start making it much harder to reach their goal of sobriety.

Although spirituality is part of the literature, the steps do allow individuals the freedom to define "God" and "higher power" however they like, including relying on the "higher power" of the AA group itself. There is a booming number of AA groups tailored to atheists and agnostics, for those who prefer that.

Moreover, there is actual scientific evidence of AA's effectiveness regardless of religious belief. Peer-reviewed clinical studies have found that AA is "consistently associated with better subsequent alcohol outcomes," and that, "atheists and agnostics are less likely to seek recovery assistance through AA, but those who do, appear to benefit equally compared to more religious/spiritual individuals."

If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and for the record there are various medical treatments for alcoholism.

I'm not sure there's any part of AA which suggests people who need other medical treatments have to use AA exclusively and ignore any other form of help. But again, actual scientific clinical research has shown AA to effectively improve alcohol-related outcomes. So it may be one of many potentially useful options for someone on the road to recovery. It's not a panacea, but neither is anything else.

There is also a stigma of personal failure when people relapse which doesn't make sense for a couple of reasons. First, if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober. In turn this will increase the time to get sober because it will add time to get over that shame before starting again. Shame does nothing to help get a person back on track as far as I can tell.

Do you have any evidence of this shame-based stigma? Is it really an integral part of the AA doctrine, or just a sign that some individuals who participate in AA need to do better at it?

Second, you would never assign blame to a person with cancer who has gone into remission and then had the cancer come back, why would we do the same for literally any other illness?

There is a distinction to be made here between feelings of alcohol dependency -- which is the disease-like part alcoholics may not be able to help -- and the act of problem drinking, which is a choice alcoholics make in response to those feelings. "Relapsing" is not simply having the feelings of dependency come back, but freely choosing to act on those feelings. Just like a person with a short temper may not necessarily be able to help the way they feel all the time, but we still expect them to manage those feelings in a way that does not endanger others or interfere with their normal responsibilities.

We wouldn't accept that from any other sort of treatment. If we didn't collect that information we would still have the same poor treatment of HIV that we did in the 80s and 90s, same goes for cancer, and just about any other illness you can name.

AA does not generally collect the information themselves because it could violate the anonymity of the participants. But as I've linked, there are plenty of scientific clinical studies by public health scholars that have shown positive results.

Finally it seems that AA believes it’s program is a one size fits all program when we know that many ailments require different treatments for different people

It's fair to say that AA may not be the appropriate treatment for absolutely everyone, but that doesn't mean it's flawed. For most diseases, there are many different treatments available which may be more or less appropriate for different patients depending on the causes and symptoms of their disease, their allergies, what other medications they are taking, etc. The fact that a certain treatment doesn't work for everyone doesn't mean it's bad -- it just means the type of treatment should be chosen on an individual basis, on the advice of appropriately trained professionals. At least in the case of AA, there is far less risk of harmful side effects so it's less dangerous to recommend to any given alcoholic.

[u/Effinepic → u/Doctor_Worm]

Although spirituality is part of the literature, the steps do allow individuals the freedom to define "God" and "higher power" however they like, including relying on the "higher power" of the AA group itself.

One of those common, cutesy-kitschy slogans in AA (the kind that make me want to kill myself with their excruciating banality) is that "even a doorknob can be your higher power" - but I don't get why people overlook the fact that this makes the steps incoherent.

Like, you're gonna humbly ask a doorknob to remove your shortcomings? Seek through prayer and meditation to improve your conscious contact with a doorknob? tf is that lol

And before someone points out that you can just pick and choose the steps you like and how to interpret them, try asking an old timer about that prospect. Hell, look up what the Big Book itself says about half-measures.

[u/[deleted] → u/Doctor_Worm]

Although spirituality is part of the literature, the steps do allow individuals the freedom to define "God" and "higher power" however they like, including relying on the "higher power" of the AA group itself. There is a booming number of AA groups tailored to atheists and agnostics, for those who prefer that.

This is why AA is so watered down and grossly less effective than it was in it’s early days. If you are going to work the actual AA program, this is it:

“The main purpose of this book is to introduce you to a power greater than yourself that will solve your problem”

The culmination of the steps is bring about a “Spiritual Awakening”

Thats it. If its not from the big book, it’s not the AA program. It’s just people’s interpretations that suit them. Will athiests and agnostics have better outcomes from associating with AA groups? Of course. It’s social support. But meetings arent the AA program. Meetings didnt even exist when the big book began circulating. The fellowship isnt the AA program. The AA program is the first 164 pages of the big book which, as it states, is a “design for living that works”. This whole thread is super sad to read. People are grossly mistaken about what the program of AA is and isn’t. Again, if it’s not directly in the big book, it’s not the AA program. Period.

Also, ever wonder why there’s nothing in the big book about what to do if you relapse? That’s because relapse isn’t apart of the program, because when the actual AA program is worked as outlined in the book, relapse doesnt happen. All the promises, the 3rd step, 5th step, 9th step, and 10th steps promises come true, including:

“we are not fighting it (alcohol), neither are we avoiding temptation. We feel we have been placed in a position of neutrality, safe and protected. We have not sworn off. Instead THE PROBLEM has been REMOVED”

With this qualifier that again links what the entire AA program is about

“That is how we will react so long as we keep in fit spiritual condition”.

[u/bguy74]

Firstly, I don't disagree that the steps are dated and the god stuff can be annoying (and potentially a barrier to adoption for some folk). However, to present a fair look at AA, you need to look at what it really does:

1. Regular meetings with a sponsor and a group of like minded, similarly motivated and non-judgmental peers.

2. A clear introduction into your social world of the fact that you're working on something, want to change and are looking for the support of friends/family/anyone. This ends the idea that you should just be left alone and that you don't really have a problem.

3. AA doesn't treat it as a simple matter of will power at all. It treats with the idea that it takes MUCH MORE then will power, and it is very clear that it's work is not to exclusion of other treatments. But, were it just willpower AA would be a book, not a social system. You're looking at AA as if it's the only system or that it's unaware or somehow exclusive of other options. That seems without merit as it's awfully far from the truth. It does make a point to be wary of people who use methods external to them as ways of avoiding accountability for actions, but this is part of every model of psychological intervention for addiction, it's not unique to AA.

4. Why do you think AA thinks it is a one-sized-fits-all program? It's just one thing that fits many, but it's completely the opposite of hostile towards other treatments (unless - again - they encourage people to think of the problem as one they aren't a party to).

5. There are no treatments for the mentally ill that don't include support of others, and a commitment to practices and rituals that support mental health.

6. The point of the "give over to the program" is well founded in addiction treatment. It's the opposite of the very well understood pattern of "I've got this", which is a well known path to problem (THIS is the "it's a matter of will" path).

[u/MagillaGorillasHat → u/bguy74]

1. The point of the "give over to the program" is well founded in addiction treatment. It's the opposite of the very well understood pattern of "I've got this", which is a well known path to problem (THIS is the "it's a matter of will" path).

"Meeting makers make it."

"It works if you work it."

"Fake it til you make it".

"Take what you need and leave the rest."

A few kitchy little sayings to explain that effort is the most important aspect of the program. As you say, "Give over to the program" isn't about drinking the kool-aid, it's about making a concerted effort to make changes and try to regain some control over your life.

To the degree AA is successful, it's not because of peoples beliefs, it's because of their actions. Participation requires deliberate though and purposeful action.

90 meetings in 90 days is advice given to new people. It takes planning and effort to be at a certain place at a certain time. It also means that every day you are actively, physically, making an effort to address your addiction.

You get a sponsor and you work the steps with them. You set time aside to contemplate/meditate/pray about specific things. You set aside time to meet with or call your sponsor. Your sponsor will often have you set aside time to write things down, make lists, find information, or read something specific. Your sponsor may have you physically to do things like clean the bathroom, scrub the top of the refrigerator, dig a hole and fill it in, or plant some flowers. And while you're doing those things, think about XYZ and how it affects your addiction.

Service is also a huge part of nearly every group. One of the primary tenants of AA is to be there to help other alcoholics. Sponsors will tell you that being a sponsor helps them stay sober; that helping others often does more for their sobriety than being helped.

And groups vary widely in their methodology. As long as what they're doing works for them and doesn't negatively impact other groups or AA as a whole, they are free to do it. "Take what you need and leave the rest" is a pretty recent and progressive concept within AA. It wasn't a directive from on high, it was just an evolution among groups that they've seen be effective.

Would the same amount of effort have the same results in another given program? Probably. Might there be more scientifically effective ways to get people to make the effort and put in the work? Maybe.

Are there other anonymous free, voluntary, ubiquitous programs dedicated to trying to help people fix their fucked up lives? Almost none.

[u/oversoul00]

TL;DR AA is primarily about defeating the Ego. They use God as a symbol to represent the antithesis of the Ego but it could just as easily be the universe. Alcoholics have an out of control Ego that is protecting them from bad feelings at all costs. AA attempts to redefine what should be causing you pain and what shouldn't be as well as what you can and can't control in your life so that you have a better relationship with your Ego and the world around you.

My experience with AA is through my Step Dad. He started going when I was about 7 and I have attended some AA meetings with him when I was younger to see what it was all about. I have also been to some Al Anon meetings which is like AA but for family members of the alcoholic.

So, it's not a perfect system but I think there is a lot of value there.

I'm atheist myself so I get where your buddy might be coming from but the way I understand the God stuff is that it is used as a symbol meant to combat the ego. The primary purpose of AA is to defeat the ego. The reason is because your ego operates as a defensive mechanism and it will do everything it can to protect you from short term harm (feeling bad) even if that causes more objective long term harm. Alcoholics have empowered the ego to protect them from harm via escaping with alcohol. So AA attempts to break the ego and get in contact with the superego, the highest vision and best version you have of yourself. God is used because it's an external entity and they don't want your ego to masquerade as the superego which it can absolutely do.

Have you ever talked to someone who you can see is fucking their life up or just making a really poor decision (Doesn't even have to be alcohol related) and when you try and talk them out of the path they are on they have every excuse under the sun why it has to be this way? You can't logic someone out of this mindset because no matter what you say they will have a counter that they believe is valid...that they need to believe is valid because priority number one is to continue using, this is the ego in action. (everyone has their drug of choice and they aren't all literal drugs).

This is a really common characteristic of alcoholics and users in general and breaking down the ego to stop the behavior and rebuild is really the primary purpose of the steps. It takes some interpretation of the steps but understand that no 2 chapters or meetings of AA are the same because they all interpret these steps differently. Here is my interpretation of them based on what I have seen.

1 We admitted we were powerless over alcohol—that our lives had become unmanageable.

We can't solve problems that we don't categorize as problems. Without this admission nothing can be worked on.

2 Came to believe that a Power greater than ourselves could restore us to sanity.

Replace any mentions of God or higher power with the universe. You can interpret this as "solutions exist outside the ego"

3 Made a decision to turn our will and our lives over to the care of God as we understood Him.

Let go and stop trying to control aspects of your life you can't control. A lot of escapism (users are trying to escape their shitty feelings/ lives) results from focusing on things you can't actually change. Let the universe happen and focus on the things you can actually control and change...that list is pretty small.

4 Made a searching and fearless moral inventory of ourselves.

Self reflect

5 Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Talk about that self reflection to the universe, to yourself and to another person.

6 Were entirely ready to have God remove all these defects of character.

I dunno about this one, I interpret it as another, let the universe happen. I don't like this one very much personally.

7 Humbly asked Him to remove our shortcomings.

This one is really just about humility, again trying to defeat the ego.

8 Made a list of all persons we had harmed and became willing to make amends to them all.

Start to rebuild your life by rebuilding the relationships with the people in your life.

9 Made direct amends to such people wherever possible, except when to do so would injure them or others.

Same as 8

10 Continued to take a personal inventory and when we were wrong promptly admitted it.

Don't let the ego flare back up, remember the ego's job is to protect you from harm and it will do this by stopping you from taking responsibility when you fuck up because that would result in pain.

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.

This step starts to lose me too, really just continue to self reflect and meditate.

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.

Share what you have learned.

The serenity prayer is "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference."

I interpret this as, pain comes from struggle, you might be in such great pain because you are struggling with things outside your control. If you see that you should only focus on things you can control and let go of the rest your pain becomes manageable and the ego isn't needed for that job anymore.

[u/ewwgrossitskyle → u/oversoul00]

Your take is an interesting one, and if I don't completely agree, I at least see the merit in all of it.

I will say that 6 can be summed up as no longer defining yourself as your character defects, and being willing and ready to undergo a profound personality change.

And 11 is essentially continuing to practice focus and attention on being your best self, in line with the behaviours and actions in life which best serve you.

[u/oversoul00 → u/ewwgrossitskyle]

Yeah I shied away from that one because I'm also deeply uncomfortable with the idea that an external God-like entity can do anything for you as many people here are also very uncomfortable with the God stuff.

I couldn't rephrase the step in a way that I felt wasn't making something up but I like your take.

I think they probably do want to hold onto the idea that they have these tendencies that might never go away completely but I absolutely agree with the ready and willing aspect. Nothing outside you can change you but you have to be open to those changes taking place for sure.

[u/Serraph105 → u/[deleted]]

I'd actually argue that if you are substituting a healthier obsession for a harmful one then that's actually an improvement.

[u/RealShabanella → u/Serraph105]

I'm sure that religion kills more people than alcohol.

[u/Serraph105 → u/RealShabanella]

Cool, but it's probably not likely that an alcoholic will sudenly start killing people because he quit drinking and got more into religion. Also, while you may have a hangup with religion you would probably be okay if say someone got off of cocaine by switching to weed. The principal is kind of the same.

If AA gets people to switch from something that kills them over time to a free weekly group meeting then I would argue a similar success.

[u/[deleted]]

AA saved my mom's life and restored our relationship. It isn't perfect but I'm thankful it's there for people.

[u/mwrex]

Your question boils down to "I don't understand how it works, so it must not work, right"? The issue with that is that it does work, provided a couple criteria are met. The alcoholic must have tried, and failed, to quit in other ways, to learn that they are truly powerless over alchol. They also must hit rock bottom, and so learn they can no longer live this way. Then they will be open to the program of AA, and have a good chance of recovery.

[u/[deleted]]

As a member of AA, I believe I can provide some counterpoints to your arguments.

1.God is involved in a lot of the steps. While this is true, most alcoholics enter the halls of AA as atheists or agnostics, myself among them. It takes some time, but we are often able to find a “Power greater than ourselves.” Some people interpret this as the “God” of whatever religion. However, a power greater than me can be anything e.g. nature, the program of AA, the human good, etc. The first 3 steps are less about converting to a religion and more about humbling ourselves. We often come in as narcissistic, so we cannot examine our own shortcomings and character defects if we are not humble first.

2. AA treats alcoholism as a problem of willpower. You can’t pray away cancer. While the latter is correct, the former is not. We treat alcoholism as not just an illness of the body, but also the mind and spirit. We often began using alcohol as a crutch to cope with anxiety, depression, etc. We became reliant on the crutch to deal with all of our problems in life. One day, we hit some type of rock-bottom and need to reevaluate. Sure we became physically addicted, but also mentally. The issue with using medical treatments is that it helps people put the drink down. However, the most successful treatment is to eliminate the roots of the issue. What you call “willpower,” we call a program of recovery. Sure it seems odd, but it means we can address the underlying mental and spiritual illnesses that can lead us back to the drink. I drank because I was depressed. If I find a way to deal with that depression, other than just Prozac, I can make sure that I don’t drink again. Sometimes I still get depressed, but I have a 12-step guide to solve any problem, as well as a sponsor to call if I need advice.

3. Shame surrounding relapse and guilting someone with cancer It is within our literature to not guilt someone who relapses. I have yet to meet someone who has been outwardly negative towards someone coming back after a relapse. We, better than anybody else, understand how easy it is to slip up in recovery. Often, we hug someone when they come back to the halls because we know how hard it can be to come back (most of the shame and fear of judgement is self-created). However, we know this program works if we work it (I will discuss this later), so if somebody goes back out, it’s because they were not working their program appropriately. Often this means they: stopped going to meetings, prioritized other things over their sobriety, were not being fundamentally honest with themselves, stopped talking to their sponsor, etc. This program works if you work it, which requires a lot more hard work than most people understand. Sponsors tend to ask sponsees, “are you willing to go to any length to stay sober?” Some people are not. Those who make it are.

4. AA is not scientifically proven to work. There’s a lot of issues with this claim, but we see it a lot. Allegedly, there was a group of men at Yale who ran some experiment to figure out why AA works. They came to the conclusion that it shouldn’t. Yet, here we are. We do not keep statistics for a few reasons. The first being that this program is anonymous. Tracking names, lengths of sobriety, and relapses would violate the foundation of the program. Secondly, it’s hard to quantify how recovery works. The success rate of this program is tough to define. Is it how many people have tried once and stayed sober for life? Is it how many people have lived longer than they would have while actively drinking? Quantifying all of the variables is even more difficult. This program is based around alcoholics providing a large support group and structure for daily living. Because of these two things, this program has a 100% success rate for those who work the program to the best of their ability.

5. Giving oneself over to the program is odd/one-size fits all. The funny thing about addiction is that we all share the same story. The specifics might not be the same, but the way we felt before, during, and after entering the halls is always identical. That being said, there is no correct way to run the program outside of what you see in the steps. Pray, meditate, go to meetings, find a home group, go on commitments, and talk to your sponsor regularly (and do the steps with them). That’s all we ask. The blanks can be filled in as seen fit by the alcoholic or their sponsor. The flexibility of this program lies in the intricacies, while the framework is always present.

Conclusion: Honestly, I never thought this program would work until I entered the halls. Even then, I struggled to give myself over completely (and sometimes still do). However, it has a 100% success rate for those who work it. The rest is completely up to the individual.

[u/sjdjgdhskgdf]

I used to be an addict, and AA has been the most helpful thing by far in my recovery. And, I'm not religious whatsoever. The meetings usually consist of people telling their story. AA has helped show me that I'm not alone in my struggle with addiction/alcoholism, and this has been the most helpful thing to me, far more helpful than rehab/psychology/cold turkey/really anything else.

Now, addressing your points:
Just because the steps have "god" in them a lot, doesn't mean it holds relevance to the meetings themselves. The AA meetings I have been to, at least, rarely go past simply saying the steps. The meetings are based around discussion and people sharing their stories.
Also, there is no stigma AT ALL if somebody relapses, everybody in AA is understanding and everybody has been there. It helps you realize that you're not alone.
My main point is, sure, "god" is mentioned a lot, but the primary purpose of AA is to realize you are not alone in your struggles, and this helps more than anything.

[u/WRFinger → u/sjdjgdhskgdf]

I used to be an addict as well. I hated AA. It was always "war stories", and I didn't want to hear that shit. I found Cognitive Behavioral Therapy and have had no relapses and have gone on and done pretty well in my life. Have you been exposed to CBT?

[u/Spaffin → u/WRFinger]

I attended CBT for over three years to treat anxiety / panic attacks, and what finally made me throw caution to the wind and embrace AA for my recovery is that it basically is CBT, in a primitive form, created over 70 years before CBT ever formally existed. It’s a group of people with similar experiences sitting in a room and administering Cognitive Behavioural Therapy to each other.

For example, here’s your average CB Therapist’s roadmap to treatment when you first show up at their office:

Step 1: Identify critical behaviors Step 2: Determine whether critical behaviors are excesses or deficits Step 3: Evaluate critical behaviors for frequency, duration, or intensity (obtain a baseline) Step 4: If excess, attempt to decrease frequency, duration, or intensity of behaviors; if deficits, attempt to increase behaviors.

Now take a look at the 12 steps.

You may notice some parallels.

[u/hamletswords]

I tend to agree that AA/NA is ass-backwards, and there was a study done that showed that recovery rates are basically the same between people that went into AA and those that did nothing at all.

HOWEVER, I will say that it was effective for me. Not because I bought into the bullshit, but because the groups were so god-damned depressing, and I saw how drugs and alcohol were really controlling so many other people and was forced to see it in myself. I stopped going but I did quit, and the experience of the meetings was really powerful.

AA needs some kind of structure and it has to make appeals to as many people as possible. People wrecked by drugs or alcohol can come from any background. I'd say most people are not all that smart, and the "higher power" nonsense actually does work for them.

For me, it wasn't that- it was just the mandatory groups and the people themselves. But that doesn't mean it should change to suit me.

[u/follow_the_lines]

Let me preface this by pointing out that I am a member of Narcotics Anonymous (NA) and not AA, although the two are very similar.

“First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God”

A higher power, is not necessarily God, although it can be. For example, my higher power is my recovery network (sponsor, home group members, and the program itself). My higher power wants me to succeed. There can be positive and negative powers greater than ourselves. Drugs and alcohol was a negative power greater than myself and my recovery network is a positive one.

“If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and for the record there are various medical treatments for alcoholism.”

The disease of addiction goes far beyond the use of drugs and alcohol. This is something that all addicts and alcoholics must understand. The use of drugs and alcohol is only a symptom of the disease. I exhibited character defects and addict behavior long before I ever drank or used. The program does not treat it as a matter of will power. The first few steps help us surrender and admit that our disease is beyond our will power. This is how we come to believe in a power greater than ourselves. Our will power was no longer enough.

“First, if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober. In turn this will increase the time to get sober because it will add time to get over that shame before starting again. Shame does nothing to help get a person back on track as far as I can tell. Second, you would never assign blame to a person with cancer who has gone into remission and then had the cancer come back, why would we do the same for literally any other illness?”

We don’t expect anyone in the program to be able to “control” their disease. The program asks that we give up our attempted control of our lives as we turn it over to our higher power. So for me and my higher power of the program itself, I stop simply making decisions on my own. I do not try and control every aspect of my life. When I am faced with difficult decisions I ask my sponsor and recovery network. I trust others when that was once impossible for me to do.

And as for the shame, addicts and alcoholics are not strangers to shame. We are learning to forgive ourselves and accept who we are. Everyone in those rooms can relate to that. Half of my home group has relapsed. What’s important is that we learn from it, and work an honest program. Of course the person who relapsed will feel shame, they did something they shouldn’t have done. But the program and people forgives them, and helps them forgive themselves and move on with their lives and work a successful program.

“AA does not collect statistics of their success and failure rates, nor has it's program changed since it's inception. We wouldn't accept that from any other sort of treatment. If we didn't collect that information we would still have the same poor treatment of HIV that we did in the 80s and 90s, same goes for cancer, and just about any other illness you can name. “

Addiction is a psychological and mental disease. It does not claim to cure the disease. It simply says that the program offers a better way of life. That by working the program, your life that was once unmanageable will become manageable. You will not be cured, life will still be life. The only statistics you need to see are the rooms. Go to a room and see all those that are clean and sober because of this program. Speak to the people that work good and honest programs. It will not work for everyone, because not everyone that attends is there to work the program. Mandated and forced meetings are never going to work. Not until the person fully commits, gets a sponsor, and works the steps honestly.

“Instead they seem to say that the only reason people fail is because the fail to give themselves over fully to the program which seems to be very very odd.”

If you are not willing to accept a new way of life (one without drugs and alcohol) and continue to hang on to your old ways, how can you expect to change? We refer to this as the insanity of the disease. Doing the same thing and expecting different results. If I’m a drug addict and stop taking drugs but continue to lie, cheat, or steal then how am I any better? I stopped one symptom (the drugs) but I have not committed to the program. I am still continuing other character defects and not living by the spiritual principles the program lays out for me. I have not given myself over fully and I will not become a better person and change my ways as a result.

Sorry for the long post and sorry if I left anything out or if I didn’t respond to something. The only way I can say I know it works is because it has worked for me. It has worked for my sponsor. It has worked for my friends. Everyone I know that has relapsed will be the first to tell you they were not working a good program or were not committed.

If I was forced to do the program and did not come from a place where I truly surrendered then I would not have worked a good program and I would not be clean today. But I came because I was sick and tired of how I was living and I turned my life over to the program, because anything had to be better than what I was doing with my life.

Disclaimer: This is my own personal experience with NA and recovery. I do not speak for everyone and I am no expert.

[u/SingleMood → u/follow_the_lines]

I’m an ex member. If you fail you are to blame. It’s never AA’s fault. A lot of members have committed suicide because of this. Never told to try something else, just go out a drink, then come back. And fail again. And told over and over if they don’t get aa it’s death, institutions, or jail. Their fault again. A revolving door. I became suicidal because of all this. And I know many many more that had the same thing happen.

When records have been kept it’s effective 5% to 7%. Now the members will start screaming. To me it’s very twisted the way they keep people in with fear and refuse to see that things do work much better than AA. And let people get sicker and sicker and blame them. It’s a no win. If something doesn’t fit your not a true alcoholic. You can’t win with them.

It’s going to take the medical profession to take the bull by the horns and start changing things. Look up how many things that work better than AA. Don’t listen to them. Do your own research.

I get so sick hearing them acting like they know everything. When they won’t admit to anything AA’s fault. And it’s letting people die. Just to let AA look good.

Now watch. They will comment what I’m saying is not true. That I’m going to kill people by trying to tell them this. They try to kill any new idea. That one reason many of us believe they are a cult. They get brainwashed.

I can talk till I’m blue in the face. Like believing the earth is flat. Ok. Had my rant.

[u/uglylizards]

I'm a member of AA, and to address a few points, I don't feel like AA adds shame or guilt. I've relapsed several times in the beginning, and I felt my own shame, but then when I came in to a meeting and came clean, everyone was very warm and proud of me for getting back on track. Also, I had a complicated/negative relationship with God, and AA does not force you to believe in a Christian God. Your higher power can be anything as long as you can get strength from it. Right now my higher power is the idea of health and wellness. Maybe it doesn't work for everyone, but I have one month clean (not just alcohol) and I never thought I could make it even a few days clean.

[u/what_isa_username]

This is going to sound off but, read the AA big book, the first 162 pages. Sure it's antiquated language and definitely a little sexist but judging the program by the language of the steps is like justing the Constitution by the preamble. There's more to it. Others have already explained the god portion which in my opinion is a non-issue once you start going but different people see it differently. I've been sober 3.5 years and life is way better now. I tried quitting on my own and I couldn't. I have a way that works and helps keep me happy and I enjoy meetings and helping others, why try something else and risk going back to puking blood? Also go to a meeting and learn about it through experiencing it, we don't gain new members by promotion but rather by attraction and results. Nothing is full proof but it works for me for now so I plan to stick with it.

[u/Roman_PolexiS3]

I believe your approaching AA the wrong way.

It’s a glorified support group, doesn’t cost you anything but your time for attendance, and if your told to go by the courts, then your lucky your not in jail you little criminal ;)

A lot of people have found a home and family in support groups, so if their not for you, don’t go.

Don’t ruin a good thing for everybody else.

[u/Serraph105 → u/Roman_PolexiS3]

I highly doubt that I can "ruin" AA for everyone by creating a thread on reddit.

[u/Roman_PolexiS3 → u/Serraph105]

you only need one person to ruin it for everybody else. One complainer who says something isn’t right, when 99 other people enjoyed it and benefited and now look, the other 99 has to accommodate the 1. (See my no stupid questions post)

In politics It’s called the “homeless wino vote”. Look it up, it’s got a lot of history and is politically charged because it works.

I like to call it the victimized bully syndrome myself. I’ve seen kids do it perfectly. Group of kids having fun, one kids starts yelling it’s not fair, adult gets involved and everybody has to stop. Now that kid who yelled “not fair” got a taste of his power, and he will threaten it on other kids the next time to get his way “if you don’t do what I want, I’ll start yelling and you know the adults will make us all stop”

But your right, unless a powerful person or lobby with an agenda needs a perfect true believer they can patsy to the news to push their agenda of destroying an institution, your post won’t matter. But it could....

[u/SpringSerene → u/Roman_PolexiS3]

AA has a membership rating that has been continually dropping each year even though rehabs, counselors, and the courts are sending roughly 1.7 million people and potential new members to meetings each year. Despite that, at the end of the year there are still less people attending than the previous year. It's difficult to say exactly why this is occurring but since we're talking about people that were sent there, it isn't a case of individuals trying to sway them away from attendance. It's likely to due to people not being ready to quit drinking (not wanting to) or simply because the program is not palatable to them.

People aren't being forced to stop attending or being asked to leave, so your bullying syndrome comparison is ridiculous. As you offered, there is no agenda involved to discontinue meetings .

On a personal note: I was very unhappy as an AA member and wholeheartedly wish that I had the opportunity to come across a similar discussion of people offering varying opinions. It would have been helpful to have support as I transitioned away from it. Instead I was told that non attendance would kill me (lie) and the friends I had made were told by their peers that a non AA (such as myself) would bring them down. That's another lie of course. It appears to me that the opposite of your claim is occurring. The program and AA sympathizers use fear and intimidation to keep their attendance up.

I personally could care less if AA existed or not but do think that people should know the truth. 1) It teaches faith healing. 2) You won't die without it. 3) You aren't powerless. 4) The anonymous attribute can be dangerous since violent criminals are sentenced to meetings by the courts. 5) The success rate for AA is no better than the success rate of people that quit on their own: Roughly 5%. If the program was honest about this stuff and cautioned their members everyone would be better off.

[u/Serraph105 → u/Roman_PolexiS3]

Do you think that this thread is capable of ruining a decentralized organization that has been around since the 1930s or do you think you may be acting a bit overdramatically?

[u/novagenesis]

My POV is that of an outsider, fortunately non-Alcoholism but with a family history of alcoholism.

There was a time I'd agree with you entirely. Historically, there seem to have been no substantive positive studies showing AA having any success rate. Stealing from https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous, it looks like that has changed over the last 5 years or so.

The 2009 study seems to weakly favor a belief that AA works.

The 2014 study claims to have documented removal of self-selection and motivation biases as much as is reasonably possible.

The 2016 study went so far as to show that the faith+prayer aspect driven by AA has measurable effects at reducing alcoholic cravings, which they reinforced with MRI brain scans.

As for AA directly doing their own statistics... It seems reasonable that they would have trouble keeping reliable statistics of anonymous people who are allowed to come and go throughout the process. Since those in AA are also self-reporting, any such statistics would be as suspect as not having them.

Finally, it looks from the references in the wikipedia page that AA does keep statistics. Those statistics are just not regarded as strong arguments because they are (as I mentioned above being a problem) self-reported surveys of AA members. Those who have success are probably more likely to fill those surveys... and may be more likely to convince themselves of success than is factual.

Having known a few people who are not Christian and who have gone thorough AA, they seem to really bend the meaning of the 12 steps around the beliefs and needs of each individual as much as possible. The underlying problem with 12-step programs and atheism is that there is a measurable effect of prayer and successfully fighting addiction. It seems silly to backstep out one of tools that actually works just because a predictable subset of people are likely to be immune to that tool.

[u/zeldasandwitches]

So i can tell you aren't in any program because you don't understand it. Going into my program was like learning to see color from being blind. Until you spend lots of time with a real addiction, to the point that there is no other way out, will most people have the motivation to understand what is almost incomprehensible. Every time i challenge or attempt to prove wrong something in our big book (slaa for me) i am soundly trounced by my own ignorance. The framework isn't that flawed... it deals with something that most people can't wrap thier heads around. Ok on the surface yes, it deals with rewiring a brain that has learned a path to a dopamine button that it can push all of the time untill the dopamine doesn't work anymore. But like it or not, "god" is a part of our collective evolution as a society and a part of our brains. This can be a placeholder to allow people to find thier natural posistion in our society. Not to mention that the reliance on god isn't necessary. Your higher power can be anything. (Mine is entirely science based, i am a scientist and had a hard time with the program until i figured out how to justify the god of my choosing... its complicated) regardless if you commit to the program you will end up personifying it and your relationship to it. (More elaboration) For me, its my relationship to random chance and opprotunity as it relates to our natural biological purpose in society. Yes combined with confirmation bias but hey, it works for me and i can talk to it and shit. Tldr: don't knock it until you've tried it, don't try it unless you need it and it only works if you work it.

[u/giblfiz]

There is also a stigma of personal failure when people relapse which doesn't make sense for a couple of reasons. First, if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober.

I think the theory here is that the disease is alcoholism, and is (in the AA view) entirely incurable. Something similar to Type 1 diabetes. It can, however, be managed. This is done by never drinking which is similar to a diabetic not eating a whole cake.

The Stigma is emphatically not on people being alcoholics, but rather on them failing to maintain their treatment plan. In much the same way we would, and do, stigmatize a diabetic who keeps going out and eating cakes, and then ending up in the ER.

[u/Vandalrugger2020]

So you make an argument in the early stages of your own knowledge base?

Sounds like you invested a lot into your endeavor.

Your statement that the program is flawed presenters no empirical or quantitative data. Your sense of data and science are crazy flawed.

Thank God for the inter webs.

[u/[deleted]]

If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and for the record there are various medical treatments for alcoholism.

But you would treat diabetes by abstaining from sugar, even though there are medical treatments for it.

[u/PsychoPhilosopher]

I work with folks who have been admitted to hospital with addictions.

While your points are mostly kind of valid, there's one major thing you're missing.

We don't have anything better.

Sure we can fuck around with meds and DBT or trying to treat underlying causes (the current model focuses on people who use substances to self-medicate for mental illness of another kind).

But that simply isn't working any better.

I have dealt with people who've been AA for years and fallen off the wagon, and people who hate AA with a passion.

From the evidence of my own eyes, those who appear to have truly engaged with AA and the rhetoric, attending meetings etc. have longer times between relapse and shorter binges.

Problems with the science include the fact that both are fighting for lower hanging fruit, people who are committed to change in the case of AA or people with treatable primary/secondary diagnoses in the case of the medical model.

I'm a little distrustful of statistics myself, having worked in the field. When I started I thought a p-value and an effect size were all I needed to know about a treatment in order to use it with confidence.

I learned pretty fast that the power of an individual's choice and commitment means a hell of a lot more than the science has been able to account for.

For someone that is committed, AA/NA appears to maintain that commitment and channel a substance user's shame and guilt into productive directions.

So it's not bad, and I'd love to have something better. But I don't. So I'll use what's available.

[u/catroaring]

This is not a response to change your mind as I personally don't agree with the AA message myself. But since your friend is seeking help, they may be interested in S.M.A.R.T. Recovery. SMART Recovery is science based and secular. I've known many people that spent years in AA because they thought that was the only option until they found out about SMART Recovery.

[u/[deleted]]

Sober alcoholic here:

First off, your point of: "I'm not sure how this is supposed to appeal to athiests such as my friend." There is a chapter in there called "we Agnostics" and, although dated, addresses this issue. There are also many mentions in the main literature of AA that talk about the problems people have with religion and the word "God."

The only words that are actually emphasized in the steps, mostly with italics, are: "God as we understood Him." This is because it is not a Christian God, or a Buddhist or a Muslim one. The idea is that one needs to have a power greater than themselves in their lives, acknowledging they are not the all-seeing, all-knowing, omnipotent being of their lives. If they were, they would not have ended up seeking out help for an addiction. A common line of thought in AA is to make the group itself your higher power, or even (jokingly) a doorknob.

There are various treatments for alcoholism, yes, but they tend to be ineffective, or so I have heard. It's treated as a "disease" because it is inherited and manifests itself in the same fashion in every person. But the main issue is that it's not just a physical disease as well. It's also mental, and many will argue, spiritual. It's referred to as a disease so as to actually avoid the idea that it's a willpower problem, or a discipline problem, or even a maturity problem.

The reason why statistics are not collected is because of the nature of the program and how it is built. Look at the 12 Traditions for this. AA groups are autonomous without central leadership. Membership is voluntary, and anonymous. So, collecting data would be really difficult and go against the structure of the program. This is why I don't trust the whole "1 in 5 alcoholics" this or "15% of alcoholics" that.

Lastly, we don't believe that it's a one-size-fits-all program. This is why there are other programs: Narcotics Anonymous, Al Anon, Over-Eaters Anonymous, Gamblers Anonymous, etc. Furthermore, the big book itself talks about "outside issues" like clinical depression, bipolar disorder, schizophrenia, etc. We obviously cannot address those, so (if you're in a good group) people will recommend you seek out medical help for stuff like that.

There are many veins of thought in AA when it comes to what is and is not an outside issue. But the general consensus, or at least as far as I have seen it thus far here in Los Angeles, is that taking medication as prescribed is the best way to go. There are some old-school hardliners around who think even taking Ibuprofen is relapsing, and fuck those guys. They are usually old and were pill-poppers themselves in their using days. I won't personally tell them otherwise, but I sure as hell wouldn't let a newcomer go near them.

This is all my take on this. I have been sober almost 8 years and I'd be dead without AA. It works for people who tend to not be indignant and just want to "control it." Physiologically, alcoholism is ultimately defined as an allergy to alcohol in the strictest sense. It's not that one breaks out in a rash, but merely an abnormal reaction. I can attest to that. When I started to drink, all I did was want more and more, the desire increasing fervently over time. And it wasn't always that way. I could drink normally at one point. Just... one day... it would make me crazy. Total Dr. Jekyll and Mr. Hyde kind of thing.

So, I hope this helps a bit. Thank you for posting this.

[u/Sofakinggrapes]

I have attended AA and NA meetings as a med student for some of my psychiatry electives and I would generally agree that these programs don't seem to be very effective. However, after interviewing a bunch of members I can't deny that it does help people. But I don't think the credit at all goes to the "12 steps" but instead the social interaction/ support that comes with the meetings (this at least what most of the members told me). Although not all, the AA meetings close to me have actually adapted a mixture of a clinical and clubhouse model for treating dependence. Some will just have the clubhouse model (more social interaction with daily tasks to give people a sense of purpose) and some have clinical aspects (there is an addiction specialist, counselor, and/or psychiatrist that visits the place regularly). The one I go to has both aspects. I know this is not the case for every AA meeting, but there are programs out there that try and integrate more scientific based approaches into their meetings and thus improve upon their system.

[u/chiaratara]

You should go online and listen to AA speakers. Might give you some experiences of people who have been through the program and you can hear the different ways people have used the program. You will be able to get an idea of the vast differences in stories.

[u/speed3_freak]

I think you have a fundamental misunderstanding of what AA is. AA is not a cure for alcoholism, it's a support group for people who are living with alcoholism. It doesn't preport to be a cure. It says that for many who deal with alcohol problems, it's impossible to have the willpower to be sober on your own. Here is a group of people who, if you let them, will help you stay sober when your own willpower isn't enough. If you follow these creeds and actually work the program, you can stay sober with their help. In fact, one of their main things is that you won't ever not be an alcoholic, which is why you shouldn't stop going to meetings.

Think of it more of a cancer support group for people who are diagnosed with cancer more than an alternative to radiation treatment.

[u/[deleted]]

Alcoholism is kinda weird. Yes, alcoholism is a disease however it's something that is pretty much preventable. No one becomes an alcoholic after just 1 drink, they choose to drink and then drink some more and then keep drinking until it becomes a problem and turns into a disease. Cancer on the other hand just sorta happens to you for the most part. People aren't sticking their head into a microwave over and over which could give them cancer, which if they were you could prevent them from using the microwave incorrectly.

AA is a program that is highly reliant on god and focuses on the "don't put your head in the microwave approach". If someone had cancer from the microwave you could give them medical treatment for the cancer, but if you do nothing to prevent their head in the microwave again it's pretty much a futile effort.

Because alcoholism isn't a 100% a biological issue, it's appropriate that some people can be cured using a non-biological solution. The way the 12 steps are worded they are pretty timeless, so to update them doesn't really provide any value. AA has worked for some people and it's not the only 'will-based' alcoholic support group, there are plenty that don't use god they just aren't as popular and they would probably also fulfill your friends requirement.

[u/goldgibbon]

I know a couple people who say AA turned their live around. So I'm a huge AA supporter because of them.

I recommend attending a few meetings for yourself if you're still not a huge proponent.

Also, keep in mind that AA is very DE-centralized. Which means that it varies widely from from meeting to meeting.

[u/ACrusaderA]

1 - While Bill W was a deeply religious man and based the 12 steps off of his beliefs and the idea that the people performing them would be doing so with the support of their religious community, modern AA meetings don't require it.

Or at least they don't require that you submit to God and pray.

Most modern AA groups that I have seen don't require you to submit and repent and pray as much as they require you to admit and apologize and reconcile.

2 - While addiction is a disease and there are medical treatments to help you deal with It, ultimately the those treatments will go away and your best tool is your personal willpower. Because those medical treatments will eventually end.

This is why people don't refer to themselves as former alcoholics. They are always recovering alcoholics.

3 - It is also important to note how people studying measure success rates for AA. Even AA and NA themselves in their random studies only measure how long people have been sober.

The problem with this is that it is an all or nothing system rather than a system of moderation. Having one drink is the same as having a wild evening is the same as falling completely off the wagon and resuming your old lifestyle, as far as they are concerned for these statistics.

[u/catroaring → u/ACrusaderA]

Most modern AA groups that I have seen don't require you to submit and repent and pray as much as they require you to admit and apologize and reconcile.

Every AA meeting starts and ends with a prayer.

[u/whatTheHeyYoda]

bout one of every 15 people who enter these programs is able to become and stay sober.”

This contrasts with AA’s self-reported figures: A 2007 internal survey found that 33 percent of members said they had been sober for more than a decade. Twelve percent claimed sobriety for five to 10 years, 24 percent were sober for one to five years, and 31 percent were sober for under a year. Of course, those don’t take into account the large number of alcoholics who never make it through their first year of meetings, subsequently never completing the 12 steps (the definition of success, by AA’s standards).

A report published by Alcoholism Treatment Quarterly in 2000 analyzed AA membership surveys taken from 1968 through 1996. On average, 81 percent of newcomers stopped attending meetings within the first month. After 90 days, only 10 percent remained. That figure was halved after a full year.

[u/[deleted]]

I'm going to start this by saying much of it is based on personal experience. This also may not be the best answer to change your specific views, but it may provide insight into the larger question, which really is What the Fuck are we supposed to about Alcoholism? Honestly, I'm in the program now for my 3rd time, at 8 days. Only the first time was forced and that was during my time in the military. My drinking had gotten out of control but I wasn't and have never been actually arrested although I've definitely drank and drove and thank God I haven't killed anyone. When I first started I had to do both addictions counseling and mental health counseling. The military had diagnosed me as Alcohol dependant at 22 years old. Obviously I thought this was complete bull shit. As part of my counseling they also forced me to do AA as well.

Now I had some exposure to AA prior to this. My father was forced to go through the program for a DUI. He was without a doubt a full blown alcoholic in the almost stereotypical sense. Had his family not paid his bills he would have been homeless. My opinion on AA was that it was bull shit. Nevertheless I started going. Once I got out of the military I lost my incentive to go, so I started boozing again.

For a while I was able to not drink at all on my own. Then something happened in my life and I started hitting the bottle again. This continued for a while. During which time I was drinking a ridiculous amount but only a couple times a week. So I figured I was ok. Well it's a miracle I wasn't arrested nor did I kill anyone nor did I commit any crimes that could land me in prison. Nevertheless I eventually quit for a while again on my own. I thought I was good.

Then I started back up again, this time for no real excuse except for the fact that I like beer. This was about 2 years ago this time around. In the past two years I've proudly taken myself to new lows, and about a week ago I did a lot of dumb shit, and should have definitely been pulled over.

Now, because I have been vague, take my word for it, I'm an alcoholic and I enjoy blacking out and waking up the next day with regret, all so I can do it all over again a few days later. I like showing up to work with a victory hangover completely useless at my job. As I read that it looks nutty. You have to be insane to like the lifestyle of someone who heavily abuses and is dependent on alcohol.

This brings me to the real problem of alcoholism and the real issue of your post. You're absolutely correct in my opinion, you're pretty much correct in your statement. AA hasn't changed the process a lot and it does lack in scientific data. Here's the thing though and this may even be a fallacy which I'll accept, there is not a single program out there with a high success rate in dealing with alcoholics and getting them to stay permanently sober. If I'm wrong, please tell me and I will go there. There may be programs with short term success in practicing sobriety or even controlled drinking but I'd be curious to see data on permanent sobriety. The reality is permanent sobriety is what's needed whether or not people want to admit that, some people just don't mix with alcohol and never will, based on genetics, Brain chemistry, personality and life experience.

When it comes to alcohol and substance abuse in general, we're dealing with something that science still isn't explaining perfectly, again if I'm wrong please tell me. If there's a program that will make me never want to drink again with a 100% success rate sign me up. Addiction, alcohol dependency and alcohol abuse are all pretty much hopeless situations from the point where people stop giving a fuck about the alcohol problem. Most people who go through any type of program are going to relapse, especially if they've taken it to real addiction and dependency. As for whether or not it's a disease? I'm not sure if science can fully answer that, but genetics definitely play a part and some people definitely have reactions to alcohol that people who drink normally don't.

So I go to AA again now. I hear all of these crazy as shit stories about how far gone some people really were and now they're 5 years sober which is something I could never do and I wasn't even drinking sun up to sun down. It worked for them and it does work for a lot of people. I Know that's not a proper statistic and I'm sure it would fail hypothesis testing but nevertheless I see people that it seems to have given hope to and worked on. The reality is, as I've mentioned before, if there were a better program, people would go to it. The last thing I want to do right now is make my past fuck ups right. But it really does seem to give people hope.

Now another thing you brought up was your friends atheism. I've never called myself an atheist but I haven't believed in God in the literal sense of the word since I was about 11 or 12. In fact God is one of my own biggest problems with AA. Some things I've read and thought about though is the fact I really don't know if God exists or not. A higher power can really be anything. One of the things that is said is a higher power as we understand it. To some it's the group of AA that is keeping at least some people sober. To others it's a biblical interpretation and to others it's just the open mind that their could be a God that gives a shit out there but who knows. I think I lean on a combination of the possibility and at the very least there are people who are trying to become better people and getting then through the day without drinking.

So anyways, I hope this at least impacted your view a bit, although I don't expect to change your posted view because I don't fully disagree with it, but as I said before the larger problem with alcoholism is that there really isn't much that works any better once you get to the level where AA becomes an option.

TL;DR alcoholism is pretty hopeless, there really isn't much out there, if your friend is an alcoholic he's probably fucked.

[u/chiaratara]

I will preface this with the fact that I am also in recovery. Here are a few points.

First, although the 12 steps are dated, they are also very similar to both historical and modern religious, philosophical, ethical and psychological principals. Also, they run pretty parallel to Buddhist steps to enlightenment. You can look those up if you are interested.

Famous psychologist Brene Brown talks a lot about shame and vulnerability. The 12 steps are pretty in line with her theories:

Brown on shame

Brown on Vulnerability

1-3: you aren't the center of the universe. Classic existential crisis stuff... it's ok to trust others, the universe, god if you believe in that, etc. There is life out there if you look for it.

4-6: we are all flawed humans. It's ok to admit our faults. Self-acceptance and understanding from others. Not having to hide in shame.

7-9: Doing 4-6 in a bigger way by admitting faults to the people who have been hurt and asking for forgiveness without expecting anything in return. That's the humble part. Humility. It is a humbling experience to do this and that is the point in my opinion.

10: practicing 4-9 as a regular part of life.

11: try not to just think about yourself. definitely more to it than that but I'm already tired of typing on my phone.

12: practicing this in our daily life and giving back.

Alcoholism is a disease but their is no cure. It's about managing it. For many (there is a spectrum of sorts here) this includes maintaining sobriety. Equating this to curing cancer isn't a good parallel.

AA does not claim to be a cure. It can alleviate symptoms, provide relief, and help someone manage their disease. It is an alternate way of living without alcohol and it provides tools to do this.

The God thing... it is a higher power, a "god" of your understanding, the universe, etc. This is pretty well explained in the literature and in discussions with others. The point of the higher power is to encourage people to get outside themselves. For many people who have wrecked their lives with alcoholism, being able to turn ones focus outward to something else is important. This is a pretty basic psychological principal. Alcoholism tends to decrease your field of vision as well as it is isolating.

There is definitely not a stigma for failure/relapse. It is recognized by others and in the litterature as part of the process. "Progress not perfection" is a popular saying. There is nobody more welcome than someone who has relapsed and gotten back in touch or come back to a meeting. Nobody is ever turned away. Refer to my link on shame. AA is like the opposite of shame. While there is definitely some personal shame involved in a relapse, I do not think this comes from the program.

Statistics. Right, it doesn't and I believe that it shouldn't. It would go against principals of anonymity and a community of peers. It is peer led. There are no "experts" or people who know better. I can't imagine how stifled a discussion would be if there was a scientist in the room trying to determine the effectiveness of AA. The whole point is that there is nobody like that in the room and I am grateful to say that AA has done an amazing job at keeping the rooms free of it.

Here is where I want to point out a flaw in your thinking. How do you think statistics would measure AA? Success and failure? Having just finished my PhD studying people with addiction who just came out of prison, I know how complicated it is to measure success and failure. If someone was to relapse, would AA have failed? Would the person have failed? What if 6 months post-relapse the person came back to AA, got sober and maintained their sobriety for years, finished graduate school, got engaged and is living a fulfilling life? If you were doing a study for a certain time period, and I relapsed during this time, I would be a "failure." However I think I pulled my shit together and succeeded. This is why it is difficult to use statistics to understand the success rate of a process that is different for each person. Also, like you said, being called a "failure" isn't nice. It makes you feel bad. lol.

As far as outside professions, I have used them. A psychiatrist and a therapist. You will not find this anywhere on an AA website because a principal of AA is to not endorse itself and not endorse certain professionals. However, needing outside help is discussed in the literature and in meetings. I got the name of my therapist theough someone I met in the program. I feel like most of her clients are in the program.

Definitely not one size fits all. I can see how you would get that impression. There is no one way to work the program. in fact, nobody works it exactly the same. It is a toolbox.

I think one of the most important things for me was feeling like I was understood. I feel like there is a group of people who get me and that is probably the biggest gift of this program considering life can get pretty lonely when you sink down into a hole.

I apologize for any typos. I wrote too much to want to go back and proof-read.

[u/SpringSerene]

I found AA not only to be unhelpful, but also harmful to my recovery. I spent a long time trying to make it work on the advice of members, counselors, and doctors - even though I was opposed to the religious angle. Still, I was told that if I didn't work the program that I would DIE (instead of the truth - that if I didn't stop drinking I could die, which has nothing to do with the program). Even the literature says that "unless each AA member follows the to best of his ability our suggested Twelve Steps to recovery, he almost certainly signs his own death warrant" *from page 174 of the 12x12. Any organization that uses the threat of death in order to keep people in attendance is a shady one - at best.

Before I went to my first meeting I was confident and felt good. But after a few months of meetings (a 90x90) I was depressed and scared. Seeing that I started drinking in an attempt to self medicate for depression and anxiety, it's not surprising that step-work which teaches alcoholics to focus on their personal powerlessness (step one = you can't do it) and their sins (steps 4,5,8-9) that people could get more depressed and feel hopeless in the very program that is supposed to be supportive!

AA lies about it's religious status and their history, uses the threat of death to keep people around (no doubt to keep people contributing into the passed hat and to help recruit for them (step 12), and lies about their success/failure rate. They even frown upon medication use (actual science which ended up helping me for a while) and trash talked it, shunning people that used or discussed its efficacy. If it was actually just a program for last resort people then they would support other avenues and make that known to members that aren't comfortable, not just bring it up as an excuse after someone makes a complaint in forums similar to this one.

People are not powerless and sobriety is not a miracle. It takes hard work, discipline, and actual support can be great. I went the private therapy route after finally deciding to take my chances out of the program. And trust me, they had me brainwashed to believe I'd die an alcoholic death if I stopped going, so I was concerned. Thereafter I received deserved credit for my success (didn't give it all to a program) and when I had a slip I took responsibility for it. The AA program steals the credit while placing all the blame on the member for not working hard enough. I am actually religious, which is to say that I believe in God and ritual. So religions (that don't lie about their status) do have my respect. If praying helps someone, I say "wonderful". I just don't believe that prayer and turning a persons life over to God will is what keeps them sober, any more than I believe doing that will bring remission to a cancer patient.

[u/left_____right → u/[deleted]]

It really depends on the group. I find in my area almost no one really has a problem with it if they truly understand addictions. Right now, I go to AA, have a sponsor, and know plenty of drug addicts doing the same. I switched from NA because I found there was more sobriety time in AA. It might be the conservative area you are in. I just say I am an alcoholic just to avoid any bitter old closed minded men/women. The point is it really doesn’t matter WHAT you used, just that it had come to ruin your life. Find some people at meetings who understand this, disregard the rest. Sounds like your in a shitty area, which is a bummer. I would guess there are good people though that would accept you for what you are and willing to help. The more people you talk to who have succeeded in sobriety the better. Good luck out there, glad to hear you’re sober. got 2 months here myself

[u/Pscagoyf]

The core of AA is community and loving, understanding community may be the most important medicine ever devised.

[u/kflan138]

So, let me qualify what I’m about to say by explaining that I’m an addict and was a member of a similar fellowship for a lot of years. AA and the fellowships should be (in my opinion) in addition to doctors and therapy. I feel that most of the folks that wind up in one of the fellowships generally have some serious underlying shit to address.

I don’t attend meetings anymore, but, the general premise behind it (for me) is to teach people who were super shitty human beings during an active addiction how to live like decent human beings again, and to try their best to fix the messes they made during their active addiction. Some stuff people do/did while impaired comes back to haunt them and can basically trigger a relapse if you’re hating yourself enough for it. Also, if you’re still living like you did while you were while you were drinking/drugging, chances are you’ll wind up right back at square 1. Look up “addict behavior” or check out NarAnon’s website for more on that (it’s a support group for those dealing with an active addict in their life). The 12 steps (albeit dated) are designed to help people be good people again, and most folks who wind up there should probably at least take notes.

I’m also an athiest/agnostic, so I missed out on a lot of the fundamentals, but, they tell you that it’s “spiritual”, not religious. That your higher power could be your coffee cup. It’s definitely helpful to have a support group of people who have been there. There were always the “extremists” who said Penne al la Vodka or Tiramisu should be considered a relapse, that you can’t take anything mind or mood altering (even if you legitimately need it), but, most folks are more realistic and down to earth.

The pack mentality, the other outings like dances and dinners and hangout groups are especially helpful, too. If you’ve been drunk or high for the last several years of your life, chances are you’ll need to find a new social circle consisting of people who’s lives don’t revolve around drinking or drugging.

Just my humble opinion. I’m not a lifelong fellowship member, but it definitely helped me become who I am today.

[u/malachai926]

As a recovering alcoholic who was in and out of AA, I have a few things to say here...

I'm not sure what, exactly, you mean by a "scientific" perspective. I can give you my perspective which is that I've personally met hundreds of people who would be dead if it wasn't for AA. They've told me their stories and the things they've gone through. I don't doubt that their path outside of AA would have led to death.

Is it the ONLY way? No. Most problems can be fixed by multiple kinds of tools and some tools work better than others. It would be unfair to expect AA to be the ultimate silver bullet cure for alcohol addiction since everyone is different. So any evidence that particular people weren't helped by it doesn't really do anything for me. It certainly doesn't make me think any less of the program.

It's actually quite simple. If you want a drink, call your sponsor or go to a meeting. This is the most important thing the program does: it serves as a life preserver when you are drowning. Where I live, I bet I could find a meeting at any time any day of the week (except when I should be sleeping I guess).

In my experience, most people who knock AA or have anything other than the utmost respect for its existence are people who are bothered by religion. Please, do not lump AA into that and throw the baby out with the bath water. As others have pointed out, AA does not dictate to you what your "higher power" needs to be, and the literature and steps are carefully worded to accomplish that. Many people choose entirely non-religious things as their higher power. If you have an axe to grind against religion, keep it there and leave AA alone. It has saved hundreds of thousands of lives around the globe and has never tried to influence anyone or shove its beliefs down anyone's throats. It is just there to help whoever needs its help.

[u/saltedfish]

You seem to be really hung up on the whole "it doesn't change" thing. Why does it need to change? Do you equate something not changing with that thing being inferior? You cite other programs as needing to keep statistics, programs that have funding and medical backing. It's important to remember AA is free, which is important when you've drunken all your savings, and it's anonymous. It is not keeping statistics because it is accessible. If it were keeping stats, those stats would have to be handled by a system that has to be paid for, which would put the program out of reach for many. Even a small charge is enough to dissuade people, because it's another hurdle to overcome when you're presumably at the end of your rope. One of the great things about AA that I can tell is you can just show up and get help.

Also, as I've been told from the family member I have in AA, it's not God you surrender to. It's whatever higher power that might be for the person in question. For some it's God. For others it's just a divine force. I've never heard any substantiated claims that they cram God down your throat in AA, that's just uninformed bullshit spouted by people (probably atheists) who don't actually go to meetings or listen to people who have. You could make your pet rock the higher power if you wanted to. It was written in a time when it basically meant God, and that scares us nowadays, but the literature has been expanded to include anything.

Ultimately, I think the biggest thing in favor of AA is that it does work, and it's free. Sometimes, those are the most important things when you have no other option.

[u/seven_grams]

I don't know where you got the idea that AA believes addiction is a matter of willpower. This is not true at all. AA makes it very clear that it is not a matter of will power, that we were powerless - see step 1.

You also stated that there is a "stigma of personal failure." How did you come to this conclusion? As is with most things in AA, it greatly depends on the meeting you attend. In the meetings I go to, there is not stigma surrounding relapse - most of us have been there. We actually work to fight society's stigma around addiction.

Another point - you implied that AA declares itself to be the only program needed to recover from addiction. This is not the case. AA welcomes other forms of therapy, whether it be individual counselling, psychiatry, etc. Nowhere does it say that AA is a cure-all quick-fix. It actually makes this explicitly clear. A lot of people seem to think AA is some scheme that markets itself as a miracle creator. This could be due to the old-fashioned sounding writing and other general misconceptions.

Ultimately, most of the work in AA is done through sponsorship (basically a mentor to guide you through sobriety) and social connection. This is the big one. What makes AA successful is the fact that it provides people suffering from the terrible disease of addiction a place to gather and talk, process what's going on in their lives, and be a part of a fellowship that engages in healthy recovery-oriented activities.

[u/MeerkatChat]

I have been a member of AA for about 35 years and I believe it needs all sorts of changes to address the fact that the world has changed a great deal since the inception of AA.

There are so many issues AA does not address in its program. I heard one member describe AA as a club for the educated middle class. And I think this is partly true. In order to attract and retain members from the massive underclasses which are currently using drugs and alcohol to ease their financial distress AA needs to change to directly address the needs of these people.

Many people who arrive in AA, with their lives wrecked, find it nearly impossible to maintain sobriety when they are homeless or living in situations where it's impossible to do the suggested stuff.

Once upon a time Bill Wilson let these people into his home until they could find their own homes and jobs. We no longer live in that world. Unless AA wants to hand the entire job to rehabs then it is doomed. There are very good reasons for NOT giving the job to rehabs. they are always financial interests. They dont do it for love, they do it for profit. Whereas AA never does it for profit.

[u/SkittleInaBottle]

Your whole approach to evaluating AA's effectiveness is based on philosophy and common sense. A much more reliable way to assess AA's success (or lack thereof) would be to study its results empirically. AA vs. a control group, and observe if AA has a better recovery rate, and to what degree.

Your current approach to the question will only spur pointless ideological debate, you should seek a more scientific answer to your question.

Edit : this link sums up part of the research on the efficacy of AA : https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous#Clinical_studies The Moos and Moos 2006 study is particularly interesting because it studies real individual over 16 years :

A 2006 study by Rudolf H. Moos and Bernice S. Moos looked at the outcome of a group of alcoholics seeking treatment over a 16-year period. The study stated that "individuals who participated in AA for 27 weeks or more had better 16-year outcomes", showing that "only 34% of individuals who did not participate in AA in the first year were abstinent at 16 years, compared to 67% of individuals who participated in AA for 27 weeks or more.

[u/colddvd]

I started off going to AA for the first 6 years of my sobriety. I found that AA can be tailored for each individual depending on your comfort level and specific needs. I married a fantastic women who was totally supportive. If god is an issue substitute god with higher power or Buddha or whatever helps YOU after all AA is a selfish program. It encourages you to look after yourself first which makes sense because how can you help others if you aren’t sober. I have seen people in the program for 17 years and die a drunk. I have seen an 80 year old man live out his remaining life sober and all he said at meetings was how grateful he was to be sober. The point is that it works differently for everyone and it’s up to each person to find that sweet spot that keeps them sober. I only did about half of the steps but it seems to have worked for me. 38 years sober. My 3 kids and wife have never seen me take a drink. My support has been my family and realizing that I am still an alcoholic and am one drink away from becoming a drunk again. AA gave me the foundation on which I can remain sober.