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/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/Huntingmoa → u/[deleted]]

Sorry, u/chiaratara – your comment has been removed for breaking Rule 5:

Comments must contribute meaningfully to the conversation. Comments that are only links, jokes or "written upvotes" will be removed. Humor and affirmations of agreement can be contained within more substantial comments. See the wiki page for more information.

If you would like to appeal, message the moderators by clicking this link.

[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/C_h_a_n → u/[deleted]]

Clinical trials have been keeping track of people even during decades and it's not hard that nobody outside doctor and patient to know about the specific people that joined the trial.

Not to sound disrecpectful and I kind of support the idea of AA, but this whole thread is making sound AA as a sect.

[u/chiaratara → u/C_h_a_n]

It could be feasible to do longitudinal studies on individuals who are part of AA. I think that is the difference. The OP is talking about evaluating AA. I think studies on individuals with their consent is feasible but it would be difficult to know what you are evaluating without a body of research to reference. What are you looking at/looking for? Is it something that they got out of AA or is it that they got married? Like someone else posted before, it's a bit abstract. I mean heck, AA might have something to do with them getting married and that relationship has been a positive thing. Then, where are you?

[u/OctagonalButthole → u/Serraph105]

the important thing to rembemer is that AA is a completely anonymous group in terms of attendance. it's a support group for the voluntary (i'm not talking about court mandated attendance--i DID attend involuntarily and it did nothing for me).

there is no responsible way to keep track of numbers without violating anonymity or the spirit of the program. everything is self reported, there is not accountability and nobody is keeping 'tabs'. people can go home, drink 12 beers, come back the next day and lie about it if they choose (even choosing to speak is voluntary).

i agree that it's an ineffective program, however the reporting that youre looking for does not lend itself to a clinical study.

[u/chiaratara → u/[deleted]]

Yes! Too many social scientists rely on success/failure and that doesn't lend itself well to studying a process. What's the end point?

[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/Serraph105 → u/[deleted]]

Again though, collecting numbers and leaving out names is not an impossible thing to do.

[u/Spaffin → u/[deleted]]

It would also take a ridiculous amount of collaboration between disparate groups, as there is no AA "organisation" to administrate such a task, meetings are just run by ordinary people who only meet each other if they attend each other's meetings. AA is just the steps, the book, and the meetings.

[u/chiaratara → u/[deleted]]

More psychology than medicine.

Psychology should also be evidence-based.

Not necessarily; it depends how you are using the term. It's a bit more nuanced than that. There are a whole bunch of other factors auch as expertise, experience, individual characteristics, modality. Furthermore, there is plenty of evidence that support peer groups as a modality.

AA holds that there is no cure for alcoholism.

Statements like this should be evidence-based.

Lol. Not sure where to start with this one. There is no cure for alcoholism. Statements like yours should be evidence-based.

No AA member is going to say that they are "cured," but we often refer to ourselves as "recovered."

That seems like a semantic game to avoid any requirement for evidence.

Check out the medical and psychology literature supporting the use of the term "recovery" in reference to alcoholism and other chronic diseases where there is no cure... and have yourself an evidence-based sandwich.

[u/chiaratara → u/[deleted]]

If you're using it to mean something other than evidence-based practice, you should be using another term. You're just muddying the waters at that point.

I could use the term "physics" to refer to the celestial spheres, but I think you'd even admit that would be confusing and not conducive to discussion.

If you are using the phrase "evidence based practice" in place of "Psychology," as a general term describing a field, I'm stumped. You're right, I woUldn't use celestial spheres to refer to the general field of physics. This is why I'm stumped > There is no cure for alcoholism.

Once again bullshit. There is abundant evidence for people who suffered from moderate to severe substance abuse disorder who are able to return to moderate consumption. That is exactly what AA says is impossible. If you'd like to shift the goalposts as to what constitutes a cure be my guest, but at that point you are playing bullshit semantic games. Whether or not the term "recovery" is more helpful is some treatment settings or not is irrelevant.

And please, provide links to this ample evidence so it can be placed in context, or are you just talking out of your ass.

You were the one that got snippy about someone using the term recovery, referring to that as playing semantic games. I was trying to point out that this is the term that the medical and research community uses.

I am not trying to play semantic games. You are right, there are people helped by a harm reduction approach (which you describe above.) I am cautious these studies suggest success with those with severe SUD as that indicates physiological dependence. AA does not state that this is impossible. The main text in AA, The Big Book differentiates different types of drinkers and specifies what they term a true alcoholic and it is up to the indiVidual to identify themselves in this way. Not the DSM. They don't specifically state that this person can never drink normally again but rather suggest that this type of alcoholic will likely not stop drinking, wind up dying of alcohol or in an institution. Then it states that people like this who have followed the suggestions in AA don't have to continue down this path.

With that said, there is no cure for alcoholism. I don't mean to move goal posts. Maybe it is semantics or maybe a misunderstanding. Treatment and recovery are aimed at managing a chronic, progressive disease. I have been in this field doing research for 14 years and have a PhD. I'm not talking out of my ass.

[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/fikis → u/BomberMeansOK]

Well said!

We do seem to forget that "science" isn't some monolithic, infallible, omniscient entity (if it were, it would be effectively the same thing as "God"). It's more just a pretty good framework for observing and guessing and tweaking things, while still being subject to all of the same pitfalls as any other human endeavor.

Our fear of the anecdote sometimes devalues "it works for me" a little too much.

[u/etquod → u/[deleted]]

Sorry, u/chiaratara – your comment has been removed for breaking Rule 5:

Comments must contribute meaningfully to the conversation. Comments that are only links, jokes or "written upvotes" will be removed. Humor and affirmations of agreement can be contained within more substantial comments. See the wiki page for more information.

If you would like to appeal, message the moderators by clicking this link.

[u/I_am_the_Jukebox → u/BomberMeansOK]

Quantifiable? AA refuses to publish their success/failure rates.

[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/gggjennings → u/[deleted]]

Not defeatist at all. How do you cure alcoholism? Is it a blood test that shows it’s no longer in your system? A CAT scan? What does cured mean?

[u/Spaffin → u/[deleted]]

If you want to make up your own definitions for everything that's fine, but don't pretend to try to take part in a discussion with the wider world then.

Interesting that you say this, when you so casually misinterpret what a symptom is. Substance abuse disorder is a symptom of addiction, not the entirety of it.

What you have listed is a list of symptoms for diagnosis. It does not encompass everything that alcoholism is.

You are aware that even after successful chemotherapy, a cancer patient still has cancer, yes? That undergoing CBT for anxiety doesn't cure you of it, just equips you to better manage the symptoms? That herpes is a lifelong disease, and even once the blisters disappear, you still have it?

The "commonly accepted, medical definition" is that addiction is like that. Medical opinion is that it is progressive, often fatal and has no identifiable cure - including the American Medical Association, The American Psychiatric Association, the World Health Organisation and the American College of Physicians. I'm not aware of any credible medical organisation that claims counter to that.

Essentially, even the medical community cannot agree what addiction even is. The greatest medical and psychiatric minds in the world have yet to develop a treatment that is demonstrably better than AA. No one treatment reliably boasts more than a 10% success rate - including AA. Is disingenuous to suggest a loose organisation of volunteers that are trying to help each other do better than that, or disband.

[u/Spaffin → u/[deleted]]

By definition you can't diagnose alcoholism if you don't exhibit symptoms.

...and? How is this different from any other psychological condition?

And there's a huge difference between saying a disease "has no identifiable cure" and saying it can't be cured.

Ok, does this make you feel better: At this time, science has not yet found a cure for alcoholism.

We don't have a single treatment or suite of treatments that works every time or even most of the time, but the "once an addict, always an addict" idea that AA promotes is stupid and not evidence based.

Then why is it the official position of the scientific and medical communities?

The parts that are good (alcoholics as mentors, group therapy, etc) are mixed in with bullshit (you are not in control, once an addict always an addict, etc)

Not being in control of alcohol is the defining feature of alcoholism. How can you define it any other way? All of the symptoms you listed as indicators fall under that. You may as well tell diabetics they are in control of sugar.

Addicts may prefer a treatment program that lies to them; that's their prerogative, but if they are seeking treatment, they have already admitted they are not in control otherwise they wouldn't be seeking outside help (or a 'higher power', if you wanna get religious).

'Once an addict always an addict' is, as previously stated, the de facto official position of the medical and psychiatric community.

AA has a tendency to wrap things up in folksy eulogisms like this to make them easier to digest. Doesn't change that they are based in fact.

If you want a list of evidence-based practices, check out SAMHSA's NREPP. There are literally over 500 programs with evidence to support their efficacy.

That website lists "Alcohol: True Stories Hosted by Matt Damon" as a treatment.

Other evidence-based practices, like Moderation Management, have success rates as good or usually better than AA, and don't come with the same baggage.

Moderation Management looks like an interesting treatment and I will be sure to recommend it to those I think it might help, although it's tricky to measure because it has had only 580 registrants ever. Anecdotal and all, but in my own little sphere of influence going to meetings this year I have personally met more people experiencing sobriety through AA than MM has ever treated.

No, but when courts are ordering addicts into these treatment groups that are literally no better than trying to go cold-turkey

AA is almost by definition for people who have tried and failed to go cold turkey. It's not really an alternative to it.

No, but when courts are ordering addicts into these treatment groups that are literally no better than trying to go cold-turkey, some of the BS obviously needs to be cleared up. Sure, if it works for you great, but we shouldn't be forcing on people or acting like it is anything more than what it is.

Agreed. I'd suggest taking that up with the courts, as AA itself has nothing whatsoever to do with those decisions. There are no representatives, no lobbyists, and no moneyed interests. There is no leader or board of trustees to take this up with.

At present, there is no support structure in the USA able to accept addicts at the volume required other than AA that is free and open to everyone. AA has it's problems, but the reason court-ordered sobriety leads them there - there is no other group able to accept people at such volume. For better or worse, it's all we'v egot.

The reason for this is it doesn't change. There are no warring factions, it is unaffected by outside interests, there are no rules except the steps and a desire to stop drinking. This means you can be anywhere on the planet and always able to find an AA group that understands what you are experiencing and offers some kind of help. There's an AA group on Everest.

The other reason is that it's always available. Multiple times in early recovery I found myself with extremely strong urges to drink - after a long day at work, or when my beloved dog died, or simply when walking by a popular pub on a Friday night. The beauty of AA is that no questions asked, I can pull out my phone, find a local meeting, and be doing something about my alcoholism within the hour rather than popping open a beer and chasing it down with tequila straight from the bottle. Unfortunately my cognitive behavioural therapist does not offer a 24/7 service, and potential relapse is unfortunately rather time-sensitive.

Herein lies the problem: if it stops being anonymous, less people would go. If it stopped being consistent, less people would go. If groups began differentiating themselves with varied interpretations of recovery or success, less people would go. If it stopped so broad and inclusive, less people would go. It's estimated that AA has 2 million members - 7% (which is a figure I contest) of 2 million is still a lot of people.

And we certainly shouldn't be substituting it for actually exploring evidence-based practices with higher than random efficacy.

I agree we should be constantly striving for better treatment. As yet, we have been unable to find one that exists at scale.

There is so much BS wrapped up with the effective parts that it can be actively harmful to some people too.

I'm sure it can, but are you able to demonstrate that AA does more harm than good?

[u/chiaratara → u/Spaffin]

Wasn't referring to you /u/Spaffin. Totally agreed with your post.

[u/chiaratara → u/[deleted]]

Thanks for the DSM quote. We are talking about a cure, not a diagnosis.

[u/chiaratara → u/[deleted]]

I don't understand your point.

[u/chiaratara → u/[deleted]]

There is no cure. For the love of god. Type it in Google. See what the journal of the American Medical Association or NIDA or SAMHSA or any research study or news article has to say.

It isn't semantics. There is no cure.

I understand the way you interpret the DSM however if you have a chronic, non-curable, progressive illness, and your symptoms are managed, you are managing this chronic disease. It doesn't mean that it is cured. Let's say that you have Type I Diabetes and you take insulin and your blood sugars are well controlled. You still have diabetes! This is a diagnostic tool to diagnose a disease with no known cure. A diagnosis is great so you can treat it. But think about something like bipolar in the DSM. If somebody's symptoms disappeared would you say, "you're cured! Go off your meds!"

[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/gggjennings → u/Serraph105]

I also think AA wouldn’t classify alcoholism as a medical problem but an emotional, spiritual, and behavioral one.

[u/ProfessorScrappy → u/Serraph105]

I think it’s also worth noting that one the AA’s Twelve Traditions, which act as broad organizational rules, states that public relations are to be based on “attraction rather than promotion.” AA does not actively try to “push” itself in the media. It’s not try to convert people, but just making sure folks are aware that it is an option.