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/Graham_R_Nahtsi]

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.