From: carnes@quip.eecs.umich.edu (Richard Carnes)
Newsgroups: alt.recovery
Subject: Re: AA beliefs?
Date: 15 Sep 92 23:51:53 GMT
Organization: University of Michigan EECS Dept., Ann Arbor

altshule@skid.ps.uci.edu (Eric Altshuler) writes:

>>The admittedly sparse empirical evidence (it's extremely difficult to
>>do reliable research on AA) indicates that the AA program is an
>>effective treatment for a small minority of problem drinkers
>>(something like 5-10 percent); the great majority would be better off
>>with different recovery methods.
>
>5-10 percent?  Where do you get these numbers?  You must have read
>them somewhere, heard them somewhere, or made them up.  If you read
>them somewhere, I would be very interested in the source.  

According to AA's 1989 triennial membership survey, only 5% of those
who attend AA meetings continue attending for a year or more.  Of
course, some of these are "repeaters" who have been to AA before, so
the true percentage of all who have ever attended AA who stay with it
for at least a year would be somewhat higher than 5%.  But of these 5%
or more, nowhere near all of them attain long-term (say 5-year)
sobriety.  So this is one way of getting a ballpark idea of AA's
success rate, if we define it as the percentage of all those who have
ever attended AA meetings who achieve long-term sobriety.

If you define the success rate as the percentage of those who "work
the program", you run into two problems.  First, how do you define
working the program?  You can't define it as "staying sober"; staying
sober is the treatment *goal* (or the main one), not the treatment
itself.  Second, what about the huge numbers of people who attend AA
and then quit the program, for whatever reason?  Do we say it's their
own fault for rejecting AA because of "character defects", "lack of
honesty", "lack of motivation", and the like?  If so, we are returning
to the bad old days before AA when alcoholism was regarded as a moral
failure.  Let's be more honest and say that for these people, AA has
not worked, at least so far.

This is the problem with the statements like "the program works" or
"it works if you work it" that we read every day in a.r.  If they just
mean "the program works for me", no problem.  But they also might mean
"if you don't follow the program, you have only yourself to blame if
you fail to achieve sobriety", which is pernicious BS.  It's going
back to blaming alcoholics for their condition, putting oneself on a
pedestal of superiority, looking down on the "sinners" who stubbornly
refuse to repent and be saved.  But just as you have good reasons for
working the AA program, others have good reasons for rejecting it.
E.g., to many people AA is a "cure" worse than their "disease".

>I am a member of AA who feels not enough science, medicine,
>psychotherapy, and other methods are discussed.  But I am looking for
>only information with sources.

Here are a few sources on the effectiveness of AA (and other
treatments), with some quotations:

W.E. Miller and N. Heather, eds., TREATING ADDICTIVE BEHAVIORS, Plenum
Press, 1986, pp 135-36, 161-63.  "Given the absence of a single
controlled evaluation supporting the effectiveness of A.A. and the
presence of these negative findings, however, we must conclude that at
the present time the alleged effectiveness of A.A. remains unproved."
(p 136) "American treatment of alcoholism follows a standard formula
that appears to be impervious to emerging research evidence, and has
not changed significantly for at least two decades." (p 162)

R.K. Hester and W.R. Miller, eds., HANDBOOK OF ALCOHOLISM TREATMENT
APPROACHES, Pergamon Press, 1989, pp 165-68.  "Therefore, although we
see AA as an important component of treatment and recovery, the data
do not exist to support the widespread belief that AA is the *most*
effective treatment for alcoholism." (p 168) 

C. Holden, "Is Alcoholism Treatment Effective?", SCIENCE 236: 20-22 (3
April 1987).  An overview of the state of research in 1987.  "As the
heterogeneous nature of alcoholism and alcohol abuse is increasingly
recognized, the focus has turned to identifying characteristics that
will predict whether a patient will benefit from treatment, and to
'matching' particular patients to particular treatments."  "The field
is clearly in need of more refined treatment strategies based on a
better understanding of the needs of individual drinkers.  Research on
Alcoholics Anonymous, which is by far the most widely used recovery
program, would provide invaluable information on what helps what kinds
of alcoholics stay sober, but AA does not like to have researchers
around, and the shifting population in any case is difficult to
follow."

Richard
Newsgroups: alt.recovery,talk.politics.drugs