This paper by Cathleen A. Mann examines the shortcomings of the 12 steps program.

In summary,  AA operates in a cult-like fashion, and does not consider the individual differences of the person entering the AA program. Additionally, AA has been atheoretical, anti-medical, and anti-research since its inception in 1935.

Mann, Herman & Heinz (2000) state that pharmacological treatment of addiction in general have had the most success.

Relapse is viewed as "neuroadaption, sensitization, and monoaminergic dysfunction," all occurring physically within the brain and  having nothing to do with acceptance or, or lack thereof, a spiritual awakening.

Criticisms of the AA:
Highly male dominated in administration.
Makes no provision for non-religious or atheists.
Antipsychotherapy and anti-medication (Ketcham, Asbury, Schulstad & Ciaramicoli, 2000).
It has not adapted in the light of new research over the last 65 years.
Despite evidence to the contrary, the AA believes that alchoholism has a moral cure.
According to Trimpey (1998), AA is cult-like in its approach.

From article: Therapeutic groups versus 12-step groups: An analysis of the AA prototype, by Cathleen A. Mann
http://www.geocities.com/drugsandalcoholinfo/webpagesandpapers/othergorupsvsaa.htm

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Advocating abstinence.

The 12-step programme only appears to help a small percentage of the population. Drop out rates are over 90%.

According to psychologist Marc Kern, the AA's treatment has not kept up with current research. According to Dr. Alan Marlatt, the idea of abstinence keeps most alcoholics out of treatment. Richard Banton, who followed the AA program for six years, felt like a social outcast while in treatment. Although sober, he was uncomfortable with the methodology. "[With AA], you are terrorized to fall into line... Anytime you say anything that conflicts with their model, then you're in denial."
http://www.addictioninfo.org/articles/30/1/Drinking-Are-You-In-Control/Page1.html

A study by RAND Corp. found that for some categories of alcoholic abstainers were at greater risk of relapse than moderate drinkers. This was backed up by research from Mark and Linda Sobell in the early seventies.
http://reason.com/0011/fe.sp.after.shtml

12 step programs may be contra-indicated for women with Post-Traumatic Stress Disorder. AA meeting may be too confrontational for some cases.
http://www.angelfire.com/wi/theosis/aaspirit.html

According to a report by Robert Westermeyer, PhD, the 12 step program advocates abstinence whereas research shows that for non-severe problem drinkers, moderation is an attainable goal. (Sanchez-Craig, et al.,1984; Miller et.al., 1980. 1981; Marlatt, 1989).
http://www.habitsmart.com/motivate.htm

According to psychiatrist Lance Dodes, 12-step programs fail because they don't address the underlying problem behind addictive behaviour.
http://www.talentdevelop.com/addictions3.html

American medical association - bio-chemical addiction.
http://aaaacheers.com/book_overview.html

The spiritual based system of AA means that atheists object to the program. In 1990, Robert Warner was by court to attend AA. He sued the probation service saying that it was unconstitutional for him to be sentenced to attend the 12-step program, which relied on God and a "higher power" as its method of addressing alcoholism, and at which prayer was a regular feature. This article also discusses how AA is no more effective than other treatments.
http://reason.com/0105/fe.st.drunk.shtml

According to Jack Trimpey - AA dropouts were afflicted with persistent self doubt and 'relapse anxiety, ' specifically related to their recovery group experience. Others also acquired a variety of emotional problems during their participation in AA.
http://www.rational.org/DPI.html

According to Mitch Bailey 'AA is trapped in a sexist and classist time-warp.'
http://www.bee.net/cardigan/attic/guest09.htm

What works and what doesn't. Research has shown that other methods work better than AA.
http://www.drugtext.org/library/articles/peele1.htm
http://www.addictioninfo.org/articles/53/1/What-works-A-summary-of-alcohol-treatment-research/Page1.html

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Individual experiences.

Marc Kern had great difficulty with the religious flavor of the programme and the embarrassing public pronouncements.
http://www.habitdoc.com/about_my_addictions.htm

The Stanton Peele Addiction Web site has a number of testimonials including "AA was helping me to continue to feel that I was a failure and unable to manage my own life, therefore I was unable to look at myself in a positive light."
http://www.peele.net/aab/escape.html

AA member - coercive and manipulative.
http://www.peele.net/aab/cultlike.html

Further testimonials can be found at
http://www.peele.net/aab/

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Books

According to a review for this book, the 12-step program was written by and for a group of individuals of a specific gender and socio-economic group - WASPy men of the 1930's.
Many Roads One Journey: Moving Beyond the 12 Steps by Charlotte S. Kasl

Books about the failure of the 12-step plan.
http://www.peele.net/bookstore/index02.html

The Real AA: Behind the Myth of 12-Step recovery.
http://www.aadeprogramming.com/choose/books_deconstruct.html

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