“Keep coming back, it works if you work it!”

This is what is chanted at the end of every meeting, but what if you have “worked it” and you still keep going back and getting drunk or loaded?

Now, most people in the program will say things like, “Well, you must not have really done the steps right,” or  “You didn’t go to enough meetings,” or  “You didn’t pray to your Higher Power,” or “You know you did something wrong or else you would still be sober!”

Since what you are told from your very first 12-step meeting is, “Your only options are to get sober using our Program, or it’s jails, institutions or death,” you tend to stop thinking for yourself, (since it was your “best thinking that got you here“), stop questioning, and just follow what other’s tell you to do.

This would be fine if this is what worked… but unfortunately, evidence is proving otherwise.

The 12-step success rate is showing to be approximately 3 percent. Yes, that’s right… only 3 percent! (Brown,Treatment Doesn’t Work, 1991). Here are some more startling statistics:

•  45% of the people who attend Alcoholics Anonymous meetings never return after their first meeting.
•  95% never return after the first year.
•  5% retention rate (Based on Alcoholics Anonymous World Services' own statistics).
•  93-97% of conventional drug rehabs and alcohol treatment centers are 12-step or AA based, so those who leave AA to look elsewhere, such as conventional alcohol and drug treatment for solutions, are essentially rejoining AA!

AA hardly sounds like a “proven method,” let alone one that works for most people. So, if only about 5% of the people are getting the help that they need, what about the 95% of the people who are not being helped? That is the purpose of this article… to provide much needed awareness to individuals, rehabilitation centers, hospitals, sober livings, and even 12-step programs themselves so that people with substance abuse problems can be helped.

The bottom line is this… is the goal to get alcoholics and addicts into AA or NA or CA, or is it to actually get them help?

Let me mention from the start that I think 12-step programs are wonderful for those individuals who it does work for. I have seen it change many lives for the better, including my dad, who has now had 15 years of continuous sobriety, maintaining his sobriety from his very first meeting.

It is also a great fellowship to share experiences, strength and hope. So, in no way am I anti-AA.

However, it is becoming clearer to me that substance abuse is not a “one size fits all” problem, and therefore, there can not be a “one-size-fits-all” solution. 

The National Institute of Drug Abuse, NIDA, has even gone on record to emphasize that no single addiction treatment method is right for everyone. They claim that matching treatment services to each individual’s specific needs is critical to success.

In addition, research studies indicate that even the most severely addicted individuals can participate actively in their own treatment, and that active participation is essential for good outcomes. According to the NIDA, counseling, either individual or group, and other behavioral therapies are critical components of effective treatment for addiction.

It’s interesting to note that participation in a 12-step program was never mentioned anywhere in this research based guide which discussed the principles of effective treatment. 

Reliance on outdated and ineffective treatment methods has created an environment that fully expects individuals to fail, and fail again until such time that rock bottom has been reached.

It is often said that once an individual has reached rock bottom that there is only one way to go, UP. The problem with that philosophy is that for many people, the ultimate rock bottom is death. (Vacovsky, Executive Director, American Council on Alcoholism, May 12, 2005).
 
Vacovsky goes on to write:
 
“Many, (if not indeed most) alcohol dependent individuals have lost faith in themselves, and more importantly hope for the future. It is common for such individuals to have numerous attempts at sobriety, most often using 12-step methods. They have been programmed to accept themselves as hopeless and powerless, with their chance for recovery being slim to none… It is up to the individual to determine what the most appropriate treatment is. It is up to the treatment community to provide options that set up individuals to succeed, rather than be expected to fail (italics added).”
 
Sadly, Americans are largely unaware that such options even exist. At least, the general public is. While the public is being told that “turning your will and life over to the care of God as you understand Him,” as AA suggests, is the only treatment for their illness, scientifically based research has been going on for decades. Results of this research are threefold:

1. We now have options for treatment that are based on science rather than fundamentalist religion;
2. Gives back choice and a sense of control to the individual, which is proving to be extremely important and
3. We now have evidence that is in direct contradiction to the traditional view of problem drinking.

What, exactly, is the research finding? Here is what some of the experts in the addiction field state have found:

•  Well-designed research conducted over more than three decades has conclusively demonstrated that problem drinking will not inevitably get progressively worse, and that this is one attribute of being a “disease” of alcoholism is simply wrong. Some problem drinkers “progress,” but the vast majority don’t.
•  What most Americans believe about drinking problems and their treatment is substantially inaccurate.
•  Drinking problems do not occur as a result of a disease. It is a learned behavior, and additional learning can therefore modify behavior.
•  For no other “disease” do so many physicians, psychologists and counselors themselves believe in the non-research-based myths of problem drinking, ignoring the research of their own peers in developing their treatment plans.
• “Problem drinkers in the United States are faced with a daunting dilemma when they seek help. They can either accept the prevailing myth that abstinence is the only effective means to resolve a drinking problem, or they can be accused of being “in denial…”
• Insistence by treatment programs to only offer abstinence has been shown to deter many problem drinkers from seeking treatment.
•  Individualizing treatment is crucial.
•  Chronic “relapsers” can actually be harmed by the 12-step model view that once a slip has started, you are powerless to stop; the stronger one’s belief in this is the longer and more damaging the relapses are.
•  The confrontation and treating alcoholics and addicts like children commonly thought necessary to help them actually often hinders any change.
•  Many providers deliberately resist change because they have too much of an attachment to their own ideas of what should work, claiming, “I know what worked for me, and I’m sure that it can work for everyone else as long as they just do what I say.”
•  The only way to resolve a problem with alcohol is to abstain for life is wrong for the majority of people. A substantial proportion becomes moderate drinkers even when achieving abstinence is the primary focus of treatment.
•  Dr. Patricia Owen, Director of Research of the Hazelden Foundation, who was a long-time supporter of abstinence-only treatment, referred to these individuals as “in recovery without abstinence” and acknowledged their presence in large numbers among a sample of Hazelden graduates.
 
Of course, not even all scientists agree on the nature of and best treatments for alcohol abuse.

But this is the twenty-first century, and no one would disagree that all patients suffering with an alcohol or drug problem have a right, just like any other patient suffering with any other problem, to be fully informed of the available options, the risks or areas of uncertainty, and, after reviewing the relevant information, in consultation with one or more providers, choose a course of action.

This is simply good, ethical medicine.  Should people struggling with substance abuse issues accept anything less?

It is also important to acknowledge that recovery programs are not necessary to discover how to quit and stay quit.

The following is from the Harvard Medical School’s Mental Health Letter, the August/September 1996 issue:

    Most recovery from alcoholism is not the result of treatment. Only 20% of alcohol abusers are ever treated… Alcohol addicts, like heroin addicts, have a tendency to mature out of their addiction…
    In a group of self-treated alcoholics, more than half said that they had simply thought it over and decided that alcohol was bad for them. Another group said health problems and frightening experiences such as accidents and blackouts persuaded them to quit…
    Others have recovered by changing their circumstances with  the help of a new job or a new love or under the threat of a legal crisis or the breakup of a family.

Study results from addiction researchers, Doctors Linda and Mark Sobell, confirm Harvard’s 20% treatment statistic:
 
Surveys found that over 77 percent of those who had overcome an alcohol problem had done so without treatment. In an earlier study… a sizable majority of alcohol abusers, 82 percent, recovered on their own.

However, even though it is possible to recover on your own, you may want a recovery program, or at least a licensed professional for support. 

The good news is that many more treatment programs are starting to provide more evidence-based options beyond just the traditional 12-step approach, and this list is growing everyday.

It is finally time to stop living in the dark ages of recovery, educate people about all of their choices and alternatives that are out there and maybe start making a dent in the alcohol and drug use problem that millions are facing each day instead of continuing to perpetuate it.

If you are one of those people who still believe that the 12-steps are the “only way” to recover, I implore you to have an open mind.

In fact, Bill W., one of the co-founders of AA said, "It would be a product of false pride to claim that A.A. is a cure-all, even for alcoholism." Bill W. repeatedly said that "our hats are off to you if you can find a better way" and "If [those seeking a different cure] can do better by other means, we are glad."

About the Author

Melanie Solomon is the author of “AA-Not the Only Way; Your One Stop Resource Guide to 12-Step Alternatives”.

She also speaks to teens at The Huntington Beach School District Drug & Alcohol Program, and leads workshops at The Learning Annex.

Please visit www.aanottheonlyway.com for more information or to sign up for your FREE discussion forum membership and updates. Books also available at www.naadac.org in their bookstore or www.amazon.com.