In 2017 medicine and medical treatment is in a new age. It is considered as some of the most advanced progress we have made as a society. Diseases have been eradicated and cures for some sicknesses previously thought incurable have been constructed. Yet there is still one disease where treatment is unchanged and has been left in the dark for over 80 years. Some of the reasons behind this are tied to the stigma that used to come with going to rehab but thanks to that tag going away new science and treatments are coming out for alcoholism. Alcoholism is a lethal disease that can lead to a myriad of problems that stretch from severe health issues to other alcohol related incidents such as drunk driving, domestic abuse, and death. Along with contributing to death excessive drinking cost the United States 226 billion dollars in 2006(Allie Bidwell). Yet the FDA has only approved three drugs to help fight alcoholism. Alcoholism afflicts over seventy-six million people worldwide (World Health Organization) and is responsible for hundreds of thousands of deaths worldwide. Yet the most popular treatment for alcoholism is Alcoholics Anonymous. Founded in 1935 by Bill Wilson and Bob Smith the program has barely changed since its founding. Some of the steps involve an open forum setting where you can talk about your issues. AA forces the participant to admit they are powerless over your drinking. It also forces them to create some sort of higher being or God that must serve as your guidance throughout the process. These methods are outdated and unsuccessful as AA only has a five percent success rate (Dodes). Alcoholics anonymous is not the best way to treat alcoholism due to its neglect for members and lack of individualization. Through multiple forms of therapy, medical treatment, and personal care much better results than the current ones from AA can be achieved.

There is a reason AA is the primary healthcare service used to treat AA and it dates to the 1950’s. When AA was created there was initially little support behind it. Support in terms of both medical research and membership were lacking. So to try and bolster their program Wilson and Smith tried to lure prominent public figure’s support for both publicity and money. This approach worked as they eventually caught the eye of the Rockefeller family who donated money to get AA off its feet. After this in 1951 AA was awarded a Lasker Prize for its contribution to public health. This led to AA becoming accepted without any evidence backing it up. When its popularity grew people who were involved with the program became involved with government and through different ways made it the premier way to treat AA. Since coming into power these ideals have remained the same and this is part of what has kept AA going.

When it comes to treating alcoholism, you must first look at the people treating it. Widely ignored by people looking to go into the medical profession, out of one million doctors only 582 are addiction specialists (Glaser, Gabrielle). Also, the requirements to provide professional treatment need to be revised. Per Glaser,” many states require little more than a high-school diploma or GED.” Fourteen states have no license requirements whatsoever even though they can be summoned to court or medical boards to testify. In twenty-eight states, only a GED is required to become a licensed addiction specialist(Glaser). Also most AA leaders lack professional training. With such a little level of education required it undermines the treatment alcoholics deserve. The evidence behind the effectiveness of Alcoholics Anonymous is also not very strong as a study done by the Cochrane Group, a healthcare research group, stated how there were no studies proving AA worked. Alcoholics Anonymous also creates its own success rates in its “Big Book” that it hands out. This misleads prospective members and gives them false hope in becoming sober. Glaser also states how AA “makes you think you must hit rock bottom to be able to find recovery.” That logic is extremely flawed as it might push people to get worse before they get better instead of seeking help. It also presents the illusion that people do not have power over their drinking. This is not the mindset to have because people do have control over their drinking and must realize that to get better. AA is not custom fit for everyone and can leave people who do not fit their mold feeling helpless. Individualized treatment options or at least more than just one option would help provide more help. In an experiment run by John Sinclair he gave Rats alcohol then cut them off cold turkey. After they were cut off for an extended period of time and then given alcohol again they drank more than they ever had previously. This disproves one of the main tenants of AA proclaiming you must not drink alcohol at all to recover. Moderate drinking is okay and AA does not accept that. Why did the rats go back to the alcohol? This is a question you must look at when studying AA. When treating an alcoholic you must identify why they want to drink and drink excessively and try to change their motivational factors. This can be done through therapy and trying to understand the patient and their individual needs. Sinclair also ran studies and published a peer reviewed journal describing the positive affects of an opioid antagonist called naltrexone. The idea behind it was that it blocks the endorphins your body gets from drinking alcohol therefore decreasing your urge to drink. Sinclair saw a seventy-eight percent success rate in reducing the patients drinks to ten or less a week. This is one of the many examples of other treatment options that are available and work better than AA. Later in the article Glaser reflects on how Finland treats alcoholics and how the US should take notes. The center she visits is cheap in the scheme of overall treatment centers. Their usual course of treatment involves “six months of cognitive behavioral therapy with a clinical psychologist. As well as a physical exam, blood work, and a prescription for an opioid antagonist.” This is much more in depth than treatment in America which can consist of glitzy houses and minimal treatment given someone who may not be qualified.  With no more new drugs in sight and the lack of professionalism alcoholics have nowhere to look but clinics with qualified individuals and other avenues of therapy. AA does not provide the therapy necessary to analyze why people drink and tailor their individual goals towards maintaining a healthier lifestyle.

Testimonies from even more researched and published professors debunk AA’s claims of success. Dr. Lance Dodes, a former professor of psychiatry at Harvard Medical School and author of “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry”, claims that the success rate of AA hovers around five to ten percent. This leaves up to ninety-five percent of people needing other kinds of treatment to overcome their problems. This is a double-edged sword as it does not provide adequate help it can discourage more people from seeking other avenues of help because they think AA is the only option. Dodes points out some more of the shortcomings of AA like how when the program doesn’t work out, it is the patients fault and not the programs. The patient must not have attended enough meetings or put in enough work when that is almost always not the case. Dodes also continues to say how in his interviews with former AA members that a lot of people who failed deeply disliked step 1 which was to admit they were powerless over alcohol. This is the wrong way to look at it because then people think they may not be able to overcome their alcoholism. They must realize they do have power over their problems and can take on and conquer them. The flawed logic of AA does little to help recovering alcoholics. Why go somewhere with such a low success rate when there are other options out there? People who through the program leaving worse than before and do not receive the treatment they really need.

In “Is Alcoholics Anonymous a Negativity Based Program” by Laura Tompkins a certified addiction expert, AA is shown how it is detrimental to recovering alcoholics. When you go to AA they approach with an attitude that you must never drink again. That moderate drinking is not okay. That is completely false because if someone can go from drinking too much to getting it under control they have succeeded in overcoming their alcoholism. Yet in the eyes of AA you are a failure. This neglects people who have succeeded and again makes people who need help feel awful. A critical part of AA is sharing your secrets and struggles with a stranger. While this may be helpful for some it can be extremely uncomfortable for others. Tompkins points out how this is hurtful to the victim because sharing this kind of information for advice with someone who is not an addiction specialist is not advised. Trying to seek advice from a stranger who is not professionally trained may not be giving the right guidance to people. Trying to work through these steps is a challenge for people who are not being given the right guidance or misunderstood by the program. Also Tompkins highlights how another uncomfortable part is admitting your problem to a higher power and seeking guidance through them. Some people do not feel comfortable doing this as they may not believe in a higher power or feel they are betraying their religion. AA has refused to acknowledge the presence of religion in their program even though God is mentioned in the twelve steps. A group of behavioral psychologists studied a particular AA group and analyzed whether the extreme presence of religion was helpful in AA. Their findings said no as religion was not found to be a major factor(Swora,Michelle). The misguidance and forced steps of AA actually end up hurting members and hindering them from recovering.

In “5 Reasons People Can’t Stand AA” by Martha Lockie the director of a Community Outreach program she also highlights some of the issues with AA. She also agrees that saying you are powerless over your drinking is not the best way to go about recovery. She also brings up the point on when receiving advice from strangers it can lead to disagreements and making people uncomfortable when bringing up topics outside of AA. While for some this might be a nice way to relax and connect it can create awkward situations for the participant and the group. You never know who is giving the advice and if they are in the right state of mind to be giving it. The founders of AA were devout Christians according to Lockie and this can be seen in the “big book” given out to participants and used at meetings. Yet Lockie argues against the forcefulness of AA in her meetings saying there are meetings for everyone but offers no proof. The reality is is that religion is in AA’s roots. It is in it’s steps that you must surrender to a higher power in order to achieve help which is not true. Help can be achieved in many ways most of which are better than forcing someone to believe in something or making them create a God. In “How Alcoholics Anonymous Works” by Michael Craig Miller a peer reviewed author from Harvard Medical school he explores some of the alternate options to AA. The first one he brings up is cognitive behavioral therapy. He wants drinkers evaluated by a psychologist to find out what makes them want to drink and what parts of the brain are affected by that. Is it pleasure? Is it to forget?  He then suggests that patients follow that up with motivational enhancement therapy. He wants to find out what motivates someone to drink and then change their goals. If you are motivated to drink because of doing poorly at work, then work on your work performance to help stop the drinking. He also suggested using other motivational tools to help curb alcoholism. Through these therapies Miller has seen higher success rates than the ones from AA and a smoother recovery with long term success.

Alcoholics Anonymous also acts as if it is a voluntary program once you have joined. In “Why Rehab Fails” by Sacha Scoblic, a former alcoholic and participant in AA, she points out how this is blatantly false. It’s steps are not a suggestion. Any tweaking or bending of them and you are deemed not a true follower. Scoblic said she has humiliated and rebuked when she did not follow the laws of AA perfectly. She points out the main flaw in AA’s framework is that when it does not work they say that you did not fit the program instead of the program not working for you. This is another example of AA inadvertently discouraging members and making them feel bad and making their road to recovery harder. A real life example is a story Scoblic tells of a drunk driver who was ordered to either go to AA or go to jail, “Three days before finishing the rehab program, the police came for her. The rehab had kicked Jessie out, claiming she’d “failed to accept a higher power” (step two). Freedom of religion was apparently not a valid excuse.” In Scoblic’s interviews she finds that some AA participants were punished for not following the rules by being forced to wear signs around their neck or having to share extremely personal secrets they did not want to tell. Scoblic also points out how people must be taught how to deal with distractions after finding recovery because after becoming sober they are usually just thrown back into the world. Some of the incentives mentioned that helped people quit drinking without the help of AA were getting paid for testing clean on drug tests, psychiatry, and medication. Psychology experts say that a recovering addict should be met with extreme attention and care yet you do not receive this in AA setting. Every person is different and needs personalized care which AA does not provide. 

As evidenced throughout the paper Alcoholics Anonymous is cleary not the most viable solution for alcoholism. With success rates estimated to be at most at ten percent it leaves other victims searching for other treatment. Sometimes victims do not even look for this other treatment due to the oppressive and discouraging nature of AA. They assume that if their program does not work for you then you must not be able to become better. Yet there are a multitude of other options to choose from. Whether it be different kinds of therapy that help analyze why you feel the need to drink and how to cut those things out of your life. The therapy can help create motivational enhancements and goals to reach to help sober up. There is also private rehab and medication. As shown in Finland some medication has been found to work and help reduce the urge to drink. Overall AA is an abusive program rooted in religion and beliefs about how to become sober but no concrete science. AA is not the best way to treat alcoholism and should not be the most popular around the world due to its poor practice.
