Dirk,

I take offense to the inherent bias in your comment. You evidently subscribe to the AA/abstinence model of treatment/recovery, and in my experience most who subscribe to this model do so with blind dedication.

Many statistics, including those from AA itself, show that the 12 step model has a very low success rate, with 5% remaining in the program after one year.

Furthermore statistics in a clinical setting by a pro AA researcher also demonstrated that the 12 step participants suceeded at a lower rate than natural remission, had increased hospitalization rates upon relapse and had a higher death rate, meaning a negative success rate.

This is not to say that 12 step programs are not beneficial to anyone. Predictors of successful outcomes to 12 step abstinence programs were: (1) coming from a judeo-christian background, (2) experiencing severe consequences to their drinking such as homelessness, job loss, loss of access to children, divorce, etc., and (3) a strong desire to abstain entirely prior to entering the program.

The reason that 12 step programs have a negative success rate are simple.

First, the emphasis on complete abstinence, and emphasis within the groups on the length of time sober (seniority) encourages an abstinence-binge cycle. A participant who is sober 364 days who has a single beer at a backyard BBQ in the hot sun will see their 24h, 3, 6, & 9 month chips become worthless, and no non sociopathic person could accept their 1 year cake the next day without tremendous guilt, especially given the honesty focus of the program. Therefore, many who slip after a long period of sobriety will relapse and relapse hard because they may as well make it "worth it". Between the increased effects of alcohol due to lower tolerance, and the feelings of guilt and failure for breaking abstinence, severe relapses with serious consequences are more likely to occur, including suicide.

Second, the religiousness of the programs turns off many people, even on some occasions those who may already be religious and beleive in a Judeo-Christian version of God. It is a bitter pill for many to swallow that the program urges participants to surrender to, pray to, and ask God to remove their "defects of character", and strip them of their dependence on alcohol. A common inquiry made by skeptical participants is, "why would God strip alcoholics of their problem by following the 12 steps of AA but not by simply being devout in ones faith", which is an excellent question as there are many devout alcoholics.

Finally, the premise of AA and its religion is somewhat sleight of hand. AA outwardly states it is spiritual not religious, and participants may feel tricked when they progress from simply attending meetings to working the steps. In the "big book" chapter "we agnostics" it specifically addresses this, encouraging members not to focus on God when dealing with skeptical "prospects", as they can be of service to God later in the program. This betrayal by AA members claiming the program is spiritual not faith based when it actually is can, and does, result in newcomers leaving the program in disgust.

Furthermore, on the subject of modern society, AA members become insular and isolated in a nearly cultlike fashion. The solution to having a craving for alcohol is to attend more AA meetings. Failure to remain sobers solution is to do the 12 steps over again. Replacement of addiction to alcohol with an addiction to AA is the solution for many, with participants having little other than AA and employment in their lives. They are still obsessed with alcohol, merely now obsessed with not drinking rather than being obsessed with drinking. Anyone who has attended a few AA meetings realizes this very quickly.

Finally, we live in a society where alcohol is widely used and socially accepted. Almost all weddings, work functions, sports games and leagues, even church functions and toddlers birthday parties, among most everything else. Being abstinent leaves someone feeling as an outsider at most social gatherings and often brings embarassing probing questions as to why one would be abstinent. Temptation is rife, and when you put this at odds with the abstinence-binge cycle it is easy to see that the AA/12 step/abstinence approach will not only not work for.everyone, but may cause them harm.

The 12 step model has not changed in 80 years. There are several other methods with much higher efficacy, with brief intervention by a healthcare professional showing the strongest results. The Sinclair Method, the front line approach in Finland, boasts of an 80% reduction in drinking to safe levels and a 25% abstinence rate, which is 5 times the efficacy of AA. The Sinclair Method encourages patients to continue drinking, and they reduce consumption all by themselves.

If my doctor suggested that he would treat my ailment using prayer and treatment from the 1930s, I would complain and likely he would lose his license. Yet this is what we are doing with 12 step/ AA / abstinenfe programs today.

It is high time the treatment establishment woke up and realized that 12 step and AA does not work, and to embrace modern medicine and psychiatric advances which are evidence rather than faith and abstinence based. The solution needs to fit the patient, not the practicioner.

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