Does alcoholics anonymous work?

Explain how substance abuse treatment works and what family interventions can look like. It explains how substance abuse treatment works, how family interventions can be a first step to recovery, and how to help children from families affected by alcohol and drug abuse.

Does alcoholics anonymous work?

Explain how substance abuse treatment works and what family interventions can look like. It explains how substance abuse treatment works, how family interventions can be a first step to recovery, and how to help children from families affected by alcohol and drug abuse. Its 12-step faith-based program dominates treatment in the United States. However, researchers have debunked the fundamental principles of the AA doctrine and found that dozens of other treatments are more effective.

Gerald Zeigler, a 44-year-old in Montana, said he is religious, but the 12 steps still didn't work to deal with his alcohol addiction. In 1952, Jellinek pointed out that the word alcoholic had been adopted to describe anyone who drank excessively. Bill Wilson, founding father of AA, was right when he insisted 80 years ago that alcohol dependence is a disease, not a moral failure. To get a glimpse of how treatment works elsewhere, I traveled to Finland, a country that shares with the United States a history of prohibition (inspired by the American temperance movement, the Finns banned alcohol from 1919 to 193 and a culture of excessive drinking.

When my book came out, dozens of Alcoholics Anonymous members said that because I had challenged AA's claim of a 75 percent success rate, it would hurt or even kill people by discouraging attendance at meetings. In 1970, Senator Harold Hughes of Iowa, a member of AA, persuaded Congress to pass the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act. Psychologists and psychiatrists, trained to provide cognitive behavioral therapy and motivational enhancement therapy to treat patients with alcohol use disorder, may struggle to admit that lay people who lead AA groups do a better job of keeping people in the wagon. However, over time, a heavy drinker's brain adapts to the constant flow of alcohol by producing less GABA and more glutamate, leading to anxiety and irritability.

Many people who meet the AA definition of “alcoholic” have successfully returned to controlled alcohol use. We once thought of drinking problems in binary terms, either you were in control or not; you were an alcoholic or you weren't, but experts now describe a spectrum. If you are concerned about your own or someone else's use of alcohol or other drugs, you can contact the National Alcohol and Other Drug Hotline at 1800 250 015 for free, confidential counseling. People with alcohol problems also suffer higher-than-normal rates of mental health problems, and research has shown that treating depression and anxiety with medication can reduce alcohol consumption.

Less than 1 percent of people treated for alcohol problems in the United States are prescribed naltrexone or any other medication that has been shown to help control alcohol use. However, the results of well-designed research called Project Match, published in 1997, suggest that AA may ease the transition to sobriety for many alcoholics. Alcoholics and Narcotics Anonymous are 12-step peer support groups in which people who have problems with alcohol or other drugs are supported by others who have had similar problems (“peers”), rather than professionals.

Warren Dicola
Warren Dicola

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