Alcoholics Anonymous vs Other Treatments

Alcoholics Anonymous has long been a treatment for alcoholism, and many, many addiction experts and people in recovery swear by the 12 step process. But what does the research show? How does AA stack up against other treatments for alcohol abuse disorder. There have been several high quality studies in recent years, and in this video Aaron will explain what they mean.

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Credits:
Aaron Carroll -- Writer
Meredith Danko – Social Media
Tiffany Doherty -- Writer and Script Editor
John Green -- Executive Producer
Stan Muller -- Director, Producer
Mark Olsen – Art Director, Producer

#healthcaretriage #alcohol #alcoholicsanonymous

[matthewmorgan]

This is extremely surprising to me. I did not vibe with AA at all. Fortunately, I had an extremely good support structure that has kept me sober so far. I might be one of the lucky ones in that regard.

[Michael-wsfi]

Alcoholic and heroin addict here. Completely sober since July 4th 2020 and glad to be here with you guys!

[Lumen_Obscurum]

The issue is, I believe the effectiveness of AA is due to the community aspect of it forging bonds and gaining understanding from people who actually understand them rather than simply claiming to. Essentially that community and support is the key counter to addiction rather than self-driven push.

[Atitlan]

AA has worked for me for 33+ years. I never would have dreamed I'd have the life i have now....I just coudn't have come up with the what AA program on my own. I tried tons of times ot stop but always got drunk again until I was presented to this program. It saveded me.
Having said that, I totally support anyone doing whatever or going wherever they need to go to treat thier addiction. My dad was a raging violent alcoholic...he went to AA for a while but didn't like it....he went to group therapy, church and some other groups and sobered up...most of all he got honest and made amends. He's been sober 30 yrs. My brother and sister sobered up in AA. They lead highly productive lives serving the community and being great parents. AA worked for them. I know people who tried but the 12steps just didn't stick.
I think it would be almost impossible to measure with accuracy the efficacy of AA. How do you define "success?". Sober for 1 year? 5 years? a lifetime?
So many come into AA, sober up and then move on and live sober lives. Many come in sober up, then get drunk again, and bounce back and forth...they leave and you never hear from them again.
A better study would be to compare groups of people with longterm sobriety to people that bounce in and out. Why do some stay sober and others don't?

[alexvancamp]

I'm a poly-addict/alcoholic. Addiction is a nightmare, especially when you're on more of the severe end of the spectrum. In fact, the 37% figure seemed optimistic to me, especially in my encounters with other addicts and alcoholics throughout my time in rehab and AA. Sobriety is possible, but the reality is that addiction is multi-layered; it's not uni-dimensional, which makes treatment difficult. There are biological factors, environmental, psychological, and cultural factors. When you break a leg, you just have to fix the broken bone. Additionally, most treatment programs do not last nearly long enough to undue years of destructive behavior. It's not that most rehabs suck; it's that they're not long enough and insurance often boots people out 14 days into their programs. A good, effective, holistic recovery program that focuses on addiction and mental illness, which two-thirds of addicts also have, lasts 3-6 months, and can cost $20, 000 a month. They're excellent, but not within the reach of 99% of addicts. That being said, you do not need rehab to get sober, necessarily. And you do not necessarily need AA as well. That being said, AA has helped the plurality of addicts get sober successfully. From my experience, AA captures the subjective experience of being an addict very well, and the raw emotion present at meetings can cut through the precarious mental landscape within an addict's mind, fostering a sense of peace and motivation. There are challenges when you first get sober that make relapse difficult to avoid. One, your life is a mess, and you have to navigate life with a flood of emotions that you're not used to feeling. Addiction destroys your stress regulation capacity. Depending on the drug you're coming off of, you will have to learn how to adjust to either a reduced or heightened sense of speed in your conscious state of being. Also, your relationships are likely fragmented, or cut off completely, leading to isolation. Additionally, you've forgotten how to enjoy your hobbies and interests sober. This is especially difficult. Finally, you've lost your sense of purpose in life. All of these things lead many back to using, besides the physical withdrawal. I highly recommend Suboxone for opioid addiction. Im a recovering opioid addict, and suboxone helped me get off prescription pain pills entirely. Many are opposed to it, especially in AA. However, it is an incredibly useful partial agonist of the opioid receptor, killing cravings for opioids for me altogether while eliminating withdrawal. For those with high opioid tolerances, it is really not possible to achieve a high on it, and increasing the dose has diminishing return. Ultimately, addiction is a disease that tells you that you don't have a disease. It repeats and repeats. Until you want to change ultimately with a new perspective, sobriety is difficult to achieve for many.

[TakeWalker]

Upwards of 37% efficacy may mean AA's better than other programs, but I still wouldn't call the "successful"...

[aureusyarara]

you're telling me that with the most successful treatment right now at best, at B E S T, 37% of alcoholics seeking to stop drinking remain abstinent?? holy fuck addictions are terrifying. we NEED to find better methods ASAP. I hope we can bring that number up in the future, people deserve to be free when they want!

[hunterGk]

I would imagine the reason AA works is because it goes some way to treating the cause of alcohol misuse. In my experience alcohol is used to self medicate, people who end up dependant are generally suffering from trauma of some description. It's a symptom which classical medicine treats as a disease in itself so I'm not surprised it's not very good. AA creates a supportive environment and connections, things that are missing in a lot of users lives, things that can't be fixed with CBT. I'd like to see a health care run programme that involved psychoanalytical therapy alongside community building exercises; fix the cause, don't just treat the symptom!

[Hanimex.]

I would be ok with AA if it didn't have the religious element to it. If there was a support system similar but without the religious connotations, I'd be more influenced to try it

[zaphodtoasty]

I note the measurement used was abstinence rather than an overall reduction in alcohol consumption

[carl]

Of course abstinence would be greater ... because other methodologies don't require abstinence, only avoidance of abuse.

[skepticalroot]

Did the research account for people being sentenced to AA meetings as a condition of bail or sentencing for OVI/DUI or public intoxication? Or to other programs?

[DoggyHateFire]

I quit drinking about seven years ago. I didn't go to AA. Instead I got hired on full-time and got health insurance. I was able to address my underlying mental health issues which gave me enough relief to finally quit. Those first couple of months of sobriety were so hard and I had nobody. I didn't tell anyone I quit until I was fairly sure I wasn't going to screw it up. It is easily the hardest thing I've ever done but also the greatest decision I've ever made. I'm glad AA helps a lot of people, but I don't like how some in the program think there is no other way to stop drinking. The program can never fail you, you can only fail it and I'm sorry, that's some cult-like shit. I was completely sober for two years, but since then I've drank very very little. Literally one or two times in a year and I never have more than three drinks. I can't even remember the last time I was actually more than buzzed. I'm sober for all intents and purposes, but a lot of AA members would of course say I'm not sober or I was never an alcoholic which is just absurd on it's face. It's unfalsifiable BS.

[SuperDoNotWant]

And further "abstinence" should not be the goal. Normalised behaviour should be the goal as it is with any other mental health disorder. Having to entirely avoid alcohol is certainly not "remission" it's just being a dry drunk.

If you can have a drink or two and stop there, then you're in remission. Then you're well.

Why are we teaching people struggling with alcohol abuse that they are incurable? Irretrievably broken? What kind of crazy "treatment" is that? Again it just seems to me that we want to avoid having to see the gross, sloppy drunks, but otherwise they're free to inflict their normal emotional harm on themselves and others.

[DrOmni]

Despite its efficacy, I'm extremely weary of AA and its methods. AA constructs its program much like a cult would, and breaks down psychological barriers in ways that prods my moral compass to unsettling effects. It's not just a measure of curing an addiction, but settling into a specific culture that treats abstinence as a prerequisite. When people who attend are already vulnerable, this ulterior motive puts a bad taste in my mouth, despite the results.

[_chpset]

What about other non-AA group therapy type treatments? I feel like the only part of AA that is of any material benefit to struggling alcoholics is the gathering of individuals to make connections and build a support system for each other. Anything more simply cannot add any value to it, unless they were on multiple treatments at once. A combination of CBT, group therapy and perhaps some medicinal approach. We have a strong propensity for using the cheapest solution for complex problems in our society. But often, the cheapest solution isn't best.

[bekkayya]

I'm really uncomfortable with this video uncritically promoting the raw numbers of AA without addressing the real negative externalities it has that the other commenters here have pointed out. You might see why if you read the replies to the comment sections and notice the common posters and how they're acting.

[JustCallMeAnonymous]

I sometimes wonder if it is the actual content of the AA program that is more successful than other treatment or if it is that it is easily accessible, you can attended multiple times a day if needed and there is a community of support around you. As far as I've seen there isn't another program with that same reach. So I think it is hard to tell whether it is the actual 12 steps that help or the other aspects because going to CBT once a week or meeting with a therapist isn't really equivalent. Also I think we should continue to research more into treatment because regardless of the program the success rate is unfortunately low.

[jimkirby]

Now we need a random controlled study to determine whether all the god-talk in AA is of any value whatsoever. Along the same lines, we need a similar study to determine if "thoughts and prayers" offer any positive benefit to accident and disease victims and their relatives. If they do, we should pay people to think and pray and if not, we should cut out the god-nonsense.

[paxundpeace]

This might be a reason to procedure some more episodes on this topic.
Are similar programs for other drugs working too?