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The Science of 12-Step Programs
Hugh Pickens DOT Com writes "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists. But there is an interesting read at National Geographic where Jarret Liotta writes that new research shows that the success of the 12-step approach may ultimately be explained through medical science and psychology. According to Marvin Seppala, chief medical officer at Hazelden and sober 37 years, attending 12-step meetings does more than give an addict warm, fuzzy feelings. The unconscious neurological pull of addiction undermines healthy survival drives, causing individuals to make disastrous choices, he says. "People will regularly risk their lives—risk everything—to continue use of a substance." Addicts don't want to engage in these behaviors, but they can't control themselves. "The only way to truly treat it is with something more powerful," like the 12 steps, that can change patterns in the brain. Philip Flores, author of Addiction as an Attachment Disorder, says the human need for social interaction is a physiological one, linked to the well-being of the nervous system. When someone becomes addicted, Flores says, mechanisms for healthy attachment are "hijacked," resulting in dependence on addictive substances or behaviors. Some believe that addicts, even before their disease kicks in, struggle with knowing how to form emotional bonds that connect them to other people. Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that.""
I would suspect that programs such as these do work, because they provide a means of seeking help, support and resisting temptation, instead of having no direction to go but down.
Donte Alistair Anderson Roberts - hi son!
Karma: Chameleon
in order to get back to the healthy, socially expected addiction to people. Makes sense.
had to quit it due to pancreatitis. fuck twelve steps, fuck the AA, fuck the higher power, fuck the addiction treatment industry.
you see what's wrong with for example the AA 12 steps? 8 of the steps are "whee I'm a christian now and can't be judged for raping my cousin" and the rest are pretty much "It's not my fault I am/was an asshole". it's bullshit.
not fucking one of the steps is to ACTUALLY STOP DRINKING! and half of the steps are practically just setting up that it's not their fault if they drink!
here's my two step program.
1) stop drinking.
2) try to fill the time with something to make things feel as fun as when drinking.
step two is hard, because, hey, drinking is highly enjoyable.
(* due to having stopped drinking, I find myself unable to stop posting obnoxious poorly spelled comments to slashdot, but hey, it works. btw if you drink, don't be an asshole. AA is geared for people who are so big assholes they can't even go to the corner shop sober because they know they're such dicks when they drink, which makes for a sorry loop).
world was created 5 seconds before this post as it is.
It's been said in the comments on the NGS web site, but it's worth repeating here: The article starts from the presumption that 12 step programs are effective, based on the fact that they are popular. The actual science on twelve step programs says something else entirely.
http://www.nytimes.com/2006/07/25/health/25drin.html?_r=1&
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/abstract
Coming up with a "scientific explanation" for how AA "works" without any demonstration that it actually DOES work seems like a load of horseshit, not to put too fine a point on it.
If there's anyone who wants to quit but doesn't like AA for whatever reason, I can recommend Naltrexone and the "Sinclair Method".
The problem with 12 step programs isn't the people who they work for, the problem is that so often they are presented as the only option. Not everyone who has ever used any addictive substance has no control over themselves.Some people used them for different reasons, and those people are often forcefully pushed into these 12 step programs right along side the people who need them.
Most schools are trying to come to terms with the fact that people learn differently, when will treatment programs come to terms with the fact that people recover differently?
As a former heavy smoker I can tell you, I did want to smoke. Hell yeah. It felt good. It was relaxing, it was soothing, it was great. Don't give me that "I don't want to smoke but I can't stop" bull. You want to smoke. At least admit it. You may not like the coughing and the shitty taste in your mouth in the morning (no, really...), you may not like how people react to you, but you do like the cigarette (or in my case, cigar), the moment you light that fire you WANT it. Don't gimme any of that crap that you light it with remorse, you don't. You lean back, you put it in your mouth, you light it, you inhale, you enjoy it. Face it, that's the truth. Lie to yourself if you prefer, but that's simply how it is.
Was I an addict? I guess yeah. Did I like to stop? Yeah, I did. But mostly because for some odd reason from one day to the next the craving stopped. I lighted the cigar and it was not enjoyable. I did not like it. I simply didn't. I put it down and that was a few months ago now. The cigar is still lying where I put it, ready to be smoked at any time. I just don't want to.
Pretty much at the same time some important changes came to my life and I think it's pretty much how you described it. The drug was a substitute. Once it's no longer needed, it will cease to provide the enjoyment that it once did. That certainly doesn't work for everyone, but nobody should give me the bull that he doesn't like his drug. If he didn't, he'd simply drop it. Addiction is nothing but a craving that you want to fulfill. A quite heavy craving, I may add, but it's still you that decides whether or not you give in or whether you look for other ways to relax and enjoy.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
I am a strong advocate of whatever works.
It doesn't matter who is right or if its the best way or stupid or God or placebo effect. I think the issue is that human beings effect one another and that people with problems of any kind do have an affect on the people around them. These problems may be the result of their experience of the people around them. Whether or not addiction is a choice or a disease or a spiritual or a social disorder really does not matter. What matters is that those who may be afflicted with this dilemma attempt to engage with society in a way that will help to resolve behavior that is inevitably harmful to the self and to the people around them. I don't mean to judge others, each individual can make that determination for themselves. But if it seems that there is wreckage and damage to themselves and to others, and if it is difficult to ascertain how to get a handle on the situation, then its a pretty good bet that engaging with other human beings might be a good starting place.
While it is also true that 12 step programs derive from a spiritual, albeit even Christian flavored template, that in no way limits an individuals personal approach or beliefs. Its just a social venue in which to engage with fellow addicts. And yes there are all kinds of people out there, from the weird to the mundane. Some with "fight club" agendas and some working on a date for Saturday night. Many are addicted to 12 step groups and some are stoned and court mandated to attend. Whatever. It doesn't matter. Its like the rest of the world - there are all kinds. But if you try to do SOMETHING, try to engage with others in a way conducive to new behavior, or another perspective, then its a good place to start.
Why a 12 step? Because its all around, in pretty much every town in the western world. It is anonymous. It is inclusive of anyone who can just be present and listen. It costs nothing. You can leave at any time. If you don't like the kooks or freaks or holy rollers or drunks then just go and find a group that is normal like you. Or blow it off. Nobody will stand in your way. Just know that it is available to you, even if its not particularly useful or interesting to you, it remains an option. And the possibilities are as varied as the human beings that comprise our world. Some are even Scientologists lurking in narc-anon.
Like most things you get out of it what you put into it. If you spend more time drinking you'll spend more time dealing with those consequences, whatever they are. For some, it just means better wine, for others its a DUI or health concerns or anything else you can imagine. If you spend a lot of times doing something else instead, then you will get other results. It may not make you happy or solve your problems, but it will take time away from drinking or gambling or eating a gallon of ice cream or it doesn't matter what else.
My point is perhaps best stated by the immortal Tom Leher. He once said,
"Life is like a sewer.... What you get out of it depends on what you put into it"
And as with most things that goes for the 12 or 13 steps as well. Let the farce be with you.
My father managed to get out of several decades of drug and alcohol abuse (and criminality) via the 12 step. He got an education in treating addicts and now work since a number of years treating others with the 12 step. It works (but that's not news).
Seeing this pretty close and talking to my father about many details, I can state this with absolute certainty that it is 100% exactly the same as any "mind-controlling" cult, but for a different purpose. It works the same, looks the same, everything - and it even has a lot of "god" in it, although many people choose to interpret that in other ways. Especially it is formed to teach you that you are powerless and must trust whatever higher power. It turns the addicts into addicts for meetings instead of drugs.
I have many many problems with the treatment as it is done today, especially since it forms a life-long dependency on something new (this is the trick!) instead of the drug, and the breaking down of the mind. But, on the other hand, it's better than the alternative. I just can't help thinking that there must be a better way than switch addiction for addiction. My father disagrees, of course, simply because for him, this is not how he views it, he sees himself as free from addiction, but he gets all jittery if he can't go to a meeting for a few days...
If we are gonna reprogram humans (it's similar to NLP?), I'm sure it would be possible to reprogram them in a better way than this.
You guess you were an addict? That's a pretty good sign you weren't.
Though I've never been addicted to anything chemical, there was a point I started becoming OCD. I had to prewash my hands before I washed them (don't laugh, it seemed right at the time). Then I needed to post wash them. I had to unlock the doors to prove they were actually locked when I left the house. Which meant I had to lock them again, which brought the need to unlock them to prove it really was locked. I knew this was odd behavior, but it felt right. I was only about 12 years old then this started, and by 14 it was really annoying me, so I started forcing myself to not do those things. It was torture. Imagine putting your hand into water you know is very hot. Maybe you know it won't actually blister your skin, but you know it is hot, and it will hurt. But you override your instincts and force yourself to do it. Eventually you can break then bad instincts, but most people don't understand this because they've never gone through it. To this day I don't know why I developed those instincts. All I can say it it seemed like I should do them, and once I started, it seemed like I should more.
There were others as well, though I don't know if they are as common for other people with OCD. I felt the need to hide around corners and jump out at people. Even when I knew there was no chance I was going to scare them. I barely thought about it, I just felt myself doing it. It all went away when after I forced myself to stop the hand washing and lock resetting (I don't recall how long it took, but it felt like months because it sucked, but was probably more like one month (being over 20 years ago my memory of the situation isn't perfect).
Addiction is a habit that has developed a chemical dependancy. Try taking a regular coffee drinker's coffee away from them for a couple of weeks. It is down right scary to watch the withdrawal.
Some have a hard time stopping others enjoy it so much they really don't want to stop. you can break the habit but because of the chemical dependency it is much much harder.
Also Habits are only a choice in the beginning. once they get going you have to choose to stop, to break the habit.
i thought once I was found, but it was only a dream.
AA's own internal figures show that only 5% of people who start AA are not drinking one year later.
The spontaneous remission rate is also 5%.
So the ones who are stopping were going to stop anyway (and kudos to them).
But what about the 95% who don't stop? Other studies show that when groups of alcoholics were randomly assigned to court ordered AA, no treatment, or a therapy program, the AA group was FIVE TIMES as likely to engage in subsequent episodes of severe binge drinking as the no treatment group, and nine times more likely than the therapy group.
Here's a sampler:
http://www.thefix.com/content/the-real-statistics-of-aa7301
http://www.orange-papers.org/orange-effectiveness.html
http://www.youtube.com/watch?v=Z0DSEdLCAUg
But to some degree, the one IS the other. And to the degree it isn't: Hospital patients regularly get physically addicted to opiates. They get much purer stuff than on the streets, and they actually get more addicted - they need larger doses to have an effect, and so on. Yet after going through painful withdrawal, these people never want to try it again - they're no more likely to become opiate addicts than anyone else.
There was a big study on Vietnam veterans, probably they expected to find the opposite. But people who had been treated with opiates during the war did no better or worse than other veterans.
Another thing is that if you meet a really long-time addict, odds are he would have gone through withdrawals many, many times the last years. Odds are also that he would have spent many weeks or months sober in periods, without help. Many, perhaps most addicts can decide to stay sober for a while if the situation demands it (for instance for special events like visits or trips). Yet they go back on the drugs.
People use drugs because they want to. Why they want to, currently psychiatrists are doing a much better job actually explaining than neurobiologists. It's just more practical to look at in human terms. Maybe it will change one day, but that's how it is now.
xkcd is not in the sudoers file. This incident will be reported.
We, as social mammals, cannot regulate our central nervous systems by ourselves. We need other people to do that.
Maybe you can't.
Exactly. Other people can offer encouragement and support, and that can be valuable, but it's not that you cannot be motivated alone to quit. It's about life values, thinking, and taking care of health, which make you quit, not some social mammal central nervous system control stuff.
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
You know, people don't wake up and say, "This is a good day to become a drunk/addict!"
If an addict read your post, they would think "Yeah, what's the point! Fuck it! I'm no good!" and then go out, get high and possibly die or kill someone.
What these 12-Step programs do is help deal with the shame and blame. The drunks feel all that guilt. They do ask themselves "WTF did I take that first shot?!"
They are numbing out feelings. Go to an open meeting sometime and you will hear story after story of childhood abuse and other horrible things that happened to those folks. Many were brought up to feel defective and worthless. So worthless that no one could possibly love them - many times they're isolated. Some started being a drunk because that were the only friends they thought they could have - the drunks they hooked up with just wanted a drinking buddy. Drugs and booze are the only thing that makes them feel good.
Many never developed proper coping skills and many had drunks for parents. When you grow up in an environment like that, you think that's normal.
The 12-Steps and other recovery groups like SOS allow these folks to connect and belong somewhere - and considering society's hangup and judgements - it's the only place where they can feel they belong. They also start to learn about the dysfunctional thinking and living. There's nowhere else to learn those things.
On the surface, 12stepping does the same. In fact, though, it never acknowledges that YOU and YOU ALONE are responsible for whether or not you drink. Not some "higher power" and you certainly are not "powerless to stop". That's prime grade bullcrap. You and you alone are responsible for your life and what you do. And you and you alone can pull yourself out of the gutter. Friends can be a boon here, whether fellow sufferers are is debatable if you ask me. But in the end, it's your choice.
Many folks need that "higher power" stuff to deal with their own hatred about themselves. "It's really not me - I have a "disease" and it's up to me deal with it." Get it? How many folks feel guilty about having colon cancer? Not many. But they take charge of their lives to get treated. Same idea here.
Granted it gets a bit tiresome -even condescending at times. (One poor guy had a tree for a higher power. The DOT took it down - snickers from all the Jesus/God believers in the room. Not a single expression of sorrow for the guy.).
But that's the thing, when you're an addict, you have no real friends - just other addicts who more than likely don't want to change. These programs give support for change and positive role models - mostly.
There are a LOT of problems with AA - some have accused it of being a cult which I sympathize with - but never the less, it does help folks from drinking and I'd rather have them being there than staying a drunk.
There is a lot of evidence to suggest that 12-step programs are nothing more than window-dressing. That they take credit for spontaneous remission - the percentage of people who just quit on their own.
For example, alcoholics have a spontaneous remission rate of roughly 5% - so if an AA program has a 5% success rate (including the people who give up on the program - the AA people don't like to count them) then AA is just a no-op.
Here's one of many analyses making the argument that 12-steppers are just bad at math.
http://www.orange-papers.org/orange-effectiveness.html
When information is power, privacy is freedom.
My AA story...
In college, I attended an AA meeting as a requirement for a Psychology class. I wan't an alcoholic or even on the path to alcoholism; I just needed to fulfill the requirement and "attend an AA meeting" was the easiest way to do that.
The first thing I noticed was that all the people in the meeeting (there were maybe 40 attendees) had replaced alcohol with coffee and cigarettes. The second thing was that all of these people seemed to care about each other. A lot. It wasn't anything explicit or obvious; it just seemed to radiate from everybody and it generated this vibe that was incredibly warm and fuzzy. I didn't announce why I was there, so unless they asked me the other attendees just treated me like another anonymous alcoholic. And they treated me like I was their son or their brother. It felt really, really comfortable and nice. At one point, I actually thought to myself "it's too bad I'm not an alcoholic, because it would be great to hang out with these people every week."
I left that meeting on an emotional high. The only way I can describe it is that it was like finding out you had a whole branch of your family that been searching for you for years, and now you've been reunited and your new family just accepts you with -- not just open arms -- but with a tangible joy that you've finally joined them. It was awesome! And then I got about 50 feet out the door and said to myself "You just got hooked by a cult!"
I was shocked because I had always assumed that I was 100% absolutely immune to cults. I had read stories about people who were brainwashed into joining them and thought that I -- with my intelligence and my skepticism and my stable family life -- could never fall for something like that. But I had only been there for two hours and they had hooked me. Had I been less intelligent or cynical or more lonely maybe I wouldn't ever have realized what was happening.
But more importantly (at least for the report I had to write for my Psychology class), I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people, and then uses that control to help them conquer their addiction demons. It's atomic fission harnessed to light up a city rather than to destroy it. And it works because we're social animals and our brains normally respond to social cues at a level far beneath our concious thought. Unless we're actively guarding against it, we can all be manipulated this way. Even you.
Please note, I'm not in any way claiming that AA is bad or that they use social power to do anything other than try to help people. People's need for social interaction is just a fact, and AA uses this knowledge as the starting point to help people stop drinking. Knowing that you have several dozen people who care about you, who would be disappointed if you had a relapse, who look to you as an example of success, or who would be happy to talk to you if you just need help resisting the urge; that knowledge might make the difference between you giving in to your addiction and you staying sober for another day. That's a good thing and if AA works for somebody then that's great.
So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
AAs success rate varies between 5 and 8 percent, about the same success rate you'd expect from no treatment.
If you can't beat the control group then it's junk science at best to try and derive meaningful conclusions from the few success stories and lends undeserved credibility to a program that is a massive statistical failure by almost any measure that means anything.
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
I think before we start analyzing why 12 step programs work, maybe we should determine if they work. While everyone just assumes 12 step programs are the answers, there is very little scientific evidence and studies on whether they work better than anything else. It is a hard subject to study, but I think something that should be done since the state is sentencing people to 12 step programs. Before we force people to go into programs (especially one that force people to accept that there is a "higher power") I think there should be strong studies done to show that these programs work better than other programs or at least better than a person just deciding to stop.
Actually, there are numerous studies on the effectiveness of 12 step programs and their success rate is around 40% versus 55% for dedicated therapy with a psychologist and less than 5% for self-treatment. I don't remember the issue, but in 2011 Scientific American had an article about it and listed several recent studies.
As for forcing people into accepting their is a higher power, nobody is forced into AA or other 12 step programs, it is totally voluntary and there are other options for therapy. As the SA article showed, they are not even the most effective programs, but they are effective. Like all forms of thereapy though, different programs/techniques work better for some than others and just becuase it works for one person does not mean it will for another. That is why courts will usually mandate therapy, but they will not mandate a specific therapy.
There was an AA meeting group in the civic center I volunteered at. A loved one and friend of mine also attended AA meetings.
Though I am an atheist without a drinking problem I helped set up and clean up, and became tangentially involved with 12 step programs over the years.
One major compulsion to attend AA and other 12 step addiction programs, especially for teen and young adult members, is the unwritten "13th Step": Sex and/or relapse into addiction with other members. Some have related to me that they were introduced to hard drugs or "milder" drugs like cigarettes and caffeine via AA... When I asked if trading one vice for another wasn't just as bad (smoking packs of cigarettes a day is very bad and severely addictive), "One addiction at a time," they would say. One need only look at the coffee expenses nearly all AA meetings have to realize the effectiveness at combating addictions are quite subjective... A cyberneticist might even say: They have changed from sating their tendency via physiological addiction into sociological addictions, either can be severely harmful; Please enjoy addictions responsibly; Everything flows, moderation is the key.
I can believe that addictive personalties may favor a certain substance or habitual activity above others (drug of choice), but I can also acknowledge that there is no such binary as "AA works" -- It's more like: AA has some success and a lot of failures: Success more likely only if you've "Hit Rock Bottom" first however, which I find quite ridiculous. Either it does or doesn't work, the belief in AA that a cathartic event that nearly destroys a person be practically a prerequisite for recovery is dangerous, reckless, and foolish -- Not based in empirical study, for certain; Only anecdote.
There was a teen 12 step program my friend was in, "Lifeway", and "PDAP", before that. These were largely modeled after AA's 12 steps, but Lifeway mushed the "you believe in a higher power" in with some other step so that it could squeeze in a step about abandoning your friends since they will cause you to fall back into addiction again... Even abandoning me because I wasn't "a winner" in life enough to help my friend "work a program". This is a common cult tactic.
The safety net gone, when my friend could not "work a program" due to being as atheist and thus incompatible with the "higher power" step, my friend's parents (upon advice from the parent meetings they attended) kicked my friend out of the house. They said the other families wouldn't let them stay with them, even though such was the apparent practice, and instead they were shown, "Tough Love". My friend became a 16 year old homeless person and flunked out of high school. My friend said they still attended the meetings, because they were too ashamed and afraid to contact an old friend like me -- they said that if the group, family, or "sponsor" found out about the contact it could mean prolonging the homelessness. Though they had been without drugs while failing to "work a program" for over a year, they started using drugs again once on the street... Of course! That was my friend's first encounter with harder drugs... This before the 3rd step of the program could even be attempted, they said.
AA and other 12 step programs do not provide the housing aspect a teenage kid requires to survive, so they were of no help, "Keep coming back, it works if you work it," is the literally ignorant motto. After months of homelessness and abject prostration before the parents of Lifeway my friend was allowed to stay with another family, but not their own family; It was more "Tough Love" they said. I saw my friend with the new family around town and was quite puzzled because they'd never hung out before, and I was given the cold shoulder when I tried to say Hi.
Later, my friend had said they had to earn back the right to live in their home, and couldn't take any chances... Meanwhile they were instructed to attend "outpatient" meetings, which my friend described as exp
...purely materialistic explanations for every phenomenon.
In my business, it's called troubleshooting. Find the problem and fix it.
The only faith required is the belief that you can do it. - Mark 10:52
“He’s not deformed, he’s just drunk!”
First of all, there's no (official) 'Christian' angle in 12-step programs. The higher power is nothing more than a technique for letting go of trying to control things yourself.
I refer you to steps 2, 3, 5, 6, 7 and 11 all of which explicitly invoke a diety of some kind. Claims that the twelve steps do not involve religion hard to swallow and frankly a bit disingenuous. It's pretty hard to buy the claim that those steps collectively are somehow independent of christian teachings. Those steps collectively are little different in function from confession in the christian tradition. Furthermore the founders of the twelve step programs themselves come from a christian tradition.
If 12 step programs clearly worked I would have little problem with that fact. If some prayer genuinely helps someone get their life together and stop drinking, who am I to judge? Anything that helps without harming others is fine with me. The problem is that it is not at all clear if they are actually effective. Some evidence points towards them being helpful for some people, much indicates that they provide little benefit and in occasional cases might have actually proved harmful. It's hard to study their effectiveness because the nature of twelve step programs tends to be secretive and there are other problems such as lack of a control group. The evidence supporting AA as an effective treatment is scientifically quite weak. Most evidence seems to show that at best it has a success rate barely better than those who do not take the program. I have a problem with the notion of prescribing religion as a treatment regimen in light of the fact that there is no compelling evidence that it actually has the desired outcome.
True, AA isn't generally "warm and fuzzy". NA is more warm and fuzzy, more of a "support" group.
At many AA groups, they'll not do the "everything's okay" bullshit. They'll tell you it's NOT okay to get drunk and punch your wife, then take your kids for a ride at 110 MPH. Did that hurt your feelings? That's okay. I care enough about you that I'd rather save your life than have you like me.
* there are tens of thousands of AA groups, who have held millions of meetings. Anything I say about AA in general may not apply to a particular meeting.
Since there are tens of thousands of groups that are all different, I can't say that anything in particular is true of every group, but the book "Alcoholics Anonymous" tells us what it's designed to be. The book is abundantly clear. Drinking can be replaced by service to others. As I write this, I'm caring for a severely autistic young man while his parents are in church, instead of getting drunk with my brother. Here with me is my beautiful wife, who wouldn't have married me if I were still living like I used to. It works for me.
The article you linked opened with Lindsay Lohan being court ordered visit a rehab.
Let me ask you this -
If she were ordered to visit a law school a couple times, do you think that would make her a lawyer? Of course not. So that means law schools don't work?
What if she were ordered to visit NASA? Would she become an astronaut? Probably not. I guess NASA doesn't work.
Ordering a person to visit a place doesn't cause them to change their lives.
Law school works - people who really want to be lawyers can go there, work hard, and become a lawyer. AA works the same - addicts who really want to be sober can go there, work hard, and become sober.
When you lose your license to practice law behind drinking, but feel compelled to drink again the next day, you start to suspect there may be a problem. A year later, when you lose your wife and kids to drinking despite doing all you can to try to stop, you suspect it might be serious. Two years later, when you find yourself in the bar after your dialysis appointment, you KNOW you're screwed. Nobody has to tell you that. At AA you'll find people who tell you "yes, I was just as powerless, I found myself in the same situations."
If you personally haven't been through that, I'm sure it's hard to comprehend. The fact is, for a real alcoholic, it's like diabetes - it'll always be part of your makeup, though it can be controlled with daily vigilance. That's fundamentally different from someone who simply has a sugar crash from eating too many sweets, or a hangover from too many drinks.
You say that you suspect that they work. But there is no data to support that. In fact, most 12 steppers fail, and the success rate for 12 steppers is as low as the success rate for people just deciding to quit without using the 12 step program. Penn and Teller did an episode of their show "Bullshit" that talked about 12 step programs and gave some interesting data on its success. I'll suggest that you may want to see it before telling more people why you think 12 step programs work. They do not. You can usually find copyright infringing episodes of this show on You Tube. This supposed report is just more Bullshit.
I'm an American. I love this country and the freedoms that we used to have.
The article is propaganda, plain and simple. In the first few sentences the author is already using words like “success” and “a miracle” to describe 12-step programs. I was interested in the article at first because the headline seemed to promise coverage of a genuine scientific assessment into the efficacy of the 12-step approach, something that is badly needed here in the USA where the 12-steps are frequently treated as The One True Religion by the established addiction treatment community. But the piece is just fluff, apparently written by a true believer who seems only interested in research aimed at retroactively determining just how 12-step programs accomplish such great things... The greatness is just assumed to already be a settled matter. The fact that AA and especially NA don’t work for the overwhelming majority of addicts is something that is just glossed over.
And that’s really too bad, because AFAIK most studies find only marginally better outcomes when evaluating 12-step program performance, on the order of a couple of percentage points when compared with alternative treatment methods, particularly over the long term where the numbers are barely statistically significant. The sad fact is that something like 99% of the addicts who walk in to a NA meeting for the first time will relapse in a matter of weeks or even days, and often just hours. As for the long term outlook, there are studies showing no measurable difference in sobriety levels after 5 years of NA versus no treatment at all. Even when the 12-step rules are scrupulously adhered to and all meetings are faithfully attended by the recovering addict, it remains a method of dealing with addiction that works only for very, very few people, although admittedly when it does work it can be a godsend. The question that needs to be asked in the USA, a country still obsessed with the patently un-winnable War On Drugs, is this: why is a program with such abysmal success rates still considered the gold standard in addiction therapy by treatment providers? Too bad you won‘t find any such question in the article.
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
Quite glib; your implied point is "it" is worthless because it just swaps addictions.
I haven't seen a definition of addiction yet, so I'll suggest this:
Someone is addicted if they repeatedly make damage-causing choices, to the point where normal life is unsustainable (e.g. cant hold a job, arrested, or maybe death).
Now instead of a question of "Addiction" it becomes a question of Sustainability: how long can somebody carry on?
Some people carry on for a full lifetime with whatever. No problem, I'd say they're not addicted.
Other people have trouble sustaining after a while.
As for "trading one addiction for another", think of it as damage control.
Different behaviors have different time frames to their consequences.
Some things, like meth or heroin, can lead to severe consequences quickly (think Trainspotting).
Alcohol tends to be longer-term maintainable; often drinkers can sustain for years, possibly even decades. Eventually health issues (like liver damage, possibly fatal), judgement issues (drunk driving, possibly fatal), and other "consequences" (getting fired, divorced, passing out in risky situations) tend to make life unsustainable.
Marijuana is perhaps more sustainable than alcohol and other drugs.
Now, let's talk about some of the other "addictions" that you're concerned about.
Coffee? (Oh noes, they iz addixted to caffeen!!) WTF! Coffee is arguably completely sustainable, it doesn't cause damage to the user or to others.
Cigarettes? *shrug* I don't know about that one but damage-wise, but it is probably safer for somebody to smoke than to routinely make poor decisions because they're blackout drunk.
Sex? (Oh noes, they are sleepn roundz!) This is pretty sustainable; arguably healthier than lots of alcohol / chemical "entertainment" options. Do actually you have a problem with people engaging in sex?
Look... whatever behavior you're thinking about, try thinking of it in terms of sustainability. Maybe some of these things are "just" substitute addictions"... but is that really so bad?
There is a lot of logic in taking people who have broken self control mechanisms and telling them that they need to rely on some external source of judgment. Fine. When they craving for a drink, teach them to call a sponsor or other group member to talk me down. Because their brain is too broken to make correct decisions in this area. But that should be the end of it. If this becomes a foot in the door to sell a story of some invisible guy up in the sky who is all powerful, well they may not be that screwed up. And attempting to make this sales pitch is often caught, even by people lacking excellent judgment as a con. Eventually, they see through the BS and reject not only the imaginary guy with the beard, but the useful support structure keeping them away from abusing substances.
Have gnu, will travel.
And so there were random data losses back in the days of the dishwasher-sized storage unit with the huge, removable platters.
As long as the scope of inquiry was the data system itself, the cause was mysterious. Random.
Then, somebody was working late when the cleaning crew came in, sporting a huge, unshielded vacuum cleaner.
Moral of the story: keep a weather eye on the guy trying to limit the scope of inquiry.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear