Gabrielle Glaser, author of "Her Best-Kept Secret," offers insights from her Atlantic piece about the failings of the famous support group, Alcoholics Anonymous (AA), and the truth about mainstream alcohol treatment in the U.S. and how it pales in comparison to Finland's science-based medical interventions.
In this video, you'll learn about the very low success rates and thus very high failure rates of Alcoholics Anonymous and mainstream AA-based and abstinence-based rehab centers. Glaser provides compelling statistics in the U.S. and Finland as well as quotes from addiction professionals about AA and alcohol.
Mentioned: Alcoholics Anonymous, Harm Reduction, The Sinclair Method, Naltrexone, Alcohol Moderation, Alcohol Abstinence, Cognitive Behavioral Therapy, Motivational Interviewing, Addiction Medicine, Anti-Craving Medications, Alcohol Rehab, and more.
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A few years ago, I set out to research a book about the explosion in U.S drinking Americans were buying more booze than ever before more of them were being hospitalized for alcohol poisoning.
And more of them were checking into rehab.
The people typically under report their consumption, they were even admitting to Gallup pollsters that they've been imbibing more than in years.
Prior today, the CDC says that 18 million Americans are on the spectrum of what's now called alcohol use disorder when I began exploring how people got better once they developed a problem I wondered about the endless number of people particularly celebrities who seem to recycle through rehab.
So I decided to take a closer look at our 35 billion dollar rehab, industry, I discovered that nearly all U.S drug and alcohol.
Treatment programs are centered in the faith and abstinence-based program of Alcoholics Anonymous, which was founded 80 years ago, seemed to make sense, I knew people in AAA who swore by it said, this 12 steps had saved their lives, it's embraced by our legal system and portrayed by popular culture as a Surefire fix.
But once I started digging into its efficacy I was shocked.
Aa is famously hard to study it's.
Of course, anonymous five of its 12 steps mentioned God.
So its religious components, make double-blind randomly controlled trials all but impossible.
That said, some of our best estimates show that aaa's success rate is in the single digits.
St, Paul's, psychiatrist, mark willenbring who used to direct alcohol treatment research at the NIH says that anecdotal evidence shows us a a works for the people it works for.
And nobody else.
Lance Dodie's is a Harvard psychiatrist who's been treating people with addictions for 40 years.
He says, the biggest flaw of 12-step programs is that they don't refer people to other forms of treatment when they fail in AAA.
When people relapse they're told to go to more rehab, more meetings or to stay longer at rehab, I didn't set out to challenge the Orthodoxy.
But it became clear to me very soon that the Orthodoxy needed challenging.
We have an over-reliance on a method that's been shown to work for just a few people or a small percentage of them anyway.
And we have other options that are far more successful, We're a nation in crisis and not just with alcohol we're in the midst of a heroin epidemic, that's killing more people than car accidents.
So why do we depend so heavily on a system developed in 1935? When our knowledge of the brain was in its infancy? We've discovered a lot about neurology since then we've learned that alcohol problems affect our brain chemistry in various ways.
And we have a whole new set of science-based tools to help people recover for a piece.
I wrote in last month's, Atlantic, I talked to about a dozen people who'd been through our treatment system for their drinking problems.
Many had struggled to make the 12-step program.
Stick one woman I met went to rehab, eight times each time for a longer period.
She said, it was like getting a bigger dose of the same antibiotic that cleared that her infection.
Clearly wasn't responding to in the first place when treatment doesn't work people like her feel ashamed blamed and usually broke these centers charge upwards of fifty thousand dollars a month to send people to Art Classes yoga, Equine Therapy.
And the AAA meetings you can get for free unlike fertility centers, which are required by law to publish their success rates.
Rehabs are totally unregulated.
They can say, whatever they want and their assertions go completely unaudited.
Most of the treatment is administered by addictions counselors whose main qualification is that they've been through a 12-step program themselves.
The rules are so loose.
Many states don't, even require a high school diploma for these sorts of jobs, even though clients can be suicidal or in the throes of a psychotic break.
Meanwhile, their CEOs are earning High six-figure salaries, a developed during a time when we knew so little about addiction, it filled a clinical and cultural vacuum.
Doctors, didn't have an answer for chronic drinking problems.
So they and the public accepted aa's belief that addicts were best suited to treat other addicts.
As a result.
Generations of doctors missed out on learning about the new effective treatments that actually do treat addictions, former deputy drugs are Tom McClellan told me that out of 170 medical schools in the U.S last year only 14 even offered, a course in addiction medicine.
That means that most medical school students get their exposure to addiction medicine, just by observing AA meetings, I decided to compare our treatment system to finland's a country that also has a big alcohol problem and shares with us.
A failed history of prohibition for the past few decades.
The fins have turned strictly to science to treat people with alcohol problems.
Students in all five Finnish medical schools.
Take mandatory courses in addiction, medicine and are abreast of new treatments that work.
They use cognitive behavioral therapy to help people identify their triggers and avoid them.
They help people learn how to replace unhealthy behaviors with healthy ones, even if it's something as simple as walking the dog, During the period you'd normally pour yourself your first drink.
They also include using a host of non-addictive anti-craving medications.
The FDA has approved some of them as well.
But only one percent of Americans with drinking problems are ever prescribed them.
Doctors, don't know about them and many somehow still believe that treating alcohol problems with drugs creates another form of dependence in July I drove to meet the late American neuroscientist, David Sinclair.
He lived on a rhubarb Farm outside Helsinki.
He moved to Finland in the 70s to study alcohol research.
He showed that the brain releases endorphins or our feel-good hormones when most people drink, he believed that among some people, the Endorphin release strengthens.
The synapses The Junction between two nerve cells, the stronger, the synapses grow the more likely.
The person is to think about and eventually crave alcohol until almost anything can trigger a thirst for booze and drinking becomes compulsive Sinclair theorized that if you could stop endorphins from reaching their target, the brain's opiate receptors, you could gradually weaken the synapses and the Cravings would subside.
He began experimenting with some drugs called opioid antagonists.
He found that when drinkers take a generic drug called Naltrexone an hour before they imbibe.
The reward of drinking is blunted I'm, not a big drinker myself, but I tried the medicine for 10 days, too I know, I'm just an N of one.
But honestly on the first night, the idea of a second glass of wine seemed about as appealing as a shot of Benadryl by using this protocol, repeatedly the brain relearns how to drink normally.
This is standard treatment in Finland, where thousands of people use the method in conjunction with CBT and motivational interviewing a technique that helps people resolve their ambivalence about drinking or using drugs, unlike the false promises of U.S rehabs.
The method used in Finland is based on rigorous studies that show a 75 success rate in reducing drinking to moderate levels that's.
Another big difference in the U.S everybody with a drinking problem, is assumed to be on a trajectory toward dependence.
So severe that one day they're going to need a glass of whiskey in the morning, just to ward off the shakes, in fact, studies show that only 10 percent of people with alcohol use disorder are actually in the severe range.
Those people probably need programs that promote abstinence.
But the vast majority of the others can benefit from a range of approaches, including learning to moderate, we have to let people know these options exist.
And they do in online and in-person settings.
So then, why does AA work for some people and not others? People have different beliefs and different needs, and Alcoholics Anonymous (AA) just doesn't fit everyone. Some people love the camaraderie that AA offers and believe that their long-term sobriety depends on going to AA meetings for the rest of their life.Is AA not a religious program? ›
Many members believe in some sort of god, and we have members who come from and practice all sorts of religions, but many are also atheist or ag- nostic. It's important to remember that A.A. is not a religious organization; we have a simple idea that there is a power greater than us as individuals.Is AA the only way to stay sober? ›
No, you can take many pathways to long-term sobriety.
Alcoholics Anonymous (AA) remains one of the most common support groups for long-term sobriety.
The great fact is just this, and nothing less: That we have had deep and effective spiritual experiences* which have revolutionized our whole attitude toward life, toward our fellows and toward God's universe.Does AA have a terrible success rate? ›
Although AA has been criticized by some sources for having a low success rate, the rate likely isn't 5% like some say it is. Addiction specialists cite success rates slightly higher, between 8% and 12%. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.Does the 12-step program really work? ›
Despite the fact that thousands of people turn to the twelve steps every day in the United States, the effectiveness of AA is controversial. However, research regarding the effectiveness of the twelve steps has found that this approach to addiction treatment can have a large positive effect.What are the 4 absolutes of AA? ›
The “Four Absolutes” of Alcoholics Anonymous were considered “yardsticks” in the earliest days of the recovery program —standards for determining appropriate behavior as measured through God's eyes. The Four Absolutes are Honesty, Purity, Unselfishness, and Love.Did the Supreme Court rule that AA is a religion? ›
Thus, the U.S. Supreme Court holds that government can not require religious participation. Lower courts have found that AA is religious.
The biggest support groups out there in recovery are AA and NA. You should know that regardless of your religious affiliations or no affiliations or god belief, you are welcome in AA and NA. The only requirement for membership is the desire to stop drinking or using.What are the disadvantages of AA? ›
Among the issues identified as limiting AA's effectiveness are the movement's preoccupation with drinking and sobriety and lack of concern for other problems. Also, the possibility is raised that AA's insistence that its members are but "one drink away from a drunk" can become a self-fulfilling prophecy.
Whatever your path is, know this: your recovery will evolve and your needs will change. It is absolutely okay to leave AA. That is your right as a person in recovery, and no one has the right to direct you otherwise.What is the hardest point of sobriety? ›
For many people, the first few weeks of sobriety are the hardest. You may have withdrawal symptoms that are physically and emotionally uncomfortable. Cravings are also common during this time, which can tempt you to relapse. Treatment can help you get through this challenging period.What is Tradition 11 in Alcoholics Anonymous? ›
Tradition Eleven: “Our Public Relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, films (and the internet).”What is Tradition 10 in Alcoholics Anonymous? ›
10. No A.A. group or member should ever, in such a way as to implicate A.A., express any opinion on outside controversial issues–particularly those of politics, alcohol reform, or sectarian religion. The Alcoholics Anonymous groups oppose no one. Concerning such matters they can express no views whatever.What is tradition 7 Alcoholics Anonymous? ›
A.A.'s Seventh Tradition states: “Every A.A. group ought to be fully self-supporting, declining outside contributions.” This means that only A.A. members contribute financially to A.A. – and even A.A. members are limited in the amount they can contribute.What to do when AA doesn't work for you? ›
- support group therapy.
- individual therapy.
- motivational interviewing.
- cognitive-behavioral therapy (CBT)
- dialectical-behavioral therapy (DBT)
- rational emotive behavioral therapy (REBT)
- crisis intervention.
Problem #3 — The Success Rate of AA Is Affected by the All-or-Nothing Mentality of AA. AA is a program of complete abstinence. For the majority of people who go to AA, that's not necessary. It's the people who can't stop no matter what and who can't moderate no matter what who need complete abstinence.Does AA work for introverts? ›
Introverts and extroverts experience problems with substance abuse across the board. But your willingness to engage in social gatherings can definitely affect your success in AA as an introvert, and therefore your long term recovery. In that sense, introverts should tread carefully.What are the criticism of 12 steps? ›
“Essentially, the criticism of 12-step programs is that it is a one-size fits all approach to a complex problem, and it also it seems out of touch with an emerging science-based approach towards a disease that grips the brain” according to Jeffrey Cohen, LPC, a psychotherapist and addiction specialist in Smyrna, ...