Why AA/NA Should Not be the Basis for Treatment of Addiction

Let me start this by saying I have no credentials in treating drug addiction, but I have some personal experience with addiction. It's quite dumbfounding to witness the drug education and addiction treatment in the United States. In the "D.A.R.E." and government based prevention programs being hawked in the public schools, there is ample misinformation. Cannabis is lumped in with much more harmful drugs such as crack, heroin, cocaine, etc. Alcohol, one of the most dangerous drugs is also glossed over, probably due to its legality. To date, there have been zero recorded deaths from the former and many from the latter. If those who peddle this information really cared about the future of our children, there would be a more honest and comprehensive approach to drug education. "Just Say No" is a nice slogan, but it doesn't work. The youth of this country have been and are being lied to, and set up for further failure when needing addiction treatment.

Even the best drug education early on wouldn't mean that there wouldn't be addicts. The typical "solution" to addiction, the 12 step program and rehab is such an utter failure, it's no wonder so few become clean. Studies have shown that the AA/NA method and 12 step program is at best 5-10%* effective in getting the addict to quit abusing substances. There are very few controlled studies on the efficacy of AA and many of those are flawed. The rate of "spontaneous remission" from alcohol is about the same % as NA. The steps are based largely on religion and not science. Step 1, "We admitted we were powerless over alcohol—that our lives had become unmanageable", surrenders any power the addict may have and is quite the defeatist attitude. Step 2: "Came to believe that a Power greater than ourselves could restore us to sanity." AA tends to claim that anything could be a "power greater than ourselves", even your dog or AA itself. Step 3, "Made a decision to turn our will and our lives over to the care of God as we understood Him" is also along the same lines, but more emphasis surrendering to the "power greater than ourselves". Step 4, "made a searching and fearless moral inventory of ourselves", is probably one of most logical steps, although that's not saying much. Drug addiction is not necessarily an issue of morals either. Steps 5-7 are blatantly faith based, yet AA claims to be spiritual and secular and not religious. Step 8, "Made a list of all persons we had harmed, and became willing to make amends to them all." is the gem amongst the steps. It's definitely a good idea to make amends with those you harmed. Step 9 is taking action on step 8. Step 10 is taking action on Step 4. Step 11: "Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out". This step can be useful as many do get value out of mediation and prayer, however God comes up once again. Step 12 is "Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs." Personally, as someone who does not believe in the Judeo-Christian God, the steps made me a bit uncomfortable. Ironically, many who do succeed through the 12 steps, fill the void in their life with Jesus and God and often become proselytizers. The history of AA is quite interesting as well, and while I won't get into it here, both founding members were religious and believed it was God who cured them of their alcoholism.

Perhaps all this shouldn't be too surprising when you consider how diseases such as cancer are treated by the medical industry. Rehabs(that are almost always based on AA/12 steps) are big time moneymakers, and many families have become bankrupt as a result of sending their kids to these places. The rehab I went to was 10k, and that's on the cheaper side. The average cost of a 30 day stay at Sierra Tucson is 50k. Even though there are benefits to going to AA meetings such as comradery, many people feel uncomfortable in AA and are subject to abusive members. AA also fails to recognize the main psychological reason that many use substances and become addicted. It's a feeling of hopelessness or helplessness. Many addicts will confess that their anxiety subsides often before taking the drug just by knowing that the drug will be taken soon. The addiction as a disease model is also troubling. I hope that either the steps are given some tweaks/additions or they just completely scrap it and come up with a new basis for treatment.

For further reading, I suggest Lance Dodes "The Sober Truth".