Gabrielle Glasier writes in The Atlantic about the problems of alcohol abuse and how it is treated in America.
The United States already spends about $35 billion a year on alcohol- and substance-abuse treatment, yet heavy drinking causes 88,000 deaths a year—including deaths from car accidents and diseases linked to alcohol. It also costs the country hundreds of billions of dollars in expenses related to health care, criminal justice, motor-vehicle crashes, and lost workplace productivity, according to the CDC.
It is a serious problem, but unfortunately America has prioritized 12- step treatments that are ineffective and more expensive than treatments that work. Glasier goes on to say,
In 2006, the Cochrane Collaboration, a health-care research group, reviewed studies going back to the 1960s and found that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”
The Big Book includes an assertion first made in the second edition, which was published in 1955: that AA has worked for 75 percent of people who have gone to meetings and “really tried.” It says that 50 percent got sober right away, and another 25 percent struggled for a while but eventually recovered. According to AA, these figures are based on members’ experiences.
In his recent book, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Lance Dodes, a retired psychiatry professor from Harvard Medical School, looked at Alcoholics Anonymous’s retention rates along with studies on sobriety and rates of active involvement (attending meetings regularly and working the program) among AA members. Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent. That is just a rough estimate, but it’s the most precise one I’ve been able to find.
It is always possible for anyone to claim success at treating addiction because, As Bethany King points out, there is a lot more “spontaneous remission” of addiction than most people think if you give people enough years partly because more years also tends to give more random chances for a major shift in life circumstances which can help too. For example, 95% of Vietnam-war solders who were addicts in Vietnam ended up spontaneously quitting after returning to the States. That is a much higher rate of spontaneous remission than we would expect to see in most contexts, but it is a sign of what is possible.
AA is part of the incredible amount of bad medical treatment that we are still using such as the “creative diagnosis” of dentists. Someday people will probably look back at this like we look back at bleeding people with leeches. Glasier goes on to explain why naltrexone and acamprosate treatments are more effective than AA and the political history of how AA came to dominate.
Unfortunately AA isn’t even the worst part of the addiction “treatment” racket in America. The flood of new money for dealing with the opioid epidemic has attracted charlatans and German Lopez has begun a new investigative series about it.
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