Alcohol and drug dependence appears to be an epidemic in the United States. Alcohol consumption is a social norm and legal and illegal drugs alike are incredibly easy to access. As a result of the enjoyable mind altering effect and the easy acquisition of substances such as these, abuse and dependence are more commonplace than one might expect.
So, the question is, where does one go for help if substance abuse has become an issue? The large majority of the professional mental and physical health community has become accustomed to shipping every alcohol or drug abuser off to a 12-step meeting. How effective is the 12-step methodology as a 1 size fits all alcoholism treatment program, though?
Statistical research on 12-step programs is hard to come by; primarily because the 12-step programs do not regularly keep track of their own success or failure rates. However, the little bit of research that has been executed suggests that programs like AA have somewhere between a 5-15% success rate. This means that of those who attend a 12-step program as a solution to their substance abuse issues, only 5-15% of them will stick with it and stay sober for more than 1 year.
Speculative theory will suggest many different reasons for the low success rates of alcohol alcohol withdrawal timeline treatment programs like AA. I personally feel that there are a few primary components that contribute to such low success rates:
1. Religious/cult like tenants
AA spawned from a movement known as the Oxford Group which was popular in the early 1900’s. The Oxford Group was an evangelical Christian organization that specialized in healing people’s vices through “Christ”.
While allowing its members to choose a “god of their own understanding”, the 12-step program still revolves around the idea that only a spiritual awakening through god is sufficient to cure an addiction and remains spiritual in nature. This rules out the success of anyone that holds an Atheist or Agnostic viewpoint and also deters others that really have no opinion on the matter but definitely do not believe that “god” is going to heal them.
12-step programs also maintain some eerily cult-like tenants. They mandate lifelong membership, ritualistic practices (meetings, prayers, etc.), renunciation of one’s ability to govern or fix their own life, semi-devotion/obedience to a “sponsor”, and harsh criticism for pursuing other avenues of success or questioning the effectiveness of the 12-steps.
2. Definition of Success
The only definition of success in 12-step programs is entire, lifelong, abstinence from any mind altering substances what-so-ever. This is, in my opinion, a fairly narrow sighted definition of success.
Many people that end up seeking help for substance abuse issues have not reached a point where entire, lifelong, abstinence is the only viable option. For folks like this, there are many different markers for success. Learning how to moderate alcohol consumption, reduced frequency and quantity, executing planned periods of abstinence, or setting up and staying within a set of self-defined guidelines and parameters for their alcohol consumption can all act as rules of success.
For those that are not able to moderate their alcohol consumption, then abstinence should be their goal. However, there are many different ways to achieve abstinence without committing themselves to a group of people and a belief system for the remainder of their lives.
3. The Disease Model
Although Addiction is recognized as a medical disease by the AMA and many mental and physical healthcare professionals, there are many people that feel this proposition is absurd, including me. Drinking alcohol and using drugs is a choice that an individual makes. It is not the same thing as cancer where the host does not have any choice in the matter.
Even when people get sober through a 12-step program and subscribe to the tenants of the disease model, they fail to realize that, ultimately, they had to make a decision to stop using drugs and alcohol in order to get well. If you can make a choice to alter the effects of a certain behavior, it’s not a disease.
I personally feel that the disease model and the theory of powerlessness contribute to more failure than success. It gives many folks a justification and excuse to continue destructive behavior because they can always use the oh-so-famous tag line “I’m sick. I can’t control it. It’s not my fault”.
Successful alternative treatment methods promote the idea that addiction is the result of choices and can only be cured by making new, healthier choices. This tends to work for those that can’t find a place in 12-step programs and don’t believe in the disease model.