Does Alcoholics Anonymous actually work?

I have a friend who has been attending AA meetings recently because he was ordered to do so in some fashion after getting a DUI (for the record I don't know if that means he was given a true option or made to attend or "choose" jailtime) and the whole thing has got me thinking about whether or not AA works and if sobriety is even the intended outcome of the program. Below I've listed the famous 12 steps and below that are my relatively disorganized thoughts on the program having looked into it for the first in any in depth manner.

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understoodHim.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take a personal inventory and when we were wrong promptly admitted it.
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.
12. 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.

Here are some of my thoughts on the matter,

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend.

If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and there are various medical treatments for alcoholism.

There is also a stigma of personal failure when people relapse which doesn't make sense for a couple of reasons. First if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober due to the increase in time that it would take to get over that shame before starting again. Shame does nothing to help get a person back on track as far as I can tell. Second, you would never assign blame to a person with cancer who has gone into remission and then had the cancer come come back, why would we do the same for literally any other illness?

Finally AA does not collect statistics of their success and failure rates, nor has it's program changed since it's inception. We wouldn't accept that from any other sort of treatment. If we didn't collect that information we would still have the same poor treatment of HIV that we did in the 80s and 90s, same goes for cancer, and just about any other illness you can name. I will say that talking about your issues with people is a good thing, but as far as I can tell that's just about the only thing that that this program gets right, everything else seems to be heavily flawed if not outright illogical.

AA worked for some of my family members, including my Dad. It worked so well I credit it with changing the course of our entire family for generations. Alcoholism is a HUGE problem, one of the worst in America. It can tear families and lives apart. It's a shame people don't take it more seriously.

I definitely agree that we need to take alcoholim more seriously, and for the right person AA can probably work and I'm very glad it worked for your dad. That said I think it's safe to say that AA is a flawed program in many ways and it doesn't seem to be doing anything to evolve and change those flaws. I don't mean to come across as a jerk by the way, that's not the point of why I'm saying this. The reason is that I'm concerned for my friend that he's not attending a program that will help him, but he's being made to attend it simply because it's so ingrained in the public zietgeist that people (including his parents) believe simply must work, while not realizing that it has many flaws and AA as program isn't trying to improve those flaws.

I honestly don't know how or what AA does today or if it's different than decades ago when my Dad went. If there is a better option for your friend, I'd try to find it. I'm glad you care about the issue though, most people don't even recognize alcoholism as a legit problem, but it is HUGE.

Much is misunderstood about addiction and this misunderstanding is embedded structurally in our culture at multiple levels.

1. Everyone needs Dopamine, in fact Dopamine makes life worth living. If we try to remove everything that gives us Dopamine, from drugs to work, then life will not be worth living.

2. People who become addicted to Dopamine (real and actual addiction not just convinced that they are) have a history of being abused or traumatized. As a result they look for escape from the pain thru pleasure of which they need more of then what is healthy.

3. To know if you might have a problem ask yourself this question 'am I doing this because its awesome and fun or am I doing it to avoid doing other things I know I will have to get around to before long'. the latter doesnt mean you are an addict, but its a sign you might be if you have those feelings all the time.

OP: your right in your assessments. 1,. the court should not be requiring (under any condition) for a person to submit to a god even by proxy. 2. If it is an actual disease then they need to treat it medically, and to call something a disease and to NOT treat it medically just screams of Cult to me

Are there medical treatments for alcoholism? Honest question. Or do they just hand out super expensive pills and hope it makes you stop drinking, like modern American medicine likes to do in general?

I dont think that there is.

and addiction is not really a disease for the reasons you illustrated.

If I was your friend I would be insulted by the State requiring me to join a religious group.

If I had tons o money I would take them to court over it

Regarding medical treatments this is what I have found. EDIT. Also in regards to my friend, s I said, I don't know the full details of his situation. It's something that I don't feel entirely comfortable bringing up just yet.

According to WebMD there three medicines approved by the FDA and a fourth that is showing promise in clinical trials that help with the treatment of alcoholism. Those drugs are Antabuse, Naltrexonem, Campral, and Topamax. These are meant to be used in combination with various therapies and potentially AA, however it's simply untrue that medicines don't exist. https://www.webmd.com/mental-health/addiction/features/fighting-alcoholism-with-medications#1

EDIT Removing a paragraph.

what do you mean you 'disagree with my last statement'

you think the State SHOULD be mandating to people to join groups that are religiously based?

That is a violation of separation of church and state in my mind.

regarding medications, I was not aware that there were any, that is intresting.

so do they have medications for work addiction? or should we just outlaw work because its addictive?

Go to an AA meeting if you want to understand better what it is.

“God” isn’t what you are thinking it is LOL. It’s just admitting you are powerless and submitting “to a higher power as YOU understand it”.

You don’t actually do any god worshipping at these meetings LMAO

All the AA groups I have been too actively promote NOT to bring up religion, politics or any of that BS.

It’s more about creating a community of alcoholics who can become friends to help each other. It is a support system. If you are a complete loser in life, AA will help you because you all have a common goal(To be sober).

You share stories. You feel amazing afterwords.

Getting a “sponsor” aka a superfriend you can talk to who basically goes through the steps with you on a personal level is a massive help. They teach you, give you a shoulder to cry on and kick your butt when you need it.

Plus they usually have free coffee. Go to a meeting for better understanding. It’s only an hour of your life.

My mistake, I'm having this conversation on two different forums and I did a copy/paste thinking that I only copied the stuff about medicine.

you have to understand when the State mandates by law that you are required to attend the meeting and you are an atheist, the very mention of 'god' by the organizations very principles is highly offensive to anyone who is of thinking person.

I'm ten months clean myself and I can safely say I never attended an AA meeting nor do I think it would have helped me. Most of what AA is about seems, frankly, like BS to me and I don't think I could have ever gotten behind their agenda, in large part because of the heavy religious element. I also very much dislike the part about telling alcoholics they're not in control. While I realize that many of them rationalize their behavior by telling themselves they're in control of it, I think a very big part of recovery is learning to be in control and taking ownership of things. Someone before mentioned cults, and like the number one thing cults do is try to break down your independence so that you can submit to their directives.

Anyway, I was just reading an article a while ago that was saying that AA works very well for people with a certain mental makeup, people who more easily follow commands and authority. For those who don't, going to AA is usually a series of constant relapses. If it works for you fine, but there should definitely be more alternatives and it should definitely not be mandated by the government.

the relgion part is the deal breaker for me.

that said, I think there is a lot of wisdom in the serenity prayer itself.

I mean, I look at the steps and there's so much I disagree with. Me, personally, I never felt like my life was unmanageable, just that alcohol made things harder than they had to be. That, and some of the people I know who went through AA don't seem to take all of these steps to heart. The one person that comes to mind doesn't seem to have "taken serious moral inventory," if anything he just went from being irreligious to beating everybody over the head with religion. Like I said, if it works it works, but I don't think we should treat rehab as a one size fits all type thing.

That being said, a lot of the people who go through the program can be pretty insightful. I tend to like the advice some of them give more than I like anything in the program itself, the serenity prayer being one of those things. That being said, I'm pretty sure the guy who wrote it stole it from Buddhism.

in my dream world of infinite money and no fear if I was ordered by a court to go to AA I would take the State to court and have them prove scientifically that its an addiction, that AA works on that scientifically proven addiction and have them explain how the religion aspect does not interfere with separation of church and state.

There are medications such as disulfiram (causes side effects if alcohol is consumed), acamprosate and naltrexone (if opioids are used as well and can reduce cravings for alcohol). Other drugs like baclofen, ondansetron and topiramate have been used but they're more expensive and are off-label so you won't generally see them used.

It works for alot of people.....lifesaver for many

honestly, it isn't about religion at all, your higher power could be a cat for all that matters...or a mouse. They don't preach religion despite God mentioned in the tenants. Have you guys attended the meetings? I was never unlucky enough to have the alcohol gene, but I know plenty of people who have, and I have sat through meetings because the basic tenants can be applicable to other problems, hence other Anonymous groups.

Point is, it works for ALOT of people, so if it doesn't for oneself look elsewhere. It does a lot of good.

One of the most important life lessons from the Big Book is concentrating on things you can control, and not worrying about the many things that you can't.

an addiction is an addiction in my books no stopping it

I do not know if AA works, however reading the comments above I can see the benefit of having a support network. If your friend isn't finding it helpful, he can try something different that has helped a lot of people break out of addictions - finding something different, new, more meaningful to do with their time & life instead of sticking to their old habits and relapsing. Change of environment and friends (who may be contributing to the addiction) can help. Does your friend have any passions in life, things that he wants to do, achieve, experience, play sports? Something that brings him out of himself, or allow him to not think about himself and his drinking? Other than that, psychoanalysis can be a great tool that can also help.

This guy nailed it perfectly, I couldn't have said it better.

This is what AA is about, many of the others here obviously haven't attended, are overanalyzing the "God" part, or lack the willpower to do it and want an exscuse to write it off.

there is no 'over analyzing the god part' when talking about the serenity prayer, when the State court has mandated to you that you must attend these meetings.

would the same group claim that AA can work even if you do not have faith in god? If I go to an AA meeting TONIGHT and ask them that what will they say?

@tryit:

It's a higher power, not necessarily any particular god. It's just a vehicle to lift the burden, nothing more.

AA works for many, I've seen that for myself. If it doesn't work for some, they can move on.

WTF is a 'higher power'?

a volcano?

I mean first off its not 'a higher power' its explicitly 'god' and its explicitly 'a prayer' and there is explicitly a separation of church and state

second off I have no friggin clue what 'a higher power' really means

and third off, you are saying its ok for the goverment to require people to worship a 'higher power';

@tryit:

A higher power can be an ant if you want it to be.

Anything you said after that needs to be referred to the explanation I quoted from "stuff". You likely haven't been to a meeting, he and I certainly have.

God was merely used in earlier times, long snice changed that meaning.

now I am even more confused as to what that even means.

so if I go to an AA meeting tonight and tell them 'i would refuse to submit to a god or a higher power will this still work for me?'

you are saying they would say yes?

feel free to explain 'higher power' to me as well.

I've always viewed it as a form of religious indoctrination. What better way to recruit people to religion than preying on them when they're at their lowest thinking they need a god in order to improve their lives. They need the idea of god, which is why they'll say "a higher power can be whatever you want it to be".

I attend one of the ___________ Anonymous programs and it works for me.

I think, like most things, it works better if you take it seriously and put work into it. It's also really nice to have a sponsor, someone you can call, text, email to bounce your thoughts off of. You attend these meetings and you can either sit and listen, or share whatever you want, but no matter what you are going to hear something that echoes your own experience, and...well I don't know how to explain it: it's like hearing someone else genuinely express your deepest, most secret thoughts, beliefs, and problems. You're going to think "holy shit, are they spying on me!?" but, no, it's just someone with your same exact problem (if not worse).

There is something incredibly reassuring about that. Furthermore, there are no judgments. It's a "judgement-free zone" and for a brief hour or so I even feel free from my harshest critic, which is of course myself.

As for the whole "higher power" bit, it's a non-issue. Yes, it's in the official script. No, you don't have to pray, believe in God, or whatever.

They would say "whatever helps you out". Seriously, man, it was one of my first questions and they said it doesn't matter, just work something in there. Just believe in gravity or the laws of physics or something. It seriously does not matter.

See my comments in quotes.

Not sure how to phrase this, but you can't take AA super serious like you need to take cancer treatments, or medicine for other things. But at the same time, those taking cancer treatments would also be seeking therapy and so forth, often in the form of group therapy.

Likewise, with alcoholism (or other addictions), the actual treatment comes from within, from your own mind. But there is the group therapy to aid you.

Yeah, I think our collective understanding of addiction is, at best, flawed. I really dislike the tendency of people to treat it like a disease, like something they just "caught" by chance and that they have no control over. To divorce the conditions in which they became addicted entirely from their addiction is missing the point in a spectacular manner. Of course, no one in our society seems to ever want to talk about many of the contributing factors to addiction (financial issues, lack of free time, overworking, etc.)

Regardless of whether or not AA is an effective treatment program for alcohol addiction, I think it has been pretty well established that addiction is a disease. Also, the conditions in which the disease was acquired are sort of irrelevant when it comes to whether or not it actually is a disease. Some people get diabetes through years of deliberate poor eating habits. That doesn't mean that diabetes isn't a disease. Some people get lung cancer because of years of heavy smoking. They didn't just "catch" lung cancer, they got it as a result of poor lifestyle choices. Does that mean that lung cancer isn't a disease?

Define disease, and established by who?

There is one thing I like about terming it a disease, and that's that people can't just turn it off. It has gotten people to realize that it's not some moral failing or character flaw that people can just overcome with grit, for the most part. However, like I said, it tends to make people infantilize them, to treat them as if they're completely helpless, which is the opposite of recovery should be about. It also drives people to look for an easy cure and, since diseases are typically dealt with pharmocologically, that cure usually excludes changing the conditions which led to the "disease" being contracted in the first place. Combine these two things, and you get a society that actively ignores the addict experience while simultaneously searching for a way to "cure" addicts, not a great combination.

You're politicizing the word. You feel uncomfortable with the results of recognizing it as a disease. I understand that. Regardless, it radically changes how the brain and the body function, it can't just be turned off, and in certain cases the physiological effects can be so severe that you can DIE if you stop taking the drug. That sounds like a freaking disease to me.

Now, to be clear...not all people who drink too much are ADDICTS. Some people are not addicts, they simply need to exercise more self-control. Also, most addicts can MANAGE their addictions with self-control (among other things). But that has nothing to do with whether or not it's a disease. Hell, you could say the same thing about lots of other diseases. Some bacterial diseases may be cured with antibiotics, and someone might be inclined to say that simply curing the disease with antibiotics doesn't exclude the conditions which led to the disease being contracted in the first place. And...okay. That's a fair point but it's got nothing to do with whether or not it's a disease. I hear that leprosy is curable. And if I keep on getting leprosy then clearly I'm doing something wrong in my life. But it's also clearly a freaking disease. The two things aren't mutually exclusive. You can recognize something as a disease while also recognizing the conditions that lead to the disease being contracted. In fact, I'd wager that that's usually more the way thins are normally handled. I regularly see PSA's about getting flu vaccinations and staying home when getting sick. It's advised to use condoms. It's advised to keep conditions sanitary and exercise proper hygeine, especially when living with potentially disease-spreading pets. It's also advised to STOP SMOKING, which is a preventative measure in order to prevent DISEASE. As far as I can tell, MOST diseases aren't viewed as "well, since it's a disease, I'll just be careless and then get the cure if I catch it." Just my anecdotal experience, which doesn't count for much, but I see a LOT of talk about disease prevention. I definitely don't think that recognizing something as a disease just makes people say, "well, f*** it, since it's a disease I'll just get it cured later."