So a rabbi I know came back from LA pretty jazzed about a Jewish addiction treatment facility there called Beit T'shuvah and so we talked about their approach and that got me curious about non-AA approaches to dealing with addiction which, my friends, was FASCINATING.
So, like, everything I know about AA is more or less from the West Wing. I'm fortunate in that no one in my immediate family has dealt with substance abuse issues, and as far as I know, none of my close friends are alcoholics. So, my knowledge is pop culture knowledge.
oops hang on gotta deal with cooking dinner--will be back to tell you about this rabbit hole in a few
Okay, so, anyway, it was interesting to me because A) I'd heard that a lot of people who aren't Christian have a hard time with AA because it's so Christian, and
B) the difference in philosophy was subtle at first glance but actually paralleled a lot of the differences between Judaism and Christianity if you dug into it.
So I got curious about whether success rates were different for Christians vs. non-Christians and started googling. Didn't find much in the way of the data I was looking for, but I *did* find something a lot more disturbing, which is that the whole thing's not scientific. At all.
The National Center on Addiction and Substance Abuse compared the current state of addiction treatment to medicine in the early 1900s, when there weren't a lot of standards for who could practice medicine. archive.org/stream/781862-…
In order to be a substance abuse counselor in many states, you don't need much more than a GED or high school diploma.
A 2006 survey found "no experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems." ncbi.nlm.nih.gov/pubmed/16856072
And I want to make clear here that I'm not saying AA is bad--clearly it's helped plenty of people. The problem is that it's touted as a universal approach. Which is a problem when it's not based on science.
AA claims that its success rates... for people who "really try"... are 75%. But the most precise study out there that's NOT coming from AA (amazon.com/dp/B00FIMWI1O) put actual success rates at 5-8%.
One of the major textbooks on treating addiction ranks it at 38th (out of 48) on its list of effective treatments. amazon.com/Handbook-Alcoh…
Moreover, the 12 steps don't really acknowledge--or provide any guidance or structure for dealing with--other mental/emotional health issues. Which is a problem when people with substance abuse issues have higher than average rates of those issues.
And to top it all off, AA's philosophy tells you that if you're not succeeding at it, it's because you're not committed/not trying hard enough/etc.
Now, if this were just one of a range of widely available treatment options, it'd be like, whatevs, different approaches for different people, etc.
But 12% of AA members are there because of court orders. Our legal system is requiring people to undergo treatment that is A) Christian-based, B) not scientifically supported, and C) doesn't work for the vast majority of people.
I mean, here's a pretty comprehensive breakdown that talks about the lack of scientific support for it, alternative treatments (like those in Finland, and naltrexone), and the fundamentalist origins of AA. theatlantic.com/magazine/archi…
The founder was a member of the Oxford Group, an evangelical organization that taught that all human problems stemmed from fear and selfishness, and could be solved by turning your life over to divine providence, basically.
He based AA on those principles, and given that the only alternative was "drying out" in a sanatorium, and that AA members would show up at bedsides there and invite inpatients to meetings, it must have looked really enlightened to people.
And to their credit, they were some of the first people out there saying alcoholism was a disease, and not a moral failing.
But, like: 
And then Senator Harold Hughes, who was an AA member, got Congress to establish the National Institute on Alcohol Abuse and Alcoholism, which promoted AA's beliefs, and sometimes suppressed research that conflicted with them: 
The standard 28-day rehab stay, prescribed and insured: 
And (read, especially, that last sentence, which is chilling): 
And, again, the idea that this is the One True And Only Way to deal with alcohol abuse leads to medical professionals ignoring research and treatment options that could be helping people. 
So, again, I'm not saying that AA is bad. I'm saying its *hegemony* is bad. It clearly *is* effective for some people. But it's not for the majority of people, and that's a problem when it's being prescribed by courts (and doctors) as if it's a one-size-fits-all approach.
And, unfortunately, I ended up reading all of this stuff and being D: and didn't end up reading about what I was interested in, which was other cultural approaches to dealing with substance abuse, and whether they're effective.
So, I'm still interested in reading about *those*, if anyone's got good links they want to share.
