Why has AA persisted for all these decades? Bluntly put, it's free. People who are in need of treatment frequently have very little in the way of financial resources. If you're wealthy in this country, you get rehab and therapy. If you're poor, you get AA and maybe evangelical religion. Whether the Obamacare mandates will improve upon this situation remains to be seen.

That said, I am one of the people whose lives were saved by AA. That was 30 years ago, and today I'm a very light and non-problematic drinker. But the seven or eight years during which I was totally abstinent allowed me to build a new and happy life in which I didn't need to self-medicate with alcohol and drugs. Like another commenter here, I was never too keen on the God stuff, but the other steps -- doing a moral inventory, desiring the removal of character defects, and making amends to people you've harmed -- taught me how to be a decent human being, a much better person than I would have been otherwise. Hanging around with other people who were bent on self-improvement, and who reinforced my steps toward sobriety and responsibility, probably was helpful, too.

Is AA perfect? Of course not. What is? I have no problem with other therapies and I'm not inclined to argue with success. At the same time, I think discarding AA without having a better model firmly in place would be akin to throwing out the baby with the bathwater. AA does, in fact, work for many people. It's ubiquitous -- there are meetings in almost every community. And last (but certainly not least) it's FREE!

The problem I have with AA and NA is that they are a cultish pseudo-cognitive behavior group therapy outfit masquerading as a psychological panacea for extremely serious conditions. Subutex, librium, and valium have extremely high rates of efficacy for withdrawals from heroin, alcohol, and stimulants. Coffee and cigarettes and a higher power aren't even close to a 20th century understanding of what treating addiction looks like.

And yet it works for a lot of people. Funny, that! Of course, there is much more to it than "coffee, cigarettes and a higher power," though. There are (most importantly) the 12 steps, which are mostly about building character. There is the camaraderie of sharing your innermost thoughts with the group, and being accepted-- even, I daresay, at times LOVED -- and sometimes receiving a much-needed kick in the pants. (No one will call you on your B.S. quicker than a fellow addict!) So ... there is kind of a lot going on there. Unless you've been part of a group, and worked the steps, that may not be obvious.

I think your comment really illustrates the difference between someone who has experienced AA and someone who has read about AA.

I'll admit that some meetings are stronger than others. AA meetings are independent and self-supporting, so they can vary considerably.

It's difficult to make blanket statements about AA's effectiveness due to this fact, but there's nothing quite like the feeling of sitting in a strong meeting surrounded by people that care about you and share your struggles.

One of my favorite memories from "those days" is the time when I broke down in tears during a meeting because I couldn't even afford a Christmas tree. I had only been sober for a couple of months, and had just left my (also alcoholic, and abusive) husband six weeks prior, and so money was tight. After the meeting, a woman I didn't know came up to me and said she had an artificial tree that I could have. She even delivered it (I didn't have a car.) Little things like that ... man, you just can't put a price tag on it. :-)

Yeah, but you're forgetting it's like all trendy and cool to bash AA these days, especially the "higher power" component. Bashing and critiquing AA is a wonderful sport, like shooting fish in a barrel. The Church of Satan has more respect than AA these days.

Absurd. Faith based solutions should be called what they are. If they work for some people, great. But they should not be masquerading as a empirical science based solution and when they are that's a problem that deserves to be criticized.

Everyone thinks it's cool to bash anti-vaxxers now, too. You know why? Because it's dangerous. And AA is dangerous because it doesn't help people. Read the article before you post.

AA absolutely helps many people that would never recover on their own. Youre making all kinds of absolute statements and you have no idea what you're talking about.

According to this article and the studies it cites, that's not true. And actually, I do know what I'm talking about. I've gone to AA and NA but stopped going because it's a terrible program that didn't work. Instead, I went to therapy, stopped doing drugs and now only drink socially. I admit I am lucky in that I never hit rock bottom or harmed anyone but myself with my use. But NA made no distinction between my problem which wasn't really severe, and the guy who crashed his car and killed his wife.

NA and AA didn't help me and they didn't help that guy either. We had two different relationships with alcohol and needed different treatments. He killed himself later and after that I refused their 12 steps. It's ridiculous and doesn't work for a huge majority of people.

I think the problem here is that AA does work for some people and you're going to have a hard time convincing those that it worked for that it's not the best approach just like an AA'er is going to be hard pressed to convince you that AA is the best treatment for you. Your respective experiences dictate otherwise. You have to admit, religion does work for some people as a panacea for their ills. You have to respect that and be happy that their lives are better off if you want to fairly expect the same in return. AA is the same. It's a faith based solution that works for some people. I'm happy for them that they were able to use it to better themselves.

I can agree with that. However, it is dangerous to say that this is the only way and many of their methods will not work for the majority of people who use it. The problem is that AA is the default and it's not very effective. But if you say that, you're a monster.

However, you are right that I shouldn't begrudge or discourage those that have found success through it.

Yeah I regret that there has been so little medical and scientific research and progress in this country in this area and no doubt, as the article above painfully documents, in the past when researchers have discovered findings at odds with AA's core principles the findings have been ridiculed and the integrity and motives of the researchers questioned and attacked from AA members that found the treatment successful for them. That's been a problem. Another is that rehab is such a huge industry in this country with AA being the primary means of treating people. Such entrenched financial interests are naturally going to be resistant and hostile to other means of treatment, especially if they prove to be more effective. That's probably the biggest problem I see today that prevents change from happening at a more progressive pace that keeps up with the science. But I do see progress. Courts are allowing other treatment options for those that get caught up in the system if they're available in the area. There's just not very many alternatives widely available and information remains much more scarce. Given the attention this article has brought to the issue I see reason for optimism. It might be slower to get there at first, but at some point it'll reach critical mass and change will be much more swift. Because a 5-8% success rate is not something I think society will just tolerate by default forever.

So your personal experience can be extrapolated to everyone on earth? Your arrogance is matched only by your ignorance.

Personal anecdotal evidence is how the AA community claims it works, If you work it. That's not true.Somehow the public believes AA works for everyone. AA has nothing to do with that of course. The people who fail AA (never the other way around) need options. I am an AA survivor who got lasting sobriety with WFS.

Your ad hominem attacks will not make you right. I admit that my experience is anecdotal. I never shy from that fact. I was responding to someone who said I had no idea what I was talking about. You should read the whole conversation before picking one comment you don't like.

It's funny that you speak of ignorance considering you're ignorant to the conversation. In my book, ignorance is when you don't and can't know better. It is forgivable. Stupidity is when you should know better. I wonder which one you are?

Exactly. Some 'sheep mentality,' idiot, who apparently believes everything printed in The Atlantic rag. I'm sure AA has many faults and problems and whatever, but I am not buying into the trendy garbage that AA evil incarnate.

Are you aware that the author of this article meticulously cites all her sources? She's not just randomly speculating, it's based on real research into academic studies and successful approaches based on modern medicine and treatment in Finland. If you've got a problem with something in the article, then you should cite what it is. I didn't read anything in it that said AA was "evil incarnate". That's your hyperbole and straw man.

Craig, there is a difference between being an addict and being chemically dependent. If you did not relate to anything said at the meetings you attended, you're probably not actually an addict. Chemically dependent people get physically attached to pills or pot for a while, but with a little treatment they're fine. For an addict, it doesn't matter what or how much you used. You will pay any price to stay high. If you are an addict and you are drinking, you will eventually find yourself in the situations you described in reference to others at meetings.

The 12 steps are free, and they work for millions of people. I have been to many AA meetings with 100 people at them in which more than half have 20+ years of sobriety. How long have you been clean? The truth is, you will get out of the program what you surrender to it. If you continue to hang around your old using friends, it won't work. If you refuse to admit that once you start drinking you're out of control, it won't work. That is all that powerlessness means-respecting the power of the disease and taking appropriate steps. Me, I have no desire to drink or use. The spiritual growth I have instead of using is far more valuable to me. If spiritual growth is not valuable to you, by all means continue to drink.

I couldn't agree more that Judges mentioning meeting attendance during any kind of hearing or sentencing is a bad thing. It is also, in my opinion a violation of AA or NA traditions. "AA as such ought never be affiliated with any related facility or outside enterprise, lest problems of money, property or prestige divert us from our primary purpose." It is not AA doing this, it is the judge making the coerced recommendation.

I don't believe I was a severe addict. And since I had insurance I had options. AA is not a horrible monster or anything like that. But it's a shame that it's the only option for most people. There are proven, inexpensive options that could easily be covered by insurance that we're required to have now, or be covered by Medicaid. I'm hoping that AA is no longer the only option for those who can't pay for anything.

Also, if you turn out to be wrong about your current treatment option, nobody at the meetings cares about any of that, you are welcome and encouraged to keep coming back. If the meeting you went to sucked, try a different one until you find one that fits. There are some really great people there who want to help.

Sure, they want to help. But they didn't. They couldn't. My problem was not their problem so AA was not for me. After reading your comments, I'm getting more convinced that it isn't a terrible thing, but it shouldn't be the first thing. It's a support group, but not a treatment group. It seems to me that it won't harm anyone and could do good if it's part of a multiple treatment format. However, using AA alone does not seem like the right choice and the people I saw who did that, relapsed every time. If you're being told that you have one drink, you're back and destroying your life, then you very well could be living a self-fulfilling prophecy. That's my issue.

There are far better treatment options out there like it's outlined in this article for people who are as addicted as could possibly be. A 78% success rate sounds far better than the 50% from your anecdotal account. Let's split the difference and say that my 10% and your 50% and say that AA gets 1/3 of people away from drinking. Admittedly, anecdotal, but let's go with that for now. The 78% effective drug is now in a generic form and costs $2 a pill. That's less than a bottle of beer in most bars.

I was lucky in that my insurance covered the cost of therapy. Very lucky also that I was not a severe user. However, the fact that I wasn't, and yet was treated as if I was, is my big problem with AA. There is no range. There is no other model. It is the 12 steps, taught by an unqualified ex-addict. Support groups are great, but they aren't treatment.

My personal experience was that I had a drug and alcohol problem. I never went to treatment. My bottom was not nearly as low as many people I've met at meetings, but I was told that it didn't matter what or how much. Yeah, if you're trying to kick opiates or crack I think you want to go to a facility for sure. Almost all people I've met at meetings use them as part of an ongoing recovery program that started with a professional treatment facility with real doctors. That goes to your point about people at meetings not being professionals, yet sometimes talking as though they are. There is at times a huge difference between what is said in the NA literature and what some individual members say. In the end a person's recovery is their own responsibility. You must filter what is said and decide for yourself what does and does not make sense to you. I have found what is said in the actual literature to be dead on, which is really pretty amazing. The program offers a lot in terms of free ongoing support that as far as I can tell is necessary for addicts.

I'm easing in my anger with AA, but I still think that this drug would've been perfect for you. You didn't seem to really need therapy, all you seemed to need was a little self control. It's not my place to make judgment and I can be totally wrong. For me, I needed therapy to deal with the real issues behind it from a real professional who understood how my mind worked. I only needed a few sessions and some training on how to control myself, but that pill would've made it way easier.

AA did not help me. It made me want to drink. Made me feel like I wasn't in control of my actions. But when I accepted that I was, and learned better ways to cope, I got over it. It took a few years of damn near abstinence and two cases of relapse that were luckily minor, but for the last four I have one or two drinks socially and stop. I have made a two drink limit and stick to that. I feel that this is a much happier place than those who were 10 years sober in my group. They were still fearing the day they relapsed again. I don't anymore because to them, I relapse once or twice a month. Except that it isn't a bad thing to have a drink once in awhile, as long as it's just one drink.

Of course, this is by no means for everyone. Some people should never drink, but if you have a situation like ours where we didn't ruin ours and others lives, it's ridiculous to say you are destined to always over drink.

Drugs as a cure for a drug problem....thats insane and illogical

Just because you don't agree with it, doesn't make it illogical. Logic should be based in evidence. The evidence has shown that drug treatment for drug addicts is actually highly effective when prescribed properly and weaned off of it. Far more effective than AA.

But your personal beliefs should trump science and saving people's lives it seems. We have a name for that. It's called being a dick.

If you believe the article, you are as gullible as the anti-vaxxers

I don't believe everything in this article, however, researchers have found that the drug mentioned in this article is as effective as it is stated. I also learned the the generic is selling for two dollars a pill and has been shown to work with people who not just dependent on alcohol, but opiates as well. The fact this isn't more well known is a terrible tragedy.

You believe everything you read on the Atlantic? Are you an imbecile of some sort? Knock yourself out with your follow the sheep mentality.
I did read that article and disagree with it 100%. Like I said- it's suddenly become all fashionable and trendy to bash AA and consider it an evil empire. Is AA for everyone? No.
But I am not buying that AA is evil incarnate. Many apparently find great benefit from it.

I don't believe it's evil incarnate. I believe it's a program that helps few people and because of that gets the benefit of doubt. It is by no means the most successful program but is free and can be attended by anyone. I personally don't have a problem with the faith part of it either. Religion can help people too. However, that doesn't mean it should be the default and it definitely should not be the only method used if their are other options available. In fact, it shouldn't be the go to method.

Of course. More Options = Better. Simple as that. I don't believe AA should be any type of default, or solely used by the courts and such. They need ten different options, twenty different options, thirty different options for treating people. I don't consider AA as better or worse than any other method. People have a problem with some "high power," great, create some atheist AA. Like Finnish methods where Alcoholics and Problem Drinkers are still encouraged to consume alcohol? Great, knock yourself out and still enjoy drinking...etc...
The part that kind of pissed me off, and this has nothing to do with you, is in the last 2-3 months I have seen articles in many major papers and online news, such as the NY Times, slamming AA. To me, that is stupid and a waste of time. Don't like it? Join, or create something better! Just please, stop whining about how bad and evil AA is. It has helped many thousands of people over the years, it is not evil trash. Clearly for some it does work, whilst it is like The Church of Satan to others.

The reason AA is being bashed is because it's violently opposed to any other methods that show the twelve steps are not effective. More and more studies are coming out and showing that it is not that effective and that's why theaters are attacking it. If an institution is an institution not because it's the best, but because it's the default especially when they're are better operations available, then it should be criticized.

One of the best things I've heard on here is somebody said "They prescribe these sobriety drugs to addicts. You know who doesn't want to take these drugs? Addicts!"

If you read the article above you'd see examples of addicts cited that wanted to and did take those drugs to get their addictions under control. You're generalizing to make a self serving point. Just like I can say "You know who doesn't want to go to AA and put effort into working the program? Addicts!".

I think the essential ingredient for any success with addiction recovery is willingness. What many here seem to think is that there is a way to get an addict who still wants to use to stay clean with a pill.

ANYTHING works for a lot of people who have decided they want to change their behavior, and now it's proven that some of the options work significantly better than AA. Don't you want alcoholics to have the best shot at getting sober?

Absolutely! The more resources, the better. What works for one person might not for another, and vice versa. When I wanted to quit drinking, I was 19, uninsured and penniless ... rehab, therapy or medical interventions were not available to me. I had to take what I could get, which was religion or AA. Being agnostic, I chose the latter. Luckily, at least for me, it worked.

Now, obviously it would be great if everyone in need of help could spend a week at the Betty Ford clinic! But it's likely there are still people out there without significant resources, or who are hampered by lack of transportation (I only had to walk about 10 blocks to an AA meeting when I didn't have a car). Etc. Hopefully, for them, AA or some other free programs will continue to be available. Some help is better than none at all, and AA *can* work if you give it a chance. Ask me how I know that ... :-)

The final 5 year follow up study in Project Match showed that the 12 Step approach had better outcomes compared to Cognitive Behavioral approaches and Motivational Enhancement. Don't YOU want alcoholics to have the best shot at getting sober?

Yes, the dozens of approaches shown to be better than AA in the above study, not the ones you cite that don't Dummy. Stop shooting yourself in the foot, it's cringeworthy.

Don't you get it dummy, the author of the article omitted all of the favorable research supporting TSF and 12 Step participation. That's the point!

Not true on a few counts. One thing is that Project MATCH was not designed to show whether one treatment was better than another. Another is that all groups fares equally as well. One can't rack one's brains for a decades trying to find a positive statistic with every statistical method imaginable and then claim the one desired result relevant.

Motivational Enhancement came out the best from a public policy standpoint. It had the same "success" as the other two but it was much, much less expensive and time consuming so it was much, much cheaper. If one is paying for something that has no determined positive effect, the cheapest one is best.

One thing Project MATCH didn't do but should have, is had a non-treatment control group so they could determine if any of the treatments were better than nothing.

Not true Ken! According to the authors of the study, "12 step facilitation continued to have a slight advantage over CBT and MET." You've also left out the fact that the U.S. Substance abuse treatment system has probably spent over a billion dollars researching M.I. and forcing counselors into expensive M.I. over the past 20 years. Moreover, researchers are constantly struggling with clinician fidelity to the model. You'd have to factor that into the overall cost. The training recovering counselors get in TSF, cost the taxpayers ZERO dollars, because it's lived-experience. This why SAMHSA has wisely moved in the direction of recovering peer support specialist working with clients and taking them to 12 step programs, which again cost the taxpayers nothing. I'm sure you know all this, rather, you intentionally omit these truths. Fortunately, SAMHSA is guided by research and facts, and isn't on the payroll of the alcohol industry like Mr. Peele.

Sorry but any study without a control group is not a rigorous study that would be accepted in any peer reviewed academic journal.

Sorry, but that's superwrong. Project Match has been in numerous peer reviewed journals, and TSF has been studied with control groups like Ken Winters study in 2000. Of course, if you really want to discuss the highest research standards, then we're talking, control group, authentically randomized, multi-site research. Sadly, hardly any research lives up to that Platinum standard. If we only looked at Platinum research, we could collapse the hundreds and hundreds of scientific journals into one single journal. So, sorry your really superwrong. We look at research in its entirety, silver, gold, and platinum. We use wisdom from both academia and experience to assess the breadth of research, dismiss the bad, consider the good, and try to reconcile it with great research.

I hate to be the bearer of bad news, but unfortunately, many peer reviewed journals have printed very flawed studies on alcoholism, including more than one with no control group.

That's terrible.

And who reports taht the CBT and MET had a slight advantage? It wouldn't, perchance, be people with a horse in the race?

Project MATCH did not test anything that was free. All three test conditions were therapist run. The M.I> group had I think a total of only four visits which is why it is so cheap.

Your describing the AA facilition as being free is simply not true. It required far more therapist visits, which is why it cost more.

It seem you have pulled you "facts" about Project MATCH and the rest from where the sun don't shine. A "study" meaning a writeup of what one wished a study had found is worthless. Try reading the original report on it.

You're assuming TSF cost more because of visits, but you don't know what the reimbursement rate was. You don't know how many people were in the groups. You don't know how much money it cost to train counselors in MET. Your making a ton of assumptions. Nonetheless, SAMHSA, is moving to recovering peer support model and 12 step meetings because it's cheaper. It's in motion nationwide. So, it looks like you can't accept reality of this sea change in behavioral healthcare, cause you've got your head where the sun don't shine.

You are just being silly now. I'm done.

Except that studies, as stated in this article, show that it doesn't work any better for people who just try to stop without AA. A 12% success rate is laughable. I get it. You stopped drinking and that's good. However, it wasn't AA that did it. It was you. You likely would've quit drinking without AA because you have a lot of personal strength and character.

Also consider what AA has done to destroy other, more effective forms of treatment and that people who run it are not experts suggesting as if they are. AA is not effective method and no study worth it's salt has ever shown it to be.