Alcoholics Anonymous (AA) has been the “go-to” treatment for alcohol addiction since the 1930s. Its group meetings of other alcoholics, some recovering and some expressing a desire to recover, offer support and a 12- Step program that is geared to breaking the cycle of drinking and regret.
AA does not require an application or approval process; there are no dues. An alcoholic can find AA meetings all over the U.S. and in many international destinations. The program is not a cure and does not pretend to be one. “Once an alcoholic, always an alcoholic” is a scientific fact. The part of the brain that craves alcohol will continue to crave alcohol no matter how long a person has been sober. Many alcoholics attend AA meetings even after ten to twenty years of sobriety. They know that if they need a meeting, they can find a meeting. A meeting may be just what they need to avoid drinking “just a little” alcohol.
But Scientific American reports that about 40 percent of AA members drop out during the first year. The data they examined suggests that AA may be helpful in conjunction with professional treatment. However, it can also be harmful, particularly if an AA group is confrontational. An alcoholic may become resistant to change when attacked by the people he expects to help him.
Drug courts believe in AA; physicians and counselors routinely recommend it, and the general public believes in it. But how successful is AA in breaking the cycle of addiction? The evidence is mounting that the success rate of AA is between 5 and 10 percent. Alcoholics Anonymous surveys its members every few years. Their survey of 6,500 members in the U.S. and Canada showed that 35 percent of its members stayed sober for more than five years, 34 percent stayed sober for one to five years, and 31 percent were sober for less than one year. The average time of sobriety of successful AA members, as reported by AA, is more than five years.
If the success rate is 10 percent or 35 percent, it is not a success for the majority of AA members. AA members who do not manage to stay sober are typically deemed failures by friends, family, colleagues, many in the medical profession, and the justice system.
Lance Dodes, author of Breaking Addiction and The Heart of Addiction believes that those who attain
sobriety through AA do so because of the supportive environment of other addicts who are recovering and want to recover. AA members welcome and support alcoholics and provide a structure for working toward and attaining sobriety. A new member is gently led to the point where he or she can stand up and declare to the group, “I am an alcoholic.” Recovery cannot begin until a problem is admitted and owned.
But why do so many self-declared alcoholics fail to remain sober days, years, or even decades after sobriety is achieved? Here is where psychotherapy can increase one’s chances of staying sober. An addict needs to understand their addiction before he or she can manage it. Addicts need to be able to predict situations that activate the urge to drink. Forewarned, they can take steps to manage the situation before being overtaken by a helpless feeling that nothing will help but a drink. And that one drink often ends in a disastrous downward spiral.
Prescription drugs combined with therapy can assist the recovering alcoholic to achieve sobriety. Roger D. Weiss, MD, professor of psychiatry at Harvard Medical School notes that “medications can sometimes reduce the desire to drink. They can attenuate [weaken] the response that people get to alcohol, to make it less reinforcing, and they can, depending on which medication you’re talking about, help reduce protracted, longer term withdrawal distress.”
Recent research on the brain’s response to addiction is opening new modes of treatment. An alcoholic should not settle for treatments that offer little hope of lasting success.