Addiction ~ Part 2: Treatment - Alcoholics Anonymous - "The Gold Standard?"

Good morning Planet Famers!

I hope you all had a good week last week, and a great weekend! It's Monday morning though, so time to get back into reality and the swing of things!

As you know, and can probably tell from the very unoriginal title of this blog, I am doing a series on Addiction. Well ultimately it will be on Addiction AND Mental Health, I just don't want to write that out everytime! HAHA! These are my thoughts, feelings, and opinions on the subjects based on my personal and professional experiences dealing with them. While I may include a statistic, or site a source, ultimately they are my opinions. You should not take anything I write here as gospel truth, as your truth may be different than mine. Nothing here should be construed as medical or therapeutic advice. If you are struggling with addiction or mental health issues, please seek out professional help! Don't take my blog, which is intended only as a means to begin a dialogue on these subjects, as treatment advice! These are general opinions of mine, but your situation may be different and thus these opinions may not work for you.

OK! Now that's out of the way! You may wonder, "why such a disclaimer?", when I already went over this in previous blogs. I mean, I was pretty clear already, right? Well, that's because today's blog, starts our exploration into treatments and approaches to treatment. What better place to start, than by taking a look at the treatment/approach that is most well known, and what most people consider the "Gold Standard"? That's right people! Today, we explore Alcoholics Anonymous! *ominous and startling- DUN DUN DUN* haha

There are just a handful of topics, when it comes to addiction and addiction treatment, that seem to absolutely polarize people. Alcoholics Anonymous though, seems to be in a category all it's own!
From what I have seen and experienced, both personally and professionally, it can be easily compared to religious fanaticism.

Those who support and believe in AA and the 12-steps, can sometimes seem as fanatical as any Westboro Baptist Church member! To question AA, to questions the 12-steps, is to question almighty God!

Those who do not support and believe in AA and the 12-steps, can sometimes seem as fanatical as any extreme Atheist! To believe in AA and the 12-steps, is to believe in magic and fantasy. They can view the people that believe in AA and the 12-steps as uneducated, illiterate, and in need of supervision!

Now, before we delve too deep into AA and the 12-steps, let me be 100% CRYSTAL CLEAR! Not everyone falls 100%  into one or the other category. Like anything else, there is a spectrum and people fall in between the two. I consider myself one of those people. I have no interest in attacking, or being attacked by anyone, on either side. Again, these are thoughts an opinions. If you don't like them, fine, but don't get preachy on me.

So, what is Alcoholics Anonymous?

The first meeting of Alcoholics Anonymous took place in Akron Ohio, in 1935. Founded by William Griffith Wilson (Bill W. in AA circles), and Dr. Robert Holbrook Smith (Dr. Bob in AA circles). While both of their stories are quite interesting, for the sake of keeping things short we'll skip over their backgrounds. If you'd like more on them though, send me a message or something.

AA was built on 12 steps to recovery. Published for the first time in 1939 as part of the book - Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism, commonly referred to as "The Big Book", they are:

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 decisions to turn our will and our lives over to the care of God as we understood him
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 our shortcomings
7. Humbly asked him to remove our shortcomings
8. Made a list of all the 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 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 and the power to carry that out
12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs

Later, in 1946, AA published the 12 traditions as a way to help fellowship be stable and unified while disengaging from "outside issued" and influence. They are:

1. Our common welfare should come first; personal recovery depends upon AA unity.
2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
3. The only requirement for AA membership is a desire to stop drinking.
4. Each group should be autonomous except in matters affecting other groups or AA as a whole.
5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
7. Every AA group ought to be fully self-supporting, declining outside contributions.
8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
11. Our public relations policy is based on attraction rather than promotion; we need always to maintain personal anonymity at the level of press, radio, and films.
12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Through the years since, AA has published thousands of books and literature on the subject of recovery, AA, "the fellowship", and recovery. Too many to go into, but if your interested in learning more, the information is out there.

Seems like a pretty simple program, right? It's pretty straight forward, and who doesn't love a progressive program?

Now, AGAIN, I'm only sharing my thoughts and opinions. If you disagree, you're welcome to do so in a civilized manner. Otherwise, I really don't have the time or desire to hear from you. I am actually a fan and supporter of AA. I don't necessarily follow their teachings or program though. I have never completed the 12-steps, never had a sponsee (we'll get into that in a moment), and only ever had a "temporary sponsor" by order of the courts. If AA and the 12-steps works for you, WONDERFUL! I am so overjoyed that you found your path to sobriety and a better life! :-) It's not for everyone though, and that is an UNDENIABLE reality!

So, what are the "negatives", or what are the..challenges that I have seen and experienced with AA? It seems like a simple enough program, right? It is widely accepted as the "gold standard" in recovery, so it must be good, right?

Well, as I said, for some people, AA saves their life EVERY SINGLE DAY! These simple steps, this simple guide to how to live your life, has literally saved thousands of lives from addiction. No one is arguing that. That being said though, here are some startling bits of information about the "gold standard" treatment approach.

1. Data doesn't lie, it also isn't consistent. Depending on your sources, AA has an estimated success rate of between 5% and 36%. That is a HUGE margin of error! And even with the high end, a 36% success rate translates to 2 out of every 3 people are unsuccessful. Not so much a "gold standard" statistic, in my opinion.
2. The sponsor/sponsee relationship. One of the key pillars to the AA program of recovery, is the concept of the sponsor. A "sponsor" is an individual that is selected by the "sponsee", or newcomer to the AA program. The "Sponsor", then helps that individual work through the 12-steps of AA. They teach and guide the individual through the program by sharing their "experience strength and hope" with them. They are a guide, a confidant, a mentor, and they help the newcomer be accountable. The general concept of a sponsor, is lovely! I am a huge fan of the concept. It is also probably the only part of AA, that I have a serious issue with. There is little, to no, consistency with regard to what qualifies someone to be a sponsor! While some people will tell you they need at least a year sober and to have completed the 12-steps, others will say 2 years sober. Others will say there isn't a time requirement, and that it should be based on "the strength of the persons sobriety"...whatever that means. There is no formal training, no standardized format to take a sponsee through the steps, and really no accountability for the sponsor other than their accountability to their own sponsor.
3. Psychological and mental health issues. AA and the 12-steps, in my opinion, do very little to address an individual's psychological and mental health issues. While some would site steps 4-7 and step 10 as addressing these issues, I believe there is a significant difference between a person's shortcomings and their psychological issues.
4. Psychotropic medications and the AA taboo. Many AA believers, particularly the "old school" AA goers, have perpetuated a dogmatic and in my opinion archaic view on psychotropic medication. Their belief system is, that if you are taking "drugs", your not really sober. Sobriety/recovery to them, means total 100% abstinence. INCLUDING psychotropic medications prescribed by, and under the care of, a doctor. Don't even get me started on the use of anti craving medication, or maintenance medications like Suboxone. They view that, almost the same as still using. This despite championing the disease model. To me, it's like saying you believe in cancer but you don't believe in chemotherapy. 
5. Oversimplification for a not so simple issue. The last point, or critique, I want to talk about in this blog is rather abstract. In my opinion, AA and the 12-steps often try to take complex problems and situations and oversimplify them. Often trying to take trauma, an anxiety disorder, or some other complex issue and "jam" it into the 12-steps. While I do believe most people struggle with over complicating things, and that simplification is a good thing, not everything fits nicely into the 12-steps. Many people that champion AA and the 12-steps, fail to recognize that. This program was developed in 1935, we didn't have the problems we have today. While trying to keep life as simple as you can is good, in my opinion, it isn't always possible. Failure to recognize that, is a failure in its own right.

After reading all that, I am sure some people disagree STRONGLY with me! Some of you probably also believe that I am "against" AA and the 12-steps. Would it shock you then, to know I have actually directed ALL of my clients struggling with addiction issues to attend AA? That I am actually a fan and supporter of the AA program?

While I may have my issues with AA, and I disagree with the idea that it is or even should be the "gold standard" for treatment, I have seen it work. If you are one of the blessed individuals, that found their sobriety through AA and the 12-steps, I could not be happier for you! It is truly and wonderful thing!

I believe that AA and the 12-steps are a wonderful ADDITION to recovery. One of the biggest and best values it brings to an individual struggling with addiction, is the community. The support, the camaraderie, the accountability, are all things a person trying to get and stay sober needs! 

I do not believe it should be considered a stand alone approach to sobriety. I believe that treatment programs that are based entirely on the 12-step model, are a ripoff. If the 12-steps alone were enough, why isn't the success rate higher? Lastly, if the 12-steps and AA are the gold standard, why on Earth would it be classified as a disease?

I know this is a controversial stance and opinion to share. I hope I have not offended anyone, as again these are my thoughts and opinions only. If you disagree, that's wonderful! It's important to have differing views! I would love to hear from you, in a respectful manner. 

That's all for now Planet Famers! Until next time, have a great week!

Sincerely,

Fames