INTRODUCTION
My name is John, and I am an alcoholic. This is the declaration made by members of Alcoholics Anonymous. Alcoholics Anonymous also claims to be the only effective means of recovering from alcoholism. Declaring to be the only effective source for recovery from alcoholism is like claiming there is only one drug to treat an illness. Alcoholics Anonymous is not an effective form of treatment for all person’s dependent upon alcohol. Studies, statistics, modern science, and rational thought have proven that Alcoholics is not effective.
ABOUT ALCOHOLICS ANONYMOUS
Alcoholics Anonymous was created Ohio in 1935 by two alcoholic men. Bill W. and Dr. Bob met and discovered that through the use of religious principles and working with other alcoholics, abstinence from alcohol was possible. The program established free regular meetings for members where they could share their experiences with one another. A textbook titled Alcoholics Anonymous was soon drafted explaining the program. The principles of the program were based on a Christian evangelical group called the Oxford Group. The Oxford Group based its ideals on the bible, and believed that through God and confession an individual can live a sinless life.
Alcoholics Anonymous follows many principles of the Oxford Group. As it exists today, Alcoholics Anonymous is simply a support group with role models rather than leaders. It has gained worldwide popularity claiming over two million members and over 100,000 groups. Membership to Alcoholics Anonymous to open to any person seeking to resolve their drinking problem. Alcoholics Anonymous alleges that it is a program fit for everyone. The program claims to work for those who follow 12 suggested steps. If all twelve steps are followed, recovery is guaranteed. The steps involve God, confession, forgiveness and helping others. Members believe that in a continuous completion of the twelve steps will result in recovery from alcohol so long as the individual refrains from drinking completely.
Members of Alcoholics Anonymous believe that if the 12 steps do not work for an individual, it is because they are not being entirely honest with themselves (Big Book of Alcoholics Anonymous). The Big Book is the book followed by the members of Alcoholics Anonymous. It reads
Rarely have we seen a person fail that has thoroughly followed our path. Those
who do not recover are people who cannot or will not completely give themselves
of being honest with themselves. There are such unfortunates. They are not at fault;
they seem to have been born that way
.
Alcoholics Anonymous alleges that alcoholism is a progressive disease that cannot be cured, but can be arrested through complete abstinence from the use of alcohol. It offers only one path to recovery from alcoholism. At the time of its creation, there were no other programs of recovery available for alcoholics.
EFFECTIVENESS OF ALCOHOLICS ANONYMOUS
Many claim Alcoholics Anonymous is an effective means of recovering from Alcoholism. However, the numbers of those who claim Alcoholics Anonymous is not effective are equal if not more than those who proclaim its effectiveness. In one study on the effectiveness of Alcoholics Anonymous, a researcher established six criteria to determine effectiveness. The criteria include magnitude of effect, dose response effect, consistent effect, temporally accurate effects, specific effects and plausibility. Using these criteria, it is easy to come to the conclusion that Alcoholics Anonymous is simply not as effective as it claims.
The first criteria are the magnitude of effect. This considers the relationship between Alcoholics Anonymous attendance and abstinence. If this is a strong relationship, Alcoholics Anonymous would be considered effective. In many studies, less than 10% of those who have attended meetings of Alcoholics Anonymous have remained sober. Thus, Alcoholics Anonymous fails the magnitude of effect criteria. The second criteria are dose response effects. This is the relationship between the quantity of Alcoholics Anonymous attendance to the level of abstinence. A strong relationship would include more Alcoholics Anonymous involvement equals more abstinences. Studies have been contradictory in this criteria. Contradictory results do not result in effectiveness.
The third criteria are consistent effect. This includes the consistency of the results of effectiveness. If most study results reveal the same findings, then the results would be consistent. As already mentioned above and as indicated in most of the literature concerning Alcoholics Anonymous studies, there are not consistent results. Studies conducted regarding consistency have not found a strong relationship between the number of meetings attended and the rate of abstinence. The fourth criteria are temporally accurate results. This holds that the relationship between Alcoholics Anonymous attendance must occur prior to abstinence in order to determine its effectiveness. Nearly all studies conducted on the effectiveness of Alcoholics Anonymous have not begun prior to abstinence. Thus, again, Alcoholics Anonymous fails to meet this criterion. The fifth criteria are specific effects. This means that there must be a specific association between Alcoholics Anonymous attendance and abstinence. Other explanations for abstinence must be ruled out. This has not been accomplished in any studies on the effectiveness of Alcoholics Anonymous because Alcoholics Anonymous studies have not used randomized samples. And finally, the sixth criteria are plausibility. This is the likelihood of Alcoholics Anonymous being responsible for abstinence. As in the other criteria, this has been difficult to determine due to the influence of other factors besides Alcoholics Anonymous on abstinence.
Relying on these six criteria, which are logical scientific evaluations that can prove effectiveness, has failed to show Alcoholics Anonymous is an effective means of recovery from alcoholism. Yet, this is not the only significant reason Alcoholics Anonymous is not effective. Alcoholics Anonymous also proclaims that any alcoholic will progress into disparity from the disease of alcoholism yet studies have shown that one out of five alcohol dependent individuals can continue drinking in moderation.
The National Institute on Alcohol Abuse and Alcoholism investigated the prevalence and correlation of recovery from alcohol dependence. Studies revealed that a substantial amount of individuals recover from alcohol dependence without Alcoholics Anonymous . The Handbook of Alcoholism Treatment Approaches ranked various treatment programs used throughout the United States. Forty-eight methods were considered. Alcoholics Anonymous ranked thirty eighth. Ranking at the top of the most effective methods were brief interventions, motivational enhancement programs, Acamprosate, community reinforcement programs and bibliotherapy. . Hypnosis, prescription medication addressing cravings, and exercise were ranked higher than Alcoholics Anonymous .
STUDIES ON ALCOHOLICS ANONYMOUS
Although there have been studies conducted to determine the effectiveness of Alcoholics Anonymous, actually evaluating the efficacy of Alcoholics Anonymous has not been possible due to the anonymity of the members of Alcoholics Anonymous and the lack of legitimate randomized studies. Literature reviews and meta-analysis have been used in studies to determine the effective of Alcoholics Anonymous. The quality of the evidence on Alcoholics Anonymous effectiveness has been one significant problem.
A 1993 study had issues with evidence quality. A meta-analysis conducted concerning the effectiveness of Alcoholics Anonymous found a strong relationship between not drinking and Alcoholics Anonymous membership. However, the study could only find a correlation as it the findings did not support conclusive results that Alcoholics Anonymous is effective. A 2012 study of on alcoholism in two cohorts of men found that the group that had acquired long term abstinence from alcohol frequently attended Alcoholics Anonymous meetings. However, the evidence is not conclusive on whether Alcoholics Anonymous results in better recovery. In additionally studies, patients participating in treatment with the involvement of Alcoholics Anonymous had better drinking outcomes than those who participated in other forms of treatment. In each of these studies, selection bias is a significant problem. Selection bias is a statistical error and provides an unrepresentative sample and questionable findings. Selection bias can only be eliminated by the use of randomized research designs. Studies of Alcoholics Anonymous have not been able to rule out the possibility that self-selection bias increases the estimates of participation in Alcoholics Anonymous.
In trying to eliminate the issue of selection bias, researchers in 2014 conducted a study using instrumental variables. This allowed removed the issue of motivation in seeking treatment from the analysis. The researchers concluded that attending Alcoholics Anonymous leads to the decrease of alcohol use, but for those who had attended Alcoholics Anonymous in the past, continued attendance had no impact on abstinence. Again, this study is faulty as it could not be conducted in a true scientific method. Contradictory results have been found in studies determining the effectiveness of Alcoholics Anonymous.
ALTERNATIVES TO ALCOHOLICS ANONYMOUS
Many alternatives to the treatment of alcohol dependence exist today. Yet, society has relied heavily on Alcoholics Anonymous, a mostly ineffective method for recovery. Anne Fletcher, the author of Inside Rehab, investigated the treatment industry and reported that nearly 80% of treatment facilities in the United States follow the twelve step program created by Alcoholics Anonymous . As a program with nearly ninety percent ineffectiveness, it would be beneficial for alcoholic dependent individuals to consider alternatives.
Alternatives include prescription drugs and therapies that can teach individuals to drink moderately instead of in excess. These alternatives are based on science. They have been studied through various types of research in randomized tests. The top three proven methods of recovery from alcoholism include brief interventions, motivation enhancement and the GABA agonist Acamprosate. One of these alternatives would be worth attempting for an individual afflicted with a drinking program.
There are fundamental flaws in Alcoholics Anonymous as it requires abstinence as treatment. Studies done by Neuroscientist John David Sinclair have revealed that complete abstinence from alcohol makes cravings much worse. The effects of alcohol on humans was not scientifically understood as it is today. Scientists have discovered that brain chemicals are responsible for the cravings of alcohol. A drug called naltrexone has the ability to alter the brain chemicals so that patients can have less intensified cravings and ultimately drink less. Naltrexone was approved by the Food and Drug Administration in 1994 for the treatment of alcohol abuse. The Sinclair Method with the use of naltrexone has been proven to reduce alcohol intake as an effective method of treatment for alcohol dependency.
The use of the anti-craving drug, Acamprosate, has also been studied and proven to be effective at an extent greater than Alcoholics Anonymous. A controlled randomized revealed that thirty-three percent of patients taking Acamprosate remained abstinent from alcohol. Acamprosate is a proven safe method of treatment for alcohol dependence with greater effectiveness that Alcoholics Anonymous.
Alcohol unlike other drugs affect various areas of the brain. Heavy drinkers’ brain chemistry changes over time. Less GABA, less dopamine, and more glutamate are many of the changes. These changes lead heavy drinkers to no longer drink to feel good but rather to drink to avoid feeling bad.. Addiction researcher G. Alan Marlatt stated that despite the lack of proven scientific verification of the efficacy of Alcoholics Anonymous, professionals still claim that alcoholism as a disease can only be treated through abstention.
CONCLUSION
Alcoholics Anonymous alleges itself to be significantly effective in treating alcoholism. This conclusion is based on flawed scientific findings and claims made by members who are unavailable to participate in valid studies. Alcoholics Anonymous is simply a support group that can assist alcoholics. It was created over seventy-five years ago when technology and science were limited and infant. Nothing in the program of Alcoholics Anonymous is based on present day science. Those who have studied the effectiveness of Alcoholics Anonymous have had contradictory results. Accurate studies are not possible. There are many alternatives to Alcoholics Anonymous that have been scientifically proven and supported to be effective in relieving alcoholism.
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