“Lagers and ails” (Alcoholics Anonymous)

AU

My name is Wayne and I’m a blogger. Today’s post will be on Alcoholics Anonymous. I’m qualified to tackle the topic, as I’ve done my share of both drinking and stopping. In my mid-20s, I drank like an alcoholic fish. Then I decided enough with the lush lifestyle and went three years with very little consumption. A second round of sustained liver pounding followed, followed by moderate imbibing, and then the light drinking I now do.

Per AA, this gradual path should have been impossible. Persons should not be able to transition in and out like that. Once drinking becomes a problem, it is for life.  AA has an all-or-nothing approach, which is problematic because not everyone has the problem to the same degree, for the same reason, or is experiencing it in the same circumstance. AA also insists that the Biblical god be invoked, which is flawed because not all alcoholics are Christian. Incorporating biblical teachings and a leaning on a network of fellow believers will work for some drunks but not all.

AA literature states, “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program.” It is affirming the consequent to say that if someone follows the path they will be cured and then use failures as evidence the person didn’t follow the path.

Few people jump on Facebook to announce, “AA did me no good, I’m hungover as we write, and that’s been me every day this week.” Similarly, celebrities highlight when they’ve beaten the bottle but not when it has landed a counterpunch. As such, people are usually only exposed to the successes and this makes it seems like it works. It would be like hearing war stories and concluding that battle is safe because all the people talking about it survived.

Gabrielle Glaser wrote a book highlighting AA flaws and criticisms of it were primarily the logical fallacies of appealing to consequences and ad hominem.  “When my book came out, dozens of Alcoholics Anonymous members said that because I had challenged AA’s claim of a 75 percent success rate, I would hurt or even kill people by discouraging attendance at meetings,” she wrote, “And a few insisted I must be an alcoholic in denial.”

This is consistent with the judgmental, absolute, our way or the heathen highway approach employed by AA. It also mirrors historical American attitudes toward alcohol. Beer was quaffed on the Mayflower, including by school-age children since no potable water was onboard. The beverage was then embraced by these earliest immigrants, who showed ingenuity by using pumpkins to brew beer when the usual malt was unavailable. However, this welcoming mindset gave way to a puritanical throttling that forbid all pleasures, including drink.  Similarly, the alcohol-infused jazz and blues era was ushered aside for Prohibition.

AA continues with this no-middle-ground mentality, hammering attendees with the mantra of, “Once an alcoholic, always an alcoholic.” But I quit when I wanted to and this strategy has many other successful adherents. In 1992, the National Institute on Alcohol Abuse and Alcoholism polled 4,500 persons who had been dependent on alcohol at some point. One-third who had treatment were still lushes, while one quarter of those who had received no treatment were. So quitting on your own was 30 percent more successful than seeking treatment

University of New Mexico psychologists perused several controlled studies on alcoholism and concluded the best bet was an impromptu encounter between a patient and health-care worker in standard medical environment. For example, a physician performing a routine physical on a 37-year-old who has two decades of sustained drinking behind him, may tell the patient, “You’d best lay off if you want to have a functioning liver two years from now.” And the patient does just that.

There are many reasons people decide to reduce or eliminate their drinking. They may realize they cannot continue their college ways if they want to be a successful young professional. They may be hit with the magnitude of parenthood and know that rolling on the floor with slurred speech and peppery language sets a poor example. They may get away with an instance of drunk driving and resolve to never play this motorized version of Russian Roulette again.

Meanwhile, an analysis of methods published The Handbook of Alcoholism Treatment Approaches ranks AA just 38th out of 48 methods. A Cochrane systematic review confirmed the effectiveness of brief interventions, while another Cochrane review found no evidence that AA works.

While the fault lies with the approach, AA participants are made to feel like they are to blame if backsliding occurs. If they drink again, it’s because they failed to follow the steps. Compounding the problem is that AA paints itself as the lone solution, so if you lose that, you have no more hope.

The first AA step is to concede powerlessness, when a better strategy would be to equip problem drinkers with the tools and means to succeed. And again, a substantial drawback is that half the steps reference the Christian god, which is going to be irrelevant and off-putting to those who follow another religion or no religion. This also highlights the error trying to incorporate faith into a medical issue. If a heart surgeon, optometrist, or neurologist told you the solution would be found with “a greater power,” “turning your will over to God,” or having him “remove character defects,” you would, I hope, seek another provider. But a patient trying this approach with AA will be told they are in denial. After all this, it’s no wonder they want a drink.

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