AA: Cult or Cure?

Is an easily accessed peer network based on sobriety. Instead of hanging out at the bar, you do your meeting, get a little love and positive reenforcement. Works for some, others find the war stories trigger cravings.

Addiction treatment kind of a crap shoot anyway. More alchemy than science.

Is my 2 cents as a primary care provider x 14 years.

Unfortunately outside of the area of emergency medicine, the same can be said for treatments in a lot of specialities in medicine in that they are neither effective nor based on a solid base of scientific evidence.

Many treatments in psychiatry (to which you are referring here) are very wishy washy in terms of the evidence the have for their efficacy (look at the efficacy of antidepressants versus placebos for example).

And don't get me started on sports medicine - just look at the sheer number of us on these boards who have been conned out of thousands of dollars by doctors who have had no idea on how to manage running injuries.

It is not really fair to pick on one treatment in medicine when there are so many others that also ineffective.

Executive Summary wrote:

This message serves as final confirmation of AA as a harmful cult. Motion passes.

I'm no fan of AA, but as others have said here, if it helps stick with it.

Many here know the 12 steps, but few seem to know of the 12 Traditions which are precisely what keeps it from being a cult.

When local groups go rogue, they tend to die. There is minimal national organization and little money. Not a cult.

It worked for my mom, sober 27 years.

Has also worked for many other folks I know.

Never met anyone that got sober using medications.

Not sure I understand peoples' problem with it. I would venture that more people than you think in your life have found success through a 12 step program.

The Cult has a few good songs (i.e. She Sells Sanctuary) but you can't really go against the Cure's entire discography

Why don't we start by having the person who started this thread explain why they posed this question? Did you go into AA on a court card or did you go to a few meetings to see what it was like and make your own conclusion? Did you work the 12 steps and give it a year? Are you an alcoholic, and addict, or do you understand what it is to be one?

a shocked physician wrote:

Addiction refers to a a strongly ingrained habit that brings about incremental reward. Examples include habitual overeating, drinking too much, and even good habits like running. Most such habits engage the dopaminergic mesolimbic-prefrontal cortex pathways. Some structural changes take place in these and other brain areas with 'addiction,' but there is evidence that such changes reverse with stopping the habit.

this guy knows what he's talking about. You haters can hate, cause you don't have the skills to appreciate.

Certain behaviors that run rampant in our society also engage overlapping pathways: sub cortex and a bit of the prefontal cortex, dopaminergic pathways, some emotional-social pathways... (the latter which would cover other neuronal chemicals and neuroanatomical locations)

Those behaviors being: sexual activity, social media addiction--it's become the norm, there is no light use of it anymore--and that also govern some people's running habits, eating habits and obedience habits.

It's good to find activities that can disengage one from the frenzy of these oft bad habits: sleeping, showering, meditation, stretching, yoga, gardening, contemplative walks in nature, playing music, healthy eating, fasts, certain reads, cleaning one's house, taking care of one's body.

jorvack wrote:

It worked for my mom, sober 27 years.

Has also worked for many other folks I know.

Never met anyone that got sober using medications.

Not sure I understand peoples' problem with it. I would venture that more people than you think in your life have found success through a 12 step program.

My problem with AA is that it encourages groupthink and it is anti-intellectual. The concept of the disease of alcoholism is not well founded scientifically or therapeutically, yet it is asserted with religiosity. But as I said before, if it works for you or your loved ones, great. It's just that it is often presented as the "only" effective treatment for alcoholism. Further, why is your comparison "medications?" There are other approaches like cognitive behavior therapy that are shown to be equally effective.

Finally, AA often presents hagiographies of early members like Bill W and Dr. Bob without telling the whole story. Bill W struggled with depression late in life and also dropped acid with Timothy Leary. I wonder if an SSRI or SNRI would have helped him enjoy his life more. Depression is often treated as a great shame among AA types and they often have negative attitudes towards pills, probably due to the over-prescription of barbiturates during the 50's and 60's when AA was really coming of age.

So one of my issues with AA is that it asserts that alcoholism is a disease, when it's not, it is a syndrome. Further, AA often has taken a negative stance on reasonable treatment of an actual disease, depression. There are plenty of AA people who will tell you that you are not truly clean and sober if you take pills. This is a very dangerous attitude and has probably resulted in suicides among depressed and anxious people who are in the early stages of sobriety or are attempting to get there.

Because of the anonymity of its members, AA success rates are very hard to track. However, the best available research

just puts it on par with two other approaches.I think that should produce a little more humility in AA proselytizers.

Hey Jamin, have you considered the benefits of doing meth?

The Cure if you are a girl or a beta.

The Cult if you are an alpha.

Ah yes. We have had this discussion many times in the ol' meetings. Actually, AA reminds me a bit of these boards. Some people VERY intelligent and insightful, many full of shit, and some hopeless. (JK, not really, sort of) AA works for me after 20 years of hard drinking and in some ways it does resembe a cult. You take what you need out of it and leave the rest. It doesn't push religion and I can't stress that enough. It promotes a spiritual lifestyle which in my opinion is vastly different from religion. Personally I didnt know how to live a decent life without booze and dope and the people and program have taught me how to do that plus the best part is now I get to help others out with similar issues. There is nothing better in my world than to watch a fellow human being get sober and take their life back. I don't care how you do it, just get it done. I've seen people do it with AA, with cognitive therapy, with exercise, etc. It can be done and I choose AA because I like it. I don't agree with everything but like I said, take what you need. It's also free.

AA has a 90% failure rate.

OlldPolarBear wrote:

Is an easily accessed peer network based on sobriety. Instead of hanging out at the bar, you do your meeting, get a little love and positive reenforcement. Works for some, others find the war stories trigger cravings.

Addiction treatment kind of a crap shoot anyway. More alchemy than science.

Is my 2 cents as a primary care provider x 14 years.

Primary care, Secondary reasoning.

You suck.

AA is a lot more than the oversimplified, foolish view you have of it.

Working the 12 steps results in a huge psychological shift.

Get out of your horrible MD training. Just because you can't prescribe a pill for it does not mean it is alchemy.

coachkritter wrote:

AA has a 90% failure rate.

You have a 100% failure rate.

I wouldn't have phrased it quite that way but this is pretty much how I feel. I went to 90 meetings in 90 days after I got out of rehab. Gradually went to fewer and fewer meetings as they seemed to be less necessary for me to remain focused on sobriety. Went to one on Thanksgiving this year and realized I hadn't been to a meeting since the same one Thanksgiving last year. I'd like to go more often but don't have the time. Still, seven years sober and AA was a big help in the process. Maybe I could have done it without the program, but I went regularly and believe that it helped me.

The key wrote:

I doubt anyone here is looking for any real help, they've already made up their minds. But as far as I'm concerned, the real key to AA and similar programs is interaction with other people who have experienced similar self-inflicted trauma. They understand in a way that no one else does or ever could. Also, you look around and get reminded how f***ed up alcoholics are and that you don't want to be like those other losers.

As a third party with no skin in this game, I do notice how the defenders of AA have not provided any reasons beyond anecdotal (it 'worked' for me, etc). My impression was this would be a reasoned discussion.

Another thought: each decision has consequences that are seen and others that are not seen as easily. Nobody here has mentioned the unintended consequences of AA permeating our society as a form of 'treatment.' Imagine an alternate world where alternate types of group therapy permeated each city (Googled Smart recovery).

To the AA people, try to engage some logic in your replies.

What about "it worked for me" is illogical?You're trying to turn this into some sort of randomized controlled experiment when we simply don't have the data to do that. Or if we do have the data, it points to the possibility that AA doesn't work very well. But we need to compare those data to the results for people who try nothing at all. Someone above said AA has a 90% failure rate. Is the failure rate for people who try nothing but stopping on their own higher, or lower?What interests me in discussions like this is why people are so keen to discredit AA. If you have evidence that it does actual harm, that it increases people's chances of continuing to drink or returning to drink after a period of sobriety, then please explain that. You speak of "defenders" of AA and also note you have no dog in this fight. I can't defend it scientifically or "logically," according to your standards. I'm not actually interested in defending it (I don't really know what you mean by that anyway) and, in a way, trying to do so goes exactly against AA's principles. All I can say is that I was on a certain path towards destruction and death with my drinking. After rehab, I attended AA regularly and I've been sober for 7 years. Maybe it helped me, maybe it didn't. I believe it did and don't understand why people want to be critical of a program that seeks to help people who are suffering.

Response Views wrote:

As a third party with no skin in this game, I do notice how the defenders of AA have not provided any reasons beyond anecdotal (it 'worked' for me, etc). My impression was this would be a reasoned discussion.

Another thought: each decision has consequences that are seen and others that are not seen as easily. Nobody here has mentioned the unintended consequences of AA permeating our society as a form of 'treatment.' Imagine an alternate world where alternate types of group therapy permeated each city (Googled Smart recovery).

To the AA people, try to engage some logic in your replies.

There is actually a lot of data on quitting with and without AA.

The concept of AA 'helping' people is akin to seeing a Shaman for a cold every time and claiming the Shaman's magical healing powers make the cold go away. Misappropriation of effect in an already highly confounded situation is rampant. It's important to distinguish the various confounders as much as possible, such as the initial impulse that brings one into a group versus the various goings-on within the group.

AA is fine for individuals - and many an anecdote have been spun about how it 'works' and is the only way to get better - but it has no place in the practice of Medicine.

Who says it should have a place in medicine?

Alternatively, should addiction specialists stop recommending 12 Step groups along with whatever other treatments they advocate for their patients? And if so, why?