Trying to beat addiction through a faith-based 12-step program—Alcoholics Anonymous being the best known of the bunch—typically means you can never take a sip of alcohol again. But Gabrielle Glaser writes for the Atlantic that AA was founded 80 years ago, "when knowledge of the brain was in its infancy." It and programs like it present an antiquated model of dealing with addiction, she writes, going on to argue that most addiction counselors today aren't qualified to help those most in need, and that there are alternatives. "Nowhere in the field of medicine is treatment less grounded in modern science," she writes, pointing out that despite the 75% success rate claimed for AA members who "really tried" in the group's 12-step bible, the "Big Book," there's "no conclusive data" the program actually works. (A retired Harvard professor who's studied AA retention rates puts that number closer to 5% to 8%, she notes.)
One of the top methods she thinks we should consider for the estimated 18 million people with alcohol-use disorder, especially now that treating it is mandated for insurers under ObamaCare: medication, especially naltrexone, one of the three FDA-approved drugs that's currently available. A couple other nuggets of note:
- The AA 12-step model is so ingrained that abstinence—not moderation—is recommended for all, and only after a drinker has "hit bottom." "Researchers I've talked with say that's akin to offering antidepressants only to those who have attempted suicide, or prescribing insulin only after a patient has lapsed into a diabetic coma," she writes.
- Regarding the use of drugs to treat alcoholism, Glaser notes a widespread resistance that's still strong. A psychologist she interviewed who used to speak about using naltrexone to curb cravings at medical conferences said "the reaction was always 'How can you be giving alcoholics drugs?' They'd look at me like I was promoting Valley of the Dolls 2.0."
Read Glaser's complete take, which includes her own experiment with naltrexone, at the Atlantic