AA Lies
Charles Bufe
There are probably more myths and misconceptions
about Alcoholics Anonymous, America’s most sacrosanct institution,
than there are about any other mass organization in our country.
Neglecting how this came to be,[1] the primary misconceptions
regarding AA are that:
1. AA is the most effective (or the only)
way to deal with an alcohol problem.
2. AA existed from the start as an independent organization.
3. AA’s co-founder, Bill Wilson, independently devised AA’s “program,”
its 12 steps.
4. AA is “spiritual, not religious.”
5. AA is a completely voluntary organization-AA works by “attraction,
not promotion.”
6. AA has nothing to do with “outside enterprises” or “related
facilities.”
7. AA takes no position on matters of “public controversy.”
AA’s Effectiveness
AA’s supporters commonly trumpet AA as the
best, if not the only, way to deal with alcohol problems. To back
their claims, they cite anecdotal evidence and uncontrolled studies;
but they ignore the best scientific evidence-the only available
controlled studies of AA’s effectiveness, as well as the results
of AA’s own triennial surveys of its membership.
There have been only two controlled studies
(with no-treatment comparison groups) of AA’s effectiveness. Both
of these studies indicated that AA attendance is no better than
no treatment at all.
The first of these studies was conducted
in San Diego in 1964 and 1965, and its subjects were 301 “chronic
drunk offenders.”[2] These individuals were assigned as a condition
of probation to attend AA, to treatment at a clinic (type of treatment
not specified), or to a no-treatment control group. All of the
subjects were followed for at least a year after conviction, and
the primary outcome measure was the number of rearrests during
the year following conviction. The results were that 69 percent
of the group assigned to AA was rearrested within a year; 68 percent
of the clinic-treatment group was rearrested; but only 56 percent
of the no-treatment control group was rearrested. Based on these
results, the authors concluded: “No statistically significant
differences between the three groups were discovered in recidivism
rate, in number of subsequent rearrests, or in time elapsed prior
to rearrest.”[3]
The second controlled study of AA’s effectiveness
was carried out in Kentucky in the mid- 1970s, and its subjects
were 260 clients “representative of the ‘revolving door’ alcoholic
court cases in our cities.”[4] These subjects were divided into
five groups: one was assigned to AA; a second was assigned to
nonprofessionally-led Rational Behavior Therapy; a third was assigned
to professionally-led Rational Behavior Therapy; a fourth was
assigned to professionally-led traditional insight (Freudian)
therapy; and the fifth group was the no-treatment control group.
The individuals in these groups were given an outcome assessment
following completion of treatment, and were then reinterviewed
3, 6, 9, and 12 months later.
The results of this study were revealing:
AA had by far the highest dropout rate of any of the treatment
groups-68 percent. In contrast, the lay RBT group had a 40 percent
dropout rate; the professionally-led RBT group had a 42 percent
dropout rate; and the professionally-led insight group had a 46
percent dropout rate.
In terms of drinking behavior, 100 percent
of the lay RBT group reported decreased drinking at the outcome
assessment; 92 percent of the insight group reported decreased
drinking; 80 percent of the professionally-led RBT group reported
decreased drinking; and 67 percent of the AA attendees reported
decreased drinking, whereas only 50 percent of the no-treatment
control group reported decreased drinking.
But in regard to bingeing behavior, the
group assigned to AA did far worse than any of the other groups,
including the no-treatment control group. The study’s authors
reported: “The mean number of binges was significantly greater
(p = .004) [5] for the AA group (2.37 in the past 3 months) in
contrast to both the control (0.56) and lay-RBT group (0.26).
In this analysis, AA was [over 4] times [more] likely to binge
than the control [group] and nine times more likely than the lay-RBT
[group]. The AA average was 2.4 binges in the last 3 months since
outcome.”[6]
It seems likely that the reason for this
dismal outcome for the AA group was a direct result of AA’s “one
drink, one drunk” dogma, which is drummed into the heads of members
at virtually every AA meeting. It seems very likely that this
belief all too often becomes a self-fulfilling prophecy, as it
apparently did with the AA attendees in this study.
1. See Alcoholics Anonymous: Cult or cure?
(second edition), Chapter 8 (“AA’s Influence on Society”), pp
105-124. Tucson, AZ: See Sharp Press, 1998.
2. Ditman, KS, GC Crawford, WE Forgy, H Moskowitz, & C MacAndrew.
(1967). A controlled experiment on the use of court probation
for drunk arrests. American Journal of Psychiatry, 124(2), pp
64-67.
3. Ibid., p 64.
4. Brandsma, JM, MC Maultsby, & RJ Welsh. (1980). Outpatient treatment
of alcoholism: A review and comparative study. Baltimore: University
Park Press.
5. Meaning that the possibility of this outcome being due to random
chance was only 1 in 250.
6. Op cit., Brandsma et al., p 105.
this article copyright 2001 Charles Bufe
You Are Being Lied To copyright 2001
The Disinformation Company, Ltd.
