Two experts in our film Wasted likely have more knowledge and wisdom about Alcoholics Anonymous than anyone else in the world. They set the record straight on key beliefs about AA. Pretty well everyone who admits a drinking problem, gets told to go to AA. Is that wise advice? Here’s Dr. Bill Miller’s take.
Dr. William R. Miller is Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico, where he joined the faculty in 1976 after receiving his Ph.D. in clinical psychology from the University of Oregon. He served as Director of Clinical Training for UNM’s doctoral program in clinical psychology and as Co-Director of UNM’s Center on Alcoholism, Substance Abuse and Addictions (CASAA). Dr. Miller’s publications include 40 books and over 400 articles and chapters. He has focused in particular on the development, testing, and dissemination of behavioral treatments for addiction. In recognition of his research contributions, Dr. Miller is a recipient of the international Jellinek Memorial Award, two career achievement awards from the American Psychological Association, and an Innovators in Combatting Substance Abuse award from the Robert Wood Johnson Foundation. He maintains an active interest in pastoral counseling and the integration of spirituality and psychology. The Institute for Scientific Information lists him as one of the world’s most cited scientists.
I’m intrigued about this upcoming documentary, and will definitely keep an open mind as I watch it.
But I’m also confused: the Nature of Things trailer has David Suzuki claiming AA doesn’t work for most people. The homepage of your website writes, “In fact, AA does not work for the majority who try it, leaving many to feel like failures.” Yet there are several blog posts this month that seemingly advocate for AA as a successful option for problem drinkers seeking help. I expect the documentary will make your position clear.
I do find it troubling, however, that your main front-and-centre message is that AA doesn’t work for most people. This claim is untestable because AA doesn’t keep statistics (which also means it’s efficacy is also untestable). So at best, you’re trying to pass off your opinion as fact. I’m just surprised you have the CBC backing this misinformation.
Dave, thanks for engaging. RE: AA does not work for most people, you’ll see the science that reinforces that in the Nature of Things film. The Nature of Things would not let me get away with passing off my opinion as fact 🙂 I’ll share a little, but you need to watch the film for the rest.
First, opinion of Scott Tonigan, world leader in addiction research at the University of New Mexico: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851049/ (Scott Tonigan’s quote: “if we look at the outcomes of 12-step-oriented treatment in general, or any treatment that tries to engage patients in AA attendance, it is less encouraging. There is an AA dropout rate of about 70 percent in the first 6 months after discharge from active treatment.â€
Number 2: AA’s own membership survey for 2014, put success rate at 1 year at 27 percent.
For more evidence, tune in tomorrow. AA is definitely a successful option for people trying to stop drinking and in fact, more studies will confirm that. As do the experts in our film, huge believers in AA. To be clear, a lot of other evidence-based treatments like cognitive behavioural therapy and motivational interviewing, also don’t get more success than 30 percent in studies. What we are saying is – the more options there are in the toolkit to treat our number 1 health problem, the better off everyone will be. We need to put AA’s success rate in context, because as long as the public and doctors believe it is wildly successful, there is no onus on anyone to fund other options and those who “fail†at AA end up very sick or dying. None of us want that.
– Maureen
Maureen,
I’m really impressed with you and Mike. You’ve done a lot to further important conversation(s) about how society views addiction and how we can potentially improve treatment options. I agree wholeheartedly with what you’re saying, “the more options there are in the toolkit to treat our number 1 health problem, the better off everyone will be”. The medical community needs to wake up and make this public health problem a priority. If I were to only make one overarching comment here, it would be “thank you”.
However, I can’t leave it at that :). You have not accurately interpreted the results of AA’s own 2014 membership survey (http://www.aa.org/assets/en_US/p-48_membershipsurvey.pdf). The ‘success rate at 1 year = 27%’ is absolutely incorrect. AA took a random sampling of 6000 members within Canada and the US and asked them how long they’d been sober. 27% were sober less than 1 year. That is NOT at all the same as 27% were sober after 1 year, and 73% relapsed within their first year. Yet you’ve used this misinformation to hook people into watching the documentary (which I enjoyed by the way ;)).
An accurate interpretation of the survey results would be this: of the 6000 members surveyed, 27% were sober less than a year, 24% were sober between 1-5 years, 13% were sober between 5-10 years, 14% were sober between 10-20 years, and 22% of members were sober more than 20 years. In fact, this still does not say anything directly about the ‘effectiveness’ of AA as a means of getting well. It is simply a snapshot in time of the distribution of sobriety length among its members. AA does not take record about who attends, when they attend, who relapses, when they relapse, nor how many times they relapse.
In this sense, it is not a clinical evidence-based treatment, and really shouldn’t be compared to such. In my opinion, the ‘effectiveness’ of AA cannot be evaluated objectively through scientific study. It is a program that offers a spiritual solution (NOT religious) to a sickness that cannot be entirely explained by physiological means. It isn’t just about dopamine receptors and the brain’s reward center.
I’ve seen plenty of evidence that AA does work for many, many people (yes – including myself for 7 years). In combination with other tools, AA can help people to transform their lives. Unfortunately, I’ve also seen many people who cannot get sober. Several have died and it is heartbreaking. So the more we can do to help people suffering (whether they’re in recovery or not) the better. Thank you and good luck to you both.