Thursday, September 4, 2014

The Sober Truth

I promised myself to read a new book before the end of the summer - The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Dr. Lance Dodes. Dr. Dodes's CV is a long and impressive one. From Harvard University to the Boston Psychoanalytic Society to decades as a practicing therapist specializing in addiction, Dr. Dodes knows what he's talking about.

And what's he's talking about is this: 12-step programs don't work for the vast majority of people who use them. According to his book - and most published statistics - only 1 in 15 people who join A.A. will remain with the program. Everyone else will drop out. Some of them will return after a relapse - and most of  them will drop out again.

If these people go to their doctor for help - or are seen before a judge for some unfortunate reason - they will automatically be prescribed A.A. or another 12-step program based on the A.A. model. If they fail in that program, they will be prescribed the same program again. And again. And again. Despite the fact there is no scientific evidence 12-step models work in a consistent way. And lots of empirical evidence that they don't (i.e. the overwhelming failure rate).

I'm only partway through the book, but I find it riveting. Right now, Dodes's is chronicling Bill Wilson's early life. "Bill W" as he's known was the founder of Alcoholics Anonymous. A very religious man from a very religious background, he also suffered from other addictions. Including nicotine, which eventually took his life. And sex (his extramarital affairs are well documented). He was also part of hospital-supervised LSD experiments during the 50s. Fascinating stuff.

But I'm not passing judgment here. I know Bill W's faith-based philosophy still helps many people cope with alcoholism. And as I've said many times, I celebrate their success. But Dodes's point - and mine - is that 12-step programs shouldn't be treated as the only solution to addiction. Because there just isn't enough evidence that they work for everyone.

As for myself, I feel so lucky that I haven't had to go to A.A. or rehab. That I've been able to reverse my own problem naturally, simply - and cheaply! Because as Dr. Dodes points out, some rehab centers charge as much as $90,000 a month! Even without a consistent success record.

Time to put up a shingle!


Sorta! ;)

But we really do need alternative methods for treating addiction. We can't just brush the condition under the rug by continuing to view 12-step programs as the only answer. We must keep searching for new alternatives. In the end, that's all cleansing is. An alternative. One of many that I hope will evolve as we learn more about addiction and how to help the people affected by it. But the only way these methods will see the light of day is if we accept that the present model is not perfect. We must find other ways. At least twenty other ways! Because if each of those helps just 5-10% of the people - the way 12-step programs do - then we'll basically have kicked addiction in the butt!