“It’s time for an AA meeting.” This greeting echoes thousands of times daily across the U.S. as well as in numerous other countries, when members of Alcoholics Anonymous attend their gatherings. AA, which recently celebrated its 75th anniversary, claims more than 1 million members in the U.S. and almost a million more in at least 100 other countries. AA has been the impetus for a number of sister organizations as well. Since this article’s focus is on alcoholics and drug addicts, who often abuse more than one substance (cross-addiction), we will simply refer to members of AA and/or Narcotics Anonymous (NA) as addicts. Most addicts have a drug of choice but will readily use others contingent upon the situation.1,2,3
Peter J. McDonald
Lori I. Furbush
Besides voluntary participation in AA/NA groups, many addicts are mandated to participate by courts, probation offices and various treatment/rehabilitation programs, both residential and outpatient. The AA/NA model is rampant and widely accepted as the modus operandi in dealing with addiction. The question that arises, of course, is whether AA/NA works.
AA/NA organizations do not allow vigorous scientific research regarding effectiveness, in order to protect the anonymity of their members. It should be noted, however, that literally thousands of studies conducted with human participants by government agencies, universities, private organizations and companies absolutely guarantee anonymity. Why, then, does AA/NA prohibit such potentially valuable research?
Still, many treatment/rehabilitation programs that employ the AA/NA model have allowed vigorous research. The overwhelming conclusion of a plethora of studies indicates a relapse/recidivism rate of approximately 60 to 90 percent.4,5,6 Research that yields much lower failure rates typically considers only those clients who successfully complete the lengthy programs, and not those who quit or who were terminated along the way.
The problem may lie in the foundation of the AA/NA model, namely the 12 Steps to Recovery as outlined in the Big Book of Alcoholics Anonymous. The Steps follow:
- We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
AA/NA members are supposed to “religiously” work these 12 Steps in their journey to recovery. A close examination of the 12 Steps discovers that seven of them (Steps 2, 3, 5, 6, 7, 11 and 12) involve the intervention of God, as we understood Him, to solve the problems of addiction. The typical understanding of God is derived from the Judeo/Christian tradition. God becomes a sine qua non in the recovery process.
It is our opinion that many AA/NA members have substituted one addiction for another. For both addictions—substances and/or God—the common theme is the lack of personal control and thus, responsibility. It is also interesting to posit that if God is the cause leading to recovery, the logical conclusion would be that God (or the devil) must have been the causal force in the acquisition of addiction.
We see two of the other 12 Steps, Steps 8 and 9, as questionable as a means in the recovery process. It is very difficult for an addict to change the past and to right all past wrongs, to make amends to all the people he/she has harmed. In fact, attempts to do so could expose the addict to numerous triggers that could quite easily interfere with the recovery process. This activity could potentially attract the addict back to a life he/she is trying to leave.
This basically leaves three Steps (1, 4 and 10) that actually address the problem of addiction and its ultimate solution.
An alternative model
With this analysis in mind, we propose a new 10-Step program, which we call the “I Program,” to fight addiction and lead to recovery. These Steps follow: