by Eve Lacroix

The meeting of the surgeon Dr. Bob S. and stockbroker Bill W., both hopeless alcoholics and members of the Episcopal Oxford Group, proved to be a turning point in the history addiction treatment. They built on the Oxford Group’s evangelistic Christian values with the added formulation that alcoholism was not simply a moral failing, as American society considered it, but a physical and spiritual malady. They broke away from the Oxford Group, creating the twelve steps of Alcoholics Anonymous in the 1930s and starting up a regular meeting. Their vision differed from the Oxford Group in that it stressed that addiction is incurable.

Groups popped up all over the country, and today you can find AA meetings everyday in most cities in community centres and churches, in prisons. Specific groups are male or female-only meetings, homosexual-only meetings, and AlAnon meetings are open for friends and family members of alcoholics. Programmes following the same format also exist, such as Narcotics Anonymous, Sex Addicts Anonymous, Overeaters Anonymous… AA and NA are such an institution that Stateside, to reduce a DUI, many people who do not consider themselves alcoholics attend court-mandated meetings, receiving, in AA speak, “a nudge from the judge.”


The first step of AA is to admit one’s “powerlessness over alcohol.” The second step is to “come to believe that a Power greater than ourselves can restore us to sanity.” Herein lies one of the major points of criticism of AA. For many alcoholics, be it because of their different religious belief, agnosticism, or atheism, the idea of giving up one’s free will to a God they don’t believe in or aren’t sure exists feels false. Instead, some AA fellows turn to their own version of a Higher Power; love, family, music, whatever makes sense to them.

However, other issues exist in the institution. Are those attending AA for the first time, or choosing to go over and over powerless in their recovery? After feeling helpless in the throes of an addiction, are they not choosing sobriety and recovery? The idea of the counter of days of sobriety being brought back to zero even after a single drink can be immensely disheartening and seems like quite a black and white vision of sobriety. Certain clinical trials of moderate drinking training in the 1980s have shown that it is possible for some to continue drinking in a non-damaging manner.

It is so common for an AA veteran to date a freshly sober member that these relationships have been unofficially nicknamed the Thirteenth Step.

Despite the common request that AA members do not date in their first year of sobriety, this unofficial rule is not always followed. The power dynamic of a sponsor-sponsee relationship, doubled with the anonymity of the programme and the fact that members are therefore not vetted or background-checked, tripled with the vulnerable state of people readapting to a dover life, many for the first time in their adult life, has seen an unfortunate undercurrent of sexual abuse. It is so common for an AA veteran to date a freshly sober member that these relationships have been unofficially nicknamed the Thirteenth Step.

I’d like to nuance my arguments. 12 Step programmes have created communities that are open to sharing, that support each other. They aid innumerable people in maintaining a happier, healthier and sober life, including friends of mine. For that, it is a great tool of healing and recovery and deserves its support. But I’d like to stress the “innumerable.” AA is not a medical system, it does not release reports or statistics on how many people it has “cured” of addiction. According to AA, there is no cure, AA could be lifelong. I feel skeptical about one single institution overruling all forms of treatment. Each person’s addiction is different, and therefore so is each person’s recovery. How does it make sense for 12-step systems to be used in rehab programmes without the medical backing?


© Alex Lake for The Observer

In an article for the Guardian, former drinker Jon Stewart rightly talks about a proven medical alternative created by the American doctor David Sinclair. Used to treat alcoholics in Finland, the “Sinclair Method” uses the opiate blocker naltrexone which inhibits positive and euphoric feelings alcoholics grey from drinking. In the UK, a similar treatment with the drug nalmefene is available on prescription. A 2001 report on Sinclair’s method showed a 78% success rate of reducing drinking, as opposed to psychiatry professor Lance Dodes’ estimate of AA’s 5-8% effectiveness. This alternative needs to be more widely publicised for alcoholics seeking treatment. Whilst I do not believe that AA is to be ignored or shunned, I think it would be useful to use in conjunction with medical treatment and therapy— because achieving sobriety does not solve all of one’s problems.

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