Science-based help is better for addicts

Published 11:02 pm Wednesday, March 26, 2014

By Staff Reports

 

Results matter. That’s one of our mantras, because it’s a principle that seems to be lost in many public policy debates. Intentions are important, but policy decisions should be based on results and evidence.

That’s true of early childhood education (evidence shows few lasting benefits from many programs) to genetically modified foods (no evidence of any negative health results) to climate change policies (ethanol production results in a net increase of carbon emissions).

But what’s good for the goose is good for the gander. Conservatives should apply the same standard to our own favorite programs — including addiction treatment.

The evidence shows that the Alcoholics Anonymous model isn’t an effective treatment for addiction. But our devotion to AA — in court-ordered participation and in our culture’s reliance on “going to rehab” have made it hard to have real discussions about the best way to help those who need it.

“Peer-reviewed studies peg the success rate of AA somewhere between 5 and 10 percent,” report Dr. Lance Dodes and Zacharty Dodes, authors of a new book on the topic. “That is, about one of every fifteen people who enter these programs is able to become and stay sober. In 2006, one of the most prestigious scientific research organizations in the world, the Cochrane Collaboration, conducted a review of the many studies conducted between 1966 and 2005 and reached a stunning conclusion: ‘No experimental studies unequivocally demonstrated the effectiveness of AA’ in treating alcoholism.”



Let’s stop here for a moment, and address the inevitable protests. Yes, AA works for some people. The statistics show that. Yes, many people feel their lives have been saved by AA and other 12-step programs. Mandated treatment has help some offenders stay out of trouble.

But what about the other 90 to 95 percent of people who need help but don’t find it in the 12 steps? We must begin to explore medically sound and scientifically supported alternatives.

What makes 12-step programs counterproductive in some cases is that it puts the blame for failure on the addict — a person the program acknowledges has limited power to change.

“Rarely have we seen a person fail who has thoroughly followed our path,” the foundational book “Alcoholics Anonymous” states. “Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.”

Of course they are; that’s what addiction is about.

“In professional medicine, if a treatment doesn’t work, it’s the treatment that must be scrutinized, not the patient,” point out the Dodes brothers. “Not so for Alcoholics Anonymous.”

There are better treatments — ones based on real science, not spirituality. But those get little discussion in policy circles, because of our faith in the 12 steps.

Should our courts and treatment centers abandon the AA model completely, and stop sending people to meetings? Of course not. For now, that’s all we have. But it’s time to seriously look at the success rates, and ask ourselves how we can do better.