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Authors: Lance Dodes
Psychological Association, summarizes the current legal status of this practice:
If you have been convicted of an offense related to addiction, it is common to be ordered to attend support groups, treatment, or both. It has also been common that you would be ordered, not just to a support group, but to Alcoholics Anonymous (AA) specifically, or to another 12-step based group.
Based on recent court decisions, if you have been ordered to attend a 12-step group or 12-step based treatment by the government (the order could be coming from a court, prison officer, probation or parole officer, licensing board or licensing board diversion program, or anyone authorized to act on behalf of the government), you have the right
not
to attend them. However, you can still be required to attend some form of support group, and some type of treatment.
These court decisions are based on the finding that AA is religious enough that being required to attend it would be similar to requiring someone to attend church. Five US Circuit Courts of Appeal (the 2nd, 3rd, 7th, 8th, and 9th) have made similar rulings. . . . The 2nd Circuit Court decision states that AA “placed a heavy emphasis on spirituality and prayer, in both conception and in practice,” that participants were told to “pray to God,” and that meetings began and adjourned with “group prayer.” The court therefore had “no doubt” that AA meetings were “intensely religious events.” Although some have suggested that AA is spiritual but not religious, the court found AA to be religious. 21
In 1966, President Lyndon Johnson proclaimed to the nation that “[t]he alcoholic suffers from a disease which will yield eventually to scientific research and adequate treatment.” 22 The disease theory and AA’s lobbying had at this point become difficult to separate. In 1970, Congress joined the consensus and passed a law known as the “Comprehensive Alcohol Abuse and Alcoholism Prevention Treatment and Rehabilitation Act,” which established the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Among those testifying to the lawmakers in support of the bill were Marty Mann and Bill Wilson.
In 1973, the “millionth copy” of
Alcoholics Anonymous
was presented to President Richard Nixon in the Oval Office. (AA is the only source for this number; to my knowledge, sales have never been publicly audited.)
According to the Federation of State Physician Health Programs, “By 1980 . . . all but three of the 54 U.S. medical societies of all states and jurisdictions had authorized or implemented impaired physician programs.” 23 A recent paper looking at state-sponsored physician health groups (for doctors who have problems with addiction) found that “[r]egardless of setting or duration, essentially all treatment provided to these physicians (95%) was 12-step oriented.” 24
In 1989, the nation’s first drug court appeared in Dade County, Florida. Its treatment plan was to remit nonviolent drug offenders to a 12-step program and to compel those who had failed follow-up drug tests to attend “supplementary” 12-step sessions. 25
Examining this history, it is clear that AA has been extraordinarily effective at influencing public opinion and policy toward a favorable view of its ideas. What is missing from this account is notable as well: these strides were achieved without any triggering event, such as a well-designed study, that might support the organization’s claims of efficacy. Most of AA’s claims were simply grandfathered in, collecting legitimacy in a sort of echo chamber of reciprocal mentions that often featured the same handful of names.
CHAPTER THREE
DOES AA WORK?
WE COME NOW TO the essential question:
Is AA an effective treatment for alcoholism?
Many people have argued passionately on one side or the other of this debate, but these arguments are too often heated and anecdotal in nature. To truly determine whether and how often AA succeeds, we must
If you have been convicted of an offense related to addiction, it is common to be ordered to attend support groups, treatment, or both. It has also been common that you would be ordered, not just to a support group, but to Alcoholics Anonymous (AA) specifically, or to another 12-step based group.
Based on recent court decisions, if you have been ordered to attend a 12-step group or 12-step based treatment by the government (the order could be coming from a court, prison officer, probation or parole officer, licensing board or licensing board diversion program, or anyone authorized to act on behalf of the government), you have the right
not
to attend them. However, you can still be required to attend some form of support group, and some type of treatment.
These court decisions are based on the finding that AA is religious enough that being required to attend it would be similar to requiring someone to attend church. Five US Circuit Courts of Appeal (the 2nd, 3rd, 7th, 8th, and 9th) have made similar rulings. . . . The 2nd Circuit Court decision states that AA “placed a heavy emphasis on spirituality and prayer, in both conception and in practice,” that participants were told to “pray to God,” and that meetings began and adjourned with “group prayer.” The court therefore had “no doubt” that AA meetings were “intensely religious events.” Although some have suggested that AA is spiritual but not religious, the court found AA to be religious. 21
In 1966, President Lyndon Johnson proclaimed to the nation that “[t]he alcoholic suffers from a disease which will yield eventually to scientific research and adequate treatment.” 22 The disease theory and AA’s lobbying had at this point become difficult to separate. In 1970, Congress joined the consensus and passed a law known as the “Comprehensive Alcohol Abuse and Alcoholism Prevention Treatment and Rehabilitation Act,” which established the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Among those testifying to the lawmakers in support of the bill were Marty Mann and Bill Wilson.
In 1973, the “millionth copy” of
Alcoholics Anonymous
was presented to President Richard Nixon in the Oval Office. (AA is the only source for this number; to my knowledge, sales have never been publicly audited.)
According to the Federation of State Physician Health Programs, “By 1980 . . . all but three of the 54 U.S. medical societies of all states and jurisdictions had authorized or implemented impaired physician programs.” 23 A recent paper looking at state-sponsored physician health groups (for doctors who have problems with addiction) found that “[r]egardless of setting or duration, essentially all treatment provided to these physicians (95%) was 12-step oriented.” 24
In 1989, the nation’s first drug court appeared in Dade County, Florida. Its treatment plan was to remit nonviolent drug offenders to a 12-step program and to compel those who had failed follow-up drug tests to attend “supplementary” 12-step sessions. 25
Examining this history, it is clear that AA has been extraordinarily effective at influencing public opinion and policy toward a favorable view of its ideas. What is missing from this account is notable as well: these strides were achieved without any triggering event, such as a well-designed study, that might support the organization’s claims of efficacy. Most of AA’s claims were simply grandfathered in, collecting legitimacy in a sort of echo chamber of reciprocal mentions that often featured the same handful of names.
CHAPTER THREE
DOES AA WORK?
WE COME NOW TO the essential question:
Is AA an effective treatment for alcoholism?
Many people have argued passionately on one side or the other of this debate, but these arguments are too often heated and anecdotal in nature. To truly determine whether and how often AA succeeds, we must