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Recovery in the News
AA -12 Step Programs - Drug Treatment & Recovery - What Works and Why?
In my opinion, treatment requires the full compliment of tried and tested practices over a minimum of 5 years in order to be effective over a lifetime.
David H. Kerr
NJ.com
January 3, 2009
This article is written in response to the Ledger's article in the Reader's Forum on January 3, 2009 - see below. It is short on facts and a more complete picture. In fact it paints a bleak picture that might have been true in 1940 but thanks to federal research dollars and treatment successes, the picture has greatly improved.
There is hope and help for addicts now if they understand the nature of their disease. I am founder and Director of Integrity House which is a long term Therapeutic Community that employs the '12-step' model as one of several approaches that describe the latter phases of treatment. This is usually after a minimum of 6 months in the residential phase. The '12-step' model has held up fairly well since 1935 but there are many improvements and discoveries that time and experience and research, combining AA with good treatment, have contributed to offer more favorable outcomes for those addicts who need help. Even for those who do not want help, the National Institute on Drug Abuse (NIDA) has found that 'you don't have to want help to receive it.' With the partnership of Drug Courts many unwilling candidates to our program have turned their lives around. Substance abuse and addiction is an illness complicated by social and biological factors and it requires continued careful review of evidence and client progress so that improvements can be made to treatment and subsequent long term recovery outcomes.
In my opinion, treatment requires the full compliment of tried and tested practices over a minimum of 5 years in order to be effective over a lifetime. We use the Therapeutic Community model that emphasizes lifestyle change and self help and mutual help. Addiction is similar to other chronic diseases requiring long term intervention but recovery protocols can diminish after time and often, substance abuse will stay in remission. (See White and Kurtz #4 below.) This is a positive statement but you should understand that with only a few weeks or months of treatment or AA with no follow up and continued support, the chance for relapse will be great. Beware of fancy treatment programs that make great claims about success even if you only have to stay for a few weeks. Often these programs cost over $1,000/day. I would look carefully at their success claims.
Here are some facts:
1. Many people suffering from alcoholism or substance abuse make the big mistake of thinking that they have an acute illness that can be 'cured' by 7 to 28 days of treatment or an AA meeting twice per week. This wrong assumption may cost the addict or insurance much money and heartache only to return to drugs or alcohol after leaving the program. Others may have a three month remission followed by relapse. When we can bring a person who has relapsed back to treatment immediately, recovery and remission often continues after only a short return to teatment.
2. Addiction is in fact defined by federal research as a Chronic bio-psychosocial disease. Please look at the facts on addiction and treatment found on www.samhsa.gov.
3. To treat addiction, we need to look at the protocols used for hypertension or diabetes. Stopping these essential prolonged treatments for these chronic diseases causes an immediate relapse. This is exactly what happens when recovering addicts leave AA prematurely or when they leave short term treatment programs with no continued care or supportive follow up.
4. In my opinion, the most compelling research arguing for the long term treatment -recovery protocol for alcohol and drug abuse treatment is the William White and Ernest Kurtz study called 'Linking Addiction Treatment and Communities of Recovery.' This shows that continued treatment and assertive case management of addicts over a 5 year period can cause continued lifelong abstinence at the rate of 85%.
5. For New Jersey, national data collected in 2004 showed that 33,728 people were discharged from treatment and 47% of these completed. This does not indicate any follow up of those who completed.
6. According to information from the AA web site, Alcoholics Anonymous 12 Step Programs have a documented 75% and 93% 'success rate' from Akron and Cleveland Ohio respectively. I can tell you stories of many alcoholics who only used AA and are clean and sober for decades.
12-Step Programs Fail, The Ledger - Reader's Forum; Bill Noren, Annandale - January 3, 2009.
Sally Goodsen suggests reading the audit of the Governor's Council on Alcoholism and drug abuse to save taxpayer money ("drug, alcohol abuse program needs more oversight," Dec. 29). I have a better idea: scrap state aid to programs that push 12-step treatments. Incredibly, 93 percent of addiction programs use the 12-step method despite no proof it works. Hapless attendees are often coerced or bullied into it by the court system, despite the Supreme Court comparing it to a 'religious organization."
Many studies expose Alcoholic Anonymous uselessness: Dr. Jeffrey Brandsma found AA members were five times more likely to engage in binge drinking than nonmembers; Dr. Keith Ditman found AA attendees were rearrested for drunkenness twice as often as those who had not attended AA. AA's own studies say 81 percent of newcomers are gone within 30 days; 90 percent in 3 months; 95% after one year. That's about a 5% 'success' rate or the same as those who attend no treatment at all.
In other words, AA is as effective as doing nothing and likely increases binge drinking.
A Harvard University study found most people quit addictions on their own. Treatment centers won't admit that because they want the money. They'll convince you you're powerless. That's not treatment, that's sabotage.
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