I come from a long and not-so-distinguished line of alcoholics and drug addicts on both sides of my family. My father succumbed to cirrhosis of the liver at 57. It was not a good death. My mother lost her entire life (and mind) to opiate addiction. It had gotten so bad that the family had to cut her off, much like one removes gangrenous finger to save a hand. Thankfully, I’ve never had problems with addiction, myself, but I know exactly what it’s like to live with addicts and how the disease (or whatever you want to call it – the jury is out for some people) can ruin lives. I tell you this because I want you to know that I don’t have a bone to pick with treatment programs of any sort, and personally feel that if you find something that works for you, then great. Having put that out of the way, Atlantic writer Jake Flanigan has authored a potentially controversial piece on what he describes as the ‘surprising failures’ of 12 step programs like Alcoholics Anonymous, and I thought it might make interesting conversation fodder here.
So how did AA gain such a place of privilege in American health-culture? How did a regimen so overtly religious in nature, with a 31 percent success rate at best, a five to 10 percent success rate at worst, and a five percent overall retention rate become the most trusted method of addiction-treatment in the country, and arguably the world? It’s a central question Dodes seeks to answer in The Sober Truth. And he begins at the very beginning.
According to Dodes, when the Big Book was first published in 1939, it was met with wide skepticism in the medical community. The AMA called it “a curious combination of organizing propaganda and religious exhortation.” A year later, the Journal of Nervous and Mental Diseases described it as “a rambling sort of camp-meeting confession of experiences … Of the inner meaning of alcoholism there is hardly a word. It is all surface material.”
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