Does AA Work?
Aaron Hillman Asks ...
Does AA work? I’ve known people that have gone to a few meetings and never had it really take hold, but as far as I can tell it’s not based on anything very scientific. I’m 24 and drink every day, and have been drinking for about 10 years and drinking hard for about the last 6 and drinking way too much for the last couple; and I can’t seem to stop on my own anymore. I know I need some help but I can’t help but think the whole 12 steps thing is kind of ridiculous and old fashioned. My fiancée says she might leave me if I don’t start going to meetings and quit (she wants me to go) but I keep telling her I’ll go do the whole the rehab thing once I can save up some money for it and that there’s no point on wasting time on something that’s not going to work. I am willing to get some help, I just want to get real help and I figure I’m only 24 and that even if takes me a year to save the money I need it’s not like I’m going to die or anything. So, is AA worth doing, or am I right to wait, save my money for something real, and get real help when I can?
Dr. David Sack Says ...
The reasons many people are successful in AA is more scientific than you think. There is good evidence that people who go to AA are three time more likely to be abstinent as people who don’t go; when people are also given support by family and friends to go to meetings they do even better.
There isn’t one treatment approach that works for everybody. It sounds like you are really quite ambivalent about giving up drinking. It’s not really a choice between AA and saving up money for rehab; if you are really serious you could find a state-funded rehab.
Many people need to take more than one approach to stay sober over the long-term. You might not be able to benefit from meetings at this stage of your addiction, so the real question becomes: what are you prepared to do next to get well?
I have long spoken about the value of AA in recovery, and for good CLINICAL reasons. For one, alcoholism causes cognitive deficits in a majority of alcoholics. It turns out alcohol impairs not only memory for things that have occurred but it actually impairs what we call prospective memory, meaning it interferes with your ability to learn new things. So how does the 12-step program help people with impaired memory? You have to remember, the 12 step process evolved in response to what appeared to be helping other alcoholics. There’s tremendous experiential wisdom about how this process works so that the first thing I would ask is, how does 12-step recovery help memory? First off, the damage to memory means it’s easy to forget what to do next. The repetition of certain core concepts in meetings addresses that deficit prospective memory (e.g., one day at a time, keep it simple, call your sponsor, go to a meeting). Second, when sharing at meetings and retelling your story, you remember the negative consequences. This is important because when you actually look at the deficits in memory there is a specific deficit in alcoholics that has to do with negative reinforcement and avoidance. Alcoholics, even when they are in recovery, have more difficulty avoiding situations that are going to be painful or have a consequence to them. Telling the stories reinforces the idea that you must avoid situations that once got you into trouble. These are just a few of the reasons AA does work for many people.
There are other options as well for you. There are medications that can help to support recovery, outpatient programs, residential programs, and non-12-step support groups such as Rational Recovery. The real question is how committed are you to finding a treatment that will work for you?