Saturday, February 26, 2011

AA Success Rate

With Charlie Sheen’s latest rant claiming that AA is a cult and dismissing it as an effective solution supposedly having only a 5% success rate, this controversial topic seems blog-worthy. The “cult” part is not even worth addressing as it is so preposterous, and if Sheen was really an AA member “for 22 years” he should certainly know that is a classic ridiculous myth. The success rate of Alcoholics Anonymous, however, is a more interesting topic…

Dr. Drew Pinsky, celebrity addiction specialist, was approached by TMZ about Charlie Sheen’s comments and noted that Sheen had a point about the success rate not being great, yet in the same breathe Dr. Drew clarifies, “but [A.A.] DOES work when people do it!”

A.A. Success Rate Impossible to Measure

From the time spent in Research Methods classes long ago, I can confidently say that it is impossible to accurately measure the success rate of Alcoholics Anonymous. There are simply so many factors that make it impossible, and countless variables that can’t be controlled for a valid study. I won’t waste our time detailing all of them here, so you’ll just have to trust me on that if you have no background in scientific research. Besides the obvious (how does one study and track an anonymous population?), I will just address a couple key points that come to mind.

How do you define success in AA? And how do you define AA membership? The problem is that most people who attempt to estimate the AA success rate base it on the number of AA members with a certain length of sobriety reported (which again, is impossible to measure anyway) compared to an overall number of “AA members” (also impossible to accurately measure!). This leads to the question of who is considered “members”.

In the 12 traditions of AA, all that is required for membership is “a desire to stop drinking”. Even by that loose definition, you still couldn’t include every single person who has attended an AA meeting because there are plenty of people who are court ordered to attend (apparently our judicial system thinks the success rate is high enough to warrant AA attendance mandatory for offenders suspected to have a drinking problem).

A.A. Meeting Attendance Today

There was a better chance at more accurately estimating the success rate of AA in the early days, when there were few groups, and members tended to have just one local meeting they attended… in contrast to today, where in some areas you could attend several different meetings in the same day in the same town… and the meetings may have 50+ in attendance which also makes it difficult to keep track of who is who, much less who has been sober for how long and who is actually attempting to work the 12 steps.

Every day, countless individuals wander into an AA meeting just to check it out. Thousands more go to numerous meetings but never attempt to start and/or complete working on all 12 steps which are the basis of AA’s method of recovery. For example, the AA literature states that those who do not complete the 5th step are very likely to relapse…. They also wrote of their own attempts at recovery: “half measures availed us nothing”. So certainly the founders expected that members must work the 12 steps if the individuals truly wished to acquire long term sobriety, as the founders did.

“Dry” or “Sober”

30 million Big Books sold
AA is a 12 step program, not a “just go to meetings” program. It is a spiritual program of recovery based on actively working a process of 12 steps and integrating them into one’s life. You can’t measure that – it’s subjective by nature. You can measure if someone is “clean” or “dry” from drugs and alcohol for a period of time, but is difficult to measure true sobriety. AA founding member, Bill Wilson advocated emotional sobriety, and the happier life that results from being emotionally sober (aka alcohol-free AND living spiritually). …which is why when Charlie Sheen publicly spews negative angry rants, and in the same moment claims he is “clean and sober”, sober AA members must shake their heads as while he might be clean of drugs and alcohol but he does not sound the least bit emotionally sober.

Success Rate of the Early A.A. Members

In the early days of AA, when it was much easier to get somewhat of an accurate estimate of membership and length of sobriety, the founders did attempt to estimate the success rate. In the foreword to the 2nd edition of the book Alcoholics Anonymous (the main text of AA), printed in 1955 just 16 years after the original edition, they wrote:
“Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with A.A. showed improvement. Other thousands came to a few A.A. meetings and at first decided they didn't want the program. But great numbers of these-about two out of three-began to return as time passed.”

Wow, so essentially they reported at least a 75% sobriety success rate of those who kept showing up and working at it. That was before the days of our modern rehabs, outpatient services, alternative 12 step programs, countless self-help books, etc. It was straight AA; the spiritual 12 step program where people were encouraged to work all 12 steps right away as Bill did, and they only focused on the main text of Alcoholics Anonymous as the instructions for sober living.

If there were a way to measure the amount of people who actively participate in AA meetings and work the 12 steps as recommended by the founders of AA, then that would be the population to survey for length of sobriety to determine the success rate of AA as a program! I wish there were a way, as I am confident the success rate would be high for those whom are honestly, willingly, and consistently working through the suggested 12 steps of recovery outlined by the founders of A.A. in the original text of Alcoholics Anonymous. …and with an accurate report of A.A.’s actual effectiveness, Charlie Sheen couldn’t blame AA’s success rate for his chronic relapses.

Charlie Sheen didn’t learn the 12 Traditions apparently…

One of the reasons Alcoholics Anonymous established the 12 Traditions was to address this type of issue- when a celebrity announces their participation in AA and then proceeds to comment about AA in the media, they are representing A.A. which is exactly what the Tradition says not to do (regardless of positive or negative comments about the program, AA does not wish to be represented by any individual on the level of press). It is good that Sheen does not claim to be a member of AA currently while his behavior seems manic, full of anger and grandiosity. As another Tradition states, AA is a program of attraction, not promotion.

Hopefully the countless hopeless alcoholics who could indeed benefit from Alcoholics Anonymous were not influenced by the ranting of one sick misguided celebrity who may be “dry” of his own accord but it not “sober” by AA standards. Thankfully, AA as a whole is too strong to be affected by Charlie Sheen’s public inaccurate defamation.