An Investigation by The Atlantic Shows other Treatments are More Effective at Combating Alcoholism

AA Meeting.

The 12-step program used by Alcoholics Anonymous has little basis in science, critics allege.

Investigation Questions Effectiveness of Alcoholics Anonymous

An investigation by The Atlantic shows other treatments are more effective at combating alcoholism.


Author and award-winning journalist Gabrielle Glaser has a message for people who struggle with alcohol dependence: It might be time to abstain from Alcoholics Anonymous.

The 12-step program has little basis in science, she says, after having done extensive research on the program and reporting her findings for a story in The Atlantic titled ” The Irrationality of Alcoholics Anonymous.”

“I assumed as a journalist that AA worked,” Glaser said at an Atlantic-hosted event Wednesday at the Ronald Reagan Building and International Trade Center in Washington, D.C. “But then when looking at the empirical evidence I found there wasn’t any.”

The effectiveness of AA’s approach has long been debated. But addiction treatment is likely to be even more carefully scrutinized as payment for programs materializes under coverage provided by President Barack Obama’s signature health care law, the Affordable Care Act.

Obamacare provides alcohol and substance abuse treatment to 32 million people who didn’t have it before by requiring state Medicaid programs to pay for it and by requiring private insurance plans to cover it, extending coverage to an additional 30 million people. Obamacare also allowed for behavioral health treatment, which encompasses addiction and mental health services, to be reimbursed in a similar way as primary care.

A recent analysis by U.S. News showed that the law has not yet resulted in adults going in droves to behavioral health providers.

The AA program involves admitting powerlessness over alcohol, believing in a higher power, apologizing and making amends to those wronged and abstaining from drinking. Television helped popularize the program – which had risen out of the Prohibition Era – during the 1950s. The organization has about 2 million members, and inpatient treatment facilities use many of the tenets of its 12-step program as part of their approach.

Data of its effectiveness, however, aren’t tracked.

“There is no other realm of medicine that is so segregated,” Glaser said of addiction treatment and the research around it. NA Daytona Meetings Have court mandates.

She points to other approaches that have worked and are based in scientific analysis, including therapy and medication. Glaser said she hopes people are able to find other approaches to treatment. ” Yoga works for a lot of people, Catholicism works for a lot of people … but it isn’t based in science,” Glaser said.

The National Institutes of Health estimates that 11.2 million men and 5.7 million women had an alcohol use disorder in 2012, the latest year for which data are available. Among teens, that number is estimated at 855,000. Beginning to drink at a young age can be a risk factor for developing dependence later in life. Genetics are also thought to play a role, and people who have anxiety or depression can turn to alcohol for self-medication, though it often makes symptoms worse. Excessive use of alcohol is a risk factor for cancer and heart disease. Of adults in need of treatment for alcohol abuse, 8.4 percent are admitted to a facility, according to the NIH 2012 data.

A recent report by the Centers for Disease Control and Prevention found that six people a day die of alcohol poisoning – the majority of whom are middle-aged, white men.

Officials with AA said the organization does not comment on reports like Glaser’s and declined to address other approaches to treatment. AA Daytona Dangerous Meetings.

“Alcoholics Anonymous is guided by its Twelve Traditions, one of which suggests that AA express no opinion on outside issues, in order to avoid being drawn into controversy,” the public information coordinator at the General Service Office of AA said in an email. “This includes expressing opinions on what others may say about AA.”

The National Institute on Alcohol Abuse and Alcoholism, part of the NIH, points to various approaches to treatment, including support groups like AA, behavioral therapies, medication or a combination of these. The same is true for the Substance Abuse and Mental Health Services Administration, which is part of the Department of Health and Human Services.

“SAMHSA does not advocate one program over another, since we believe there are many paths to recovery,” an agency representative said in an email.

Other methods of treatment for addiction, such as medication or cognitive behavioral therapy, have shown some empirical evidence for success. In reporting her story, Glaser decided to try naltrexone, a medication that prevents endorphins – the feel-good hormone – from reaching the brain, making the experience of drinking alcohol unenjoyable. The Food and Drug Administration approved the drug in 1994 for the treatment of alcohol abuse.

Glaser, who said in her article that she did not have a drinking problem but that she bought the drug online and tried it for research purposes, found it to be effective. “[A glass of wine] was about as appealing as drinking a glass of Dimetapp,” she said.

Doctors prefer not to prescribe naltrexone because it can result in liver toxicity if someone drinks heavily and takes more than the recommended dose, she told U.S. News after the event. “Fewer than 1 percent of people who have alcohol problems are on any form of medication, and so few doctors prescribe it,” she says.

Scott Stossel, editor at The Atlantic magazine who interviewed Glaser at the event, pointed out that alcoholism appears to be on a spectrum.

There is a problem with the one-size-fits-all approach, Glasser said of AA’s abstinence rule. “Some need to learn to moderate better, others can’t drink again,” she said.

U.S. health officials recommend typical adults over the age of 21 limit themselves to no more than one drink a day for women, and two for men. “I think our safe guidelines make people feel worse. They say, ‘What the hell!’ and people drink more,” she tells U.S. News.

Glaser points out that other countries, such as Italy, have different alcohol guidelines – as well as better health outcomes.

Speaking The Truth About Alcoholic Women and Elizabeth Pena

ANother excellent article by Gabrielle Glaser exposing the failed systems in place for women with alcohol addiction, and just unsafe 12 step programs like AA really are.



Elizabeth Peña and the Truth About Alcoholic Women

Alcoholism and abuse is on the rise among women. Why they drink, and why the traditional treatment methods like A.A. don’t work for them.
When Elizabeth Peña died last week, her family said she died after a brief illness. We now know that the Cuban-American actress’s untimely demise was the result ofdue to alcohol abuse, in addition to acute gastrointestinal bleeding, cardiopulmonary arrest, and cardiogenic shock. NA and AA Daytona meetings in Holly Hill Florida.It’s understandable that her family would not wish to disclose the circumstances. To be a woman suffering from a drinking problem in America is a lonely enterprise, defined by stigma and judgment. And that’s tragic. Women in America are drinking more than ever before, and they are suffering the consequences in sharply rising numbers.I spent three years researching the topic of women and drinking for a 2013 book, and I turned up some pretty arresting statistics. Gallup pollsters have consistently found that the more wealthy and educated a woman is, the more likely she is to drink. Federal studies show that the number of white, black, and Hispanic women who classified themselves as regular drinkers jumped significantly between the 1990s and early 2000s. They’re also the chief consumers of wine. According to the Wine Institute, they buy—and consume—the lion’s share of the 800 million gallons of wine sold in the U.S. each year.

On one hand, the rising drinking among women is a sign of parity. But unfortunately, this is one realm in which identical treatment has disparate outcomes. That is because women are more vulnerable than men to the toxic effects of alcohol: their bodies have more fat, and less water, than men’s. Fat retains alcohol, and water dilutes it, so women drinking the same amount as men who are evenly matched in size and weight become drunk more quickly, and stay intoxicated longer. Women also make less of an enzyme called alcohol dehydrogenase, which breaks down alcohol before it hits the bloodstream.

This may be why serious alcohol-related deaths and illnesses are on the rise. Peña’s death, it turns out, is part of a dismaying trend: Between 2002 and 2012, the number of U.S. females women who died from cirrhosis rose 13 percent. (Among men, the rate for that same period rose 7 percent.) Between 1999 and 2008, the number of severely intoxicated young women who wound up in E.R.s rose by 52 percent. From 1992 and 2007, the number of middle-aged women who checked into rehab nearly tripled.

Between 2002 and 2012, the number of U.S. females women who died from cirrhosis rose 13 percent.

We don’t know whether Peña, known for her roles in “Modern Family,” “La Bamba,” and “Down and Out in Beverly Hills,” sought help for her alcohol use. But if she did, it’s likely she was treated with one of a myriad 12-step programs derived from the principles of Alcoholics Anonymous. The program, developed in the 1930s, demands that it members abstain from drinking, cede their egos, and accept their “powerlessness” over alcohol.

And that’s a problem.

My research showed that the majority people do not get better—or worse, are harmed through what often amounts to unsupervised group therapy. Anonymity rules help obscure people with criminal records, and many new members, especially women, report being the targets of unwanted sexual advances. A.A. members euphemistically call this “the 13th Step.” After my book appeared, dozens of women wrote to tell me what one study already showed, that a majority are harassed. Many are groped and some are raped. Some are even murdered. In 2011, Karla Brada Mendez was strangled to death by Eric Allen Earle, a man she met at a 12-step meeting. (He was convicted last month.) Unlike Brada Mendez, Earle, who had a violent past, was not attending A.A. voluntarily. A series of judges and parole officers had ordered him to go as an alternative to jail. Because of anonymity rules, none of Earle’s extremely violent past was made known to other attendees, and Brada Mendez’s family recently filed a civil suit against A.A. for wrongful death.

Monica Richardson, a Los Angeles actress and singer, was a longtime A.A. member who became so disturbed by what she found to be growing cases of violence in the group that she left, and has made a documentary about A.A.’s dangers.

Dozens of women wrote to tell me what one study already showed, that a majority of women in A.A. are harassed, groped, or raped. Some are even murdered.

While it is sadly too late for Ms. Peña, there is hope beyond these dismal facts. A growing number of U.S. practitioners are using what therapists and doctors in Europe have been using to treat alcohol use disorder for decades: evidence-based practice. Some, like Manhattan psychologist Dr. Andrew Tatarsky, embrace harm reduction, which seeks to reduce the negative consequences of alcohol or drug use. Others, such as the Centers for Motivation and Change in Manhattan, employ a variety of tools, such as cognitive behavioral therapy and motivational interviewing, a goal-oriented form of therapy, with their patients. A growing number embrace the use of anti-craving medications long approved by the Food and Drug Administration for the use of alcohol dependence.

And some specialize in treating women, who have different risk factors for excess drinking. Women are twice as likely to suffer from depression and anxiety disorders as men, and they are more likely than men to treat their symptoms withalcohol. Other risk factors include a history of sexual abuse and bulimia, both of which also affect more women than men. Dr. Mary Ellen Barnes, co-director of an alcohol treatment program offering science-based treatments in Rolling Hills Estates, Calif., says A.A.’s message of “powerlessness” is not helpful to most women—and is likely harmful. “Most women are not drinking to excess because they feel ‘powerful’ in the first place,” she says. “Women need to feel powerful, not like victims. If women go to treatment that tells them to embrace being powerless and diseased, how is that going to help?” Barnes uses cognitive behavioral therapy and assertiveness training, a skill she thinks is crucial for women who are problem drinkers.

“Many of the reasons women drink too much have to do with not asking for what they want and need in their personal relationships and the frustrations that come from that,” Barnes says. “When women learn to be assertive, their needs start getting met, they feel happier and more powerful. The reasons for their problem drinking start to go away.”

As a fan of Elizabeth Peña’s performances for decades, it saddens me that her career has been cut short. Almost certainly, it didn’t have to happen.