AA Abstinence vs Therapy, Medication and Drinking in Moderation

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Many of us have met a person who self-identifies as “an alcoholic” or “a recovering alcoholic” and offers how long he or she has been sober. Many testify to the life-saving nature of Alcoholics Anonymous. Some attend AA meetings for decades and find a lifelong, balanced path in the faith-based philosophy and emotional support of the peer group.

But some who work in the field of substance abuse and addiction – and some people who have struggled and failed to erase the desire to have a drink – do not embrace the basic belief of Alcoholics Anonymous that abstinence is the only way.

“Although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation,” said Gabrielle Glaser in the article, ”The Irrationality of Alcoholics Anonymous,” in the April 2015 issue of The Atlantic. “Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work.”

Glaser interviewed American neuroscientist John David Sinclair, who settled in Finland to continue his research, in which he found that giving rats alcohol and then taking it away completely only made them drink more next time.

“Sinclair called this the alcohol-deprivation effect, and his laboratory results, which have since been confirmed by many other studies, suggested a fundamental flaw in abstinence-based treatment – going cold turkey only intensifies cravings,” said Glaser. “This discovery helped explain why relapses are common.”

Glaser points to the book The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Lance Dodes, a retired psychiatry professor from Harvard Medical School, who estimates an AA success rate of 5-to-8 percent.

An estimated 18 million Americans suffer from alcohol-use disorder and only about 15 percent of them are at the severe end of the spectrum, said Glaser, the author of Her Best-Kept Secret: Why Women Drink and How They Can Regain Control. Glaser’s point is that it’s time to offer treatments that cover a wide spectrum of alcohol use, including diagnosis of mental-health issues such as depression and anxiety that can be treated and in turn, reduce the desire for alcohol.

References:

Glaser, Gabrielle, “The Irrationality of Alcoholics Anonymous,” The Atlantic, April 2015.

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