David Sheff, author of Clean: Overcoming Addiction and Ending America’s Greatest Tragedy, and Beautiful Boy: A Father’s Journey Through His Son’s Addiction, wrote a small piece on Time.com about the need for more treatment programs to use evidence based treatments for substance abuse. In the author’s box at the bottom, there is a very common disclaimer, that the author’s view’s are his own. Unfortunately, in this case, that may be a truer statement than we’d like!
Case in point, one recent commenter. JeffT writes that “any successful treatment model today includes A.A. after treatment”. He goes on to write about the “self-absorbed addict”, and that “the addict has to be willing to change” for any change to occur. These kinds of statements are evidence of how far we still have to go in changing the conversation around substance abuse treatment, including the many myths about substance abusers, as well as misunderstandings about how effective treatment works.
First, to respond to the commenter, while AA is a critical component of change for some, there is no evidence that it is a critical component for all people, or even many people in the process of making and maintaining change. In fact, the suggestion that one needs AA can be one reason some people don’t enter into treatment in the first place. The lack of attraction to AA as a change route can come from many places, none of which have to be that this reaction is an example of “denial”. The “AA or bust” idea also dismisses the role that organizations like SMART Recovery, Women For Sobriety, and SOS can play for a given person as alternatives to 12-step programs.
Second, the commenter talks about “addicts”, lumping everyone with a substance use problem together under one label. This popular belief, that there is one thing called “addiction”, and one type of person called an “addict” is a commonly held idea, and is not backed up by science. This lumping together under one roof also includes ideas like “addicts are not motivated”, and “addicts are self-absorbed”; again, there is no evidence that this is true. In fact, the Community Reinforcement and Family Training (CRAFT) approach, which has close to a 70% success rate at helping to get someone who isn’t in any treatment for substance use into treatment, is proof that not only can you help someone make change even when they aren’t “willing”, but that you have an impact on them! They may not be so self-absorbed after all!
None of this is meant to be a knock on AA, or any other treatment program. AA can be VERY helpful to people, and it should have a seat at the table. Just not the only seat. We as consumers, whether you’re an individual looking for help, or a person who cares about someone with a substance problem, or a general consumer of information, need to ask critical questions, see all of the alternatives, and have increased access to alternative approaches that have been proven to be successful.