Is it harmful, wrong, and illegal to force people into the 12 steps?

Juliet Abram described for The Fix her unhappy time in AA (she was also in 12-step rehab), forced there by the Ohio court system after each of her three DUIs. Except, following the last, she started her own chapter of S.O.S. rather than repeat this dysfunctional cycle. As Juliet says, “hadn’t I heard in AA that the definition of insanity was doing the same thing and expecting different results?”

And, as Juliet also notes, “I am in the majority!” The National Institute on Alcohol Abuse and Alcoholism (NIAAA) interviewed 43,000 Americans about their lifetime substance use. Remarkably, the research (called NESARC) shows that the majority of people eventually overcome addictions. Three-fourths of people will recover from alcoholism within 20 years of its onset. Abstinence and AA are not the only ways to beat an addiction – they are the minority routes: 75 percent of alcoholics recover on their own without rehab or AA. And over half of those who recover from alcoholism cut back instead of abstaining totally.

How come we don’t know these things? Well, not everyone joyously welcomes the news. Or accepts it. When I debated the former head of treatment at Hazelden, Saul Selby, he had never even heard of NESARC.* Why should he or Hazelden, a world-famous 12-step treatment center, care about the largest study ever conducted of the course of alcoholism for Americans?

Most of the responses to Juliet’s article recount similar experiences to hers, and success outside AA. But here is a different kind of reaction to Juliet’s post:

time4numma4:
No threats, just predictions based on watching what happens to alcoholics since before you were born.

Here’s how that works. People with 3 duis like yourself who keep drinking like get 4. People with 4 [DUIS] get to see the inside of jail for a while. That’s you, in jail still with no useful solution. Upon exit, should you keep chippie drinking you’ll experience #5 and some hard time in prison.

It matters not at all that you prefer things would go otherwise and that you have decided firmly that further trouble will be avoided. You felt that way after 1, 2, and 3, surely. Your feelings this time around carry as much power to alter the reality of your condition as they did the other times.

The chance is strong that in your coming disasters you’ll cause serious harm to yourself and/or the completely innocent. Your dislike of AA’s solution and the people who succeed at living through using it will not assuage the guilt you’d then carry. It changes nothing though, and those with zero solution continue to live miserably with their guilt.

Juliet’s article and the responses to it give us insight into the many people who don’t succeed at AA and the 12 Steps, but who overcome alcoholism and addiction by relying on their own resources or using other types of treatment. In our book, Recover! Stop Thinking Like an Addict, Ilse Thompson and I say, “Isn’t it more encouraging to realize that most people overcome addiction, which is true, rather than thinking that it dooms them to a lifetime disease?”

Do you think time4numma4’s vicious bullying might discourage people from revealing their distress with AA? I write about how there is no percentage in declaring that you have recovered without the 12 steps. Consider Drew Barrymore, formerly in recovery and now a film producer as well as a famous actress – and also now married and a vintner. One woman, who said “I love Drew Barrymore,” described how Drew is doomed:

If you’re an alcoholic you can’t drink in safety. It’s an allergy. Paula

I’ve been living a fabulous life clean and sober for 30 yrs and that means not drinking and not doing drugs. Period. Sure. Occasionally you think, “I would love to sit on the deck in Newport and have a martini.” But the reality is the name of my disease is MORE… I will eventually want MORE booze, more drugs, more business… Even a wine company !!

Sadly, drew is a CLASSIC example of alcoholism raising its ugly head and is out to ruin [h]er wonderful life. She has several wonderful successful businesses. She’s happily married. A newly wed! BUT, She still has to open her OWN WINE LABEL!?! Are you kidding me?? LOL

Most counselors share time4numma4’s and Paula’s views.

Hello Stanton: I would like to advocate your solution for a young relative (20) who has been through a couple of 12- step based rehab centers and in AA. Although he remains a consistent abuser of drugs and alcohol, he rejects the idea that he is an addict or alcoholic and refuses to have anything to do with AA or any rehab program based on AA.

I have discussed your approach with the counselors involved, but they reject it because none of them know of any serious abuser who got sober without AA, whereas they see hundreds of people in AA who are sober.

My counterargument is that he is rejecting AA and continued attempts to force it on him will be counterproductive. He thinks what we are doing is akin to forcing religion onto him.

So none of the counselors knows of a single person who recovered without AA! AA works so well, why would we even consider another approach from that perfect one developed in 1935? Like the former director of treatment at Hazelden, these counselors presumably never heard of NESARC. Not knowing the largest outcome study in their field conducted by the national alcoholism agency might seem to constitute malpractice.

Their comments also suggest that they’ve never heard of S.O.S. or SMART Recovery, or that anyone ever succeeded in achieving recovery in these and other alternative programs. How did Juliet, a young non-professional, know about S.O.S. and succeed with it, and professional counselors don’t know about any such treatment/support alternatives?

In the case referred to me above, a 20-year-old is being sent to AA, to be informed (and to parrot) that he or she is a lifetime alcoholic. Have these counselors never heard of young people who outgrow their problem drinking? Turning to another government source, here is data from the 2011 National Survey on Drug Use and Health detailing drug and alcohol abuse/dependence across age groups which Ilse Thompson and I reproduce in Recover! (This survey is conducted by the U.S. Substance Abuse and Mental Health Services Administration.)

Age Group % with Abuse/Dependence
20–22 -> 20
30–34->  12
50–59 -> 5
These data show a sharp drop off – a halving each decade – in dependence on both alcohol and drugs. This maturing out phenomenon was first detailed by Charles Winick in 1962. In 2012, William White documented the massive occurrence of natural recovery: “Recovery is not an aberration achieved by a small and morally enlightened minority of addicted people. If there is a natural developmental momentum within the course of these problems, it is toward remission and recovery.” White is the revered recovery icon who wrote Slaying the Dragon.

Let’s now turn to these counselors’ complete willingness to disregard this young man’s feelings about religion. It’s not just their disrespect for his values (the kind Juliet describes in her blog). What they are insisting on also happens to be illegal.

The country’s national law enforcement agency, the Department of Justice, through its Office of Civil Rights, tells us about coercing people to attend AA and 12-Step rehab:

Is a twelve-step recovery program such as AA or NA an inherently religious activity?

Yes. Courts have analyzed this question in reference to the Establishment Clause of the First Amendment to the United States Constitution. Courts have repeatedly found that traditional twelve-step programs contain religious content and are religious activities. It is important to keep in mind that a program or activity does not need to be a traditional form of religious worship to be a religious activity; a program can have a secular purpose such as providing drug or alcohol treatment but its programming may contain religious content. These activities must be separate in time or location from the program supported with government financial assistance and participation in these programs must be voluntary.

So, any counselor or treatment group that receives any type of government consideration who forces anyone to attend AA or a 12-step rehab, or even a rehab where people are encouraged to attend AA or that practices 12-step treatment in the facility, is hereby noticed that their actions are illegal, they are violating the first Amendment’s separation of church and state, and they are subject to criminal penalties and civil liability.

Everybody get that?

Of course, that happens tens of thousands of times across the United States daily. But, now that The Fix’s millions of readers have been noticed about this violation of American law, I trust it will never occur again.