Ms Loder states that the Big Book of Alcoholics Anonymous is
"...periodically updated but retains substantial original content." The
"meat" of the Big Book ie how it works and the 12 steps is unchanged from
when Bill W. first set it down in 1939, and as such retains all the
thinking of 75 years ago. It has never been updated to recognise the
advances that have been made in the world of addiction medicine.
Alcoholics Anonymous (AA) retains the dogma of the Oxford Group, where
salvation ie sobriety, was attained by prayer to a God in the Judaeo
Christian mold.
Alcoholism does remain difficult to treat, and AA has been seen as a
ubiquitous and cheap alternative for doctors who patients present to them
with drinking difficulties, but now there are alternatives to AA, which
are scientifically based and may be more acceptable to people who baulk at
placing the responsibility for their sobriety in the hands of a
supernatural being, or being told that they must attend AA for the rest of
their lives, if they wish to remain sober. These people are not being
given the opportunity to move on with their lives, they are told by the
programme that they are "powerless".
Alternatives that have started in the UK of recent years, include
SMART - Self Management and Recovery Training, Rational Recovery,
Moderation Management. These therapies use cognitive behaviour therapy to
provide tools for continuing sobriety, or controlled drinking in the case
of Moderation Management.
In "Review of the effectiveness of treatment for alcohol problems"
Raistrick,et al NTA 2006 p44 in a list of treatments for alcoholism AA is
number 38 in a list of 48 treatment modalities, but this is because there
are few published studies of AA's effectiveness. The Big Book and it's
message is still is accepted by many in the medical profession as the last
word on alcohol treatment, but without any evidence to the contrary.
Rapid Response:
AA and the BIg Book - time to move on ?
Ms Loder states that the Big Book of Alcoholics Anonymous is
"...periodically updated but retains substantial original content." The
"meat" of the Big Book ie how it works and the 12 steps is unchanged from
when Bill W. first set it down in 1939, and as such retains all the
thinking of 75 years ago. It has never been updated to recognise the
advances that have been made in the world of addiction medicine.
Alcoholics Anonymous (AA) retains the dogma of the Oxford Group, where
salvation ie sobriety, was attained by prayer to a God in the Judaeo
Christian mold.
Alcoholism does remain difficult to treat, and AA has been seen as a
ubiquitous and cheap alternative for doctors who patients present to them
with drinking difficulties, but now there are alternatives to AA, which
are scientifically based and may be more acceptable to people who baulk at
placing the responsibility for their sobriety in the hands of a
supernatural being, or being told that they must attend AA for the rest of
their lives, if they wish to remain sober. These people are not being
given the opportunity to move on with their lives, they are told by the
programme that they are "powerless".
Alternatives that have started in the UK of recent years, include
SMART - Self Management and Recovery Training, Rational Recovery,
Moderation Management. These therapies use cognitive behaviour therapy to
provide tools for continuing sobriety, or controlled drinking in the case
of Moderation Management.
In "Review of the effectiveness of treatment for alcohol problems"
Raistrick,et al NTA 2006 p44 in a list of treatments for alcoholism AA is
number 38 in a list of 48 treatment modalities, but this is because there
are few published studies of AA's effectiveness. The Big Book and it's
message is still is accepted by many in the medical profession as the last
word on alcohol treatment, but without any evidence to the contrary.
Competing interests: No competing interests