What goes on in alcohol rehab (Hazelden)?

Do you have a cite (or more) from a scientific, controlled study in a peer-reviewed journal?

This article says:

Alcoholics Anonymous is famously difficult to study. By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous. No conclusive data exist on how well it works. In 2006, the Cochrane Collaboration, a health-care research group, reviewed studies going back to the 1960s and found that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”

I would say that my cite is myself. Over 50 years in the “world”. My mother is an addiction counselor and my dad was an alcoholic. It’s a truism in that world that AA works; it’s just accepted as fact.
But, you asked for actual science…
Here’s an update to that Cochrane Collaboration study cited in that Atlantic article you quoted:

For the review, the researchers updated Cochrane Collaboration’s 2006 systematic review of AA’s effectiveness, which had been based on eight studies. The 2006 review found that there wasn’t sufficient evidence available to determine whether AA was more effective than other methods.

Since 2006, higher-quality research—including randomized clinical trials and quasi-experiments—on AA’s effectiveness has become available for the Cochrane Collaboration to update the 2006 review.
. . .
Overall, the researchers found AA appears to result in higher rates of sustained abstinence and when compared to other treatment programs. According to the researchers, AA may result in between 22% to 37% of participants remaining abstinent, whereas other treatment programs may result in about 15% to 25% of participants remaining abstinent.

Those percentages show that it is notoriously hard to treat addiction. Another truism is that almost no one gets sober the on the first try. A big attraction of AA is that it’s free, and there is no judgement when you fall.

Here is the Harvard Gazette article on that study.
And here is a separate study done by Stanford. (which Discourse tells me was cited by Qadgop earlier)

My biggest issue is that the thousands of dollars spent daily at a rehab center and then AA is all they’ve got once they’ve gone past physical withdrawal symptoms.

Surely we can do better than pray to the doorknob and make amends for cheating on your ex?

The problem is, of course, that the AA cult has fervent devotees who dominate the rehab industry and put the cotton right back in their ears when it comes to any other method, especially those which involve a medical treatment.

Are you just looking for a drug?

There’s no pill that cures it.

There’s one that will make you sick if you drink (antabuse), and there’s another (naltrexone) that blocks the euphoric-type sensation.

I’m not sure what the bug you have about AA comes from. They’re just groups of people and groups of people all have their own dynamics and a lot of people are full of shit.

Nobody has to keep going to AA. Most people don’t.

Well, so far there are only 3 medical therapies for alcoholism: antabuse, naltrexone, and cambral. Each of those has a very high efficacy while it’s being taken, but does nothing once stopped.
For most addicts some sort of behavioral modification is necessary. That can come from individual therapy with a doctor, or from some sort of group therapy, like AA.

Right now there is no magic bullet. Different approaches work for different people. AA is not for everyone, but it does work for many.

Eta: ThisisTheEnd ninja’d me on the drugs.

And his obsession with doorknobs. :upside_down_face:

I have a huge problem with courts sentencing people to attend it.

mikecurtis – The links you provided are studies comparing AA with other types of psychotherapy. And they do not indicate what the relapse rate is for any of them. The articles did not indicate whether there were control groups, etc. And the studies did not compare therapy (or therapy plus medication) to medication.

I acknowledge that many people, including close friends of mine, have been helped by AA. But this does not prove that AA is the best treatment for most people.

From The Atlantic:

[quote] # The Surprising Failures of 12 Steps

How a pseudoscientific, religious organization birthed the most trusted method of addiction treatment


MARCH 25, 2014[/quote]

Thorough article on AA. Success rate from 5% to at most 31%. Retention rate of 5%. 5% of 31% is not impressive.

That’s the problem. There is no one path to sobriety that is better than the rest.
I think what some of you are not understanding is that addiction is comprised of two parts: physical dependence, and psychological dependence.
Often, (depending on the drug and the duration of dependence) all that is needed to overcome physical dependence is time. Other times intensive medical therapy is involved.
For some, once they’ve cleared the physical dependence, they’re good to go. For others the end of physical dependence is just the start of a lifelong struggle with the psychological.
Many, many people have been helped by AA, and many many have not. And if you ask each of those who have been helped, they’ll give you a different reason why.

It is when you compare it to everything else. There’s a reason why almost every addiction rehab center incorporates some part of the twelve steps into its program.

The Atlantic article did not compare the success of other treatment modalities. The statistics above are only for AA, not in comparison.

Rehab centers may incorporate because it costs them nothing, unlike the cost of having staff accredited in evidence-based treatments.

My experience is that rehab staff usually are accredited in psychotherapy. And its used intensely - along with prescriptions like anti-depressants - for the period of time you are in rehab. But you leave rehab. And psychotherapy is time consuming and expensive. And so AA becomes part of the program because no matter where you go or if you stay sober after leaving rehab or not, you will be able to find an AA meeting to support you when you need it without an obligation to pay. It isn’t like rehab is 28 days of AA meetings. And it isn’t like people get sober and its a done deal - for a lot of people it remains a struggle for the rest of their lives.

And its got a lousy success rate - addiction recovery is TOUGH. Its like chemo for pancreatic cancer - it probably won’t help. You use it in combination with other treatments and hope for the best.

The doorknobs come from the AA spiritual but not religious nonsense. If you’re not Christian, you can pray to the doorknob.

But I think the relapse rate is high with or without AA, right? I’m asking b/c I honestly don’t know.

My old man and oldest sister were both substance abusers. Both did AA. Both relapsed but had lengthy periods of recovery and abstinence in between falling off the wagon.

Dad was a physician and hated the religiosity associated with a lot of AA chapters, and frankly, he was also a bit of an elitist who didn’t have time to listen to less educated blue collar types crediting Jesus for their sobriety. But he did manage to a group that was composed of other working professionals and stuck with that for a while.

My sister ended up meeting and marrying a fellow AA ‘member’. Had two kids. Marriage was good until he started suffering a mental breakdown due to workplace stress and started hitting alcohol and the Colombian cargo (so I’m told). They eventually went through a rocky divorce and she was never the same.

Doorknobs open up doors so I guess if it helps you open up the door to sobriety it makes sense. You can also meditate for strength, its a personal choice.

I also tend to agree that many places use AA meetings as filler time in lieu of actual one on one or group therapy and then charge insurance for the time spent. This is just plan wrong as AA is a supposed to be a voluntary nonprofit organization instead of court ordered forced therapy. And time spent in AA meetings should not be billable. It’s crap like this that isn’t sanctioned by AA that gives AA a bad wrap.

Yes, relapse rate is high no matter what you do. AA lowers the relapse rate slightly. Psychotherapy lowers it slightly. In-patient rehab lowers it slightly. If the root cause of the addiction is self medication, prescription meds can lower it slightly. But there isn’t anything that you can do that lowers the relapse rate enough that its really anything but “throw what you have at it and hope.”

Some people don’t like AA because people often “find God” - the spiritual component can be a big deal. Frankly, I’d take my beloved addicts becoming really annoying fundamentalists over being active addicts any day - A belief in God is less likely to kill them or make them homeless. That seems like a more than reasonable trade. My experience has been that most people I know who got sober through AA still think religion is for the birds and most people who have a problem with AA really have a problem with religion.

I agree that court ordered AA is problematic. We should be making sure addicts get into programs that are more full service - AND we shouldn’t be putting addicts into AA who have no desire to stay sober just to meet their court requirement - that isn’t healthy for the people who are there because they are struggling to stay sober. But teaching someone who is in a rehab program to find comfort in ubiquitous and free AA meetings (which means regular repeated AA meetings to build the habit and associations while in inpatient care) seems like a good idea since most addicts will relapse and not all will be able to do multiple stints through in-patient - or even out-patient - programs.

As far a rehab centers go, Hazeldon is better -and pricier- than many. Whatever his length of stay he will have been exposed to the rudiments of AA along with whatever clinical services they feel he needs. He will leave with a Big Book, phone numbers of Hazeldon “alumni” in his area a recommendation to attend AA meetings regularly. Like anyone else, he’ll have the choice to follow some, all or none of those recommendations. I know people who have opted for each with varying degrees of success.

I once heard a nun state from a podium that “…there are a lot of aholes in AA, but why that should surprise anyone is a mystery, there are a lot of aholes everywhere”.

My personal experience has been that if I allow the possible appearance of an a**hole or two prevent me from going somewhere, I didn’t really want to go anyway.

Guess what? There are a lot of drunken assholes in bars.