Alcoholics Need More Options than AA

It's no surprise that faith-based programs are particularly ill-suited to atheists and agnostics

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Should atheists be forced to participate in faith-based recovery programs such as Alcoholics Anonymous (AA)? The 9th Circuit Court of Appeals recently said no, unanimously siding with drug offender Barry A. Hazle Jr. after state officials mandated his participation in AA. Court documents state that Hazle’s requests for a secular alternative were repeatedly denied by both his parole officer and representatives from the state-contracted mental health service provider, West Care. For violating his parole, Hazle was arrested and incarcerated for over 100 additional days.

The appeals court ordered a Sacramento district judge to consider preventing state officials from requiring 12-step treatment as a part of the parole program. But it’s going to be difficult, because this one-size-fits-all prescription – 12-step meetings and 12-step-based group therapy for everyone – reigns supreme in treatment today. Nearly eight out of ten private programs use 12-step recovery, with two-thirds compelling patients to attend meetings, according to researchers working on the University of Georgia’s National Treatment Center Study and cited in Inside Rehab by Anne Fletcher. Public programs, frequently starved for funding, aren’t much better. In fact, West Care, California’s sole drug treatment provider, only contracts with religious-based treatment programs.

(MORE: Addiction Treatment in America: Not Based in Science, Not Truly Medical)

But even if they’re rarely acknowledged in today’s treatment community, there are many alternatives to 12-step fellowships such as SMART Recovery, Secular Organizations for Sobriety, and Specifically For Women. This is important because a national survey published in 2007 concluded that an addicted person was just as likely to stay sober whether they were involved in AA or another support group. In fact, it would behoove treatment providers to match people with a support system that’s suitable to their preferences, because group participation is associated with increased abstinence.

(MOREStudy: Men and Women Benefit in Different Ways From AA)

Of course, almost all rehab programs advertise a wide range of options, evidence-based services as well as mutual-support groups, but tradition dominates. As a young opiate addict, I went through two inpatient hospital facilities, an outpatient program, a sober house, and a sober coach before learning that an alternative to AA (or NA) existed. Even the methadone program I paid to enroll in, a public program designed for heroin addicts, was 12-step based. This is odd, considering traditional AA communities don’t acknowledge medication-assisted sobriety as genuine sobriety.

To be sure, faith-based, abstinence-only fellowships like Alcoholics Anonymous can be a very helpful, affordable resource. But these mutual support groups were designed to be voluntary, certainly never to be confused with medical or court-mandated addiction treatment. Meanwhile, the alternatives remain widely unknown, an ignorance that presents a real barrier to those in desperate need. When asked what kinds of treatments are available for addiction, 60.1% of respondents to a 2012 national survey said groups like AA or NA.

(MOREQ&A With Author Gabrielle Glaser: Wine, Women and the Dangers of AA)

Addiction is our nation’s most costly and preventable health problem. And because individualized care is so frustratingly difficult to find, California’s state officials now have an opportunity to make some long overdue changes. By taking concrete steps to make alternatives to 12-step recovery more available, these state officials can encourage all addicted Californians, not just parolees, to invest in their future.