Beyond Addiction

Why is there no debate about the effectiveness of 12-step-based treatment programs from addicts and alcoholics who have recovered?

Because for them, it works.

A recent op-ed in The Washington Post written by Bankole A. Johnson, chairman of the department of psychiatry and neurobehavioral sciences at the University of Virginia, claims that treatment doesn't work and that even Alcoholics Anonymous is largely ineffective. Dr. Johnson argues there are no real data proving most people get well. And he spits in the face of 12-step programs, calling them "weak medicine."

This from a doctor whose practice appears to treat addicts and alcoholics with medications, ignoring the reality that addiction is not only an illness that affects the mind but also one that affects the body and the spirit.

There is no doubt that the addiction treatment field has done a poor job of collecting long-term outcome data for patients. Alcoholics Anonymous, which is not treatment but is a recovery program that began in 1935 and today thrives around the world, has had a hard time gathering such data, too. After all, its members are anonymous, and what numbers do exist are self-reported.

But in claiming that treatment is "ruinously expensive" and doesn't work, Johnson offers no context. And so I ask him: Compared with what?

The cost of untreated addiction is unimpeachable. Drunken driving injuries and deaths, crime, homelessness, visits to the emergency room, lost profits in the workplace, the millions of broken lives of fractured families everywhere — nobody is immune to addiction's impact. There are scores of credible studies about how treatment reduces these problems.

Also, researchers and scientists tell us that such treatment is effective when compared with outcome data for other incurable chronic illnesses, such as asthma, diabetes and hypertension.

I never have been a numbers guy. I leave that to the experts. And even though statistics never lie, experts on both sides of a contentious matter such as this one can spin the numbers to support their cases. Instead, I prefer to tap into the experiences of the real experts who aren't in this debate: the addicts and alcoholics who gathered last Monday around a table at their meeting place on Summit Avenue in St. Paul, Minn.

In that crowded room were people in recovery. A middle-aged mother who once had had seven years of sobriety but was back with seven days. A police officer with a sudden urge to drink a six-pack of beer even though he had tasted his last cold one about 15 years before the meeting. A student from the University of St. Thomas who announced it was his 21st birthday and his 20th month of sobriety on the same day. There was also a woman there who nervously admitted it was the first time she had been to a 12-step meeting. She had been drinking the day before.

I was there, too. Four treatments over five years, starting in the late 1980s, and now sober almost 16 years.

There were no failures in that room, only varying degrees of success. Our own experiences highlight what works and what doesn't. It's what got us to that place in the beginning and what keeps us going back there day after month after year.

But don't just take it from me. I am not objective.

Dr. Ronald Earl Smith, a U.S. Navy captain who has spent the past 33 years treating alcoholism in the military, said it best in his letter to the editor about Johnson's claims: "Two million sober members of AA ... will see his article and know how wrong he is for them."

William Moyers is the vice president of foundation relations for the Hazelden Foundation and the author of "Broken," his best-selling memoirs, and "A New Day, A New Life." Please send your questions to William Moyers at wmoyers@hazelden.org. To find out more about William Moyers and read his past columns, visit the Creators Syndicate Web page at www.creators.com.

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