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This is a peculiar and needlessly confrontational article. It seems to start with a straw man and go downhill from there.

The low success rate of AA is known. The varying ways people respond to AA is also known. Indeed, I have observed it myself.

It is notable to me that there seems to be no mention of the success rate of other approaches. What is there that works better? The anti-AA psychology disagreement has been going on for more then 3 decades. Surely is there IS data showing something that works better than AA the writer could mention it.

It seems likely that addictive behavior has several causes. Therefore it seems likely that one therapy will not work for all who display such behavior. Further those who stop displaying addictive behavior with respect to things like alcohol or medication may still show compulsive behaviors in other ways.

Some people who go to AA seem to get really better, a LOT better. Others, to mention just one imperfect outcome, just become addicted to going to AA — which still beats being addicted to a substance which in sufficient doses is a poison.

Not only that, but the proposed approach involving insight may well be insufficient in many cases. The inner state which leads to the displacement or compulsive behavior could be organic in origin, for example. The “talking cure” can only go so far with organic illness.

My conclusion is that, as it is, this is a pretty vapid article which seems to be self-serving somehow.

There is a large, ever-growing amount of evidence that contingency management is critical in the treatment of substance-abuse disorders.

Here is a link to a recent issues of the Journal of Applied Behavior Analysis, all about research on the treatment of drug abuse (http://onlinelibrary.wiley.com/doi/10.1002/jaba.2008.41.issue-4/issuetoc)

Here is a link to a recent review article on contingency management (http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2006.01581.x/full)

The 'low rate of success' for AA is a rather phony argument. Part of it is how you count success and failure. Is someone who goes out after six months and then comes back a success or a failure. I would say a success because they came back.

Not everyone who comes to AA for the first time wants to quit. Many of these are those who come for back problems. They want to get the wife, the boss, or the judge off their back. They are not interested in staying sober.

It is an axiom of AA that everyone has to hit their own personal bottom. Only then will they be willing to do the personal housecleaning that is necessary to stay sober.

I almost died of acute Pancreatitis on my 51st birthday. It was stop drinking or die. No ifs, ands, buts, or maybes. I didn't want to die and didn't know how to not drink. AA helped me when I couldn't help myself. Eight years later I am still sober.

AA is not for those who need it. It is for those who want it. Those who want it bad enough will learn and stay sober. After a time they will then be able to help the next new person who comes in asking, "I don't want to be drunk any longer. What do I need to do to stay sober?" Those people we can help.

Anyone CAN follow the AA program. Not everyone WILL follow the program.

Garde la Foi, mes amis! Nous nous sommes les sauveurs de la République! Maintenant et Toujours!
(Keep the Faith, my friends! We are the saviors of the Republic! Now and Forever!)
LonePalm, le Républicain du verre cassé (The Broken Glass Republican)