So, in today’s paper there is a New York Times article that says that AA works. Well, more precisely, it says there is now scientific evidence that supports what has been obvious for years – AA works. A recent study out of Harvard reports on a Cochrane review of studies of the effectiveness of various treatments of alcoholism. A Cochrane review is a scrupulous analysis of published scientific articles on a subject, and the results can be trusted with a high degree of credibility. There have been problems proving the obvious – that AA works – scientifically. Scientists can design studies in which patients are randomly assigned to one or more treatment (or placebo) tracks, but can’t control the patient’s behavior. For example, a patient who is assigned to a cognitive behavioral therapy (CBT) track, or a placebo arm (e.g. watching vampire movies on Netflix) might still decide to go to AA. Also, funding sources might be more interested in funding a study that would hopefully show that their medication works better than placebo. There can also be disagreement about what constitutes success. On the one hand, AA would consider total abstinence success. Some patients might prefer not to quit altogether, but rather to moderate their drinking to avoid harsh consequences (health, legal, family, employment.) Some scientists might agree with decreased numbers of days drinking, or decreased number of drinks per drinking occasion, or decreased number of adverse consequences as success. Study design could reflect these differences. In the long run, such plans are ill-advised for the most part, but often do work for the short duration of the study. Another issue is verification of abstinence. Study subjects might lie about or underestimate their drinking. Drug screening is usually part of the outcome study, but it can’t fully quantify the strictness of adherence to a plan of alcohol consumption/ non-consumption. Yet another potential confounder is the degree to which patients who attend AA actually utilize the program as it is designed. Patients who attend several meetings per week, get a sponsor, and actively work the 12 steps are more likely to experience success than those who limit their involvement to what they feel like doing or what makes them comfortable. Nevertheless, there were enough high quality studies in the most recent Cochrane review of this topic to allow for the conclusion that AA works better than any other single intervention. They estimate that it works for between 22% and 37% of attendees. This is not to argue that other approaches lack value. In his work, Mike has encouraged AA attendance, counseling, family therapy, and use of MAT (Medication-Assisted Treatment) as a comprehensive treatment approach. In the past 2 weeks AA attendance has been challenged by our current COVID-19 pandemic. Most meeting places in most parts of the USA have closed. Many groups are reorganizing themselves as on-line meetings, often on a zoom platform. This would work for regular members, but not for newcomers wishing to join the meeting. No doubt, ways will be found to solve these problems. There are also on line forums such as intherooms.com which run meetings all day long. This site also has NA and other 12-step groups. Also, meetings can be found in chat rooms at such places as aa.org. It will be interesting to see how this all works out. My biggest concern is newcomers who won’t be able to experience the hands-on welcoming warmth of the groups.
So, the world around Happy Meadows is getting more locked down every day. Most people are taking the danger seriously. I hope all of you do as well. Be well, be safe, pray for world peace, and pray that all people get cared for in these difficult times. So long for now from Happy Meadows.