That’s right – judges may no longer legally send you, or anyone else, to AA. Unhappily, a lot of judges, along with lawyers, haven’t gotten the message, or even more commonly, judges continue to order people to AA unless you object.

Please note, all of these courts have ruled that Alcoholics Anonymous is a religion or engages in religious activities:

• the Federal 7th Circuit Court in Wisconsin, 1984;
• the Federal District Court for Southern New York, 1994;
• the New York Court of Appeals, 1996;
• the New York State Supreme Court, 1996;
• the U.S. Supreme Court, 1997;
• the Tennessee State Supreme Court;
• the Federal 2nd Circuit Court of Appeals in New York, 1996;
• the U.S. Court of Appeals for the Seventh Circuit;
• the U.S. Court of Appeals, Seventh District, 1996;
• the Federal Appeals Court in Chicago, 1996;
• the 9th U.S. Circuit Court of Appeals, September 7, 2007.

The United States Supreme Court has refused to hear challenges to those rulings, or to change or over-turn those lower court decisions. By letting them stand, the Supreme Court has made them the law of the land.

There is no greater abuse of individuals by the courts these days than the continued orders to attend AA, AA /12 Step based treatment, or other coercive mandates to equally ineffective, and frequently counter-productive, forms of so-called treatment.

“No, Judge. No AA!”

Yes, you and your attorney may have to be emphatic – NO AA! You may have to offer alternatives to AA, and you may have to dig a little to find them, but we do exist.

What constitutes an AA alternative? Counseling and/or treatment based on research regarding what actually works including:

• CBT;
• Motivational Interviewing;
• Naltrexone;
• Fitness;
• Couples Counseling;
• Adult Development;
• Assertiveness Training

Remember too, it’s not just judges who sentence people to AA but also the licensing and certification boards that send “impaired professionals” to AA and 12 Step based treatment – a practice so fraught with graft and corruption that many states have eliminated the programs altogether.

Again – you cannot legally be required to join the AA cult!

Why do these abuses of power continue to appear?

Certainly ignorance of the law contributes, though judges are supposed to know what they can and can’t do. More often it’s the assumption that defendants and their lawyers won’t know their rights or will be too overwhelmed to object. Too often this assumption proves to be right and another poor sucker gets sent off.

But that doesn’t have to be you! You can “just say no” to AA and to the abusive and exploitive programs it has created – programs that actually prevent you from fixing your problems.

Worried about what lies ahead? Give us a call and discuss your particular situation and how we can help divert you away from AA and into a program that actually works at a fraction of the cost.

Don’t allow yourself to be punished repeatedly!

Just remember, “No, Judge. No AA!”

According to presenters at the “New Perspectives” conference on Vancouver Island, British Columbia, this past fall, at least 85% of all clients seeking help with alcohol abuse are being misdiagnosed, and mistreated at virtually all of the treatment programs across Canada, the U.S., and Australia. How is this possible?

The problem is that 97% of these “programs” are based on the discredited AA/12-Step “disease” model which doesn’t differentiate between alcohol abuse and alcohol dependence. This failure to accurately assess is then compounded by program staff that are, at best, poorly trained, and usually mis-trained.

The result? People with alcohol abuse problems are discouraged from getting help in the early stages when, as with any real disease, curing it is fairly easy. Additionally, those who are better advised to abstain are labeled and directed to follow a demeaning life-long regimen that isn’t just unnecessary, but counter-productive for the vast majority of those with alcohol problems.

What can you do?

Frankly, your choices are limited. You can look for programs that are “Non 12 Step” but many of these also adhere to the same disease model. Your best chance is to carefully find help that includes Cognitive Behavioral Therapy (CBT), anti-craving medication (Naltrexone) support, professional staff who aren’t “in recovery,” and that offer real assessment rather than just lumping you in with everyone else as an “alcoholic.”

What should assessment consist of? Good programs and counselors are more interested in strengths, abilities, and interests than in your faults and failings. They are also more interested in your current circumstances and future wishes than in your past. The best will spend very little time talking about alcohol beyond getting a picture of your particular drinking patterns.

Following assessment, which will look at aspects of your life ranging from your health to your work, education, family, social and recreational situation, you should be looking at how you want your life to be without alcohol abuse. Then you should be helped and coached to set goals, make priorities, and develop systems for achieving that life.

None of this should take all that long – certainly not more than 5 days. Do not be sucked into believing that you need 30, 60, or 90 days of residential “rehab” – less than 10% of current clients do. You do not, after all, need a vacation from reality – you need to fix whatever’s wrong and improve your real life in ways that leave no room, or reason, for abusing alcohol.

Again, do not fall into the “treatment traps” of being forever “in recovery;” maintaining an alcohol focused life centered on endless meetings with people who are never going to sober up; adopting a self-fulfilling “alcoholic” label; and giving up your ability to manage your own life.

Remember, you aren’t powerless, you don’t have a disease, and you can leave alcohol abuse behind – permanently.

You do have an understandable and learned short-term coping behavior called alcohol abuse which has helped ease loneliness, boredom, anxiety, passivity, and various other emotional and physical pains, aches, and discomforts. You can learn and adopt better long-term solutions that will make you happy to have left alcohol behind.

You can become an ex-drinker just as people become ex-smokers. Been there, done that. Alcohol abuse is no longer a topic or activity of any interest.

If you’re ready to enhance your life, rather than to diminish it even further, there are options available. Real ones based on research and experience.

Don’t sell yourself short.

By Dr. Ed Wilson and Dr. Mary Ellen Barnes

The Answer Isn’t the One You Expected to Hear…

Did you know that the real research has shown that many “alcoholics” actually return to moderate drinking every year? If you think about your own friends and acquaintances you’ll probably remember any number of them who went through periods of alcohol and drug abuse, but who got over it.

You’re not alone in your impressions. For decades the research, both formal studies and informal observations, has shown that some alcoholics can return to moderate or controlled drinking, and that many do.

However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn’t an alcoholic – no matter how obvious the evidence to the contrary.

Abstinence Isn’t Always the Only Answer

While traditional AA/12-Step conceptions and definitions have caused these organizations to reject the mounting evidence, they haven’t been alone. The treatment “industry” – one founded almost exclusively by people seeking to spread the 12-Step gospel – recognizes only one “disease” and one “cure.” Since they don’t have meaningful solutions for most of us, suggestions that other outcomes are possible are very unwelcome.

But everyone would be better served by the different picture painted by an analysis of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Based on a sample of 43,000 U.S. adult alcoholics, the study found that more than one-third of those with alcohol dependence that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism).

About one fifth of the fully recovered individuals abstained, another fifth moderated their drinking back to healthy levels, one-quarter were still dependent, another quarter were in partial remission, and a tenth had moderated but showed symptoms of possible future relapse.

Alcoholism is Rarely a “Progressive Disease.”

One of the many problems with the “disease” model of alcoholism is its adherence to the supposed progressive nature of the condition. Trouble is, it usually isn’t. More often it’s static with people maintaining the same level of consumption – healthy, abusive, dependent, and so on – for decades. And, political correctness to the contrary, we all know someone whose alcohol abuse just stopped for no apparent reason.

It turns out that remission isn’t unusual and occurs with “alcoholics” more often than with any actual terminal disease. Alcoholism may occasionally be progressive, but it’s far more often static, and at least as apt to be regressive.

“Bottoming Out” is Dumb!

Another part of the mythology says that people don’t “recover” until they have “bottomed out.” Most drinkers are never going to get to that desperate, homeless, penniless condition so often described. That doesn’t mean that their lives aren’t filled with negative consequences. But the myth keeps people from getting help with problems before they reach extremes, and keeps family members from suggesting help before the condition gets completely out of hand – which it may never do.

What should people with alcohol problems, their spouses, families, or employers do? Obviously it would be good to be able to intervene early and jumpstart some progress. The real news is that by doing so you allow for a variety of possible outcomes.

Get Real Help, Not a Life-Long Label.

Just as you don’t want to be stuck with a stigmatizing label, don’t sign up for a “progressive terminal disease” you don’t have. You can also afford to skip onerous treatment that you don’t need, and outcomes that diminish you and your life.

Getting the right assistance will help you sort through current problems more quickly, deal with them more effectively, and correct them more efficiently than you are apt to manage on your own and that’s help worth having. Just don’t sacrifice too much of yourself to a cult mentality in the process.

If you are ready to get real help, call us today at 888-541-6350. We would be happy to talk with you about helping you get through your current problems in the fastest possible time.

This short article was written by a recent client who came to our 5-Day Intensive program. His wife accompanied him and was an active participant in the program. – Mary Ellen Barnes, Ph.D.

by Carl and Nicole of Minneapolis Minnesota

Imagine yourself at a center for dealing with alcohol abuse. And imagine – really imagine if you can – that the week is wonderfully inspiring. Imagine that the week is filled with laughter, joy and lots of humor. Imagine feeling pampered, perhaps as if you where at a California health spa or golf course. And imagine that you tackle some very good “hard work” with the active engagement of tremendously dedicated and experienced coaches – but that ninety-five percent of the week is NOT on the topic of alcohol or alcohol abuse! On top of all that, imagine that a confident pathway is designed, creating a life filled with health-generating practices and pleasures that make excessive drinking irrelevant and simply not needed.

Nicole and I have just finished a wonderful week with Ed Wilson and Mary Ellen Barnes – and it was a total surprise. On the surface there wasn’t anything surprising, for example, there was the everyday schedule of meetings all morning and then afternoons free for whatever we wanted (we went to a world class golf course, coastal walks and a health spa). But deep down the whole experience was completely different from that of a treatment center, or a program in the AA tradition. Not once was I treated as if I had a life-long disease. Not once was I “diagnosed” for my failures. Not once was there the instillation of fear and threat or the mantra (one that our society teaches) that “this is a life-long problem” or something that you will have to always keep at bay. Instead there was a radically different approach.

What was it? Well, it was a combination of things. Yes, there was hard and honest reflection. It was a luxury really, a week where two amazing coaches devoted intense focus on my total life space and context. It was a week where we identified visions of health, assets and strengths, and looked at life as a whole. It was a week where Nicole and I were helped, not alone but together, to forge a shared vision of an exciting, healthy future. It was a precious week where Nicole and I deepened our 30 years friendship, marriage and our love. And it was a week where I came away with real hope and a new calm. It’s hard to explain but it’s true. Nicole and I “high-fived” it after our final session. We were proud of our work. And we left with a feeling of gratitude. It may have been luck that we stumbled upon this revolutionary approach. But I don’t think so.

By Maia Szalavitz for MSN Health & Fitness

Although addiction and alcoholism treatment research has advanced tremendously since Alcoholics anonymous was founded in 1935, many people do not know that equally effective alternatives to 12-step programs exist-nor do they know how to find them. In popular culture, AA is often portrayed as the only way.

Worse, while reality TV spotlights tough family “interventions” as a way of getting people to enter treatment and often shows rehab as a “boot camp” or exercise in humiliation, research finds that both these approaches have significant risks, and other less risky tactics have equivalent or superior benefits.

So, how can you find evidence-based addiction and alcoholism treatment for yourself or a loved one instead of-or as an addition to-12-step approaches? Here are five “dos” and five “don’ts” that can guide you to the best treatment.

1. Do start your search for treatment with a full psychological or psychiatric evaluation from an M.D. psychiatrist or Ph.D. psychologist.

At least 50 percent of people with alcohol or other drug addictions have an additional mental illness, such as depression, anxiety, attention-deficit disorder or bipolar disorder. But unfortunately, many addiction counselors do not have the expertise to diagnose these disorders-let alone treat them. “If you go to a barber, you’re going to get a haircut,” says William Miller, Ph.D., emeritus professor of psychology and psychiatry at the University of New Mexico, a leading expert on addiction treatment. “If you go to a
substance abuse treatment center you’ll get substance abuse treatment, but they may not be well-equipped to deal with the other things that come along with it.”

Adds Alan Marlatt, Ph.D., Professor and Director of the Addictive Behaviors Research Center at the University of Washington: “If you get a proper diagnosis and evaluation, someone may be able to offer integrated treatment to deal with both without having to be shunted back and forth between
substance abuse and mental health centers.”

Since people with mental illness often self-medicate with addictive drugs, treating those conditions can be critical to starting and sustaining recovery. However, in many cases, that isn’t enough: Once someone has
developed an addiction, even if the problem that the person was trying to medicate away has been solved, the addiction may continue. Avoid the chicken-and-egg debate-treat both simultaneously for the best results; also, look for providers who specialize in “dual diagnosis.”

2. Do look for therapists who use “empirically supported” or “evidence-based” treatments like cognitive behavioral therapy or motivational enhancement therapy.

Although many people believe that treatments must be proven to work before they can be used in practice, this is not the case for talk therapies like those used for addictions. In many states, an addiction counselor doesn’t even need a high school degree-and some inpatient programs for teens are
completely unregulated in terms of staff qualifications and basic health and safety requirements.

Fortunately, there are several talk therapies that have been proven to help with addiction. These include cognitive behavioral therapy, motivational enhancement therapy (sometimes called motivational interviewing) and 12-step facilitation for those who are involved in 12 -step programs.

Cognitive behavioral therapy involves understanding and changing the thinking patterns that produce urges to use psychoactive substances as well as altering habits that drive the addiction.

Motivational interviewing helps people increase their ability to change their addictive behavior, by helping them achieve the goals they personally consider important.

12-step facilitation introduces people to 12-step programs like AA and Narcotics Anonymous and helps them affiliate with these support groups.

Matters are complicated by the fact that some people who claim to use specific techniques know all the right buzzwords but haven’t been trained in the therapy, or don’t apply it correctly. Ask about specific training; ideally see a practitioner with a master’s degree or higher and for teens, look for such qualifications in those who treat them day-to-day at any program.

3. Do make sure you feel safe and understood by the therapist or treatment approach you choose.

While evidence-based techniques are valuable, their effectiveness relies on the listening skills and empathy of therapists who use them. In fact, therapists’ abilities in these areas are directly linked to good outcomes. “You should feel respected and feel that the person is interested in understanding your perspective, not imposing their reality on you,” Miller says. While many people feel that an ex-addict or alcoholic counselor will be more likely to empathize, in fact, the counselor’s own experience is less
relevant than her actual skills in relating to clients, he adds: “‘Is this a kind person?’ ‘Did I come away with skills I didn’t have before?’ is a good litmus test.”

4. Do get as much social support as possible-and don’t limit your search to traditional support groups.

The research is clear that social support for a healthy lifestyle is an important part of recovery. But this doesn’t have to come from 12-step groups-it can come from your friends, family, even from a hobby, church group or other interest group that opposes-or simply doesn’t involve-drinking or other drug use. “Look for people who are rooting for you to get free,” Miller says. “If you don’t have them in your natural
network, it’s important to find them.”

SMART Recovery is one of the largest alternative recovery support groups. Says Tom Horvath, president of SMART, “We’re pushing 400 groups worldwide, with some in correctional facilities and we have a strong presence online.” SMART’s website had about 16,000 unique visitors in March. “It’s a practical, pragmatic, problem-solving approach,” says Horvath, “The tools we incorporate into our meetings have been studied-it’s as close to evidence-based as we can get.”

Other recovery support groups include Women for Sobriety, LifeRing Recovery and, for people with drinking problems who want to moderate but not quit, Moderation Management. Many churches, temples and mosques also have religion-specific recovery groups.

5. Do consider the use of anti-addiction medications.

Some anti-addiction medications offer considerable help to those trying to kick drugs, when used in conjunction with other support.

For alcohol, naltrexone (reVia) and Vivitrol (a longer acting naltrexone, only needed once a month) help reduce craving by blocking opioid receptors and reducing the “high” from drinking. Acamprosate (Campral) works by calming the brain’s glutamate system, which is believed to be over-active during alcohol withdrawal and thereafter (though some studies failed to find a benefit) and disulfiram (Antabuse)
produces an extremely unpleasant reaction if alcohol is consumed.

Interestingly, Antabuse also seems to reduce cocaine use-and not just by making it impossible for people to drink while trying to come down or by causing a bad reaction to cocaine. “Something’s going on,” says Frank Vocci, Ph.D., director of the Division of Pharmacotherapy for the National Institute on Drug Abuse. “We’re not quite sure what.”

Two other medications that are approved by the U.S. Food and Drug Administration for other conditions, topiramate (Topamax) and ondansetron (Zotran), have also been found to help alcoholics quit. “There’s sufficient evidence for physicians to feel comfortable prescribing them,” says Vocci. For heroin or painkiller addiction, buprenorphine (Suboxone, Subutex) can be used either for detox or for maintenance and can be prescribed by doctors, not just specialized clinics.

Methadone is also useful, especially for those who have used opioids for long periods of time at high doses. Maintenance treatment does not mean that the person is still “high” or “not really in recovery”-neither methadone nor buprenorphine produces ongoing impairment when used as prescribed. For methamphetamine, new research suggests that for people who use less than 18 times a month, the antidepressant bupropion (Wellbutrin) may help increase abstinence.

6. Don’t accept treatment that is confrontational, humiliating or degrading.

For much of the 20th century, addiction treatment involved humiliating rituals like being “confronted” and having your personality flaws attacked in brutal detail. “There’s no evidence that it’s helpful and there is
evidence that it’s harmful,” says Miller, “Don’t buy the line that it’s good for you or the only language your addicted child can understand. There’s no scientific evidence for it-it’s simply cruelty.”

7. Don’t think a formal “intervention,” in which family members confront the addict about his or her problem, is the only way to help.

Although the reality show “Intervention” presents this as current practice, there are gentler, more productive techniques. Community Reinforcement and Family Therapy has been found to be twice as effective in helping families get loved ones into recovery. A book on how to do it if you can’t find a
local therapist who practices it is now available.

Traditional interventions can produce family rifts and are even implicated in some suicides. “The evidence doesn’t support it,” Marlatt says. “Courtney Love pulled together an intervention on [rock star] Kurt Cobain. A few days later, he committed suicide.”

In contrast, CRAFT offers positive steps to help families attract their loved ones into recovery. It teaches practical techniques to families which involve helping the addicted member associate negative consequences with substance use and offering hope, rather than fear, to motivate change.

8. Don’t assume inpatient treatment is superior to outpatient treatment.

People tend to believe that more expensive is better-but in fact, research doesn’t find costly inpatient rehab to be superior to outpatient, except for people who are homeless. “It’s marketed to parents-’Mortgage your house to pay for our treatment to save your kid’s life,’” Miller says. “But ultimately, the kid has to deal with life back in the community. They’ll say, ‘Sure, you need aftercare.’ Well, what is aftercare? Outpatient treatment! And then the question is why you need hospitalization to begin with.”

“It’s not a sprint, it’s a marathon,” says Horvath, “If you only have a limited amount of money to spend, it’s better to spend over a longer period of time than a shorter one.”

Vocci notes that if people stick with any kind of treatment for 90 days or more, the outcomes are much better. “We don’t know why, but that does seem to be the case,” he says.

9. Don’t use a facility for “troubled teens” that treats multiple disorders with a one-size-fits-all approach.

Some “boot camps,” “wilderness programs” and “emotional growth boarding schools” are marketed to parents as solutions for addiction problems. There is no evidence that these are more effective than alternatives which have proven results-and because the regulations on these programs are lax (in
some states, non-existent), they can be dangerous. These programs also claim to treat other disorders like depression and Asperger’s syndrome, but the treatment is not individualized. “One size does not fit all,” says Marlatt.

10. Don’t give up!

Studies find that smokers-who have what addicts with experience kicking multiple drugs say is the hardest addiction to quit-often try nearly a dozen times before they succeed.

“When someone says, ‘I can’t do it, I’ve relapsed four times,’ I say, keep trying, you’re not even halfway there yet,” says Marlatt.

“Persistence is the greatest virtue in recovery,” says Horvath, “If you keep making mistakes but work to understand them, eventually you will run out of mistakes to make. In SMART, we say, if you slip or relapse, please come talk about it because everyone will learn from it.”

“We are blessed with a nice range of evidence-based treatments,” says Miller, “If what you are trying isn’t working, try something else.”

Maia Szalavitz is a freelance journalist and senior fellow at media watchdog, Stats.org. She is co-author with Bruce D. Perry, MD, PhD, of The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007)

By Dr. Ed Wilson and Dr. Mary Ellen Barnes

Do You Want A Life Long Disease And Label And To Be In Recovery Forever?

Your first decision will be based on how you decide to view yourself and your relationship with alcohol. 95% of all U.S. treatment programs follow the AA/12-Step, so-called “Minnesota Model.” The first “Step” is admitting you are powerless over alcohol. Believing this is also the #1 predictor of relapse.

You will also be signing up for maintaining alcohol as the primary focus for the rest of your life, attending meeting forever, and having a 95% chance of relapsing.

Or would you rather put alcohol abuse behind you?

Those of us in the other 5% generally follow a research based model that addresses the underlying issues. We view alcohol abuse as the symptom it is, not the cause.

Fixing the real problems frees you to get on with your life unhampered by alcohol’s effects, and also free of the alcohol focus that leads over 95% of traditional treatment clients right back to the bottle within five years, and usually within six months, of completing treatment.

Why would you choose residential treatment?

Everyone knows that people “go off to rehab.” The assumption is that somehow escaping from day to day reality will result in a miracle cure. Trouble is, with some rare exceptions, escape, whether into a bottle or a rehab program, does little to fix what’s wrong with your life.

Unless you have enormous amounts of money to spend on a spa experience with a lot of annoying conditions, save your money and invest in real help, not a cover story.

Remember Lindsay Lohan….. Enough said.

But outpatient is too little and too slow!

There was a time when you’d have been right about that but that’s no longer necessarily the case. Now you can do intensive outpatient programs with good long term follow-up.

Here in Southern California, for example, we do five days of very intensive work with clients who come from all over the U.S. and Canada (and occasionally other parts of the world too), just one client a week, and follow up with three months of aftercare that’s more than just the usual chat rooms and AA meetings that most programs pass off as aftercare.

Our clients in fact get the best of both inpatient and outpatient services. Quick, intensive, and professional with real long term involvement. The average residential program, for example, may offer five hours of professional services a week and none after discharge. We offer up to twenty hours in five days and even more in follow-up. That’s far more hours of real help than either traditional residential or once-weekly therapists provide.

What about activities? And staffing?

Again, residential programs have tons of hours to fill and 24 hour staffing needs. This results in a lot of “filler” activities – AA groups, equine therapy, hikes, journaling, chores, etc – which do nothing to help you solve your particular problems. All told, these activities, meals, and sleep will account for about 22-23 hours out of every day. You can see how much time is left to address your concerns and needs.

Staffing follows a similar pattern – it takes a lot of bodies to provide 24/7 coverage and in most programs these positions will be filled by “lifers” – former clients who can’t stay sober outside of a continuous treatment environment. Most programs will try to sell this as an asset – “all staff are themselves in recovery” – but in fact you don’t have to be very sharp to know that someone who can’t manage to live soberly outside of treatment isn’t apt to help you to do so.

Yes, we have experience both with personal alcohol abuse and with family problems around drug and alcohol addiction. But we both did a lot of unrelated things both personally and professionally before we decided to help other people who wanted to recover and put alcohol problems behind them. We have a vested interest in freeing you, not tying you to an alcohol cult.

Confidentiality – there isn’t any in 99% of treatment programs.

As you know from television, there isn’t any privacy with residential treatment. You may not be famous now, but someday you may be, or you may want to run for office, or buy insurance, or do any of a number of things that being a diagnosed alcoholic will interfere with. The program may not expose you – though obviously most will – but your fellow clients certainly will, as will things like medical insurance records (no, they’re not confidential).

The same is true for any outpatient or individual counselor who uses groups. While there may be some value in properly facilitated groups, these rarely exist in rehab, don’t exist in AA/NA/CA and so on, and will always result in you being exposed and labeled even if it turns out you don’t have an addiction – as is the case with over 30% of our clients.

Why would you want to involuntarily expose yourself to unnecessary risks now
and into the future?

Vacation From Reality Or Real Help?

You can take a very expensive vacation from reality, enjoy the sanctuary (or incarceration) that a residential program offers, agree to be diseased and powerless and graduate with the perfect excuse to continue drinking for the rest of your (shortened) life.

Or you can elect to get real, professional, competent help at affordable prices and put your alcohol problems behind you.

That doesn’t seem to us to be all that hard a choice to make.

Ready to get some real help with your alcohol problem?
Call us at 888-541-6350

We recently returned from a conference on alcohol treatment called “New Perspectives.” The conference, hosted by Edgewood treatment center in Nanaimo, Vancouver Island, British Columbia, was, indeed, as advertised. Presenters echoed the same theme: the usual methods of “treating” alcohol abuse and dependence don’t work. While this isn’t news to some of us who’ve looked at the statistics for over twenty years, it is the first time we’ve ever attended a conference that wasn’t hyping the same old failed models. Perhaps being Canadian – a country not quite as enamored with the Minnesota 12-Step Model – helped. Whatever the case, it was a refreshing change.

Happily, the conference’s focus was on differentiating between clients engaging in alcohol abuse and those suffering from true dependency, and differential treatment based on the individual’s condition, not a monolithic “one-size-fits-all” regimen. The presenters’ stats paralleled our own experience – 85% of people with alcohol problems are abusers and only 15% are the dependent ones for whom a “disease” label may be warranted. That estimate correlates with our experience, but we go a step further and suggest that the very few in the “dependent” category ever seek treatment and that the perspective client population is more like 95% alcohol abusers and only 5% dependent.

What difference does that make? For starters, it means that 95% of current treatment practices are only applicable to 5% of the client population, if that. Frankly, current practices serve no one but the industry that employs them – a revolving door business dependent on promoting ineffective methods and relapse in order to keep profitable beds filled.

Since current practices aren’t effective, what is? The research is clear, and has been for a long time: motivated clients with outside support and a belief in their ability to change their alcohol abuse have an excellent prognosis. Clients especially benefit from intense, short-term, outpatient treatment with support from anti-craving medications and the use of Cognitive Behavioral Therapy.

So why are we still stuck with ineffective programs? There really are two major reasons – first, treatment is a multi-billion dollar industry with no financial incentive to change. The marketing of the “powerless, disease, forever-recovering, 12-Step” model has been spectacularly successful and no one has any incentive to prune that money tree simply because it doesn’t help clients.

Secondly, effective treatment is hard work and requires staff with actual skills, knowledge, and expertise – something beyond merely having stopped drinking last month or last year. But residential programs require huge numbers of low level staff and have hundreds of hours to fill. How better to accomplish that than by employing “lifers” who can’t stay dry outside of continuous treatment, and an endless repetition of the “Steps” as “doing something,” and meetings passed off as group therapy?

Are things changing? Not really. Twenty years ago we were told that our research based methods were “twenty years ahead of the times.” Two decades later we’re still eighteen years ahead. The problem is that providers have no incentive to change, the public has been effectively brainwashed, and most programs start off based on false premises which even the best intentioned reinforce.

For now, the real message is clear – if you want help with your alcohol problem, be very, very careful where you get it. Most programs will not only take your money, but will also leave you drinking more within a few months, and frequently within a few hours, of discharge. Sadly, treatment centers have no motivation to do what actually helps – quite the opposite. Remember that when you look for help for yourself or someone else.