Twelve Steps to Nowhere? The Sobering Truth about Alcoholics Anonymous

Every now and then, attorneys at Americans United for Separation of Church and State will receive a call or an email from a person who has been ordered by a court to attend Alcoholics Anonymous (AA) and doesn’t want to go because of its religious nature.

When this happens, AA’s defenders usually assert that the organization isn’t really all that religious and that the “power greater than ourselves” referred to in its famous twelve-step program doesn’t have to be God.

A look at the entire twelve steps quickly debunks that notion. In fact, AA is replete with religiosity. Seven of the steps contain references to God, spirituality, or prayer. Step five, for example, calls on alcoholics to admit “to God, to ourselves, and to another human being the exact nature of our wrongs,” while step six admonishes alcoholics to be “ready to have God remove all these defects of character.” Step eleven, meanwhile, calls for “prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.”

This isn’t surprising. Remember, the twelve steps were created in 1935 when American society was much more religious. The steps were also fashioned by a man who had undergone a dramatic religious conversion; they reflect his experience and his belief that recovery must be anchored in faith.

What’s surprising is that AA’s program continues to be the leading alcohol recovery technique for millions of people. Remarkably, an approach rooted in a kind of religious self-help program and devised eighty years ago when the science of addiction was largely unknown, is still considered the gold standard by many people who grapple with addiction or who work in the recovery industry.

I know people who have been helped by AA, and many individuals in recovery have told impressive stories of how they were able to overcome addiction thanks to the twelve-step model. But I also know people who fell off the wagon while in AA. We must keep in mind that anecdotes, no matter how powerful, are not data.

So what does the actual data say about AA? What’s available indicates that the approach is not particularly effective. In a recent article for The Atlantic, Gabrielle Glaser wrote that one researcher puts AA’s success rate between 5 to 8 percent. Glaser calls AA a treatment approach that “took root before other options existed, inscribing itself on the national consciousness and crowding out dozens of newer methods that have since been shown to work better.”

Among these options are medical interventions, forms of psychotherapy, and drugs (such as naltrexone) that work to curb a drinker’s appetite for alcohol. As Glaser notes, the science of addiction has come a long way since 1935, yet many of the treatments for alcohol dependency still begin with AA’s twelve-step model.

The founder of Alcoholics Anonymous, William Griffith Wilson, described the program as intensely spiritual. As Wilson told the story, he was lying in a hospital bed trying to recover from a bout of heavy drinking when an evangelical friend visited and told Wilson that only the Christian god could help him.

Wilson subsequently cried out to the deity for help, shouting, “I’ll do anything! Anything at all! If there be a God, let Him show Himself!” He then described a sensation of seeing a bright light and feeling a sense of calmness come upon him. Wilson never drank again.

Although Wilson’s experiences were grounded in Christianity—the friend who visited him in the hospital specifically recommended that he pray to the Christian god—the twelve steps that eventually emerged as the AA bible are more or less nonsectarian. At some point, people began claiming that terms like “a Power greater than ourselves” and “God as we understood him,” which are found in the twelve steps, could be secular.

Many nonreligious alcoholics in recovery disagree. They find the AA program rife with religiosity and note that some local meetings begin and end with prayer and have a default Christian cast to them. They say that being forced to take part in a spiritual program by court order is a violation of their rights.

Several federal courts have considered this issue and ruled that prison inmates and people on probation can’t be required to attend religion-based programs like AA. Yet other courts in other parts of the country continue to mandate AA attendance for many people in the criminal justice system.

Often this occurs because there is simply no other alternative. Or there are alternatives, but they are too expensive. But there may be another reason as well: the stubborn belief many Americans cling to that religion is capable of solving just about any problem.

This belief, this faith in faith as the ultimate solution to social ills, is firmly entrenched in American culture and its legal and political systems. Consider so-called “faith-based” initiatives, which have been all the rage since the administration of President Bill Clinton. The premise behind these initiatives is that an embrace of religion (and by “religion” more often than not we mean a form of evangelical or conservative Christianity) can spur people to triumph over problems like addiction, poverty, chronic joblessness, a predilection to commit crimes, and so on.

Is there any empirical evidence that religious programs are more effective at tackling these problems than secular ones? No, there isn’t.

In fact, from a public policy perspective, the faith-based approach makes little sense. Most congregations in the United States are small and consist of a few hundred members at best. Even backed by government grants, these institutions are too small and lack the necessary institutional support to make much of a dent in systemic social problems. Their scope will be necessarily limited.

But the biggest drawback to this approach will always be constitutional: the government has no right to compel or even urge people to get right with God before they get help for their problems.

Addiction touches the lives of many families, and anyone who has witnessed a loved one grapple with alcoholism or drug abuse—or experienced it themselves—knows how hard those chains are to break. It’s just common sense that there is no “one-size-fits-all” solution. We need a variety of approaches, and we have them now. It’s not 1935 anymore.

Religion may be an answer for some. For others, it is wholly inadequate. We can—indeed we must—do better.