Doctors Treating Alcoholics Should Go to Some AA Meetings: Expert

Clinicians who treat patients dealing with alcohol abuse often refer them to Alcoholics Anonymous (AA), but many have never gone to a meeting and are not familiar with what goes on there, according to an expert on Twelve-Step programs.

“Any doctor treating addicted people should go to at least a few AA meetings, so they can discuss it with patients in a knowledgeable way,” says Marc Galanter, MD, Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse at NYU Langone Medical Center. “It’s very experiential, and doctors should have a sense of it. They should also learn the steps of AA.”

Dr. Galanter, who has studied the long-term outcomes of AA and Narcotics Anonymous members, says his findings are encouraging. He discussed them at the recent American Society of Addiction Medicine annual meeting.

Marc Galanter, MD, Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse at NYU Langone Medical Center
Marc Galanter, MD, Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse at NYU Langone Medical Center

In one study, published last year in the Journal of Addictive Diseases, he found that among 266 highly committed young adult AA attendees, the average length of abstinence was 44 months. They had attended an average of 233 AA meetings in the previous year. He found 66 percent had served as sponsors, and 92 percent reported experiencing an AA “spiritual awakening” which decreased the likelihood of alcohol craving. “Their craving for alcohol was inversely related to their involvement in the group, and the degree of spiritual awakening they reported,” he notes.

In a soon-to-be-published study, Dr. Galanter found similar results with a group of physicians who were long-term members of AA. He noted that unlike most studies of the AA fellowship, which tend to focus on people who have recently come out of treatment, his research centers on people who are long-term stabilized AA members. “They have been abstinent on average for five years and they go to an average of five meetings a week. Most serve as sponsors for other members. Almost all of them work the AA steps.”

“Long-term members constitute the majority of people who are at an AA meeting at any given time—they are the core of the fellowship,” Dr. Galanter observes. “They make AA work because they set the tone for it, and they are very stable.”

Doctors should understand the types of people their patients will meet at AA, who will serve as their sponsor, and the nature of the group’s spiritual orientation, he says. “We found that the majority of members we asked said they experience God’s presence on most days—that’s a particular kind of experience that is not necessarily what clinicians would expect. It’s important for them to appreciate it, because that’s what their patients will encounter.”

19 Responses

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    Betsy Longoria

    May 8, 2013 at 3:35 PM

    I was surprised when a therapist who counsels drug and alcohol abusing adolescents and their families told me he had never attended an Alanon meeting. Plenty of AA meetings, thank goodness for that, but practitioners are missing alot of insight they could be getting from groups for families of addicts as well … especially if they are counseling them.

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    Chuck Tucker

    May 8, 2013 at 2:11 PM

    Ya think??

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    John Fox

    May 5, 2013 at 11:32 AM

    One problem with studying the effectiveness of AA/NA is that these institutions have enjoyed predominance in addiction treatment for so long and are the defacto cheap treatment option, that treatment providers and physicians recommend them without thinking about other options that might appeal to people who do not ascribe to Judeo-Christian belief. It’s like asking the people of Cuba, “Who was your country’s most effective leader?” Chances are, they would say Castro for lack of any other predominant political figure or other option. There are also no studies unequivocally proving the effectiveness of AA.

    Good treatment should offer universality and AA marginalizes nonbelievers, offering condescending invitations to the nonbelievers (in the 12 and 12) who they pejoratively reference as people who are yet to have a spiritual awakening.

    Furthermore, AA has been around since the 1930’s (which predates the true inception of psychopharmacology) and a case could be made that it follows traditions that prevent critical updates based on new scientific data. Most quality medical treatments undergo dramatic revisions and are sometimes discarded entirely based on scientific data. AA, however, remains stuck in the timewarp of the 1930’s. If addiction treatment is every to evolve, I think that we’re going to have to graduate from AA to something better, and stop extolling its virtues simply because it’s there.

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    Stephen Grinstead

    May 3, 2013 at 9:40 PM

    In the Psy D course I teach for future psychotherapists I have my students attend 12-Step meetings and then come back to make reports to the class on what they learned that will make them better therapists. Many of my students are reluctant at first but are surprised to find how much the can learn at these meetings.

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