What is the Most Effective Treatment for Alcoholics?
Since I have worked in a treatment center for 5+ years I have often wondered what the most effective treatment for alcoholics really is.
In talking with various people who come into rehab I think you can sort of get a general idea. Of course you are going to get some bias in there based on your limited observations, but if you are genuinely curious and you keep talking with people and hearing their stories, you can get a decent idea I think.
For example, there is a program in my area that is sort of a “tough love” approach that is set up to handle challenged kids who have fallen into legal trouble. A lot of people who came to our treatment center had also been to this “tough love” rehab as well in the past. In all of my years of talking with people, I never heard one person say a good thing about that place. Apparently they force an awful lot of stuff on you. So simply based on the feedback I was hearing about that particular rehab, I had to conclude that what they were doing was probably not working so well. In fact, it sounded like they might even be completely counter-productive at getting people the help that they needed. They were not 12 step based, though I am not sure exactly what model they used for recovery, other than the fact that it contained some element of religion to it.
What are the options for overcoming alcoholism?
There are a few options that jump right out, and several others that we may consider to be “hidden” from the public view.
The obvious options are these:
1) Go to treatment or rehab. This is the good old 28 day program. Probably get introduced to either AA or some form of religion.
2) Group therapy. Use support groups to help you stay sober.
3) AA. Go to meetings. Dry out on someone’s couch if necessary. Get a sponsor and work the steps.
4) Religion. Go to a church. Find support there. Use religious conversion to find a new life.
5) Counseling or therapy. Go see a therapist or counselor and use their advice to steer your life in a new direction.
The “hidden” options are things such as:
1) Use a holistic approach (as I advocate on this website) to push yourself towards personal growth. Prevent relapse through progress and achievement.
2) Physical based approach. Recovery through exercise and physical challenge (see programs such as “Racing for Recovery” etc.)
3) Medical approach? I hesitate to list such an idea because the reality is you cannot just pop a pill and cure alcoholism (yet). Though that day may be coming. They are definitely working on it from a drug development standpoint.
An alcoholic could also use a combination of the above ideas in order to try to sober up. During my whole journey into recovery, I probably used at least 4 or 5 of those ideas above at one time or another.
Interestingly enough, the way that I actually stay sober today borrows two of the idea from the “hidden menu.” I basically use a holistic approach and I also rely heavily on exercise as a means of staying sober. I don’t go to AA any more nor do I rely on a religious community for support or help in staying sober. And I don’t go to counseling or therapy either. But I do keep pushing myself to grow on a regular basis and I also exercise on a regular basis.
I have found a path that works for me.
Is there one method of treatment that is more successful than all of the others?
By the numbers you pretty much have to hand it to AA and the 12 step model. But this is not to say that this is the best solution for everyone, or that we should just try to force this solution on every single alcoholic and drug addict.
In fact, if you carefully consider the success rates of the 12 step model then you would probably pause and raise your eyebrow for a moment. Most estimates of success rates run right around 2 to 10 percent or so. This is a very difficult problem to “fix” and so I do not necessarily fault the AA program for doing a bad job of it. On the other hand, I think the industry is still quite young and I am hopeful that progress can be made. In other words, could we see a world in the next, say, 20 years where treatment centers have more like 30 to 40 percent success rates rather than 2 to 10 percent? Perhaps this would be driven by:
1) A better understanding of addiction and how it works.
2) A better understanding of recovery principles and the ability to teach and convey that to struggling alcoholics.
3) A breakthrough in medicine that helps us to regulate addiction at the level of the brain.
4) A new treatment methodology that proves to be superior to what we currently know.
I don’t know the future but I have to believe that in a world of progress like the one that we live in now, something better awaits us in the future. If we keep pushing to try to solve the problem of addiction and recovery then my hope is that we see some better results some day.
Because, to be honest, the results that we get today are sorely lacking. 2 to 10 percent success rates are horrible. But like I said, addiction is a very tough problem to solve. For all I know it may never get any better.
My experience has taught me that various recovery programs seek to “straighten someone out” through changing their behavior and their thinking.
You can do this with a program (such as AA) or you can do it on your own. The choice is yours and that choice should depend entirely on how you are motivated.
If you tend to be a self motivated person then you may not need a formal program of recovery. On the other hand if you rely on others to motivate you then AA is probably a good fit for you.
Surrender and getting started is half the battle. The other half is following through
In any effective recovery program there are going to be certain fundamental elements of recovery.
For example, the biggest fundamental is definitely the concept of surrender.
No one can recover from alcoholism until they surrender to the disease. This is true if you go to AA. This is true if you go to rehab. This is true if you go to counseling or therapy.
No matter what you do or how you try to recover, you are not going to make serious progress until you reach that critical moment of surrender. That moment when you throw up your hands and say “That’s it. I give up. I don’t know how to live and how to be happy. Please show me what to do. Tell me what to do. I will listen to whatever you suggest, because what I have been doing has not worked for me.”
That is true surrender. Until you reach that point, all struggle with recovery is pretty much futile. You cannot make progress in recovery until you reach this critical point.
This is such an important concept in recovery that I would argue that it is at least half of the entire battle. Surrender sets you up for success. Lack of surrender insures that you will relapse, no matter what you do.
The type of recovery program that you attempt to follow may not even be critical at all. Right now they tend to push the majority of people towards AA and NA. They also funnel a certain percentage of recovering alcoholics into religious based programs. Then they have a very tiny percentage who also go to counseling or therapy.
If you look at the overall numbers of how people recover, they are going to match up very closely with who is going to what treatment model. In other words, it is not really about “which treatment is more effective.” Rather, it is about “which treatment model were you exposed to at the moment of true surrender?” Because once you surrender in full, it doesn’t really matter where you go for help or which model you choose to follow. It is going to work. The reason it works is because you surrendered fully, and you are ready to put in the effort now (whereas before you had surrendered, it did not matter what you did because you were simply not ready to change, and therefore nothing worked).
This is how bias creeps into recovery models. People struggle with alcoholism and addiction and they try to get clean and sober many times. Most people have to try several times, in fact, before they finally “click.” So when they do finally “stick and stay” in recovery, they give credit to the recovery model that finally helped them. Maybe they had tried a faith based treatment center in the past and it failed for them and they relapsed. But then later on they surrender fully and they happen to go to an AA based rehab. So then they give all of the credit to AA and they later basically shun the church as being useless. This is a very foolish conclusion that is clouded with bias! What happened is that they are just giving all of the credit to the last place they went for help, because they finally surrendered fully.
They did not get clean because one treatment model is better than the others. They got clean because they finally reached that critical point of true surrender. The treatment model that you choose probably has very little impact, or none at all.
It is all about the timing.
Are you truly ready to change your life?
Are you willing to do anything to change your life?
No? Then it does not matter where you go for help. No rehab or treatment center can help you at all. You have not surrendered yet.
This is the dividing line that determines who will relapse and who will remain sober. It has very little to do with your choice of treatment method. It has everything to do with surrender.
That said, your follow through is still important.
It does not matter if you go to AA or if you do your own thing in holistic recovery, you still have to follow through.
Now what exactly does that term mean, “follow through?”
It implies action. Many, many people go to rehab and then relapse.
Why do they relapse?
Because they fail to follow through. They leave rehab and maybe they hit a meeting or two. But they don’t really dig their heels in and get busy in recovery. They think that they can be lazy and essentially take little to no action and still recover. They are hoping that their sobriety will simply stick without any effort on their part.
They are wrong. If you coast in recovery then you relapse. Coasting leads to relapse every time. If you stand still or “coast” then you will revert back to your addiction eventually.
You must move forward. You must pursue growth. This is the only way to really prevent relapse in the long run.
This is what I would call “the other half of the fundamental principles in recovery.”
You have your surrender. That is absolutely critical. Without surrender you cannot even get started. You don’t have a chance.
But after you surrender you are faced with a choice. Now you must take action. Now you have to follow through. Without this follow through you do not have a chance at long term sobriety. It is fundamental to successful recovery.
This is true in AA. It is true if you don’t go to AA as well. In fact, going to the AA program is simply a backdrop in which you can pursue these two fundamental principles. The first principle is surrender. The second principle is “growth.”
Many people in AA who have been sober for a while still end up relapsing. They try to pin down exactly what went wrong, what happened. In the end, their excuses and reasoning all leads back to the same thing:
A lack of growth.
A lack of action.
A lack of positive change.
They got lazy. They stopped doing what they needed to do. A lot of them will blame it on the idea of “I quit going to meetings.” That is but a symptom of the real problem. The problem underneath “I quit going to meetings every day” is really “lack of growth.”
It doesn’t matter if you are in AA or if you are doing your own thing with a more holistic and self motivated approach. If you stop taking positive action in your life then you will eventually relapse. If you start “coasting” in recovery then you will eventually relapse. If you are not engaged in personal growth then you will eventually go back to drinking or drugs. It is as simple as that. This is because “personal growth” is a fundamental principle of recovery. You either take positive action or you eventually relapse. It is as simple as that.
Being in AA is no insurance against this. Just because you go to AA meetings every single does not insure that you never relapse again. The key is not in sitting in daily meetings, the key is in growth and positive action.
Now you may go to AA meetings every day and also push yourself to make positive changes, to engage in growth, to push yourself to create a better life. If this is the case then you are using AA in a very smart way, the way it was meant to be used. You are using AA as a platform for growth and for change. When we see people like this in AA we label them as “a winner.” They have a saying in the meetings: “Stick with the winners.”
I have news for you: There are winners outside of AA as well. They are doing the same things, only without the backdrop of AA to guide them. They are taking positive action and they are pursuing personal growth. They just don’t go to meetings every day in order to do it.
So in my opinion the most effective treatment for alcoholism contains two fundamental principles (which cannot be reduced any further):
2) Personal growth.
We can definitely dive into these two concepts and come up with all sorts of details. But that is the overall outline for success in recovery. If someone succeeds in staying sober then they have done both of those two things. If someone fails and relapses then we know that they came up short on one of those two concepts (either they failed to surrender, or they failed to follow through).
That is recovery in a nutshell. From what I have reasoned out you cannot reduce it any further than that.
So the most effective treatment for alcoholism is whatever happens to motivate you to do those two things. You must surrender and you must follow through and pursue personal growth. If that means that you have to be in AA for the rest of your life then so be it. That is a small price to pay for sobriety. Likewise, perhaps you can motivate yourself to pursue personal growth instead without the daily AA meetings or the 12 steps to guide you through the process. If you can improve your life and also improve your life situation through your own motivation then you definitely do not need AA.
I am not for or against AA. I am not for or against any other treatment method for recovery. What I am saying is that you must master these two fundamental principles if you want to remain sober. You must surrender and you must pursue personal growth.
Personal growth is relapse prevention.
If you are excited about your life and you are excited about the positive changes that you have made and are still making then you will not relapse. Simple as that. You will be too excited and happy about the positive changes that are occurring in your life to take a drink and ruin it all.
Personal growth is relapse prevention done right. It is win-win. Your life improves, your life situation improves, and you protect yourself from drinking. This is a fundamental principle of success in recovery.
Look at it another way:
If someone is supposedly staying sober but they are not engaged in any sort of growth, change, learning, or positive action, then where does that put them as far as success goes? They may be hanging on to their sobriety by a string, but are they really sober? What is their prognosis for the future? Are they headed for relapse possibly? Is their life improving?
Without personal growth, your recovery is of questionable value (and questionable stability). Personal growth is what builds you a better life, one that is worth living. If you are not enjoying personal growth in your journey then what motivation do you have to stay sober?
There is no cure but you can still make a decision and take action
There is no cure for alcoholism but this should not prevent you from taking action.
We can still arrest the disease and stop it dead in its tracks.
In doing so we can build a brand new life for ourselves, one that is worth living and challenges us to keep growing.
Remember the 2 fundamental principles. These are more important than any specific treatment program that promises to fix your life.
Surrender and growth. Look for both of those concepts in any path that you may find yourself on. Without both, you are surely headed for relapse.