The preponderance of research on people with substance use problems shows that the vast majority – a full 75% – end their substance use problems without ever receiving any sort of professional treatment, and without attending 12 step groups. For a lengthy discussion of some of the data behind this fact, please visit my page on the NESARC study of alcohol and related problems, at the following link:
CLICK HERE: Substance Dependence Recovery Rates With and Without Treatment
This phenomenon (and that may be a misnomer since it implies that it’s rare) is known as Self-Change. Nevertheless we are constantly told that if you have a substance use problem then the only way to change it is through treatment and 12-step programs. There is much evidence that these programs may actually decrease the clients chances at success, and at the very least, what little success these programs claim may not be a function of the program at all, but only a function of the self-change the client was bound to go through whether they received “treatment” or not. Thus, for a true solution to substance use problems we shouldn’t look to treatment attendees, we should look at the most successful group – the self-changers – and follow their lead. What leads to their positive life changes? What are the beliefs and values that push them away from addiction? What do they do to change? When we answer these questions, we will understand how to solve a substance use problem.
Luckily, there are some dedicated researchers working on answering these questions. I will be compiling and analyzing that research on this page. In the meantime, if you want a program of help based on this priceless information, check my help page.
One of the clearest themes that has emerged from studies on self-change is that a cognitive appraisal/evaluation process is almost always a factor. What this means is that people consciously choose to change. This flies right in the face of those who would say that addiction is compulsive and that the sufferer is unable to choose to stop their own behavior. Follow the links below for discussions of research related to this principle:
I’m still struggling to understand this simple statistical anomaly – if 75% of people “mature out” as Stanton Peele and yourself put it, what happens to the other 25%? I’m guessing they die or get sober using some sort of treatment? So what if, instead of measuring effectiveness of treatment methods based by benchmarking against the total population, you benchmarked against the 25% of the population who don’t “mature out”? Wouldn’t that give you a better measure of the effectiveness of treatments? the only challenge I see – and it’s a big one of course – is being able to profile addicts as to which portion of the total population they belong in advance. What if, for instance, AA drew it’s membership primarily – or even solely – from the portion of the population who wouldn’t mature out?
I suppose though the challenges of profiling the alcoholics a la Match but more precisely, and therefore establishing a control group, mean that the hypothesis is very hard to evidence.
75% of the people who may indulge in drugs and alcohol a little too much…. Probably are like my father. He tells me was an Alcoholic when he was in the Service. But stopped once he met my mother….that he just grew up. You know, most of my highschool buddies are in that 75%. They drank like me, when we all went to jail we all decided to quit. out of 10 of us. 8 were able to quit. the other 2 were real alcoholics. And we could not quit. The people who adament that they are not powerless, say that because they are not. AA talks about these people. That given sufficient reason they can quit under their own power. They may need hospitilzation (treatment) to do it, but they can. The real Alcoholic or addict…. That’s what makes them an Alcoholic.
This idea that an Alcoholic can just choose to stop? Seriously. The social problem that has plagued societies since the first person caught a buzz, is just people choosing? Seriously….. girls selling their babies for heroin and crack, straight men giving gay men sex so they can buy drugs. A girl going back to a crack house she was raped and robbed in a week ago, A guy who all he had to do was not drink for a few years and would retire with a full pension from the military, but he drank again… a guy on parole and all he has to do is not smoke weed for a year and he’s free, but he’s going back to prison. First, I don’t believe anyone has balls big enough to throw that kind of comment in someones face, So, I think the truth is they don’t understand what alcoholism or addiction is. And I am sure they may have used and suffered some consequences…. some may have been horrible. But they had one thing a an Alkie or junkie doesn’t…the ability to choose. So why wouldn’t they think that AA is full of shit? Because they can choose, and they think they are an Alkie or junkie. The problem is they believe they are in the club, and they are not.
Here’s the deal… If it’s just a choice. Then what does it matter if they go to AA when they choose to quit. It should be irrelevant if they go to AA. It should be irrelevant where ever they go. I mean they could join a knitting class, and just choose to quit. So long as they are non Alcoholic it’s gonna work.
I will tell you, I have done it all. From Bhuddism to RR, to MM, councelors, therapy, medication, clergy, exercise and vitamins….and AA is why pulled m out of my hell. And I will tell you, I had no more choice in drink then I did in breathing.
What you don’t understand is that you have chosen to quit. Whatever it is that you are doing in AA – perhaps passing it on, or heavy meeting attendance with sober parties and the whole nine, or if you feel you’ve really chosen to do god’s will rather than your own, or whatever it is that you’re now doing and/or thinking about differently than when before – you came to believe these choices will bring you greater happiness than your former choice to drink heavily. Thus, you chose. And I assume you don’t realize that, since you believe that freedom of choice over substance use for ‘real alcoholics’ like yourself is impossible.
I abhor your “real alcoholic/addict” argument. I’ve also heard it about a billion times. It’s fallacious reasoning. There’s a name for the logical fallacy you’re committing with it, called the “no true scotsman fallacy.”
http://rationalwiki.org/wiki/No_True_Scotsman
https://yourlogicalfallacyis.com/no-true-scotsman
You might think of it as “moving the goalposts.” For example, if you go to a 12-step meeting, you’ll be told that if you made it there, then you’re definitely an alcoholic. But then, all of a sudden, if you are able to happily quit or moderate your drinking without constant AA involvement, you’re told that you weren’t a “real alcoholic” because real alcoholics can’t keep from drinking alcoholically without AA. That is brazenly absurd and illogical.
But worse than that is the fact that there is literally no proof that people can’t control their drinking. In fact, when this has been legitimately tested, the evidence points the other way – that alcoholics/addicts are in full control of their substance use: http://www.thecleanslate.org/do-alcoholics-lose-control-the-results-of-priming-dose-experiments-say-no/
Of course, employing the no true scotsman fallacy, you’ll probably write off those results by claiming that the subjects weren’t “real alcoholics.” In fact, that reasoning means that absolutely no research would be good enough for you. We could pull subjects who had been long time 12-step members to whom a thousand people who had witnessed their struggles and relapses could vouch for as being “real alcoholics” – and if we put them through the experiments and found that they didn’t lose control after the first drink etc you would dismiss the research and say that the one thousand AA members must have been wrong about these test subjects, that their history of struggle were meaningless, and that they weren’t real alcoholics to begin.
The amazing thing is that you’ve openly and self-contradictorally declared this fallacious reasoning as a policy of yours. First, you purport to prove powerlessness by citing tales of continued substance use in the face of negative consequences. Then you declare that even if you have met that criteria (having continued to use substances in the face of negative consequences) and eventually chosen to quit/moderate, then you were never a “real alcoholic” or really powerless – that the same evidence you claim as proof of powerlessness is meaningless in that case.
I am one of those cases. I continued to use substances despite negative consequences for several years. It landed me in jail, homelessness, and openly committing crimes for which I knew that I’d be caught (such as check fraud), and yet I continued to make substance use the central activity of my life. But then I quit without subscribing to powerlessness; the addict identity; or a lifetime of “managing my disease.” So my behavior in the several years I was involved in 12-step programs would be proof of powerlessness if I had stayed in the 12-step recovery culture – but the minute I extracted myself from that, my entire history became meaningless as evidence about the nature of addiction, and my “real addict” status disappeared.
I really hope you can understand how absurd this is.
-Steven
Dear Steven
You seem to have leaped to a well used argument and managed to use it inappropriately. Both myself and the other commenter responded to the statistic in the article – that 75% of addicts will spontaneously remit or mature out. You’ve responded by trundling out a well worn – and wrongly applied in this instance – argument. I’m didn’t introduce the “real addict” – you did. I trust you understand straw man arguments too?
I’m like this website for help in my critical reasoning.
http://www.criticalthinking.org/pages/defining-critical-thinking/766
Hey Paul – thanks but I wasn’t responding to you. Note how my comment is nested under “Jame D.”s comment, not yours. And I absolutely gave the correct response to him. He used the “real addict” argument to discount those who stopped without AA. Don’t believe me? Read it again. If you still don’t get it, then I don’t know what else I can say.
-Steven
The problem with the “real alcoholic” or “true addict” phrase is one can’t predict ahead of time whether a person is one. The definition seems to be “can’t quit without taking the 12 steps.” Only those who have quit and give the credit to their “Higher Power” and the 12-step programs are Real Alcoholics.
Ben, former Real Alcoholic.
Dear Ben
See above. I understand the difficulty of “real” alcoholism or addiction, but I’m simply responding to the 75/25 split mentioned here and frequently around the internet. There is a problem in predicting ahead of time – but there is no doubt retrospectively in being able to pick out the ones who die from it as a result of incessant use, not accident.
As the son of an AA member, it’s a blessing to see a post like this. My entire life I was raised to believe that “alcoholism wasn’t a choice”, and because my father was an alcoholic, I didn’t have a choice either. Either stay sober, or let this “monster” called Alcohol kill me. I was raised believing that no one could fully recover from anything, everyone had character defects. and that the root of all my problems was that I was a selfish person. I was raised being told I am selfish by birth right, unable to make choices for myself, and in need of a “program” to prevent my downfall into alcoholism. Thank goodness I was intelligent and rational enough to know this was false. Alcoholics anonymous is a cult, and you ALWAYS have a choice.
I am quite glad I came across this website! my significant other just was admitted to a private treatment center and I have become more and more alarmed by what has become a focus on the twelve step process, and the use of “disease”.
She is a very smart woman, and a medical professional of 14 years who started abusing prescription medication. Last night she told me that she has learned that her addiction is a disease and I should look at it like cancer. I am still dumbfounded and angry, this woman was treating cancer patients, how could anyone have convinced her so quickly that it was a disease?? My military back round solves this by associating it with creating a scape goat.
My big underlying question is, hopefully to be answered here on this site, is it right for a private company to collect 30k a month to treat people by adopting the 12 step program as their method? Is that the best that is available? according to other medical professionals, re-licensing is possible, but only through recognized programs (this one, although fancy, is not recognized). So is this just an over priced group hug? how do I talk to her, and propose some out of the box thought when she is locked down?
thanks
Doug – while I don’t personally ascribe to 12-steps, that does not invalidate the structure. Addiction may not be a disease, but it’s neurological manifestation make changes in the brain like any psychiatric condition can (i.e. depression, ptsd, etc). Certainly over time these effects can be altered – and the most contributing factors are hope, belief/faith in a recovery, and a sense of belonging. While I don’t agree with all 12-step philosophical, the group certainly provides these elements… And honestly, a big group hug is EXACTLY what an addict needs. I thinj you’re military background may be a bit harsh a lense to view addiction.. consider how the military treats its conbatant’s mental health concern… shameful.
Aaron,
first off, why are you commenting on the military and its treatment of combatants mental health? that is not linked in any matter to my comment; I was alluding to the simple fact that when you isolate a group of folks from society and control their exposure to outside thought or influence you can pretty much shape them any way you want.
Regarding the group hug comment, my biggest fear is that this is an extension of the idea of not taking responsibility for one’s actions, and just hanging it on the idea that the person is sick. I don’t agree with that definition, although I see the merit in treating it as something more serious than just failure to control impulses. But, if you tell someone that they are not capable of controlling their actions and will need a lifetime of treatment then you have created the perfect base for not only a long term source of income (treatment centers) but also perhaps change that persons life trajectory simply because they have been told that their condition is incurable- just manageable.
So I just randomly showed up here. 🙂 Fascinating site, I appreciate your efforts, Steven. I can only imagine how many debates you have going at times. I’m not going to AA anymore because of choice people taking over the meetings. Nobody’s right or wrong, but that’s just it, when the new guy comes in, I struggle to meet him with my spiritual approach because I’m ganged up by choicers. Embracing breakthrough models is what people who empathically serve their fellow man are all about. And I’m good with it, but the people who light up with spirituality I believe are happier. Maybe crazy, but happier. Choicers are always complaining and then they disappear. I’m not one for an singular approach one way or another. It’s case by case. College class, your model probably works great. Back alley, you might get yourself killed. Anyhow, ideologies aside, most people are not coming to hospital, treatment facility, detoxification or programs with a whole lot of individual confidence that they could simply choose to not do drugs anymore. I don’t see in this context how your system has much practicality. Do you apply it after a few weeks post hospitalization? You attempt to instill that individual confidence in a fresh case, could get you hurt pretty bad. There’s a lot of anger in the sick. The point AA makes is that they have tried to quit and failed utterly, I believe is how they put it. That tells me AA is a program for ones who have tried and proven undoubtedly they can not quit. Putting a bunch of quitters in the rooms, well that’s another thing entirely, and a probably the biggest reason why AA has lost it’s touch.
So your saying yes you can, try this workbook or someone else saying no you can’t try this workbook, doesn’t really matter if the desired result occurs. When I started coming to, I had little idea what the heck was happening. Someone was feeding me, I couldn’t talk and my eyes looked like they could pop out of their sockets.
I believe, am no expert, at that early stage of detoxification or de-fogging, a spiritual approach could work, but it requires defeat as the precursor. Many of the stories, ones that include little chats between the hospitalized and some AA member include details like the sick man saying he’s cooked or given up hope of ever being able to quit on his own. What you might consider discouraging, degenerate comments are actually a good sign that a spiritual technique could work.
After all, what makes the steps interesting is they’re not at all about arresting drinking and drug use. Let me state that again, AA is not for quitting drinking, it’s not for learning how to be a good guy and how to put your life together. That’s for, um, those who don’t know. The steps are a design for having a spiritual awakening. From there everything you ever dreamed may begin to come naturally as a byproduct of this new perspective.
This usually turns off the scientific, medical and psychological communities. Most addicts dwell in a hellacious existence while active. Bedeviled behaviorisms they have little or no conscious protection from. This program doesn’t come right out and say it, but they’re trying to insight spiritual confidence enough that some day one suffering member may have the privilege of being the hand of divine providence on the life of their fellow man. This is about saving people’s lives. Just for today, and plug in the juggers are breeds of recovery folk, but often times academic and missing the entire meaning of a spiritual life.
It’d be interesting to see a study on whether AA is more effective at promoting sobriety than Mormonism, Islam, or any other sobriety-based religion. I’d imagine the results for all sobriety-based religions, AA included, are pretty similar. Biggest difference is that doctors don’t send people to the madrassah or to Utah.
AA is as good at making people sober as Islam is at making people not eat pork. Exactly that good.
This is fascinating. This is exactly what I’ve always known to be true without realizing it. When people finally want to change/quit, they do. The problem is wanting to want to. That’s how most addicts are they want to want to quit but they don’t actually want to. The mechanism that gets you from wanting to want to, to actually wanting to, is the whole key and cure to addiction. If we could determine exactly that mechanism then everyone could do it. I’m following this topic hopefull of a cure.