Dear Surgeon General,

Your recent public announcement on addiction is receiving a fair amount of media attention. It was surprising that those that summarized it said that it was hoped to be as ground-breaking as the announcement that cigarette smoking wasn’t healthy in the 60s.

My views of your release on “addiction” are far less favorable. You don’t say anything particularly new in this release for anyone that is already aware of the issues that govern treatment and recovery philosophy. You also fail to mention important treatment options. I think, but I’m not sure, you try to address the idea of therapies outside of 12 Step by saying “self-help groups like AA,” as if this would include groups like SMART, but I can’t be sure. If you want to mention the alternatives to AA and 12 Step you really need to actually mention them. I aware that ibogaine is not currently legal in the US, however, since the US government uses the drugs on operatives, your exploration of its uses could help make it available to the general public.

10 Major Alternatives to AA
(circa 2016)
Free Self-Help
hamsnetwork.org
smartrecovery.org
sossobriety.org
womenforsobriety.org (includes men for sobriety)
lifering.org
moderation.org
reddit.com (entirely online)

Help involving paid professionals
rational.org
sinclairmethod.com (for alcohol)*
ibogainealliance.org (for opiates)**

Sinclair method and Ibogaine use medication to rewire the addiction pathways in the brain
*most doctors can prescribe the medication Naltrexone, but Goodmancenter.com is a treatment center specifically
based on the Sinclair method.
**aftercare is recommended, such as genesisiboganiecenter.com, holistichousevegas.com, and medicineheartrecovery.com

You also minimize the controversy that is increasingly surrounding AA and 12 Step, as in you do not even mention that there is a controversy surrounding 12 Step. In addition to ignoring the studies that say that AA only has a 5–10% success rate (see especially the work of Lance Dodes), you also ignore that in recent times AA culture has been increasingly linked with a culture that blames the victim. This works to explain why AA and NA, in particular, have such endemic problems with the 13th Step (sexual exploitation, usually involving Old Timer men lying to Newcomer women about their intentions, and using their status as “spiritual” to manipulate women into sexual acts, not unlike the behavior frequently seen in religious cults). Within the culture of AA, it is mostly the fault of the woman for not knowing that claiming to be “spiritual” in AA is more or less empty in real world terms because AA doesn’t have the same standards on morality, again because they have a very strong tendency to blame the victim.

Lance Dodes deals with another aspect of this blaming the victim culture when he says because most people believe “AA works if you work it,” those that AA doesn’t work for are blamed for being a kind of inferior personality, one that is not honest or one not willing to do the work. However, again AA only has about a 5–10% success rate (a rate consistent with my personal observation as a former member of AA) so saying that 90% of the people who try it are at fault rather than the program methodology is at fault is probably the most serious problem besetting drug treatment today.

While I do think it is useful that you mention the medications that have been shown to help with addiction, you actually put drug users at risk by implying that taking these medications can be supplemented by the self-help of 12 Step. Because 12 Step is a religion-based ideology that revolves around personal “powerlessness” and total dependence on the group of AA and one’s Higher Power, medication is strongly discouraged. Most sponsors will not work with someone on medication. I cannot tell you how many times when I was an active member of 12 Step fellowship that I listened to very young adults who had newly been released from a drug treatment facility saying that they were going to finally take the step their sponsor was more or less insisting upon and that was to go off the medications that were controlling their opiate cravings so that they could “finally” work the steps. Then within a few weeks the person would disappear, and sometimes it would be announced in a meeting that the person had died of an OD, that is if the person were well-known enough. This would be consistent with recent findings that indicate that an opiate user is 50 times more likely to die if involved in a 12 Step program, if I’m not mistaken, than if he or she just continues to use on their own.

I”m not saying that AA doesn’t work for some people who enjoy and benefit from the ideology that revolves around blaming the victim and personal powerlessness. This group is so vocal about their success, it is hard to ignore. However, those that do well in the life-long Program of AA in the minority, despite how loudly they proclaim the success of AA and 12 Step.

Thank you,

Silver Damsen

The film, My Name is Bill W: The True Story of the Founders of Alcoholics Anonymous could be more inaccurate than it is. I believe that the producers of this film tried to relay the biographical information depicted in the texts of AA, particularly, Alcoholics Anonymous (the main text of the entire 12 Step Program and its subsequent branches, a text called The Big Book among 12-Step followers), and even at times to go outside these boundaries.

For example, the film My Name is Bill W even goes further than The Big Book by suggesting that Bill W’s early infidelities to his wife, Lois, actually occurred. The Big Book implies that impotence or other related problems caused by an excess consumption of alcohol kept Bill faithful, something like God’s divine will intervening to protect the sanctity of his marriage.

The film also does a fairly good job of showing the symptoms of Bill Wilson’s narcissism, his need to always be in charge, and his love or ordering others around. However, the film still interprets this energy as contributing positively to the growth of AA. This slant is still doing a disservice to its viewers by failing to note that this kind of narcissism is consistent with religious cult leaders and is not generally beneficial to anyone. It is also a trait that has lead to many abusive but standard practices in the groups of AA, such as an unhealthy amount of power that Old Timers wield against Newcomers.

The film is also more accurate than I believe The Big Book is in depicting Bill Wilson as far from an ideal husband, whether drunk or sober. However, the film still fails to note that Bill Wilson was a horrific womanizer of Newcomer women to AA, as well as fathered at least one child out of wedlock while he was what might be considered the Supreme Head of AA. Indeed, it is said that other Old Timer men had to work diligently to keep Bill W. away from young women when Bill was doing tours for this reason.

Of course, the way that Bill W’s narcissism as a whole, and his related sexual addiction, is treated the same in both AA culture and the film, and that is to say that Bill W. wasn’t perfect but somehow that he wasn’t perfect makes him more of an ideal to follow. In non-cult contexts this kind of thinking would be considered highly illogical and incorrect. However, narcissist sex addicts are more likely to show up as religious cult leaders than anywhere else, perhaps because the idea of being spiritual somehow justifies the sexually illicit behavior.

I also fear that all the time that I have spent discussing Bill W’s sexual addiction and tendency to exploit women, in general, and female AA members, in particular, leaves me little time to discuss the even larger problem with “blaming the victim” in 12-Step culture. However, a little rumination on the part of the reader should lead to a conclusion that “blaming the victim” actually ties in neatly with sexually exploiting Newcomers to AA. According to the actual teachings of The Big Book if one is exploited by another member of AA, the person who is in pain is told that it is their own fault that they were hurt, and often even told to read p.62, which teaches:

Sometimes they hurt us, seemingly without provocation, but we invariably find that at some time in the past we have made decisions based on self which later placed us in a position to be hurt.

So our troubles, we think, are basically of our own making (Alcoholics Anonymous, p.62)

Thus, despite attempting the truth, this film fails because it is still in the end just propaganda for a movement/religious that should be considered more of a cult than cure for alcoholism.