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The Reality of Treatment Success Rates

Coming to treatment has always been a hard threshold to cross – but more so now… Working in treatment for a long time, I’ve experienced greater consumer wariness.

 

People are more hesitatnt to send their loved ones to treatment and ppl who are looking for treatment are more hesitatant to come. I think one of the reasons is the discourse about addiction, treatment and recovery has hit the mainstream, and one of the things that has come out is that the success rate of treatment is like, 15% 🤷‍♂️

 

But why are success rates so low? Several reasons:

 

Poor treatment. Treatment that’s not set up well & doesn’t understand the various personalities of the population they’re working with and their underlying conditions and problems. Like a bad mechanic.

 

Shady treatment that just isn’t trustworthy. Meaning their intention wasn’t to figure out how to help people recover. Their intention was to make money. That type of intention can be disasterous.

 

The nature of addiction and recovery. The nature of addiction is… it’s chronic. It is not a problem that can be solved with an event. It’s something that has to be worked with over time.

 

A good analogy to understand why treatment success rates are low is to think about something like the gym. My guess is you’re going to see like ten, fifteen percent success on those goals of fitness of people who signed up for memberships. Right?
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Recovery is the same way. Recovery is similar to a muscle you have to exercise consistently. Lots of people will sign up for something that they won’t follow through with. It’s the really hard part of treatment and recovery.
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It’s this mysterious question of the will, why some people have the will to change certain parts of their lives and other people don’t, and honestly it’s not a place where we have good answers.
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Many times we just wait for people to be ready to change, but if you have a loved one or a spouse, or kid who is – shooting heroin – you really don’t feel like you have the luxury to wait around for them to change.
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So people intervene, and people are in different stages of readiness for change, and there’s not an easy solution for that.

 

 

 

 

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Dogma in AA: Trusting in the Spirit of Reality

Dogma is not actually something I would want to get rid of within Alcoholics Anonymous.

 

I would also say dogma is not something that I want to get rid of in alcoholics anonymous. On some level, what it means to be a person in recovery, who’s engaged in traditional 12 steps is to have some sense of acceptance, that you are not in charge of the world.

 

And it’s sort of like trusting the spirit of reality and they call it God’s will, right. It’s a little bit more loaded of a term, I’ll just call it the spirit of reality. Meaning, I have to accept what is. Right?

 

I could fight it, but I’m going to lose, because – what is. And so if what is, is there are dogmatic personalities in alcoholics anonymous, who am I to fight that?

 

Am I in charge of how people should be in meetings? And the answer is no, I’d be a hypocrite. Right? Am I dogmatically against people who are dogmatic? Well, no.

 

There’s another reason why I wouldn’t get rid of dogma in alcoholics anonymous. It’s helped a lot of people. There’s a, sort of a spectrum of meetings, there are meetings, a late-night Hollywood meeting, it’s like a comedy show fiasco. It’s totally insane and foul and people yelling. A bunch of jesters all in one space acting out. There’s no order. It’s total chaos. Great Energy. I thought I sober was gonna be boring, this meeting is wild!

 

And then you have very rigid (you have to wear a tie) and other groups that have developed their own culture which is much stricter, much more dogmatic, much more rule-bound, and all are helpful for a lot of people.

 

That kind of container and that rule of structure and not having to question everything, and just being able to take direction feels really safe, and it feels good and it helps them build lives.

 

So there is dogma in the personalities in alcoholics anonymous. It’s not a bad thing, and if the traditional 12-step is something that’s going to help you, there are ways for you to belong that work for you.

 

 

 

 

 

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We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

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AA tries NOT to be dogmatic

Alcoholics Anonymous

Although somewhat known for dogma – actually has gone out of the way to NOT be dogmatic.

 

Everything is languaged from a place of suggestion as opposed to declarative statements for how you are supposed to be.

 

When you see it in the literature of Alcoholics Anonymous, you notice that these were people who were not only NOT particularly dogmatic, but they were also sensitive to the fact that people would be sensitive to dogma.

 

I am half African-American, and when I read the core text, the Big Book of Alcoholics Anonymous, I’m shocked that the word “negro” isn’t in there.

 

It’s 1936, pre-civil-rights-movement. It says nothing about who can come and who can’t…

 

So there is dogma in the 12-steps, it’s not my cup of tea, but it largely has to do with the personalities that exist in certain meetings within the fellowship.

 

 

  

 

 

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We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

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How to Deal with Dogma in Traditional 12-Step Recovery

The One major, legitimate critique of traditional 12-step recovery that I hear a lot (and agree with) Dogma.

 

Which is basically some authority prescribing rules or structure, usually rigid or fixed rules, to a system.

 

You find that in AA, and for some people that’s a big turn off

I don’t like that, I’m a questioner, a doubter, I’m curious… and it doesn’t work well with me or a lot of people.

 

So how do you deal with this? You can choose not to participate, but maybe 12-step or traditional recovery is a huge part of what is going to help you change.

 

What people need is some clarity. The program itself is actively not dogmatic. It’s not hierarchical, there is nobody in charge. In order to be dogmatic, really, there has to be someone prescribing the rules.

 

People project dogma because they experience dogmatic personalities in Alcoholics Anonymous, and that makes sense. Often dogma comes from pain and brokenness. In response to my difficulty, I might create a whole crazy rule structure to how I have to be… …and if I go too far down that road, I might create a whole crazy rule structure about how you have to be.

 

 

  

 

 

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We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

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The Rebel Side of Alcoholics Anonymous

What to expect in this episode:

 

  1. People suffering from addiction often feel very rebellious inside
  2. Alcoholics Anonymous is rebellious, it rejects traditional hierarchy & is free
  3. The most radical thing about AA is that it’s completely detached from the market

 

Alcoholics Anonymous is for Rebels 🤘

 

The other thing about Alcoholics Anonymous; addicts and alcoholics often feel rebellious inside.

 

There’s a rebel piece that grows inside of us during the teenage years and sometimes we have a hard time growing out of.

 

(…Maybe we shouldn’t grow out of it.)

 

I would say Alcoholics Anonymous is very rebellious. 

 

When I say its free, that’s a big deal, it also is completely disconnected from the market place. Its not only that it doesn’t cost any money to go there. There are non profits that you can go to that don’t cost money; but it actually has little to no relationship to the market place at all other than people putting a dollar in a basket to pay some cheap rent at a particular building. 

 

SO it is totally disconnected from our economic system, and I would invite anybody to name any other institution that’s completely disconnected from our market economy. I think that’s important. 

 

There are no commercials or advertising for it, somehow it’s just its own temple, or sacred space. It hasn’t been invaded by a lot of economic forces that we are all at the whim of. So I think there is something special about that. 

 

The other thing about AA is that it’s not hierarchical, not that there is no hierarchy, it just a very flat hierarchy.

 

There’s nobody in charge; when you go to a meeting, there is someone leading the meeting, that rotates every 6 months based on a democratic process usually, that people vote on. 

 

You might ask, “Who is in charge of these millions of people in Alcoholics Anonymous?” nobody knows, no one is in charge. It is people coming together to help each other in a way that has now worked for 80 years. It’s incredible to have that kind of flat hierarchy and it’s worked now through 3-4 generations of people.

 

That’s deep, religion is not like that, corporations are not like that, and my family is not even like that… well sometimes it’s like that… 

  

 

 

 

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The Controversial Nature of Alcoholics Anonymous

What to expect in this episode:

 

  1. Where, specifically, is your resistance coming from?
  2. CBT & DBT are nice , but they are cost prohibitive
  3. The most radical thing about AA is that it’s FREE

 

The Controversial Nature of Alcoholics Anonymous

 

The resistance that people have to the 12 steps can be overcome.

 

What it takes is a person understanding specifically where your resistance is and walking you through it; allowing you to see it and understand it in a way that’s palatable for you. Showing you that in the beginning you can tolerate it and in time come to enjoy. 

 

I’m not into force or coercion, so a person has to say, “I am open to learning about this”. For a lot of people 12 step recovery is the biggest resource they’re going to have. There are quite a few things about 12 step that are really incredible and are not replicated anywhere else as of now, in terms of support for addicts and alcoholics. 

 

The first thing I would say that is really radical about the 12 step program is that it’s FREE. I hear a lot of critique from psychologists and psychiatrists, and honestly I don’t like it, about the 12 step program. That it’s not sophisticated enough, it’s a religion; the same critique that clients have, they parrot those (opinions) back in NPR. 

 

So I will ask, “What is your solution then, for addicts and alcoholics”? They will say CBT, which is particular therapeutic modality or DBT (another therapeutic modality), or psychiatry, etc. 

 

That’s great, but what about the hundred million people who can’t afford to go see a therapist 3 times a week, at $120-$180 per hour in LA. What about the million people who can’t afford $400 per hour to see a psychiatrist monthly? What about those folks? What is going to be their consistent support? SO they critique it, but they don’t have another good solution in the end.

 

If you were to ask me, “How many people do you know in recovery”? I’d say, “I know about 2500 people in recovery”. If they said, “how many of those people had a 12 step experience as a foundation for their recovery”? I’d say, “Probably about 2475”. 

 

Now that’s not evidence that this is the only way to do it, or the only way that works, it’s the most available way to do it, so that makes sense. However, if you were to say, “Yeshaia, how many times have you seen people use an alternate route to recover successfully”? My answer would be 330-40, or something like that. 

  

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

 

 

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