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Sunday, 12 January 2014

Alcoholics Anonymous (AA) is a Cult? (contd)


See here for original blog entry
Under Readers' comments. We quote:
AA Retention Rate - Jim - Sep 18th 2009

AA in 1993 had 2.3 million members worldwide in it's group count records. (The triennial survey does not survey membership numbers.) The AA group database last year said the total membership shown by all the groups worldwide was 1.89 million I believe. In other words, using the same database, membership has declined about 400,000 from the peak. So, from the treetop level, AA has a negative growth rate. So the "success rate" is actually negative from that viewpoint.

The number of people in the US each year who go through drug and alcohol treatment programs is estimated at about one million. 93% of those treatment programs are 12th-step based. So, several hundred thousand people each year are exposed to AA meetings for some period of time. There are 1.3 million AA members in North America by AA's official group count. My conclusion is that there are a few hundred thousand core AA members with long-term sobriety and the rest of the "membership" is those treatment people cycling through each year.

It's hard to know how many long-term AA members there are. The Grapevine, the official magazine, first reached a circulation of 100,000 subscribers in 1978. It peaked in '93 at the same time the membership peaked, at 138,000. Today the GV circulation stands at 102,000. Again, no growth. The GV surveys estimate that the magazine has a "passalong" rate of 4 X. So, we have possibly 400,000 members who are devoted enough to read the official magazine. Not much to hang your hat on, but just as good as all the other guessing that goes on in an anonymous organization that keeps virtually no records and does little or no research to speak of.

I joined AA in 1981 when we had one million members. On my tenth anniversary, we had more than doubled. That would be a growth rate of 7.2%. With a current count of 1.89 million, we have a growth rate since I joined of less than 2.5%. Given that more than 10-15 million people at least have been introduced to AA in that time by treatment centers and courts, etc., it's hard for me to conceive of the merits of a debate about AA's "retention rate" or its "success rate." Neither are very high, very obviously, if you know the mega picture. (Here we could venture into the unknowable and say, well maybe a whole lot of those quit drinking because of what they learned in a few AA meetings. I don't know many AA's who would regard that as a "success rate," however.)

On AA's 30th anniversary in 1965 Bill W. asked "so where are the 600,000" that came and didn't stay? We have the same question today, but the number is in the high millions as AA gets ready to celebrate its 75th anniversary on June 10 next year.

AA's triennal survey shows the membership to be an average age of 47, sober about 8 years I think off the top of my head. Approximately 90% of the members are white, and those numbers are not changing appreciably with the dramatic demographic changes in the US population. The US census bureau estimates our country will be minority white by 2042. AA is going to somehow have to miraculously either bring in the minorities that have not flocked to it over the decades, or else it is going to have to dramatically increase its penetration rate in the white population, if it is to remain anywhere near its current size in a decade or so.

Between the "demographic determinism" of the above, the increasing secularization of the US, the decline of residential treatment programs, the obvious retreat from the disease model of alcoholism and the retreat of professionals from the AA "model" in favor of pharmaceutical and behavior treament programs, it's very easy to surmise that AA will likely be a very small organization on its 100th anniversary. I could add as well the information now available on the internet that makes two things very clear: AA is not the only way by any stretch to quit drinking, and there are plenty of downsides to AA groups almost everywhere.

I say the above as an AA member who will celebrate 28 years of sobriety next Tuesday and will say unabashedly it saved my life and enriched my life. But I am not among those in AA who wishes to pretend (in the face of the obvious evidence) that this is a movement that is thriving in its attractiveness to newcomers, is retaining some outlandish percentage of those who come to it for help, or that if AA would just get back to some model of "primitive AA," all would be well. We have a core group of a few hundred thousand members in the US--many of them the 50,000 or so who will attend the San Antonio convention next July--and the rest are the folks cycling through from treatment centers and the courts.

I have several observations about what may have happened to AA. One of them is this: The first members who wrote the Big Book said, "We know only a little. More will be revealed." Bill W. and many of the early leaders were fascinated with what more could be learned about alcoholism, how it could be treated, etc., and, most importantly, how AA could be most responsive to the next alcoholic who walked into the rooms.

Today AA is not a learning organization. It is not open to new ideas. It is not open minded to listen to either its concerned friends or let alone its critics. We are frozen into organizational rigidity at a time of incredible changes in the societal milieu in which we exist.

AA member's response to all this--there being none from the headquarters or general service conference--is to flail about trying to say "the numbers our critics use have got to be wrong...you don't know how high the success rate is in my group..." or, alternatively, to retreat into primitive AA mode and say, "We'd get back to the 75% success rate if we made all the newcomers get on their knees and recite the Third Step Prayer just like Dr. Bob did."

It's going to be incredibly fascinating to see if some leadership emerges in AA to change the organization's future, if AA fractures into a myriad group of organizations, or if it gets replaced by a support organization that is more palatable to those who need help. The trigger for change could be more court decisions that stop the flow of newcomers from that source; it could be the growth of treatment centers that offer alternatives to step-based recovery; it could be additional breakthroughs in medicine that go beyond the somewhat promising pharmaceutical tools physicians now have; or, it could be a sound study of sufficient stature that says "there are a few things AA has discovered that actually work, but here are the things that must be added for it to be most efficacious for the largest number of alcoholics."
Cheers
The Fellas (Friends of Alcoholics Anonymous)
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2 comments:

  1. I truly hope aa continues in its purest form..unorganized..chaotic..haphazard and healthy..my personal belief is that the cult effect has had a far more negative impact than we give it credit for...if aa fails to deal with some of its more extreme elements ie.expel them then eventually it will be associated with those elements and the majority will be powerless to watch as members gradually drift away!...I always feared aa would be destroyed from within and sadly it is looking more and more likely!

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  2. Excellent post with well thought out causes and effects analysis. I appreciate your efforts but do differ on some conclusions. I do not think that AA needs to morph to adapt to a modern approach to alcoholism or should care about how society has changed. I believe that AA should stay true to its basic model. If you be alcoholic like us then you might want to do what we did. Bill W. wrote that there were 3 types of problem drinkers. To paraphrase, the first group could moderate on their own. The second group could stop on their own. The Third, the real alcoholics we can serve because only they will have the desire born of desperation to pick up the tool kit of simple spiritual principles. No one else will want to do it unless under the lash of alcoholism. Under the guise of trying to raise the bottom or trying to do the most good for the most alcoholics we have abandoned our core method of recovery and our core of attraction rather than promotion. The secondary obsession has been the membership numbers. As our effective rate has gone down so has our numbers. I believe two things have happened, one as we allowed too many level one problem drinkers to be dumped on us via the courts and to a lesser extent the treatment industry. We created a whole group of people who return to bars telling stories of how "bad" AA was and that it didn't work. Thereby spoiling the mind set of other alcoholics and potential alcoholics. Secondly, the AA that served the current long term AA's was being removed in place of this "plant the seed" program. Long term AA's were willing to come AA and carry the message only when there was a willing party there to receive it. The meetings are flooded with parties that do not have desire to be there and therefore not receptive to the message. AA's are human and once your efforts are rebuffed you will eventual come to believe that the newcomer is not an opportunity to serve but and opportunity to tolerate. We will tolerate even to our own demise. We should refocus on real alcoholics and let the courts, the churches, the treatment centers use their methods to deal with the first and second level alcoholics. We should trust God to deliver alcoholics to where they need to be instead of practicing inclusion to the point of losing touch with the singleness of purpose.

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