There are a couple of recent documentaries on the culture of Alcoholics Anonymous (see The 13th Step the film which documents systemic psychologically damaging dynamics), and the $35 billion dollar business arm called the ‘rehab’ industry (thebusinessofrecovery.com which documents deceptive business practices). Those films have only started being distributed in the last year, and not widely. A book called The Sober Truth: Debunking the Bad Science behind AA and the Rehab Industry by Lance Dodes also takes a good critical look at evidence.

While these are newer attempts to inform the public about real problems with AA, complaints are not new and have been increasing. Rehabilitation programs like Straight, Inc. in the eighties were controversial and faced lawsuits for false imprisonment and abusive practices. In 1999 a doctor won a case against a rehab program for false imprisonment, fraud and medical malpractice. In 2001 the Department of Justice issued a statement that any use of DoJ funds to indoctrinate religion (specifically 12-step programs) was a violation of the 1st Amendment, yet my own investigation found that state programs are still very actively involved in spreading the AA message.

Several cases have set precedent that it is illegal for judges to order people to AA, and yet they still do it. Many doctors who have heard about getting help with an addiction problem entered into Physicians’ Health Programs only to find that they will lose their licenses if they don’t attend a 90-day rehab (at their own expense), 3 AA meetings a week (for years) or try to dispute mandatory, random drug tests (paid for by them). These programs establish behavioral contracts with the license as leverage and any violation adds YEARS to the contract and severe consequences (such as loss of license, with no ability to dispute or argue). (see disruptedphysician.com ) Doctors, nurses, pilots who have lost their livelihood, when they don’t kill themselves, sometimes realize they have nothing to lose anymore and decide to speak out. Many of them straightforwardly identify the system as a racket, unfair, and ‘kafkaesque’.

Sober living environments are presented as a treatment option, and often turn out to be not much more than slumlording as a non-profit — no actual treatment, no medical oversight, but maybe a pee testing scheme to make money for each ‘head’ from insurance companies. These places are often even considered ‘rehabs’ or halfway houses but often are nothing but houses with AA members in them.

AA through its pamphlets teaches members how to promote these professional systems and rehabs through the media, and yet denies any involvement or responsibility. What is called the New Recovery Advocacy Movement is the cultural cooption of AA alternatives (like MM and SMART) and tries to gather them all under the umbrella of ‘spiritual recovery’ and the rehab and sober living industry. One example of this is a movie called The Anonymous People which found some data about 20 million people in America being considered ‘in recovery’ because they had a substance use issue and resolved it, and used that to enhance the image of ‘Recovery Culture. In reality there are only about 2 million people in AA and the majority recover without treatment or religious conversion, and there is even evidence that treatment is counterproductive. I could go on and on.

This is all to say that someone approaching AA with a methodological atheist standpoint will be tempted to reinterpret AA in secular terms assuming that the interpretation will explain ‘how it works’, when it actually doesn’t (as treatment). The assumption that it works in the first place is only an assumption. Even the concept of needing a support group is mostly an invention of AA, and prematurely assumed to be an important aspect of any secular approach.

A closer look at evidence, even the positive evidence such as experts claiming it works or that “they don’t force people into AA anymore” doesn’t stand up to scrutiny, and these dynamics (such as the fact that critics may never be allowed to BE professionals in the recovery industry and may in fact not want a piece of it) does more to explain how racketeering, censorship and misinformation works than how a treatment for ‘alcoholism’ works.