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The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry
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The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry

Rating: 3.5 out of 5 stars

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AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5-10 percent success rate-hardly better than no treatment at all. Despite this, doctors, employers, and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model.

In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program's overall success.

But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA's rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.
LanguageEnglish
Release dateJan 29, 2019
ISBN9781977342294
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry

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Rating: 3.685714211428571 out of 5 stars
3.5/5

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  • Rating: 4 out of 5 stars
    4/5
    This book looks at the AA movement and whether or not 12-step programs are truly effective. It's long been known in the psychology field that generally, AA is not effective for most people who try it, but it's so ingrained in the substance disorders field that it's difficult to find a program that doesn't use AA principles. Dr. Dodes provides a summary of some of the empirical evidence for the efficacy, or lack thereof, of the 12-step program, and also some background about the program and how it has gained the power that it currently holds in the field. He decries the fact that so many programs use a program that fails to provide evidence that it works. There is actually good evidence that around 50% of people who get and stay sober, do so without any treatment at all, while AA has only about a 5-10% success rate, indicating that it's no better than not getting any treatment. The book does a good job of presenting evidence about AA and also that debunks the disease model in general, but one thing that I found fascinating, and hypocritical, is that he also presents a model of the etiology of addiction, that it's the result of "displacement" and addicts feeling helpless, without presenting even one scientific study that supports this assumption! This may be his theory about why people become addicts, but it is far from established fact, nor is it even the prevailing etiological theory. I think he does a very good job of making a case against the current state of rehab programs in this country, but he hurts his own credibility by then presenting his pet theory without any empirical support to back it up. If you are interested in getting a wider view of rehab as an industry, and exploring the background of AA and how it became so popular, in spite of it having no real basis in science and there being little evidence that it's very helpful for most people, this book is a good place to start.

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  • Rating: 4 out of 5 stars
    4/5
    Alcoholics Anonymous has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5-10 percent success rate-hardly better than no treatment at all. Despite this, doctors, employers and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model. The Sober Truth explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem.
  • Rating: 4 out of 5 stars
    4/5
    A very good book about really bad science methodology and accountability. The author is swimming against a strongly ingrained sociological tide, but he is a recognized expert inside the field who backs his proposals with accessibly presented, peer-reviewed research from numerous sources as well as powerful patient testimonials. Should be mandatory reading for all judiciary members, NIH staff members, social workers, substance abuse counselors and therapists, and loved ones of those currently attending AA/GA/NA and/or struggling with addiction issues. Thank you to Early Reviewers for bringing this book to my attention.
  • Rating: 3 out of 5 stars
    3/5
    I really didn't love or hate The Sober Truth. I thought this book had some limitations. Dodes' major criticism of 12-step programs is the ineffective research, and low success rate. Yet, Dodes advocates his use of psychodynamic therapy to be a better solution to treating addiction, but doesn't provide adequate research to substantiate this argument. I do agree that 12-step programs are not a one size fits all solution to overcoming addiction. However, some people simply cannot afford 1 hour a week of psychotherapy. While, psychodynamic therapy may have worked for some of Dodes patients, I do not believe that all patients will have the same success rate by a practitioner using only a psychodynamic theoretical orientation. People are too complex to be reduced to any one size fits all approach whether it be psychodynamic therapy or attending 12-step programs.
  • Rating: 4 out of 5 stars
    4/5
    The Sober Truth is a clear and concise look at alcohol addiction and it's treatment.  Both are greatly misunderstood thanks to false wisdom purpetuated by the largely unchallenged 12-Step orthodoxy.  Dodes looks into how a religious program that has consistently misrepresently it's efficacy through dubious reporting became sacrosanct in the field of addiction treatment.  And in doing so he overturns some misconceptions that ought to be obvious if they hadn't become gospel.  Here are a few.1. 12 step programs are neither scientific nor medically sound.  There success rate falls somewhere between 5-8% successful, a number comparable to the success rate of people who get sober without any treatment.  The big red flag is that a legitimate medical treatment would never be excused from it's failure to act as designed by blaming the patient.  In this way 12 step programs take credit for successsful treatment while blaming the vast number of addicts the program does not help.2. Addiction is not a disease and addicts are not broken or fundamentally different than other people.  It seams obvious when you think about it, but this oft cited truism is completely absurd.  Alcoholism can't be traced to any particular biological cause, despite endless hunts for an "addiction" gene.  More telling is the fact that normal diseases don't reappar experessed in completely different ways as recovered addicts often develop new addictions to replace old ones.3. Alcoholics Anonymous is a religious program.  Despite their ceaseless claims to the contrary their 12 steps, on multiple occasions, require the participant to believe in and depend on a "higher power".  The frequent defence that it could be anything, even a "doorknob" ought to be met with the credulous disdain it deserves if they want us to believe that having faith in a doorknob could facilitate recovery.  Thankfully some states have recognized the religious character of the program and have made it illegal for courts to mandate attendance as to do so violates the separation of church and state.There are more but I'll leave that to the book.  But Dodes isn't hear to drag AA and it's emulators through the mud (that's what the Orange Papers are for).  At it's core The Sober Truth is designed to despell the widespread misinformation and provide better information and treatment alternatives.  This book couldn't be more right for people facing addiction either in themselves or loved ones.  And I hope that the information here gets to more would be ex-addicts before they are herded into the dubious and often detrimental programs based on AA's 12 steps.
  • Rating: 4 out of 5 stars
    4/5
    A well-written and researched book focusing on the problems of Alcoholics Anonymous and its 12-step program which has been accepted whole hog by much of the medical and popular establishments and adopted by many rehabilitation facilities. The thrust of the argument against AA and 12-step methods is their lack of grounding in scientific research proving any of the approach's effectiveness; in fact the authors claim that as few as 5% of people who attempt to treat their own alcohol addiction via AA are "cured" of their dependency, however, the 12-step and even medical communities refuse to do the kinds of studies that would gather needed data in order to properly evaluate their approach. The authors carefully pick apart the 12-step method, showing its lack of scientific and psychological merit, and they even look at many of the very expensive rehab facilities out there which base their treatments on 12-steps, such as the Betty Ford Clinic, showing that they avoid any attempt to measure the effectiveness of their programs; and as examples of their weaknesses, the programs often lack any individual psychotherapy, generally charge over $1000 a day, and require patients to stay 30 days, which is coincidentally what most insurance programs will pay for. The authors' arguments are strong and well-laid out. I did have some questions about the authors' own statements that psychodynamic therapy was the best and nearly the only approach that works, rejecting theories that genetics or neurochemistry could also play a role as ideas pushed by drug companies. I appreciated reading this book and highly recommend it. My guess is that many people for whom AA has worked or who know a friend or family member who claim that AA has saved their lives may feel very threatened by this book and pan it without much critical thought.
  • Rating: 3 out of 5 stars
    3/5
    Prior to reading The Sober Truth by Lance Dodes and Zachary Dodes from LibraryThing, I was aware of three different opinions about AA and the twelve-step program. The positive one from a good friend who feels that AA saved her life. She has been sober for 23 years, and does her AA "work" by taking new participants through the Big Book. The negative opinion from a family member who says "No" --- it did nothing for him. And then there's my own opinion, which is that if you want to get beyond something, it would only make it harder to do if you were faced with having frequent reminders in going to meetings where you have to stand and say that you are an alcoholic (translation: you like to drink, Oh yeah --- thanks for reminding me).This book does an excellent job of laying out the problems with AA and how it fails for many more persons than it ever helps. The authors make an eloquent plea for more studies and a look for new approaches to the problem.
  • Rating: 3 out of 5 stars
    3/5
    I received "The Sober Truth" by Lance Dodes MD & Zachary Dodes from The LibaryThing Early Reviewers give away program. This book basically "debunks" AA and the 12 step program while offering a more scientific approach to rehab.It reads like a text book but is interesting at the same time. It's apparent that much research went into the writing of The Sober Truth. I especially enjoyed reading the chapter about the myths of AA. Also, I'd never heard of the Oxford Group before so that was educational to me. I'd recommend this book to anyone interested in addiction rehab.
  • Rating: 5 out of 5 stars
    5/5
    As the title indicates, it takes the 12-step programs based on AA to task for spreading myths about the effectiveness of that approach for treating addiction. As he correctly argues, AA is nothing more than conservative religion cloaked in different jargon and it's founding was based on Christian beliefs. It also addresses the harmful "disease" mantra concerning alcohol addiction when there is no clinical support for such contentions. The rehab industry became lucrative selling such a proposition and most using the 12-step model often do more harm than good. Unless of course, one goes to the " celebrity" rehabs where riding on yacht is supposedly a good cure for addiction. While worth reading for anyone suspicious of the claims of AA or turned off by their zealous religiosity. Which by the way, the best studies done, show a success rate for 12-step treatments as between 4-8 %, though they deceptively make outrageous claims boasting of much higher success rates.