Clinicians who treat patients dealing with alcohol abuse often refer them to Alcoholics Anonymous (AA), but many have never gone to a meeting and are not familiar with what goes on there, according to an expert on Twelve-Step programs.
"Any doctor treating addicted people should go to at least a few AA meetings, so they can discuss it with patients in a knowledgeable way," says Marc Galanter, MD, Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse at NYU Langone Medical Center. "It's very experiential, and doctors should have a sense of it. They should also learn the steps of AA."
Dr. Galanter, who has studied the long-term outcomes of AA and Narcotics Anonymous members, says his findings are encouraging.
He discussed them at the recent American Society of Addiction Medicine annual meeting.
In one study, published last year in the Journal of Addictive Diseases, he found that among 266 highly committed young adult AA attendees, the average length of abstinence was 44 months. They had attended an average of 233 AA meetings in the previous year. He found 66 percent had served as sponsors, and 92 percent reported experiencing an AA "spiritual awakening" which decreased the likelihood of alcohol craving. "Their craving for alcohol was inversely related to their involvement in the group, and the degree of spiritual awakening they reported," he notes.
In a soon-to-be-published study, Dr. Galanter found similar results with a group of physicians who were long-term members of AA. He noted that unlike most studies of the AA fellowship, which tend to focus on people who have recently come out of treatment, his research centers on people who are long-term stabilized AA members. "They have been abstinent on average for five years and they go to an average of five meetings a week. Most serve as sponsors for other members. Almost all of them work the AA steps."
"Long-term members constitute the majority of people who are at an AA meeting at any given time—they are the core of the fellowship," Dr. Galanter observes. "They make AA work because they set the tone for it, and they are very stable."
Doctors should understand the types of people their patients will meet at AA, who will serve as their sponsor, and the nature of the group's spiritual orientation, he says. "We found that the majority of members we asked said they experience God's presence on most days—that's a particular kind of experience that is not necessarily what clinicians would expect. It's important for them to appreciate it, because that's what their patients will encounter."