Alternatives to AA (and other non-12 step programs)
In this article I introduce a number of alternatives to AA that can help anyone suffering with alcohol addiction to learn how to stop drinking and get sober. These non-12 step programs vary from alternative spiritual approaches, non-spiritual support groups, rehab, 1-on-1 counselling, approaches that require abstinence and ones that don’t and, finally, good old fashioned DIY methods.
Before we begin I’ll give a brief overview of the recovery landscape today and how it has developed over the past 100 years. This will explain why people are searching for alternatives to AA! Then I’ll jump straight into listing what these alternatives are.
Alternatives to AA: developments in addiction recovery over the past 100 years (aka why people search for alternatives to AA)
Due to some high quality hustling by its founders (what is it with devout believers and their commitment to spreading their solution?) AA and its 12 step program has become the gold standard for alcohol addiction recovery – it’s even mandated by courts.
Some may find it bizarre that a spiritual solution has become the go-to solution for curing alcoholism. But, at that time of its inception, there really did seem to be no other answer to the problem of alcoholism.
That was then – this is now.
“Treatment for alcohol use disorder (AUD), once essentially limited to the mutual support group Alcoholics Anonymous founded in 1935, has seen many significant advances. In addition to mutual support groups, AUD can be treated with medications and behavioral therapies, as well as combinations of treatments. Technology—such as email and the Internet—has opened new avenues for diagnosing and treating people with AUD. And researchers continue to develop alternate treatment strategies that can offer help to everyone who wants to change their drinking habits.” USA National Institute on Alcohol Abuse and Alcoholism
Needless to say, a lot has changed since 1935 (hello, moon; hello, internet; goodbye Hitler). As in many other areas, our understanding of addiction has come on in leaps and bounds in the past 80 years.
I’m not saying that AA doesn’t work – it clearly has helped many people get sober. But what I am saying is that:
1. AA is not necessarily the best method of getting sober available today (given the progress that’s been made in understanding addiction since its inception in 1935)
AA hasn’t changed in 100 years – they still use the same core text (“The Big Book”) written in the middle of the last century and they more or less worship their founder, Bill Wilson. This rigid thinking, glorification of the past and dogma (manifested as lack of openness to improved solutions) are the same issues that have driven many away from the other spiritual solutions of our time (i.e. organised religion).
2. AA doesn’t work for all types of people (given its failure to be open to improvement and spiritual approach)
So whether AA is the right solution for you will depend largely on the type of person you are: on the one hand you have the “if it ain’t broke, don’t fix it” traditionalist types while on the other hand you have those that believe in the scientific method of constant iteration and improvement.
Luckily for you if you’re of the latter type, AA and its 12-step program is but one of many solutions to the problem of addiction and alcoholism today.
So, what are the alternatives to AA?
Alternatives to AA can be grouped into 4 categories:
- Other spiritual mutual support groups
- Non-spiritual mutual support groups
- Behavioural therapies (i.e. non-support group based)
1. Other spiritual mutual support groups:
- Buddhism based:
Refuge Recovery (http://www.refugerecovery.org)
“a mindfulness-based addiction recovery community that practices and utilizes Buddhist philosophy as the foundation of the recovery process”
Online meetings are available as well as group meetings in USA, Canada, Australia, Denmark, Finland, Netherlands, Sweden, Thailand, UK, Germany and Guatemala (check the website for latest info).
- Christian based:
Celebrate Recovery (http://www.celebraterecovery.com)
“A Christ-Centered Recovery Program”
According to their website, there are meetings held in over 29,000 churches worldwide.
2. Non-spiritual mutual support groups:
- LifeRing Secular Recovery (http://lifering.org)
“LifeRing Secular Recovery is an organization of people who share practical experiences and sobriety support.”
LifeRing encourages each individual to discover what works best for them, with no set program but instead by facilitating self-directed learning based on discussion with other members of the group.
Online meetings are available as well as more than 200 group meetings in the US, Canada, Denmark, Ireland, Sweden and the UK (check the website for latest info).
- SMART Recovery (http://www.smartrecovery.org)
(SMART stands for: Self-Management and Recovery Training)
“SMART Recovery is the leading self-empowering addiction recovery support group. Our participants learn tools for addiction recovery based on the latest scientific research and participate in a world-wide community which includes free, self-empowering, science-based mutual help groups.”
SMART Recovery uses a “4-Point Program” based on (and evolving with) the latest scientific knowledge (e.g. behavioural therapies) in addiction recovery.
Online meetings are available as well as group meetings in the US, Canada, UK and Australia (check the website for latest info).
- HAMS: Harm Reduction for Alcohol (http://hams.cc)
“Support for safer drinking, reduced drinking or quitting”
HAMS stands for Harm reduction, Abstinence and Moderation Support. As the name implies, unlike the majority of recovery programs HAMS does not require members to aim to abstain totally from alcohol, instead accepting the goal of alcohol moderation as sufficient.
- Women for Sobriety (http://womenforsobriety.org)
“Women for Sobriety, Inc., is a non-profit organization dedicated to helping women discover an abstinent New Life. It is the first self-help recovery program based on the unique emotional needs of women. WFS was founded in July, 1975, and has been helping women in recovery from alcohol and drug addictions for over 40 years.”
- Secular Organisation for Sobriety (http://www.sossobriety.org/)
Secular Organizations for Sobriety (SOS) is a nonprofit network of autonomous, non-professional local groups, dedicated solely to helping individuals achieve and maintain sobriety/abstinence from alcohol and drug addiction, food addiction and more.
Note: This list is not exhaustive – there are new secular mutual support groups for alcohol recovery being formed all the time. Please [get in touch] if you have any suggestions of additional groups to add to this list.
- Antabuse (Disulfiram)
The original “stop drinking pill”, Antabuse deters users from drinking by causing the body to react to alcohol creating the effects of a sever hangover immediately upon alcohol consumption.
Check out a more detailed article on how Antabuse is used to stop drinking here: [3 ways to use Antabuse to quit drinking]
Naltrexone prevents the activity of opioids, which results in a greatly reduced sense of pleasure when alcohol is consumed. This in turn reduces the desire to drink alcohol in the first place.
Check out a more detailed article on how Naltrexone is used to stop drinking here: [Quit drinking alcohol with Naltrexone]
Acamprosate is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcohol withdrawal [American Academy of Family Physicians]
- Other medications:
“Although not approved by the U.S. Food and Drug Administration for this indication, the anticonvulsant topiramate and several serotonergic agents (e.g., fluoxetine, ondansetron) have been shown in recent studies to increase abstinence rates and decrease drinking.” American Academy of Family Physicians
4. Behavioural therapies
There are a whole range of behavioural therapies for recovering from addiction. I’ll cover the main methods here and list further methods below.
- Rational Recovery (http://rational.org)
Unlike the rest of this list, Rational Recovery is not a behavioural therapy in itself. Instead it is an individual, independent program (i.e. no support groups) which uses the Addictive Voice Recognition Technique (which is loosely based on a number of behavioural therapies) to overcome addiction.
I have included it in this list as it is based on behavioural therapies and offers an individualised alternative to the mutual support groups listed previously.
- Cognitive Behaviour Therapy (CBT)
CBT for addiction is a method where the patient learns to identify and replace the erroneous thought patterns that lead to addictive behaviour, thus eradicating this behaviour. CBT is generally administered in 1-to-1 sessions by trained psychologists. CBT has proven to be effective in a wide number of scientific studies [source].
- Rational Emotive Behaviour Therapy (REBT)
REBT is actually a specific form of CBT which focuses on solving emotional and behavioural problems that lead to repeated use of alcohol.
Other behavioural therapies include the following (among others) – just google the terms for more info:
- Contingency Management
- Motivational Interviewing
- Dialectical Behaviour Theory (DBT)
- Community Reinforcement and Family Training (CRAFT)
- Multidimensional Family Therapy
- Integrative Approach
- Person-Centered Therapy
- Matrix Model
- Eye Movement Desensitization and Reprocessing Therapy (EMDR)
I hope it is clear from this article that I’m not anti-AA. AA has helped many people get sober. However, certain AA literature claims that AA is the only know solution to alcohol addiction. While this may have been true at the time of writing, it is not true today: as this article has shown, there are many alternatives to AA.
AA is the most well-known program for alcohol recovery, and it is still the first port of call for many who are trying to stop drinking. I have written this article to show that alternative methods do exist for those people who may have been disillusioned by their initial experience of AA or who are reluctant to attend AA in the first place.
It may be that AA is the most active mutual support group in your area and you choose to attend in-person AA meetings for the community support (while not practicing the AA 12-steps) while also attending non-12 step program meetings online, working with a CBT counsellor and taking Antabuse.
You are responsible for your own recovery. No one can (and indeed most healthy people will not) tell you a certain way is right or wrong, or that only one way can be successful, because the truth is that there are many methods than can be, have been and are being used to successfully stop drinking. It’s up to you to try these AA and or these alternatives to AA (be it one method or a combination of methods – none are mutually exclusive!) and to find and do whatever works best for you.
Want to learn more? Read this article for a step-by-step guide on how to stop drinking without AA.