Obviously, drunk drivers should be kept off the roads, and some of the individuals coerced into treatment do need help; but research indicates that A.A. is not only ineffective, it may actually be worse than no treatment at all.
There have been only two studies of A.A.'s effectiveness conducted with the proper scientific controls. Both of these studies indicated that A.A. attendance works no better than, and perhaps not as well as, no alcoholism treatment at all. One of the studies showed that a secular approach, Rational Behavior Therapy (now known as Rational Emotive Behavior Therapy), worked much better than A.A.
In the first of these studies, conducted in San Diego in 1964-65, 301 "chronic drunk offenders" were randomly divided into three groups, which were assigned to A.A., to treatment in an alcoholism clinic, or to no treatment. Within a year, 69% of the group assigned to A.A. (and 68% of the clinic group) had been re-arrested, compared to only 56% of the untreated group.
The second study was carried out in Kentucky in the mid 1970s. This time, 260 subjects who were "revolving door" alcoholic court cases were divided into five groups: one assigned to A.A., a second to nonprofessionally led Rational Behavior Therapy (RBT), a third to professionally led RBT, a fourth to professionally led Freudian therapy, and the fifth group to no treatment.
As a strictly voluntary choice, 12-step programs can work--for those who like and respond to their religious approach. But the research shows no grounds for forcing individuals to attend when 12-step religiosity offends their belief (or nonbelief) structures.
Some hope can be found in the legal system. In the late 1990s, four appeal-level courts (the 2nd and 7th federal circuit courts of appeal and the state high courts in New York and Tennessee) ruled that government-coerced attendance at A.A. violates the Establishment Clause of the First Amendment because A.A. is religious in nature.
But the Supreme Court has not ruled on the issue, so government coercion into the religious institution of A.A. continues throughout most of the country. And all the significant court challenges to 12-step coercion have involved individuals coerced by the penal or court system, leaving unaddressed the issue of coercion by employers, licensing agencies, and other institutions.
No one thinks addicted people shoud not receive help with their problem, especially if they endanger others. But we should offer them help that works, not involuntary religion disguised as treatment.