How Much Do We Really Need to Spend on Substance Abuse?
Austin Frakt had a post the other day, summarizing studies comparing Alcoholics Anonymous (AA) and other 12-step programs with “other psychological treatments.” His conclusion: There is no evidence that AA is better.
I would turn that around. Remember, AA is free. Mental health parity bills in Congress and at the state level are all backed by “professionals” who want to charge beaucoup bucks for their services. If we really believe in comparative effectiveness research, I would say let’s start with the folks who charge high fees and can’t prove they make any difference.
See my previous post on this. Here is another post by Frakt and Steve Pizer. And another post by Frakt.
These substance abuse programs have made a difference for Lindsey Lohan. She quit at least 8 times last year.
Another point to consider – AA has been around since the 1930’s. Are there any other substance abuse programs that have that kind of logevity? What part does that play in determining effectiveness?
Basically, people have to want to quit in order for a program to be effective. Even then, the program is just providing peer pressure and assistance to people (who want to be sober) from periodically falling off the wagon.
Offering expensive mental health parity regulations will create a cottage industry of professional counselors treating those who have not yet decided to abstain from alcohol or drugs.
Many facility-based treatment programs are mainly AA-type programs (which include any 12-step imitators) in sheltered environments. They cost a lot, whereas AA is free. However, the goal of AA, as I understand it, is not just abstinance, but the achievement and maintenance of contented sobriety — a tall order. And though AA is not a religion, it is a spiritually based program.