US of AA: How the Twelve Steps Hijacked the Science of Alcoholism

by Joe Miller

In the aftermath of Prohibition, America’s top scientists joined forces with AA members and put their clout behind a campaign to convince the nation that alcoholism is a disease. They had no proof, but they hoped to find it once research money came pouring in. The campaign spanned decades, and from it grew a multimillion-dollar treatment industry and a new government agency devoted to alcoholism.
But scientists’ research showed that problem drinking is not a singular disease but a complex phenomenon requiring an array of strategies. There’s less scientific evidence for the effectiveness of AA than there is for most other treatments, including self-enforced moderation, therapy and counseling, and targeted medications; AA’s own surveys show that it doesn’t work for the overwhelming majority of problem drinkers.
Five years in the making, Joe Miller’s brilliant, in-depth investigative reporting into the history, politics, and science of alcoholism shows exactly how AA became our nation’s de facto treatment policy, even as evidence accumulated for more effective remedies—and how, as a result, those who suffer the most often go untreated. US of AA is a character-driven, beautifully written exposé, full of secrecy, irony, liquor industry money, the shrillest of scare tactics, and, at its center, a grand deception. In the tradition of Crazy by Pete Earley and David Goldhill’s Catastrophic Care , US of AA shines a much-needed spotlight on the addiction treatment industry. It will forever change the way we think about the entire enterprise.
 

Genres: Nonfiction, History, Addiction, Psychology

208 pages, Hardcover

First published January 1, 2019

About the author

I’m an assistant professor of writing at Columbus State University in Georgia, and I’ve written for Vibe, Salon and Popular Science. My first book, Cross-X, won a William Rockhill Nelson Award and a Harry Chapin Media Award and was named one of the best nonfiction books of 2006 by the Chicago Tribune, Kansas City Star and Publisher’s Weekly.

Reviews

[Morgan Blackledge · Rating 4 out of 5]

US of AA

Fantastic!!!

I loved this book.

In brief, it’s simply a history of Alcoholics Anonymous (AA) and the political, economic and academic interests that have shaped the current beliefs, policies and practices of the current American system of addiction treatment.

I’m the program director of an intensive outpatient clinic for treatment of substance use disorders and co-occurring mental health diagnosis.

I’m also a licensed therapist, and I have worked on the frontline of the recent addiction epidemic in many capacities and contexts.

I have worked in harm reduction, medication assisted treatment and abstinence based modalities.

I have worked in non-profit research based facilities, publicly funded community mental health agencies, insurance based and cash only, for-profit programs.

I have served a broad range of socioeconomic groups including; homeless populations, low income child and family clients, adolescents in foster care, working class and middle income insurance based clients, as well as wealthy cash pay clients in high-end high amenity luxury treatment.

I did community outreach for LA county for bit, where my full time job was to attend any every type of community based, peer facilitated support group available including every type of 12-Step, SMART recovery, National Association on Mental Illness (NAMI), Bipolar Depression Support Alliance (BDSA), Refuge Recovery and more.

Although I am not a researcher. I am highly invested in understanding and treating substance use disorder and co-occurring mental health diagnosis, so I consume a lot of the research on the topic and I consider myself sufficiently up to date on the emerging science.

Oh yeah. One other thing. I have a history of recovery from substance use and abuse (and oh so much more).

As the adage goes.

Research is me-search.

So anyway, if some or all of that qualifies me, and if you care to read on, I’m here to tell you:

Addiction treatment in America is about as factional and contentiously debated as any contemporary American political issue.

Which is to say; it’s a shit-storm of superstition, rancor, confusion and cash.

The book chronicles how that came to be, and tacitly, how it is that we are still stuck in the same spin cycle 80 years later.

It would be easy to see this as a fight between good and evil, or red versus blue truth.

But it’s not.

It’s better understood as a tremendously difficult problem with no easy solution.

Hanlon’s Razor is a useful heuristic that directs us to: never attribute to malice, what is adequately explained by incompetence.

And our current beliefs and system is woefully incompetent to the task at hand.

In other words, we suck.

And addiction is complicated.

Extremely Fucking Complicated.

There is an irreducible level of complexity that needs to be understood in order to think about the issue intelligently.

Just like any other human behavior, there are a host of important factors that come to bear on the issues of addiction including; 1: biological, 2: psychological, 3: socio-cultural, and some would add 4: spiritual factors, all of which interact in ridiculously complicated ways for each individual and family dealing with the issue.

Under those broad categories are factors including; brains, genes, neurons, neural-plasticity, neurochemistry, stress, grief, anxiety, depression, trauma, attachment, family systems, relationships, work, money, politics, systemic and interpersonal racism, sexism, homophobia, all manner of discrimination, lack of meaning mission and purpose, identity confusion, lack of freedom, lack of connection, lack of personal insight, growth and accomplishment, lack of clarity regarding what matters and how to step to that, and a lack of skills for transcending our thoughts and feelings without dumbing and numbing.

Addiction is a chronic and typically relapsing disease, elicited via exposure to drugs of abuse and use dependent conditioning of the brain, and which effects motivation, judgment and behavior, and which is highly subject to psychological, social and environmental influences.

It’s not like any other disease(s).

There is no cure and there may never be a cure.

If you want to understand and recover from addiction, you need to work hard at it.

And most people don’t want to work.

But if you do work at it.

And if you take advice (form a qualified other).

It’s totally doable.

It is 100% possible to recover from substance use disorder, and co-occurring mental heath issues including the immense and completely unnecessary suffering that every ordinary, healthy human mind creates.

Millions and millions and millions of people do it every ding dang day.

That being said.

In addition to simply quitting the alcohol and drug use. You typically have to do some other stuff too.

You will probably have to get out of so-called black and white thinking.

There are some core dialects that you will have to embrace and master.

1: you have to accept what you can’t change and change almost everything else, and you’re going to also have to clearly understand the difference between those two.

And that’s like no big deal, but it’s probably not what you think it is. So you’re probably going to need help.

And that’s the next dialectic.

2: you have to do the work but you don’t have to do it alone, and you probably shouldn’t do it alone.

Alcohol and drugs modify your brain, destabilize your mood and hijack your motivational system.

People routinely fall back into chronic substance use after periods of hard work and abstinence because they are blind to their own deeply biologically based motivations, and they are either going at it alone or not taking advice.

People are blind to their own motivations under the best of circumstances, so get over yourself and get help.

And getting over yourself is a big part of the next dialectic.

3: just because it worked for you doesn’t mean it works just like that for everyone.

Let’s say you find your way.

Awesome!!!!

Please please don’t jam it down everyone else’s pie hole, like some kind of post-booze John the Baptist.

It’s fucking soooooo fucking obnoxious when you do that bro!!!

Remember attraction not promotion?

Oh yeah, that!

And that leads me to the last dialectic I will discuss in this forum.

4: the solution is highly personal for everyone, and completely not personal at the same time.

AA, therapy, yoga, niacin, prayer, bearded sky daddies, nature, the universe, the doorknob, atheism, Buddhism, high colonics, animal rescue, ketogenic, paleo, crystal-lite, whatever you’re into, that’s so fucking mellow man.

Honestly.

But if you want to establish causation, you need a sufficiently powered randomized, double blind, placebo controlled trial, and if you don’t think so, than you probably don’t know what that is.

Neuroscience, psychology, psychopharmacology and psychotherapy are not a threat to your religion of sobriety.

It’s not a conspiracy.

We’re all on the same team folks.

So both/and, please.

Any way.

If we don’t know our history, we’re doomed to repeat it (and even when we do, we’re still pretty fucked because most people don’t and won’t).

So get this thing and read it.

Why 4/5 stars?

I’m one of those people who does not recommend moderation in early recovery.

You probably can’t use “just a little bit” of your drug of choice if you have had problem use in the recent past.

You might be able to moderate, but your brain probably can’t.

Brains simply don’t work like that.

All drugs of abuse destabilize your brain.

And that thing that you call you, is a pretty small function of your brain, so you can’t really “will” that into submission.

That’s sort of the point.

It’s literally not possible.

The book isn’t clear about the science behind all of that.

So I’m holding back my highest endorsement.

But it’s still a block knockin’ hella god as fuck read.

So go get it!!

[Melissa Leigh · Rating 1 out of 5]

This is a big DNF for me. Not because I myself am in recovery and attend weekly AA meetings but because the author spends the first portion of the book explaining how he didn’t properly do the steps and avoided getting a sponsor after three told him he’d need to do a fourth step. It’s evident he didn’t actually try to utilize AA, so why would I trust his opinion on the topic?

Would you trust the law advice of an aspiring lawyer who dropped out of three schools because they told him he’d have to study the course topic? Would you trust a self proclaimed car expert for advice on how to fix your car when his only experience is entering and leaving trade school multiple times because he was told he’d have to put in work? So why trust someone who wants to write a book on AA without ever having learned the process, read the books or worked the program?

A few notes:

On the first page the author states that AA claims the only cure for alcoholism is God. Nowhere in AA is God ever mentioned. Ever. I am not religious, I believe in science and evolution and AA works for me because God is not a part of AA. I should have stopped reading here but I pressed on.

The author states that after finishing his fifth step he went home and wrote a journal entry about a resentment he felt towards his room mate. This entire sentence is a contradiction. He clearly had not worked, let alone finished this step as he was still harboring resentment.

He then says he went to his psychologist and asked for a prescription for an alcohol treatment drug and was refused and told to go to AA. He says he went back but when his new sponsor told him he’d have to redo a by the book fourth step he found another sponsor. When the new sound is told him the same thing, he decided he didn’t need a sponsor.

It’s evident the author never worked the program of AA. He wanted the cure without putting in any of the work and when his psychiatrist and all his sponsors informed him you have to work for it, he got a chip on his shoulder. He made the classic newbie mistake of thinking he’s different and unique and special and he wrote a book about it.

I won’t be finishing the book. Not with the authors manipulating and misleading his reader from literally the first page one. I’ve always said if you have to twist the truth to fit your narrative, your narrative is likely wrong.

[Rick Wilson · Rating 4 out of 5]

It’s good. I think it’s a much needed dose of realistic and reasonable criticism for 12 step programs. There is sort of a “La La La I can’t hear you” mentality with some of these that ends up resulting in an echo chamber. And realistically, I’ve seen a work for a lot of people across a lot of different circumstances. I think I am reluctant to dismiss it out of hand, and find that I place the onus on new information and research.

I do think there are a couple issues with some of the studies that this author proposes to criticize AA with in that many of the “moderation” studies end up relying upon self-reports, which are notoriously awful. Same with many of the AA studies so this is not an exclusive issue to this book. There are a lot of methodological difficulties when it comes to studying sober people as a population. But again, in the sort of spirit of “there’s a fence, let’s not remove it until we know why it’s there“ I do think there’s a higher burden upon demonstrating the ineffectiveness of AA.

That’s sad I think this book represents a lot of very real and reasonable counterpoints to what is essentially a program of religious recovery proposed in the early 1900s. The fact that it’s become dog Mattick and stuck is a constant point of frustration in my own recovery and exposure to AA over the past five or so years that I’ve been sober.

[Brian · Rating 5 out of 5]

Bout time the blinders were lifted

What a great biography on the Great American Rehabilitation Tragedy.
I've watched so many people become damaged by the disease model of addiction with its insistence on shame, powerlessness, and stigma and the need to surrender to your cravings. AA never made sense to me and I don't begrudge those that it helps, but leave me and others that choose a different course the hell alone.
Like the majority of people I learned to solve my drinking issues my own way. There's something to be said about living your life on your own terms. It's empowering, which is exactly what AA is not. It's about taking personal responsibility and to stop blaming others or even a false disease for your problems.
Upon reading some of the more critical reviews, I'm not at all surprised at the defensiveness of AA members who always seem to have trouble with facts and truth and choose to ferociously attack anything that may cast doubt on their precious belief system. AA is a religion with cultish qualities so what would you expect?
I always knew I didn't have a "disease."
More people quit their addictions than do not and do so without treatment of any kind. Smoking would be a pretty good example of that and it is one of the hardest to quit.
I'm so weary of the AA dogma and the disease model and I hope this book sheds a little more light on the myth, that many times, does more harm than good.
I actually wasn't aware of how powerful and instrumental AA was in the creation of the disease model and the creation of the
Well researched and written and I didn't notice any bias in Joe Miller's approach to the subject. He seemed very fact based and objective to me.

[David Wineberg · Rating 4 out of 5]

The history of alcoholism is colored by the fact it has spent almost the entire 20th century trying to be recognized as a disease. In Joe Miller’s brief but more than sufficient history of Alcoholics Anonymous, US of AA, doctors play almost no positive role until the 2000s. Ordinary Americans, suffering the effects, tried to figure out the extent, the how, and the why of alcoholism. They had their successes and plenty of setbacks, and by the 1960s were at the level of the Supreme Court, arguing it was a disease, not a crime.

Alcoholism was finally declared a disease in the late 1960s, not by doctors or the AMA, but by President Lyndon Johnson, who by then had been part of the organization for 20 years. Funding in the millions began to flow from federal coffers to agencies and commissions led by AA supporters. The focus was almost entirely on total abstinence as the only treatment. But as the rest of the world knew, that’s not true, not what it looks like, and not how it works.

Alcoholics Anonymous (AA) is one of the strongest brands in US history. Everyone knows it means constant meetings of verbal self-flagellation and obeisance to God, to ward off the temptation to drink. That members monitor each other with the sole intent of preventing the consumption of a single drop of alcohol by other members. Doctors all but automatically send patients to AA rather than any other course of treatment. It is an astonishing branding achievement by a small group of alcoholics.

Even more astonishing is their failure rate – 90 to 95%. AA is far from a proven cure. There are 25-40 million Americans who have recovered from alcoholism and addiction, and less than 20% did it by total abstinence. And even fewer are lifelong AA members. The vast majority learns to manage and control it, and can drink socially without getting blind drunk or go on weeklong binges.

AA chapters pop up all over the country, mostly thanks to the efforts of alcoholics who were saved by AA. They become evangelicals, who can’t wait to share with others. AA members are quick to work intensely with any alcoholic (above age 40) and get them on the path. Their method is to point out it is a disease, not a moral failing of theirs, that it can be overcome, that they are proof of it, and that a whole fruitful life lies ahead. But they avoid people in their 30s, because they haven’t yet hit bottom, and so have more trials and suffering to endure before they capitulate for real. A very odd disease, indeed.

Even stranger is the medical establishment’s avoidance of it all, despite the evidently huge market for treatment. Miller tells the story of the end of Prohibition, when drunkenness became so pervasive, the New York Times was certain the constitutional amendment would be repealed and Prohibition would return forever.

Few clinical studies, less research, and nothing in the way of political will mark the journey from the AA founding until about 60 years ago, when public relations efforts finally brought the public, at least, to believe it was a physical disease. To AA, alcoholism is like an allergy – a systemic physical defect that causes the alcoholic to crave the stuff if even one sip is imbibed. That’s sensitivity in the extreme.

The story Joe Miller has researched is one of constant conflict – getting alcoholics to admit they are, getting doctors to take AA seriously, getting governments to acknowledge alcoholism as a clinical disease. And it’s not just medical doctors who are a problem; psychiatrists play an important role in the fog of alcoholism. Miller himself had to go to numerous psychiatrists before he could find one to prescribe a most useful medication to reduce his own alcohol cravings.

With no small irony, Bill Wilson, the founder of AA, spent his dying days in bed with emphysema, begging for and demanding whiskey. His wife and medical team refused. Some alcoholism just doesn’t go away.

David Wineberg

[Mark Anthony · Rating 1 out of 5]

This book could just have easily been entitled "I have an Axe to Grind with AA."
I would give it zero stars, or a negative rating, if I could.
Every several years a new book is published that decries the shortfalls and / or horrors of AA. If you're in to that then this book should be right up your alley.
I find it truly ironic that Mr. Miller has gone to such lengths to blast a group that has made it possible for him to get a prescription medication that helps him to drink in moderation! If AA advocates hadn't worked to establish alcoholism as a disease then Mr. Miller would not be able to get a prescription for Naltrexone for that disease!
Mr. Miller is apparently a recovered alcoholic who drinks in moderation. Hmmm.... That seems to be a non-sequitor to me. I haven't met Mr. Miller but I know many alcoholics and many moderate drinkers and not a single alcoholic in recovery who is also a moderate drinker. In fact the AA big book states very clearly that if you can control your drinking then the program is not for you. AA's big book also suggests that prospective members only commit to the program "when all else fails." Today that would include CBT and Naltrexone. By the way, CBT and Naltrexone also have shortcomings and failure rates.
The only requirement for membership in AA is a desire to stop drinking. Mr. Miller does not have that desire. Mr. Miller has a desire to be a moderate drinker - and more power to him for that. But as such, Mr. Miller cannot be a member of AA and his book should never been given a title that implies otherwise. There can be no "Us of AA..." when the author does not qualify for membership in AA.

[Alena · Rating 4 out of 5]

As someone working in the recovery field - specifically for a secular nonprofit dedicated to supporting individuals struggling with addiction (which may or may not be mentioned in this book) - I found this to be an incredibly interesting read.

Before I continue, I want to emphasize that I harbor no ill will toward AA or those who find it helpful in their recovery journey. However, I am deeply frustrated by the pervasive belief within the recovery community that AA is the only path to recovery. Not only is this not true, but it actively harms individuals who don’t connect with AA and creates barriers that limit the visibility and accessibility of alternative approaches that could be more effective for some people.

While I felt the book went a bit too heavily on AA's history, it does an excellent job illustrating some of the questionable methods that has allowed AA to dominate the recovery field. It also provides context which highlights the long overdue need for changes in how we approach and view recovery as a whole.

Ultimately, our goal should be to offer those in recovery the full spectrum of support and tools available. Instead of monopolizing the recovery space, we should focus on encouraging and highlighting diverse methods to give individuals the best possible chance at success in their recovery. What works for one person may not work for another, and everyone deserves a recovery path that resonates with them and meets their unique needs.

[John Gutierrez · Rating 2 out of 5]

This book was actually super enlightening on historical aspects of Alcoholics Anonymous difficult to find in AA. Honestly, it was just a boring read. Mr. Miller wrote the book like a drab narrative of an uninteresting documentary. It read like “this happened then this happened because this person did this thing and then there was this other person and here is there affiliation then this thing happened and this person was there and they did this thing and that thing which is connected to this person who did this thing and was responsible for this thing”. I am a regular member of AA but have been exploring outside of its conventional wisdom since I began my journey with the organization. I have been sober for three years & I do owe it to AA. However, there is a very limited mindset within AA which can limit exploration into alternatives to something other than it’s own philosophy. I argue constantly in meetings the archaic practice & irrational reverence for the Big Book. I don’t believe AA will withstand another 20-30 years because of its own inability to expand its understanding. This book felt like Joe has a personal angst (or *insert eyeroll* resentment) against his experience. I get it-It’s not for everyone. If you’re exploring sobriety then AA can be a great option. It’s weird & confusing at first but ultimately it’s ghetto church that feels cultish but is actually just strangers attempting to be friends through a common experience. If you’re looking for reasons to hate AA then you really don’t need this book. However, Joe did help answer or lead to further exploration of questions & doubts I’ve had within the program itself since I first walked in the doors. Ultimately, I may not always stay with AA but it truly saved my life & I’m grateful for it.

[Carolyn · Rating 4 out of 5]

Addiction. Substance abuse. Dependence. Alcoholism. One would be hard pressed to find a person whose life has not been touched in some way by the complex social, psychological, chemical, emotional, and physiological effects of alcohol (and or other drugs).

And yet, when it comes to dealing with disordered behaviors around alcohol, we are constantly bombarded with the structural propaganda of Alcoholics Anonymous and its ubiquitous twelve step program.

But where did AA come from? How did it become almost the only option for those seeking to deal with a drinking problem? Why is there no sound scientific data to prove this method? Why does a program that claims to treat a disease INSIST as one of its main tenets that the patient believe in and surrender to a god/"higher power?" What is a person to do when they are told they are either not sick enough because they have not reached rock bottom, or that they are hopelessly weak willed and incurable?

I strongly recommend this book to anyone with a friend or loved one who struggles with alcohol or drugs. AA seems to work for some people, but there are other methods of treatment and recovery that have more scientific backing and less dogma. Addiction does not manifest the same in every person, nor should it be treated the same in every person. A thought-provoking read as well as an interesting perspective on the history of alcoholism as we have come to know it

[Jessica DMJ · Rating 4 out of 5]

Miller is the faculty adviser of The Saber, my university's student-run newspaper. I've had the pleasure and fortune of having Miller as a professor and guiding force in one of The Saber's most difficult years. When he told us that he'd a book coming out soon, and that there'd be a signing, I knew that I wanted to attend and get myself a copy of that book. So I went downtown one Saturday morning, and walked into the CSU bookstore to get myself that book. The reading was a treat, and I knew that as soon as the semester ended, I wanted to read it. Others have criticized Miller for "having an axe to grind with AA" in this book, and maybe he does, but Miller expertly explains the history of AA as it is, revealing the darker side of one of America's oldest and most influential alcohol abstinence organizations. Although Miller does explain his own reasons why he's not a big fan of AA, he doesn't outright condemn them—he even says that it works for some people, and it doesn't for others. Miller wants everyone to know that AA isn't a be-all cure-all to alcoholism, and that it shouldn't be advertised as much, considering its questionable history and effectiveness. Miller's text reminds me of a Jon Krakauer book: he tells a meticulous narrative to uncover something everyone should know about. Although the book ends a bit abruptly—in my opinion—Miller accomplishes his task effectively, masterfully.

[Jessica Harwood · Rating 4 out of 5]

Definitely an interesting read, especially for those of us that didn’t quite fit into twelve steps. Although I got sober in AA, it currently is not part of my recovery. Making the decision to leave program was very difficult for me because I was under the impression that AA was the only “true” path to sobriety and I must be doing recovery wrong because it wasn’t working for me. Reading about the history of AA and how it gained its strong majority in the recovery community over the last 90ish years has helped ease some of the questions I’ve had about leaving the program. Alcoholism as a singular disease (defined by AA) and its “cure” (the 12 step program by Alcoholics Anonymous) is only one small portion of the recovery puzzle, and Miller does an excellent job of laying out the rest of pieces for the layman to consider.

[Clayton · Rating 5 out of 5]

Those giving this one star because of the introduction are echoing most of the same historical arguments that AA-only proponents were featured making throughout this book. This is well-researched and gives a rich and engaging history of how AA came into being. Some of the programs benefits are recognized, as well as the drawbacks of it being pushed as the only “cure.” The characters throughout AA’s emergence and the federal and government involvement were truly intriguing stories. I encourage people to read it through and recognize how the reliance on AA as a cure-all takes away from the benefits of the program itself, rather than shutting down after the introduction, which may work best if skipped and saved to read with the epilogue after finishing the main text.

[Rebecca · Rating 5 out of 5]

Outstanding book. Digs deep into the history of treatment of alcohol use disorder in the US. What it uncovers is nothing less than shocking. Makes me concerned for the outcomes of many of my clients forced into treatment for substance use issues due to court involvement.

[NE · Rating 5 out of 5]

In this book, Miller explains the literal history of Alcoholics Anonymous, from the foundation of its ideological principles to its development into a massive international organization. The author assumes an antagonistic position of the organization. His primary argument seems to center on the absence of replicable research regarding AA's efficacy in helping individuals remain sober. His book was reminiscent of another I had read, "The Sober Truth" by Lance Dodes. I quickly understood why I had been getting "Sober Truth" vibes because he cites Lance Dodes several times in his arguments.

Regardless of your position on AA's efficacy as a means to help individuals find sobriety, the history behind it is quite interesting. Bill Wilson, the founder, and co-author of AA's bible, "The Big Book", seemed like a well-meaning man just trying to carve out his own path to sobriety through creating a group of other sober fellows. I was appreciative of the groundwork the original AA leaders laid in exploring alcohol use disorder as a disease. Although Miller is clearly not pro-AA, the book was less of a hostile position paper and more of a historical narrative. He got his point across by telling an interesting story.

Overall, looking at the history of AA, it can be understood how an organization with well-intended origins may benefit from increased scientific infusion and commitment to more modern evidence. It can also be seen for the need to educate legal, medical, and social institutions on the existence of AA alternatives such as Sober Recovery. From this reading, it can be clearly understood that changes to AA as a whole, let alone altering community perceptions of AA internationally, is daunting. The program is rooted in principles that were cultivated on a stringent sense of tradition, used to create an impenetrable community. We can understand why the original members of AA worked hard to create a solid community for themselves and focused so much on adherence to the steps and Big Book. Now that the organization is a thriving, international alliance, it should consider itself in a great position to update its 1930's principles with modern information.

[Anne · Rating 3 out of 5]

I can't write a review better than one I read on Amazon by Paul. It's one of the top rated reviews, check it out. He summarizes my take: a well-researched book that brings up good points about today's addiction treatment models but is polemic. Yep. When the word "hijacked" is used to describe an organization's actions like it does in this book title, I know I'm not going to read a fair and even evaluation. Add to the fact that the author has his own personal and emotional reactions with said organization, and any kind of journalistic objectivity goes flying out the window. This is the second anti-AA book I've read that is written by a journalist who struggles with drinking but doesn't want to practice abstinence. Fair enough, today there are many ways to tackle alcohol misuse. But why does AA, a purely nonprofit organization who states their only goal is to help the alcoholic, becomes the enemy?

[Lindsey · Rating 5 out of 5]

I always give all books 5 stars and try to find a reason why they deserved five stars. This one deserves five stars because, as a skeptic of AA, it made me believe in the AA model more. I am not entirely certain what Joe Miller thought he was proving with this book. I read it as an attempted smear campaign to the original founders of AA.

AA doesn't work for everyone, but it works for some people. To try and write a book that says it doesn't work and actually causes harm is a fair endeavor, but it would need more evidence to prove this reader. This was a decent history on the origins of the science behind alcoholism, but did little to disprove the AA methodology. I think it's great to shine light on other options, but this book didn't do that. I really, really disliked it. But am a bigger supporter of AA now!

[Brady Hanson · Rating 4 out of 5]

Good little book with strong research and insight behind it. Main point being:

“It was apparently lost on him (Marvin Block backing AA) that he was describing a dangerous notion that would lead problem drinkers to drink even more—and suffer more consequences—so as to become a textbook example of a sufferer of the disease of alcohol and thereby be ready to embrace the cure.”

[Jamie Fuller · Rating 5 out of 5]

This made me want to stab people, but it was excellent. Should be a required read for anyone dealing with substance abuse ever in any form.

[Elizabeth C · Rating 3 out of 5]

Book provides interesting history of AA. The title is unfortunate as it might scare people who support 12-step recovery from reading but wherever you stand, it is worth trying.

[Bryen · Rating 3 out of 5]

I wish this wasn’t such a slog. It read like a scholarly textbook for a class. I kept thinking it could be a research source for a docudrama and wish someone would do that - tell this analysis through the stories of the people.