EXPERT WITNESS: Does forced participation in AA help?

By Michael G. Brock

For a lot of years now, judges have been requiring people picked up for alcohol and drug related offenses to attend AA meetings in addition to or in lieu of psychotherapy. Many of them object strenuously, and I've heard all the arguments against it by the client's themselves and treatment professionals who feel that this is an unnecessary burden to place upon persons for an alcohol related offense; how it violates the separation of church and state, etc, etc. I've even heard the objections of AA members that the force feeding of their sacred program is not its intended purpose, and how it violates their own tradition of anonymity if they sign the attendance sheets court referred members bring with them.

But I believe I also have some insight into why judges and probation officer take this approach, even though only a fraction of those sent to AA become long-term sober members of the organization.

It would seem obvious that judges are caught in a dilemma regarding what to do with those whose addictions, legal or otherwise, become a threat to society. They know that alcoholism and other addictions represent a health problem, and that most addicts are powerless without some type of intervention to overcome their overwhelming desire for their drug of choice. They also know that these people are not criminals in the usual sense of the word; there is no criminal intent, especially on the part of those who use alcohol or other legally prescribed drugs.

But these same judges are equally aware that drunk or drugged drivers kill thousands every year behind the wheel1 and it is their job to protect the public from inadvertent as well as intentional harm. Some of these judges are themselves recovered alcoholics who have found a way to deal with their own problem and would like to offer the same opportunity to fellow sufferers, but most are simply people who are aware that this is a problem whose magnitude is the result of the huge population explosion of the last century, the vast majority of this increase being concentrated in urban areas, and virtually all of whom drive.

Moreover, it is not practical to lock up everyone in this country arrested for drinking and driving; we don't have the jail space and we can't really afford to keep the real desperados behind bars. Their addictions notwithstanding, many of those arrested for DUI are productive and useful citizens with good jobs and families who rely on them for support and who would suffer greatly in their absence.

So many judges, long before the emergence of drug courts, have sought an alternative to incarceration for the addicts who come before them. The question is, does it work?

From my view in the treatment field, I would have to say it does; for while I don't believe there is any really accurate statistical evidence about alcoholism, recovery or AA available, there is plenty of experience.

My experience is that, first, most of those people being referred to AA today are coming from the courts, judging by the recovered alcoholics/addicts with whom I have contact, and that is quite a few. It wasn't always this way; when I first started as a treatment professional at Garden City Hospital in 1977 the majority were coming from treatment centers like Brighton, Maplegrove and the like. Only a few of these centers are still in operation, and they are mere skeletons of what they used to be, now barely having enough time to detox clients before releasing them, let alone providing quality treatment.

Secondly, and perhaps equally or more important, the courts are catching people much earlier in their addictions than the state at which they would enter treatment in the past. Many of the cases I saw in the early days were people dying of liver disease, on the verge of losing their jobs and families, and overall much further along in the progression of their condition than those I see coming to me and being referred to AA from the courts today.

This is important because the earlier a person is confronted with serious consequences to his or her drinking, the better chance they have of establishing permanent abstinence, with or without AA support.

One of the functions I perform is that of substance abuse evaluation for those going before the DAAD to seek reinstatement of their driving privileges. Many of these people have been exposed to AA, but have found the support necessary to stay sober from family, church and other traditional support systems, not long term AA membership. In my view, these traditional supports are rarely sufficient for someone with an advanced case of addiction. 12 step groups are almost the only thing that works with any consistency in these cases, and then it only works for a minority of those who attend.

AA members have talked for years about the need to "bring up the bottom," that is, to get people into treatment before they lose everything, destroying many of those they love in the progression of the disease. But it has been the intervention of the courts that has succeeded where education programs and the concern and pleading of loved ones have failed, and it is not necessarily out of love and compassion for the addict that they have done this.

It is mostly the result of public pressure through groups like Mothers Against Drunk Drivers, forcing the courts to act in the interest of public safety. Besides saving the lives of potential victims, these groups have required the courts to administer tough love to those caught driving or otherwise violating the law while under the influence of substances; and, in so doing, they have saved many alcoholics and addicts from much suffering and an early grave.

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1 13,846 in 2009, down from 26,173 in 1982 According to the National Highway Traffic Safety Administration (NHTSA) http://www.alcoholalert.com/drunk-driving-statistics.html

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Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; (313) 802-0863, fax/phone (734) 692-1082; e-mail: michaelgbrock@ comcast.net.

Published: Wed, Apr 18, 2012

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