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The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry

3.89  ·  Rating details ·  400 ratings  ·  83 reviews
An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.
AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors
Hardcover, 192 pages
Published March 25th 2014 by Beacon Press
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Start your review of The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry
"You're sick. And you'll always BE sick."
- Darla, BtVS, Episode 1.7

This book is a case of very interesting subject matter, but boring execution.

I'm going to break down this book for you so you don't have to read it. Let me explain the author's views to you:

- AA programs blame, humiliate and shame addicts.

- AA has too much emphasis on religion and a higher power.

- AA promotes the incorrect and untrue statement that only addicts can treat other addicts.

- AA says alcoholism is a disease; the a
Leigh Sewell
Mar 06, 2014 marked it as to-read
I became a heroin addict after witnessing my fiances murder. In and out of in patient and out patient rehabs as well as countless NA and AA programs, the 12 step program never worked for me. I congratulate those it did work for but being out spoken about it not working for me in this community, well, I may as well have shouted hail Satan in church. I'm really looking forward to reading this. Fingers crossed to win the giveaway.

Oh PS I'll have five years clean in a couple months. :)
Mar 28, 2015 rated it really liked it
As a therapist who frequently works with clients struggling with substance abuse, I’m baffled that I’ve never considered the fundamental question of whether the AA model is actually effective, and under what circumstances it may be contraindicated. How have I gone so long taking such care to provide individualized treatment in relation to mental health issues, but blindly relied on a cookie-cutter approach to substance abuse? One-size-fits-all thinking and treatment represents the direct opposit ...more
Jan 08, 2015 rated it it was amazing  ·  review of another edition
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, co-authored by brothers Lance and Zachary Dodes, is a far less dry and more radically change-oriented book than its title might suggest. What makes this read so compelling and its ideas so unusual, IMHO, is the primacy of individual human beings who struggle with addiction issues -- their personal thoughts, feelings, experiences -- in its assessment of the value of treatment options for those . Because of ...more
May 26, 2014 rated it really liked it
This is a curious book. I picked it up for a book club that I'm going to soon, but I wanted to get some thoughts down while it's still fresh in my mind.

A little backstory, I have a history of substance abuse primarily with alcohol, and have been to a few AA meetings myself. I've been sober for almost three years now. I went to AA as part of a rehab program that was mildly 12 step based, but really was just group and education based. Rehab really helped me, but the actual AA meetings themselves
Aug 05, 2018 rated it liked it
Not a bad book per se, but there is some misleading and deceptive bias in this book if you look at the cover!
The book addresses mainly the scientific-medical ratio of success of AA program put in relationship with the legal court-orders to follow a 12-steps program and its reliability from a scientific-medical point of view. Fair enough! This is what part of the title states. THEN, the book starts to address the rehab industry which is based on the 12-steps program (with the brouhaha of money,
Scott Helms
Jan 16, 2016 rated it really liked it
AA works...about 5% of the time.
rehab isn't much better and is EXPENSIVE!
this is tragic.
we need real medical AND psychological solutions to help with substance abuse problems in our world.
Joseph M. O'Connor

I'm in AA. I've been sober for over 13 years. Throughout that time I have made my own interpretation of what The 12 Steps actually mean, and how to work them. My "renegade" attitude fits very closely with what Dr. Dodes is talking about in his more meaningful chapters.

Take note! Dr. Dodes has meaningful chapters in his book and chapters in which he just seems to vent his anger at the AA process. That really isn't productive; indeed, his invective nearly prevented me from reading furt
Lauren Mcarthur
Mar 09, 2014 rated it liked it
So, I thought this was an interesting book. I agree kind of with it, though I never have had to face a drug/alcohol problem I know many who did. I don't want to discount the 12 step process completely because I know it is a long hard process to become sober, and it has worked for some people I know. However, I was shocked to see some statistics in the book. Now, I don't know if they are all reliable because this book is written subjectively against the 12 step program, and I'm sure if AA were to ...more
"The program works if you work it," is one of the least rigorous statements ever made. Any evidence of the efficacy of twelve step programs is entirely anecdotal, and proponents of the programs openly admit that there is a high recidivism rate. Yet there have been very few studies about the long term efficacy of twelve step programs and those that have been done suggest that rehabilitation isn't nearly as successful as the common lore would have it.

I could have done without the testimonial chap
Holly Whitaker
good, but ultimately biased towards psychotherapy

I thought this book was ripe with relative and valuable points why as doesn't work. But completely biased towards the authors own profession and yet just one more account I "do it my way".
Nov 06, 2014 rated it really liked it  ·  review of another edition
A detailed look into the shortcomings of Alcoholics Anonymous, The Sober Truth refutes many claims of AA's efficacy (citing many studies that have been done over the years) and contemplates what it would take to scientifically find and validate a truly effective addiction treatment paradigm.

This book is written in the same vein as Inside Rehab: The Surprising Truth About Addiction Treatment—and How to Get Help That Works and Clean: Overcoming Addiction and Ending America's Greatest Tragedy, so
Mar 11, 2014 rated it really liked it
Shelves: first-reads
I received this book through the good reads first read program.

I enjoyed this book. It was scientific without being too scientific and could be read by someone with no psychological knowledge as well as someone with an extensive degree.

I fully support the idea that the 12 step idea is significantly flawed and unreliable.
Mar 31, 2014 rated it really liked it
Important book. People need to be more aware of the failings of the 12 step model in order to start funding research into alternative methods to beat addiction.
Lynn Kearney
Jun 02, 2014 rated it liked it
It certainly debunks 12-step programs but I'm not completely convinced by the alternatives suggested for addiction treatment. ...more
Mar 27, 2019 rated it it was amazing
Shelves: top-100
Before I existed, my grandmother had a good friend who was an alcoholic. My grandmother accompanied the friend to to a couple of AA meetings. At one of the meetings my grandmother picked up a fridge magnet featuring the AA version of the serenity prayer:

God grant me the serenity to accept the things I cannot change
Courage to change the things I can
and the Wisdom to know the difference

As I kid I would read that prayer and think how nice it sounded. To be able to just deal with not being able to d
Jan 19, 2016 rated it really liked it
The premise is great. Why is AA the go-to recommendation for addicts? Although it sifts through data and explains research methods ad nauseum, it puts forth a great argument that there's no scientific reason that AA should be the only treatment method for addiction. I wish they would have spent more time going into detail about their recommended alternative. But, it's a great read that's quite thought-provoking. ...more
Mar 06, 2017 marked it as to-read
Shelves: not-read
I can see the flaw in this book already through the title. AA is not a program based on science. "Bad" or otherwise. It is a spiritual program and who is to say that any spiritual program is "bad" or good? ...more
Robb Bridson
Feb 20, 2014 rated it really liked it
What I enjoy most about this book is the way it is a microcosm of the problems we see in science in general and in society as general. There are problems showing up in the bias of peer-reviewed journals, in the bias of what sorts of studies attract funding, in the way funding and bias shape studies and interpretation of results, in the way culture shapes popular views of science, and how these cultural biases create "facts" from thin air.

I used to work in a local government substance abuse agenc
Alex DiFrancesco
Mar 11, 2014 rated it really liked it
I should mention that I received this book as part of a Goodreads give-away.

I should also mention that part of the reason I was interested in this book is because I went through a 12-step program when I was younger, and largely credit it with helping me become a better human being and even being one of the things from that stage of my life that saved my life. However, I've grown away from 12-step programs, and was interested to read more about why other people have, too, and why they do not serv
Kelly McCubbin
Dec 17, 2015 rated it liked it
Coming from the point of view of an A.A. member, I find it hard to argue with Dodes assessment of the effectiveness of A.A.. He's right, it's got about a 5% success rate. And the studies that try to enhance and elevate that rate are hopelessly flawed. He also points out, very fairly, that folks who are driven to stick with it and stay in the program for a long time, have a much better success rate than those who are lacksidasical about it. He also, very fairly, implies that A.A. is often used by ...more
Jul 23, 2015 rated it really liked it
I checked out this book because I have an unpleasant history with twelve-step treatment programs, and wanted to prove to my family and care providers that there are other, better ways. For that purpose, it did not disappoint. The Sober Truth does exactly what it says on the tin: debunks the unscientific claims to success of AA/NA, rehab, and myriad other twelve-step-based programs. In fact, it goes a step farther in taking a wrecking ball to AA's cherished disease model, in which addicts are see ...more
David Ward
May 27, 2016 rated it liked it
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Lance Dodes (Beacon Press 2014) (616.8606). Premise: Alcoholics Anonymous (AA), a twelve-step program for alcoholics, is only effective in overcoming addiction about 5% or 10% of the time. That's the claim on this book's dust jacket. And that's not good enough, says the author, who is a physician.
Even more pointless than the AA program are “rehab centers,” which combine the Alcoholics Anonymous princi
victor harris
Apr 05, 2014 rated it it was amazing
As the title indicates, it takes the 12-step programs based on AA to task for spreading myths about the effectiveness of that approach for treating addiction. As he correctly argues, AA is nothing more than conservative religion cloaked in different jargon and it's founding was based on Christian beliefs. It also addresses the harmful "disease" mantra concerning alcohol addiction when there is no clinical support for such contentions. The rehab industry became lucrative selling such a propositio ...more
Mar 12, 2014 rated it it was ok
The Sober Truth by Zachary and Lance Dodes is a free Goodreads advance reader copy of a hardcover book that I read in one evening in early May. Cinco de Mayo, in fact - a traditional, Corona-sponsored drinking holiday. Funny how that works.

I had requested to receive The Sober Truth totally on a whim and, in reading it, I realize that I have a lot of positive bias toward theraputic environments and coping strategies that the Dodes don't necessary share. I see the benefit of familial support, the
Rob Dinsmoor
Jun 05, 2014 rated it it was amazing
Dr. Dodes takes on the claims made about Alcoholics Anonymous, arguing convincingly that there is scant scientific background to supports its effectiveness and highlighting the downside of buying into AA's philosophy and approach. With this, I have no problem with. My only objection is that he appears to very casually dismiss the idea that there is a biological component to long-term addiction. He argues something to the effect, "If exposure to alcohol were enough to cause addiction, then everyo ...more
Mar 15, 2015 rated it liked it
I really didn't love or hate The Sober Truth. I thought this book had some limitations. Dodes' major criticism of 12-step programs is the ineffective research, and low success rate. Yet, Dodes advocates his use of psychodynamic therapy to be a better solution to treating addiction, but doesn't provide adequate research to substantiate this argument. I do agree that 12-step programs are not a one size fits all solution to overcoming addiction. However, some people simply cannot afford 1 hour a we ...more
Matthew Lawrence
Nov 22, 2014 rated it really liked it
It's not the most compellingly written book-actually, it feels like the authors went to a great lengths to stretch it to 160 pages at all-but it's a really interesting subject. I didn't realize that AA success rates are as low as they are (10% on the high end) but ultimately the book argues the greater point of how psychology is now taking a backseat to biology in addiction studies, largely because pharmaceutical companies are better equipped to fund studies these days. There is also a lot bat t ...more
Oct 14, 2015 rated it it was amazing
Shelves: 2016
This is a life-changing book for me. I even plan to buy it, and that's saying something.

It is significantly flawed, however. The author, a psychoanalyst, stops his ideas for effective treatment at the door of American individualized psychology models, most notably psychoanalysis, and also supports psychoactive medication. Although both those tools have helped me, I was disappointed that he paid no attention to systems of power and oppression, and the role of community in mental health and substa
K Ryan
Feb 19, 2015 rated it it was amazing
What I liked about this book was not so much the anti-AA argument (of which I'm sure there are plenty more out there), but the fact the authors analysed research studies and meta-analysis. What they found was very interesting and there is a definite need for further research into the efficacy of rehab programs, most of which are based on the 12-step model.
It did feel a little one-sided at times and I would have liked to hear more from advocates of the 12-step model, in an intelligent argument.
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“Any substantive conversation about treatment in this country must reckon with the toll levied when a culture encourages one approach to the exclusion of all others, especially when that culture limits the treatment options for suffering people, ignores advances in understanding addiction, and excludes and even shames the great majority of people who fail in the sanctioned approach.” 1 likes
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