Talk:Alcoholics Anonymous/Archive 9

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first sentence

Someone substituted "spiritual" for "mutual aid" in the first sentence and I reverted back. While it is true that AA identifies itself as spiritual, that is probably not the most important aspect for the first sentence. The article is very much lacking comentary about the spiritual/religious nature of AA.Desoto10 (talk) 03:40, 11 November 2012 (UTC)

Fellowship or Movement

AA describes itself as "...a 'fellowship' of men and women..." This what we had for a long time, then it became a 'movement'. Given the 12 traditions I would say that AA is not a movement at all as it does not push for anything or actively (except in 12 step focused rehab) recruit members. Desoto10 (talk) 01:21, 31 March 2013 (UTC)

I'm of the opinion that AA is a fellowship, the 12 step program as a whole is a movement but that is one editors opinion. Coffeepusher (talk) 03:31, 2 May 2013 (UTC)

Retention vs. "success" or "effectiveness"

It seems to me that we are confusing retention with effectiveness. Granted, one could consider retention as a measure of how well AA retains members, but there is no evidence (in this article, anyway) that compares AA attendance with sobriety. I would like to add some subheadings to that effect, such as "Retention of members" and "Sobriety" under Survey results. Desoto10 (talk) 03:42, 29 April 2013 (UTC)

I like the idea. The way you broke up the survey section reads really well and makes sense. Cheers! Coffeepusher (talk) 03:19, 2 May 2013 (UTC)

The movie "Flight"

under the section about movies and alcoholics anonymous, the statement about the movie Flight is incorrect. In the movie Flight, Denzel Washington got sober in a prison support group. At no time during the scene of Denzel getting better in the support group are there any mention of Alcoholics Anonymous nor did he nor anyone else in the scene state they were an alcoholic. The scene only depicts a support group and does evidently depict Alcoholics Anonymous in anyway. Even looking under the wikipedia page for the movie Flight, you will see that it mentions a support group and nothing more not even Alcoholics Anonymous. — Preceding unsigned comment added by 184.155.162.101 (talk) 22:23, 5 May 2013 (UTC)

I have a question about the use of the acronyms

I am curious about the proper use of the acronyms in this article about Alcoholics Anonymous. I have only made test edits in my sandbox because there are many and even after reading the MoS article I am unsure about the proper use. The MoS article re acronyms states "wikipedia generally avoids the use of full stops" with the capital acronym and so I removed the full stops. Where the apostrophe is concerned (plurals) the MoS stated there should be no comma for example AA's should be AAs, however, how about the use of the apostrophe wear ownership is concerned? Example AA's twelve steps or should it be AAs twelve steps? I hope this isn't a dumb question and appreciate your help in advance. Also if you could confirm for me that it is alright to copy an article to my sandbox for testing purposes like I have done here? In other words I can use the sandbox for pretty much whatever I want (within reason of course) right? Ț♥ttØØdẄ♥itre§ 15:51, 8 June 2013 (UTC)

Okay, I couldn't find anything in the MoS that is universal on this so here's my understanding of the English Grammar Rules from Who Knows When:
  • When using an acronym, full stops aren't generally used unless they're needed to distinguish it from just a capital word. On Wikipedia, full stops are almost never used.
  • When using an acronym and having it be plural, the correct thing would be to say "AAs". This means that we are talking about more than one AA, in this case more than one Alcoholics Anonymous.
  • When using the acronym and having it be possessive (i.e. saying they own something, as in "Bill's car"), the correct way is "AA's". This means whatever noun comes after AA's is what we are talking about, and that AA owns it.
  • When using the acronym as a plural and possessive, the correct thing is "AAs'". This means that multiple AA groups or AAs all own this thing that comes after that. The subject would be the thing that comes after AAs'.
On the subject of sandbox, make sure you put a hatnote on it that says something along the lines of "This is a sandbox for [this] version of [this] page on [this date and time]." The first link should be a permalink to the version (click on the date and time in the history), the second to the current page OR the page history, and the third should be the date and time that the edit was made that you copied from. This is required to maintain attribution for all editors.
And yes, you can use your sandbox for anything within reason. Remember that even though WP:N won't apply to everything in sandboxes, WP:BLP and other important policies still apply in their full, as do rules against copyright violations.
Charmlet (talk) 16:33, 8 June 2013 (UTC)
Thank you so much for your help. That is wonderful information. I am very grateful! Attempting to add the talk template by copying from above. It's been so long I don't remember if this is right. Also adding sig here as I thought on ll talk pages we are suppose to do that? tattoodwaitress (talk) Ț♥ttØØdẄ♥itre§ 16:59, 8 June 2013 (UTC)
Yep, signatures on talkpages are good. Mine's there, it's just the standard signature so far so it may be hidden, look at the very bottom of my reply. Aside from that, have fun working on the draft! Charmlet (talk) 17:03, 8 June 2013 (UTC)

Should I update or add?

In the section titled "literature", the third edition of the big book (alcoholics anonymous) is listed. There is a newer edition that was published in 2001 being the fourth edition. The link that is listed for the third edition (online) is no longer valid because as the new editions are published AA replaces the online edition with the newer publication. I would like to add the fourth edition as the literature that is used however I would like to know should I add it or update what is already there? Also, I cited the fourth edition book just a few moments ago and am wondering if my work can be checked by a qualified individual please and thank you. tattoodwaitress (talk) Ț♥ttØØdẄ♥itre§ 18:13, 8 June 2013 (UTC)

Hello tattoodwaitress, I suggest adding the fourth edition to the list. The third edition may still be relevant to the article. It does not matter that the link doesn't work anymore (simply add {{Dead link}} inside the <ref>...</ref> tag for it). Someone may find a web archive for that link and be able to update that link so that it works (kind of, they would actually change that link to say "original source" which would still be a link to no where but they would add a link the the archive of the source). Anyways, I'll be watching this page for a little while... If you have a any further questions just leave them here. Technical 13 (talk) 18:50, 8 June 2013 (UTC)
Hello Technical 13, Thank you very much. The dead link will not really be a dead link, it will just go to the 4th edition instead of the 3rd, but I can understand what you are saying so I will follow suggestions. Thank you for your help. tattoodwaitress (talk) —Preceding undated comment added 18:58, 8 June 2013 (UTC) Ț♥ttØØdẄ♥itre§ 19:03, 8 June 2013 (UTC)

Need help with a dead/non existent link

In the references section I attempted to add the dead link template including a date and it is giving me trouble, it looked funny and didn't put the citation where I had actually put it. I am assuming because in this particular instance there are no < ref > tags to put the template between as suggested by another user to me this morning.

This. . . * Speak, Darius (2009). "aaspeak: www.aaspeak.com". online. {{cite web}}: Missing or empty |url= (help); More than one of |host= and |last= specified (help) is the line in question. Speak Darius (2009)

I have done a little research and the webpage is no longer in existence but can be purchased from godaddy if you wish. I can find no other ref to the data mentioned any where else.

How would you add the dead link citation to a citation with no ref tags? I am trying to get rid of the Unknown parameter |host= ignored error in red text. Thank You Ț♥ttØØdẄ♥itre§ 22:33, 8 June 2013 (UTC)

The template didn't have a parameter "host", that was why you were seeing that error. I've removed the parameter and that should now be fixed. It's a Fox! (What did I break) 22:46, 8 June 2013 (UTC)
Thank you Ț♥ttØØdẄ♥itre§ 23:57, 8 June 2013 (UTC)

Hospitals

A section was added with information about the relationship between the founders of AA and their experiences at hospitals. While the information is useful, it would be better to find sources that are not directly associated with AA to describe their involvement with hospitals and, presumably, other treatment centers. I don't think that we can make any statements about how it may have helped the founders or other AA members stay sober unless we have some independent verification, not just quotes from the book. The alternative is to insert a bunch of "they claimed that...", which is not all that useful. To the editor who added this text, please think that I am arguing with the content, just the sourcing. I will edit it, but by all means, if others think that it is OK as is, just revert. Desoto10 (talk) 04:34, 12 June 2013 (UTC)

I agree with you and apologize for the mess up. I wasn't quite thinking correctly at the time I guess, and by all means will add additional sources. I am actually logging out for the evening but will def make an effort to improve this section when I come back.

TattØØdẄaitre§ 04:55, 12 June 2013 (UTC)

No worries. I will look around for reliable, independent sources for the relationship between AA and treatment centers. It is an interesting topic and I am glad you took a shot at it!Desoto10 (talk) 18:46, 12 June 2013 (UTC)

Triennial Survey

"The 1990 commentary evaluated data of triennial surveys from 1977 through 1989 and found that the distribution of those with one year or less indicated that one quarter (26%) of those who first attend an AA meeting are still attending after one year. Furthermore, nearly one third (31.5%) leave the program after one month, and by the end of the third month, almost half (47.4%) leave. Of those who stay for three months, half (50.0%) "

It's not possible to conclude these percentages from the third A.A. triennial survey with any surety. One can only reach the 26% retention percentage in bad faith - by assuming certain conditions which are not explicitly stated in the survey. The survey itself is obviously written by someone deeply estranged from correct statistical methods, leaving the only one possible interpretation of the graph data: That for the explicit time window the survey was taken, only 5% of attendees at meetings were in either in their twelfth month of attendance, or had attended at least 12 months, or had attended for 12 months but less than some other arbitrary period. The condition required to reach the 26% conclusion - that the first datum point of the graph refers to people "in their first month", is clearly stated as being the other way around in the graph title - and as such is ambiguous. It's not possible to reach any percentage stated in this above quote with the surety implied. Frankfff (talk) 22:13, 8 June 2014 (UTC)

Lawsuits, etc.

I notice that there's nothing in the article about the recent lawsuit against AA (and I believe that there may be other suits as well). Is this intentional, or should it be added? 122.249.238.158 (talk) 05:05, 18 March 2015 (UTC)

There has been no mainstream press coverage of the lawsuit, except for a couple of columns in the back pages of a regional newspaper where the lawsuit is taking place. There needs to be more coverage from reliable sources for us to include it in an article for an international audience. Heck, there was supposed to be a demurrer hearing on the case yesterday, but there has not been a peep from the press on how that went, or even any mention of there being a hearing at all. Defendingaa (talk) 22:58, 26 March 2015 (UTC)
Correcting myself: There have been a couple of other mentions of Brada's death that touch on the lawsuit, mainly in low quality tabloid press and a single true crime television segment: The Raw Story re-ran a column originally published in ProPublica, and there was that 48 Hours TV segment, which has the same content as the ProPublica article. The lawsuit was mentioned, but only as an aside: The story was mainly a True crime story about Brada's tragic death. A single news event discussed only in tabloid and true crime press is not enough coverage to make it part of this high-profile article as per our undue weight policy and our policy on covering one-time events, especially from sensationalist sources. Wikipedia is not for scandal mongering or gossip. Defendingaa (talk) 15:46, 28 March 2015 (UTC)

Intro

Why on earth should evidence from a cochrane review be excluded from the intro? 79.97.226.247 (talk) 02:43, 24 January 2015 (UTC)

So I have read the summary, and what I have done is worded it so that it would reference and summarize the effectiveness section while at the same time maintain faithfully to the article itself. This study was actually already in the body of the article so I used the shortened reference. Cheers! Coffeepusher (talk) 05:03, 24 January 2015 (UTC)

The Cochrane review on alcoholism and addiction treatments comes from 2006 and is outdated. We are about to have a new Cochrane review publised this year that will be more positive towards 12 step programs. The author of the last Cochrane review blogged pretty positive things about AA last year.

That in mind, placing this outdated information in the lead is undue weight. I have removed it. Defendingaa (talk) 03:01, 28 March 2015 (UTC)

I don't agree. Once the "new" Cochrane review is out, then we can replace the old one. An Atlantic article about what is "going to happen" is pretty weak.Desoto10 (talk) 05:42, 10 May 2015 (UTC)
I will concede that the relevant guideline does specifically name Cochrane reviews and not being outdated within five years, but I disagree with the summary of the Cochraine review as posted here. The previous consensus last time this was discussed was to use this wording: "A Cochrane Review of eight studies, published in between 1967 and 2005, measuring the effectiveness of AA found no significant difference between the results of AA and twelve-step participation compared to other treatments. To determine the effectiveness of AA, the authors suggested more studies comparing treatment outcomes with control groups were necessary." This wording is consistent with how the popular press has summarized the Cochraine study, for example, in one reliable blog source, they summarize the Cochraine study thusly:
She quotes Cochrane’s conclusion that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.” She neglects to mention that the 2006 report also examined studies comparing twelve-step programs to other treatment methods. The result? “Severity of addiction and drinking consequence did not seem to be differentially influenced by [twelve-step programs] versus comparison treatment interventions,” Cochrane states, “and no conclusive differences in treatment drop out rates were reported.”
When the New York Times summarized the Cochraine review back when it was published, they said that "no data showed that 12-step interventions were any more — or any less — successful in increasing the number of people who stayed in treatment or reducing the number who relapsed after being sober."
That in mind, I have changing how the Cochrane study is summarized here. Defendingaa (talk) 18:56, 11 May 2015 (UTC)
Thinking about it some more, I agree with Sunrise that the bit about needing more controlled studies is not really relevant for the lead. Defendingaa (talk) 13:56, 18 June 2015 (UTC)

Retention in Lead

The retention figures from the AA survey and those from other sources should not be confused with efficacy. That someone is or is not attending AA after arbitrary amounts of time says nothing about whether or not the program is effective in dealing with alcoholism. I suggest that we remove the retention figures from the introduction but leave the highest quality efficacy review (the Cochrane study). In any case, the concept from Macintire (sp?) where the argument is presented that only those who have attended for 90 days should be counted in retention counts has been discussed and rejected before, I think. Retention statistics must include those who walk in the door, turn around, and walk out.Desoto10 (talk) 02:06, 16 March 2015 (UTC)

My issue with having this 26% retention number in the lede is that it is original research. The actual survey does not give us a solid number like 26%. The number is probably a reasonable conclusion based on the graph on page 12 of that survey, as explained by unreliable sources, but we really need to have a medically reliable source before having that, or any other retention number, in the lede. That in mind, I have removed it. Defendingaa (talk) 19:14, 11 May 2015 (UTC)
I have reverted this edit because:
1) The revert was not discussed here on the talk page to try and find consensus
2) The edit was done without referring to a medically reliable citation with the 26% number in it.
3) Again, to take a hand drawn graph without 26% anywhere on it and conclude that it states a 26% retention is original research.
4) If this was really AAWO's statement on the matter, I would think it would be put on their web page and not relegated to some document someone posted to Scribd which may or may not be authentic.
Please discuss these changes here on the talk page before reinstating this information in to the lede again. Defendingaa (talk) 13:00, 29 May 2015 (UTC)
AA itself does not have published retention figures, and there are no reliable sources which state "these are AA's own retention numbers" (a Scribd document from over two decades ago which was never published is not a reliable source, much less a currently relevant medically reliable source), but do have number of years sober broken down as follows: According to AA's most recent membership survey, from 2011, 27% of members are sober under a year, 24% are sober 1-5 years, 12% 5-10 years, and 36% of members have over ten years sober. Source: Alcoholics Anonymous 2011 Membership survey I have added this information to the lede. Defendingaa (talk) 13:16, 29 May 2015 (UTC)

To bring the point home again, that 26% number was derived using statistical methods. The stated Wikipedia policy on the matter is that "Summarizations based on statistical methods, however, are original research by synthesis, as they involve the reinterpretation of data". Defendingaa (talk) 16:55, 30 May 2015 (UTC)

To be fair, Lance Dodes, in The Sober Truth, looks at the same source we have been looking at and came up with the same 26% number. Now, I don't think Lance Dodes's "26%" quote based on this document we've all been looking at is a medically reliable source (as long as things like articles in New York Magazine are not considered reliable sources for medical information about AA, we can't consider a book published by the Beacon Press medically reliable either) Defendingaa (talk) 03:33, 23 June 2015 (UTC)

NLAES and NESARC

We have had the following for a while:

Two surveys that sampled the general population produced independent results on AA continuance rates. The 1990 National Longitudinal Alcohol Epidemiologic Survey (NLAES) found that Alcoholics Anonymous has a 31% continuance rate.[74] The 2001-2002 National Epidemiological Survey on Alcoholism and Related Conditions (NESARC) indicates a slightly higher rate, at 35.2%.[75]

Neither reference provides sufficient information to determine exactly what was found. What I mean is, we need page numbers and, if possible, a link to this information. These are massive studies with hundreds of pages of tables. I am not contesting this information, just want to verify it. Thanks.Desoto10 (talk) 02:05, 16 March 2015 (UTC)

Reference 75 is behind a paywall at http://link.springer.com/chapter/10.1007/978-0-387-77725-2_15. Does the number "35.2%" appear anywhere in that 21-page article, or is this another case of a random Wikipedia editor performing statistical analysis? Defendingaa (talk) 14:27, 18 June 2015 (UTC)
@Desoto10 and Defendingaa: I have the document and there’s definitely no mention of “35.2%” or even “35.2”. After quick statistical analysis on the low–hanging fruit, I have no idea where this figure came from. The closest the article gets to the data we’re trying to source is this: the “Abstainer at 1 year follow-up” rate is “257/720” (p. 273). However, even that is vague enough to possibly mean that the subject was drinking for the majority of the year and abstained the week of the followup. Let’s delete the reference to "Epidemiology of Alcoholics Anonymous Participation" and the zombie data. LLarson (talk) 17:27, 6 August 2015 (UTC)
I can’t find the 1990 National Longitudinal Alcohol Epidemiologic Survey online, and it came from the same edit as the one which claimed (incorrectly) that the 2001-2002 survey said 35.2 in it (it doesn't), so I'm removing the 1990 reference too. If anyone wishes to restore it, please quote the part of the survey with "35.2" or any other figure used in the Wikipedia article; any kind of statistical analysis of data is considered original research as per Wikipedia consensusDefendingaa (talk) 04:47, 8 August 2015 (UTC)

Brandsma 1980

In my research, I just discovered that Brandsma 1980 (Outpatient Treatment of Alcoholism: A Review and Comparative Study) appears to not actually be a peer-reviewed study. It is referred to in peer reviewed studies, but not positively. PMC2746426, for example, mentions "concerns with the Brandsma trial which call its experimental results into question", and PMC3602358 says that studies like this are "significantly limited in their methods or interpretability". That in mind, and keeping in mind that WP:MEDDATE tells us to avoid having 35-year-old studies, I am removing this reference. Defendingaa (talk) 21:30, 23 August 2015 (UTC)

I have added two citations from reliable sources but not medically reliable sources.

I have added a couple of bits of information about how effective Alcoholics Anonymous is from reliable sources but not medically reliable sources:

  • The 2015 Cochrane review concerning how effective AA is has not been published yet, but one if its authors has commented in New York Magazine that he thinks it will be more positive towards 12-step approaches than the 2006 survey was. It's generally considered a reliable source, and it's the comments of an author of the upcoming review.
  • Lance Dodes's 2014 book "The Sober Truth" actually has that 26% number based on the 1990 Triennial AA survey in it.

One potential problem with these two sources is WP:MEDPOP: "The popular press is generally not a reliable source for scientific and medical information in articles." Would it be better to remove both the 26% number as well as the note from one of the authors of the next Cochrane Review on 12-step programs, since neither comes from a scientific journal? Defendingaa (talk) 15:00, 23 June 2015 (UTC)

Since User:Desoto10 feels the reference about what the upcoming Cochrane report will say is not reliable as per this edit, we can't include the 29% figure (or really, anything else) from The Sober Truth either. Defendingaa (talk) 16:09, 20 August 2015 (UTC)
Sorry, but I don't see the connection. My only objection to the future Cochrane review is that we, and the coauthor, really have no idea what it will say. I don't see how we gain any information by referencing someone's opinion about something that does not exist yet. In any case, what does this have to do with The Sober Truth? Hasn't that been published? Ah, I see the part about "scientific journal". Yeah, I don't know; there is so little quality, unbiased scientific data out there on AA that these opinion pieces get thrown in (very much like the Diamond paper). Everybody has an agenda. Until somebody figures out a way to do a blinded, randomly assigned, controlled study of the relationship between AA and drinking outcomes over many years we are stuck with what we ended up with years ago which is "some say it works, some say it does not". In any case, we seem to have lost most of the interested editors on this article (which was a hot bed for a while). It would be nice to get some more eyes on this again.Desoto10 (talk) 20:36, 20 August 2015 (UTC)
Yeah, I wonder where all the editors went. I just can't think of a way to keep Lance Dodes's information on this page while not allowing John Kelly's comments to be here also, without violating WP:NPOV. Since it did violate WP:MEDPOP (and no, we don't need the Gabrielle Glaser article on here along with all of the press reports refuting it, and we do not need every single one of Stanton Peele's weekly columns here), better to just remove. In terms of the scientific data, what I'm seeing is a slow turn towards a general scientific consensus that AA somewhat helps. Personally, I think AA is great for people willing to work it, but that it's really difficult to motivate an alcoholic to work the AA program. And, yes, a lot of members, especially people without long-term sobriety time, like to be dogmatic, which understandably turns off a lot of people from AA, but the actual Big Book isn't dogmatic (Page 164: "Our Book is meant to be suggestive only"). Heck, the dogmatism turns me off, and yes, I can see why people call it a "cult." Defendingaa (talk) 02:28, 21 August 2015 (UTC)


The WP:MEDPOP references above are now in the Effectiveness of Alcoholics Anonymous article. Should we remove them from both articles, or is it OK to keep them in the sub-article? Defendingaa (talk) 16:50, 20 August 2015 (UTC)

We should probably keep both articles in line with each other. As I recall, the Effectiveness article arose during the heyday of edit wars here (I would call it a POV fork, but that is just me). I think the idea was to move the discussion of efficacy out of the main article but, as far as I can tell, the Effectiveness article adds little to what we already have. To be honest, I have pretty much given up on the effectiveness aspect of AA...too many confounding variables. What I am interested in is the spirituality/religious aspect of AA. Tonigan has published a lot on this, but he does not spend much time trying to define spirituality as different from just bland religion. Our Spirituality article does not help much. At least that section is not ruled by Medical sources. Trouble is, again, you get hardcore people on both sides so maybe it would be best to just let it sit as is.Desoto10 (talk) 01:46, 25 August 2015 (UTC)
That Effectiveness article was and still is a bit of a mess; but I think it has the potential of becoming a quite useful article. 35, 45 years ago, yeah, there were a lot of studies saying AA did not work. I mentioned Brandsma 1980 below and touch on why this ancient study which showed a negative correlation between AA attendance and sobriety was garbage. There is also the infamous 1970s Sobell study which claimed chronic alcoholics could drink moderately again; that study was so bad, the Sobells were investigated for fraud. The study itself was about as accurate as Wakefield's vaccines-autism study. Yet, there are articles in the popular press and even textbooks which cite these outdated and poorly done studies; Gabrielle Glaser's recent hit piece in The Atlantic argues that the Sobell study was accurate because the authors were not convicted of fraud. Anyone holding on to the Sobell study, in my opinion, is up there with the anti-vaxxers and young earth creationists in their lack of critical thinking.
Whether or not AA works has been a point of controversy in the scientific recovery community, yes, but the scientific consensus right now is that people who go to meetings are a lot more likely to stay sober -- the correlation can not be questioned at this point. Even Lance Dodes admits to this correlation in his hit piece The Sober Truth. The science is now struggling with whether AA is helping alcoholics stay sober, or if people who were going to stay sober anyway end up being the ones going to AA.
Now, until the new Cochrane comes out, I don't think we can really summarize how studies are getting more and more favorable results with AA effectiveness in this article, but the sub-article is a nice place to mention a study, summarize its findings, and maybe even point to an article in the popular press about the study; I've done that with about four different studies so far and plan on adding more. I'll probably end up adding Brandsma 1980, but mentioning how newer studies discuss why that study is so inaccurate, as well as the Sobell study and the study refuting Sobell from the early 1980s.
In terms of the spiritual angle: The only requirement for membership is a desire to stop drinking. Full stop. Nothing in the third tradition about needing to believe in God or join a church. The program in the Big Book is suggested and the Big Book itself says so, right there on page 164, in a reading sometimes read at the end of meetings. I have no problem adding a link to http://www.agnosticaanyc.org/worldwide.html in the article, and am about to do so, but the only way I can think to put it there in an encyclopedic manner is in a footnote. Defendingaa (talk) 05:54, 25 August 2015 (UTC)

Relapse prevention. An overview of Marlatt's cognitive-behavioral model.

For a while now, we've listed "Relapse prevention. An overview of Marlatt's cognitive-behavioral model" as a peer-reviewed scientific study showing that Alcoholics Anonymous does not help. However, reading over the actual survey, there is not a single mention of the steps nor of Alcoholics Anonymous in the entire paper, and a Google search does not show anything promising.

That in mind, I am removing this survey. Defendingaa (talk) 11:21, 25 August 2015 (UTC)

Removing that class project on the "13th step"

Since both User:Desoto10 and myself felt that the class project writing about AA's 13th step does not belong here, we should, as a lesson to this student, explain why the edits were by and large reverted. The problem is the quality of the majority of references in those edits:

  • The Fix is not a reliable source suitable for inclusion in Wikipedia articles, especially this one which falls under more strict rules as per WP:MEDPOP
  • Ditto with Lighthouse Recovery Institute.
  • Orange Papers is definitely not a reliable source. As another editor put it 'The Orange Papers' website is one anonymous guy in his bedroom who hates AA.
  • The Public Slate looks to be a self-published source; articles look to be published with little or no editorial review.
  • AA's own website is a reliable source when about AA.
  • That said, using AA's own big book to conclude that AA excludes women because one woman's story was not published in the second edition is original research.
  • Ditto with the notes on gender used in AA's literature. The use of male gender to mean "male or female" was normal in mid-20th-century works, and the Big Book makes it clear that "he/his/him" means male or female (such as on page 30 of the Big Book).
  • Ditto with the notion that the AA literature pushes people to believe in a Christian God, again using AA's own literature as a reference, when said literature says no such thing.
  • Page 58 does not say you will get drunk if you don't work the program. It says you will probably not get drunk if you throughly work the program, as long as you are honest with yourself. This is yet another example of how this editor is not correctly understanding or interpreting the AA literature.
  • Laura Tompkins' blog entry in the Huffington Post is not as reliable source, as per WP:NEWSBLOG

We have kept one reference which was a medical journal article about 13th stepping, but the rest of this essay is a strong personal opinion that has no place in a widely read encyclopedia article. Defendingaa (talk) 18:06, 26 December 2015 (UTC)

Humphreys, K., Blodgett, J. C. y Wagner, T. H. (2014)

We have had Humphreys, K., Blodgett, J. C. y Wagner, T. H. (2014) in here for a while; it is a very recent (2014) study showing that Alcoholics Anonymous helps. Indeed, this paper, despite being recent, has already been cited 9 times:

There is no freely available studies in English (or Spanish) which contradict the conclusion of the Humpreys 2014 paper, but if anyone can read some of the articles which are paywalled, it would help. Defendingaa (talk) 13:03, 3 March 2016 (UTC)

Some recent edits

Yet another editor tried adding WP:MEDPOP-violating references to the article: [1]. Somewhat interestingly, it looks like not only is Lance Dodes' book unreliable because of WP:MEDPOP, but he doesn't agree with his own numbers. In this edit, the number was 5%-8%, but Dodes elsewhere claims 26%, as I once pointed out: [2]

I also removed a paragraph based on a 37-year-old article, because of WP:MEDDATE. Defendingaa (talk) 01:40, 3 March 2016 (UTC)

Since it was brought up (again), we allow AA's own literature in this article because WP:SELFPUB allows an organization's own literature to be used as a reference when describing said organization. WP:MEDPOP and WP:MEDDATE are for the medical claims made in this article: Claims about AA's effectiveness, the disease theory of alcoholism, etc. Defendingaa (talk) 04:48, 4 March 2016 (UTC)
"The number of people who continue to show up" is not exactly "biomedical information", which is a key phrase you will find throughout MEDRS.
MEDRS does not respect SELFPUB sources or advocacy websites for biomedical claims. It does, however, permit the use of books such as Dodes'; see Wikipedia:Identifying reliable sources (medicine)#Books. Look right underneath MEDPOP to see what MEDRS thinks of the AA website as a source for biomedical information.
Also, Dodes never says that "the number" is anything, because there are multiple numbers in question. He says that AA says that "the number of people who continue to show up for more than 12 months" is 26 percent, but "the number of people who maintain sobriety for more than 12 months" is 5 to 8 percent. AA, by the way, appears to have never contradicted this latter number, even though they don't happen to promote it. WhatamIdoing (talk) 05:32, 4 March 2016 (UTC)
Since Alcoholics Anonymous is the most commonly used treatment for alcoholism, it is a medical treatment. The published literature treats AA as a medical treatment -- including, yes, having Cochrane reviews which discuss AA -- so we Wikipedia editors need to do the same. Defendingaa (talk) 06:16, 4 March 2016 (UTC)
Does the medical literature treat the number of people attending a meeting as WP:Biomedical information? MEDRS doesn't cover just anything health-related. It's specifically about biomedical information. "Biomedical", as in "you must have some biology there". Non-biomedical information (e.g., sociomedical information) isn't covered.
But... even if MEDRS fully applied, MEDRS directly says that a pop sci or pop medicine book from an expert, published by a reputable press, is actually MEDRS-compliant. It also says the opposite about the websites of advocacy groups. WhatamIdoing (talk) 06:32, 4 March 2016 (UTC)
Statistics about prevalence of recreational drugs is considered biomedical information, so information about alcoholism treatment is also biomedical information as per Wikipedia policy standards. Defendingaa (talk) 06:39, 4 March 2016 (UTC)

WP:MEDPOP allows direct lay summaries of peer-reviewed articles

While WP:MEDPOP does not allow us to link to popular press articles and books which either do not use peer-reviewed source, or use a combination of multiple peer-reviewed sources to come up with their own conclusions, is does allow us to link to articles which are lay summaries of peer-reviewed literature, as long as we also include the peer-reviewed article in question. This in mind, I am adding the New York times summary of Humphreys, K., Blodgett, J. C. y Wagner, T. H. (2014) as a separate reference, since Humphreys himself wrote a lay summary of his article which is in the reference, and we can not have multiple lay summaries in a reference because of limitations with the template. Defendingaa (talk) 14:18, 3 March 2016 (UTC)

I invite you to read the section in MEDRS about books, and to tell me if you can find any requirement for peer review anywhere in it. Please do also tell me when you get to the sentence that begins "Additionally, popular science and medicine books are useful sources". You'll find it at the beginning of the second paragraph in that section. WhatamIdoing (talk) 05:04, 4 March 2016 (UTC)
"The Sober Truth" is hardly a "medical textbook" (it certainly is quite biased) and its publisher is not known for making medical texts. Accepting this book's claims without looking at peer-reviewed literature on the subject which contradicts Dodes' conclusions violates WP:UNDUE. Defendingaa (talk) 06:34, 4 March 2016 (UTC)
concur w/ WAID opinion as to MEDRS (as it pertains to this particular article)--Ozzie10aaaa (talk) 11:18, 4 March 2016 (UTC)
I appreciate your input. The reason for the really high bar for sources in this article is based on consensus we hammered out last year. I do know that consensus can change -- and, if it does, then there are a number of sources I would like to see included in the article:

[outdent]

There may be some value including the Dodes book and the 2015 Glaser article in this article, but including both without including the reliably sourced information from other experts just as or more qualified than Dodes and Glaser would be a flagrant violation of a fundamental pillar of Wikipedia policy.

We will end up with "Dodes says this, but the New York Times considers his book deeply flawed, and John F. Kelly with Gene Beresin wrote an article saying the science contradicts Dodes' findings." Is this what editors want? Is this the new consensus for the article? Defendingaa (talk) 15:33, 4 March 2016 (UTC)

For the record, I agree that Dodes' book isn't a medical textbook. It is, however, a "popular medicine" book ("popular medicine" means medicine explained for non-professionals, not a best seller  ;-), which is what the second paragraph in that section discusses.
I always like 'compare and contrast' for opinions. However, the NYT book review may have some problems. For example, the same 1990 comments from AA on their survey that Dodes cites (approvingly) as the source of the 26% statistic is the same one that disavows, in the appendices, the 75% efficacy statistic that the NYT book review asserts as their current position: 'Individuals may rebel against this result as contradicting our time-honored statement that "half get sober right away, another 25% eventually make it," etc. That statement applies to observations made at an earlier time, and there is no reason to doubt that changes in society and in A.A. since that time could create a different circumstance today.' And book review's actual complaint with the Dodes book – the flaws he perceives – isn't about Dodes' disparagement of AA; it's with what Dodes recommends as an alternative. The nicest thing that the book reviewer says about AA is a half-hearted statement that it "may be better than nothing" for some small fraction of people. The book reviewer wants people on prescription drugs, and Dodes wants people in psychodynamic therapy; neither of them seem to actually support AA.
The Cochrane review should wait until it's progressed beyond the science by press release stage. It's likely that we won't have to wait very long for it.
The WBUR piece is interesting for highlighting bias. Dodes reads a Cochrane review that says "No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems" and concludes "no evidence that they work". The WBUR authors read the exact same sentence and conclude "AA and 12-step treatment were shown to be as effective as anything else to which they were compared".
Both of these statements are true: it works just as poorly as the treatments it was compared to. Homeopathy has been shown to be "as effective as" the placebo that it's compared to in clinical trials – but it does nothing. Multiple different chemotherapy regimens have been shown to be "as effective as" each other for late-stage lymphoma – but you will probably die, no matter which one you choose (CHOP-R is standard because it has slightly fewer side effects than the alternatives). "As effective as" doesn't mean "actually effective" in an absolute sense. It also misrepresents the recent research. PMID 19207347 doesn't say that AA works; it says that if you tell people to go to AA, and they actually go, then they do better than the people that you told to go to AA but didn't go (that's what "Evidence also suggested that the effect of the directive strategy on abstinent days was mediated partially through AA involvement" means in plain English). PMID 19309183 says that if you tell people to change their social networks, then AA attendance is one of the results. PMID 19581057, which begins with the words "Drop-out from 12-step groups is notoriously high" (that's approximately what Dodes' numbers say, right?), seems to be about AA facilitation (and is more of the psych stuff that the NYT book review disparages).
So the bottom line for me is that none of these actually seem to disagree with Dodes' claim that very few people who show up (i.e., for at least one meeting) are actually successful at achieving and maintaining sobriety as a result. WhatamIdoing (talk) 16:52, 4 March 2016 (UTC)
As you point out, there isn't anything out there with a track record better than the 12 steps. This is not what Dodes tries to imply in his book. He tries to imply that he has found something that works better -- but he hasn't. There is a strong correlation between regular meeting attendance and continuous sobriety; in The Natural History of Alcoholism Revisited, there is a table showing that 48% of the people who experienced stable remission had attended 300 or more AA meetings, while only 2% of the people who were chronic alcoholics had attended 300 or more AA meetings. Because of the universality of Alcoholics Anonymous, it's hard to tell if this is a correlation or causation (Dodes tries to argue, unsuccessfully, that it's 100% correlation -- the old "AA is no better than spontaneous remission" chestnut which the majority of modern peer-reviewed science on addiction disagrees with), but PMC4285560 makes a strong case that it's the program itself (and not self-selection bias) that is helping people.
It noteworthy that you mention cancer treatments. We routinely give patients expensive treatments for cancer even when we know it will almost certainly not work. But, when we suggest that people with alcoholism problems attend Alcoholics Anonymous meetings, people get upset at suggesting this treatment, even though AA is free (Though, yes, I always put $2 in the basket). The New York Times review of Dodes' book is not saying AA doesn't work -- it's saying that it's foolish to not recommend AA when it's free and sometimes works.
When I first joined AA, I knew the numbers. I knew the chances of achieving long term sobriety were statistically low. But, that didn't stop me from regularly going to meetings. I found a mentor -- sponsor -- who got me to read the Big Book and work the program as described there. Just as the Big Book promised me, I had a spiritual awakening -- that was about three decades ago and I haven't had a drink since then.
I would like to see a peer-reviewed study where they see the success rate of people who do the things we suggest people in meetings do: Get a sponsor. Work the 12 steps as written in the first 164 pages of the Big Book. Some studies get close to that (PMC2220012, etc.), and they show that engaged members can and do get sober.
The failure rates that biased authors like Dodes like to quote are based on statistics involving people who attend meetings because of a "nudge from the judge" or other outside coercion. People who do not work the program usually do not get better. But to imply that these low success rates exist because the Alcoholics Anonymous program does not work is downright dishonest. The program works -- the peer-reviewed research shows that it works -- but most people who are attending AA on a court slip will not work the program we suggest newcomers work to achieve long term sobriety. Defendingaa (talk) 17:38, 4 March 2016 (UTC)
One final point before I go for the day: The discussion in that New York Magazine article about what the next Cochrare review on Alcoholism treatment might say is not science by press release; it was the journalist who sought the scientists, not the other way around. Defendingaa (talk) 17:46, 4 March 2016 (UTC)
Actually, there seem to be more effective treatments – just probably not Dodes' favorite one. (You may have noticed that we aren't mentioning Dodes' favorite treatment, as that's irrelevant to the topic at hand.)
What is relevant is the fact that, in your words, "the chances of achieving long term sobriety were statistically low". Every source agrees on that point, especially if you're depending upon AA alone to get you there. So why doesn't this article say exactly that, in plain English?
By the way, it's not mathematically possible for court-ordered attendance to cause these low success rates, even if we assume that the prospect of jail and probably losing your kids isn't extraordinarily motivating. According to AA, 88% of members aren't under court orders. Excluding all court-ordered attendees from Dodes' calculation would raise the rate of one-year "survival rate" (abstinence plus continued attendance) from his estimate of 5–8% only up to 6–9%. That's still ineffective (by AA's own chosen standard of success) for more than 90% of people who ever attend an AA meeting, and it's still a third of the number that the FDA says are significantly helped by Vivitrol (to give one example of a more effective [on average] treatment).
I agree that the NYT book review doesn't say that AA never works. Can you agree that it also never says that it actually does work, or that Dodes' estimate of overall success is wrong?
Even Dodes agrees that the people who are most likely to be successful in AA are the people who put the most into it. That view is common in the literature, but strangely underplayed in these articles. I think it's reasonable to include all of this information:
  • If you count all the people who ever attended an AA meeting, then the long-term success of AA is quite rare – maybe one in 20 people.
  • Most people drop out within weeks or months. Many don't "really try", to use AA's phrase, even if they continue attending.
  • But success rates are higher (unknown, but higher) for the people who continue to work hard at it.
Maybe providing this complete picture of reality would help readers the most. It might help set realistic expectations for courts and family members about the limited benefit of forcing someone to attend. It might encourage members to "work the program" instead of hoping that showing up is enough. It might help general readers remember that addiction is complicated, that "better than nothing" isn't necessarily "good", and that it's a hard journey. WhatamIdoing (talk) 06:41, 5 March 2016 (UTC)

Removing 1990 Triennial survery; Adding Lande Dodes

I have removed the following:

Internal AA surveys suggest that about 40% of the members sober for less than a year will remain another year. About 80% of those sober more than one year, but less than five years will remain sober and active in the fellowship another year. About 90% of the members sober five years or more will remain sober and active in the fellowship another year. Those who remained sober outside the fellowship could not be calculated using the survey results.

This paragraph used the following reference: "Comments On A.A. Triennial Surveys". Alcoholics Anonymous World Services. December 1990. {{cite journal}}: Cite journal requires |journal= (help) But I can not find the "40%", "80%" and "90%" numbers claimed in the paragraph; this appears to be original research.

I have replaced it with a paragraph about The Sober Truth by Lance Dodes; it describes both Dodes' figures and the counterarguments to those figures, as well as mentioning Glaser's 2015 article about AA. Since the Dodes book and the Glaser article got so much attention, it's probably a good idea to mention them in this article, as long as, in the interest of WP:NPOV, we have other reliable sources with different points of view. Defendingaa (talk) 12:49, 15 April 2016 (UTC)

AA is not a temperance movement

My personal experience, strength, and hope as an AA oldtimer: AA is not a temperance movement. AA's success stems from the fact it does not try to keep people who want to continue drinking sober. The kinds of sources which claim AA is a temperance movement are ignorant of how the fellowship work and tend to not really like AA (for example, Gabrielle Glaser's hideously inaccurate anti-AA polemic claims AA stems from the temperance movements). Indeed, AA members criticize the Washingtonian movement for concentrating too much on trying to regulate other people's drinking.

In my many years in AA, I have only heard people rail against drinking in general a handful of times. The general attitude is, if someone is enjoying their drinking, don't let us ruin their fun. Defendingaa (talk) 05:42, 10 August 2016 (UTC)

"tangentially related" for See also section

"Whether a link belongs in the "See also" section is ultimately a matter of editorial judgment and common sense." I'm not sure what value it has to the article. What is the argument for listing unrelated organizations? - Scarpy (talk) 06:16, 9 August 2016 (UTC)

Hello User:Scarpy and thank you for your comments. I am unsure why you are having trouble seeing the connection between the temperance movement and Alcoholics Anonymous. AA themselves discuss how they were influenced by the temperance movement (see article). I would encourage you to read that article, published by Alcoholics Anonymous, to gain a better understanding of the history of AA. As for you adding a "dubious" template to the article--those two texts published by academic presses hardly fit that classification. I would encourage you to self-revert. I hope this helps. With regards, AnupamTalk 06:40, 9 August 2016 (UTC)
AA has no relation to temperance movements as stated in their literature. You will find on page 19 in the section titled "Is A.A. a temperance movement?" "No. A.A. has no relation to temperance movements. A.A. 'neither endorses nor opposes any causes.' This phrase, from the widely accepted outline of the purpose of the Society, naturally applies to the question of so-called temperance movements. The alcoholic who has become sober and is attempting to follow the A.A. recovery program has an attitude toward alcohol that might be likened to the attitude of a hayfever sufferer toward goldenrod."
As far as "influence" goes, this would be similar to saying that AA is a psychoanalytic movement because of some of the early and well-known correspondence with Carl Jung. The only difference being that AA has never explicitly stated that it has no relation to psychoanalysis in it's literature, which only makes the claims that it is, or is related to, temperance movement more dubious.
I would encourage you as well to take the time read the article you linked, published by Alcoholics Anonymous. It's titled "What A.A. Owes to Its Antecedents" and a good exercise for the reader would be to go through each of the sources discussed and actually try to pin point what parts of, if any, are currently incorporated in AA (e.g. is any part of it in AA's program now, or are they only related in the sense that they also dealt with alcohol or alcoholics). What you'll find is that much of what is discussed there is not practiced by AA or in some cases the the opposite of what AA advocates now. In the cases that they are not, the source was not a temperance movement.
As far as the other two citations go, it looks like you went to Google Books or Google Scholar and searched for like alcoholics anonymous and temperance and found somethings sources published by an academic press that discuss relationship and influence in vague ways. If the case is as strong as you are saying it it, I would love to see scholarly sources that discuss the exact "influence" or "relationship" AA has with any temperance movement stated in clear terms, again "relationship" here being more than superficial. - Scarpy (talk) 14:56, 9 August 2016 (UTC)
I never stated that AA is itself a temperance movement (although I have found other scholarly sources that do make that claim). Rather, the temperance movement, along with the Washingtonian movement, was an antecedent to AA, as stated in an official AA publication. You state that it would be desirable to "go through each of the sources discussed and actually try to pin point what parts of, if any, are currently incorporated in AA". However, that would constitute original research; I am talking about AA being influenced by the temperance movement as a historical phenomenon and the sources published by academic presses clearly support that. I found an additional peer-reviewed source published in the Journal of American Studies titled "AA and the Redeployment of Temperance Literature" that also discusses the influence of the temperance movement (specifically its literature) on AA. If you still object to the inclusion of this referenced material, perhaps we could start an RfC to gain input from the wider Wikipedia community to see whether the clause should be included in the article. I hope this helps. Thanks, AnupamTalk 16:56, 9 August 2016 (UTC)
An RfC is fine. - Scarpy (talk) 17:47, 9 August 2016 (UTC)
I would encourage you, however, to at least state your case clearly. The Washingtonian Movement is an antecedent to AA in the same way that the Neolithic era was an antecedent to AA, it "a thing or event that existed before" AA did. If you read the article you've now linked twice, the point is that while the Oxford Group, for example, had an influence on AA the Washingtonian Movement didn't and if anything is very different from AA in an important ways. That's why I actually would desire you to do through each of the sources discussed in the article and actually try to pin point what parts of, if any, are currently incorporated in AA. Not to include in Wikipedia, but because I see no indication you read any of it passed the title. If I'm wrong here, please correct me.
Again, if you want to say something "influenced" AA, you need to answer the question "in what way did it influence AA?" You can't just do a Google Scholar search for Alcoholics Anonymous and temperance find an article using some language indicating a vague influential relationship and copy and paste a quote and then say there's an "influence." That's a WP:SYN. - Scarpy (talk) 18:05, 9 August 2016 (UTC)
I can appreciate that you agree to an RfC if this matter is not resolved between us. I did read the publication that I provided to help you understand the antecedents of AA. One example that delineates how temperance movement influenced AA discusses the Washingtonian Temperance Society: "At several points in his writings, A.A.’s Bill W. reflected on the Washingtonians as an object lesson for Alcoholics Anonymous. The two were similar in many respects: alcoholics helped each other, held weekly meetings, shared personal experience. Each featured the fellowship of a group and the availability of its members, reliance on God, and of course, total abstinence" (page 3). The peer-reviewed article I linked to above discusses how literature from the temperance movement influenced AA. The threshold of inclusion on Wikipedia is that the information we add here is verifiable by reliable sources. I have presented several sources that meet this standard and in light of these facts, the clause should continue to remain in the article. Cheers, AnupamTalk 07:08, 10 August 2016 (UTC)
In addition to verifiable and reliable sources, there's also issues of novel synthesis, as I've pointed out before, and due weight. So far, I've only seen one peer-reviewed source discussing this "relationship" in any specific terms, and the abstract describes it as between "publication materials from the temperance and Prohibition periods with the Big Book to show how AA's narrative antidotes to the traumas of modernity (sited in alcohol abuse) were as much the product of premodernist and turn-of-the-century hysteria as they were an attempt to write a new chapter in America's relationship with alcohol based on contemporary medical and social research." Boiling this down to "[AA] was influenced by the temperance movement" is WP:SYN.
If you can, however, find enough peer-reviewed sources discussing how AA's narrative antidotes to traumas of modernity are products of premodernist and turn-of-the-century hysteria such that they should be given due coverage in this article, I'm all for including a section on it. I'll admit, while I've done substantial research for this article and related ones, I've never looked specifically in to the topic of narrative antidotes to traumas of modernity. That being said, it sounds like a fascinating research topic.
Similarly, spelling out the similarities and differences between AA and The Washingtonians (who, by the way, were not strictly part of the temperance movement) and similar groups would be worthwhile. I know in that case there is more than enough WP:RS to support it so there's no argument from me on undue weight there. It would fit best in the History of Alcoholics Anonymous article in my opinion. - Scarpy (talk) 21:18, 10 August 2016 (UTC)
As I've said above, we have sources published by academic presses that state that AA was influenced by the temperance movement. In addition, we have a document from AA itself that states that the temperance movement (including the Washingtonian Temperance Society) was an antecedent of the organization. Therefore, we can include this information in Wikipedia, citing those sources. Repeating what reliable sources state is the standard practice here on Wikipedia. As far as due weight, a seven word clause about an important influence on AA is a long shot from being sufficient. If you can accept a WP:COMPROMISE of leaving this in, I can agree to leave out the "see also" wikilink that you removed. I hope this helps. With regards, AnupamTalk 06:07, 12 August 2016 (UTC)
The first reference, "Gender and Addictions: Men and Women in Treatment", might be a good reference for talking about issues AA has with the "Thirteenth Step" (and may have helped User:Not4credit keep more of the stuff they tried to put on this page last year), but it's not talking about the history of AA or its supposed origin from temperance movements. The second reference, "Clinical Psychology: Historical and Research Foundations", appears to only mention the supposed influence of the temperance movement on AA as an aside. Neither is a reliably sourced in-depth look at the origins of AA and how it stems from the temperance movements. Defendingaa (talk) 12:06, 12 August 2016 (UTC)
I have removed the dubious comparison to AA and temperance movements. It can come back once we get a reliable source which makes an actual case that AA was influenced by those movements, instead of just mentioning it as an aside. Defendingaa (talk) 12:17, 12 August 2016 (UTC)

Walker and Straussner sources

Below are links to the Google Books previews for the sources currently cited to demonstrate the "influence" of the temperance movement on Alcoholics Anonymous. These don't represent serious discussions of an "influence" or "relationship" between Alcoholics Anonymous and temperance movements by any stretch of the imagination, but rather only briefly discuss AA. While these are from academic publishers, they're not serious works on the information they're citing and as such are highly dubious for the claim they're intended to cite.

- Scarpy (talk) 18:32, 9 August 2016 (UTC)

Court rulings section

I'm debating the best home for the following sections:

My motivation for doing this is that I don't think this discussion belongs in the Pagans in Recovery article, but I'm not sure where it does belong. What do others think? A new article? A section of this one? Sondra.kinsey (talk) 23:21, 10 December 2016 (UTC)

@Sondra.kinsey: Why would the section in the AA article on court rulings belong anywhere else? I don't follow your rationale that it doesn't belong in Pagans in Recovery. I agree it doesn't belong there, so leave it in the AA article. For that matter, why should the other two items you link be moved from their current places? Sundayclose (talk) 23:33, 10 December 2016 (UTC)
@Sundayclose: Most important to me is that there be a single authoritative source on the topic, and right now three articles discuss the matter without recognition of each other. Secondarily, I'm struggling with the appropriateness of including this content in articles like Pagans in Recovery. It's obviously an important topic to members of this group, but for an encyclopedia, it isn't about Pagans in Recovery at all, it's about AA. Sondra.kinsey (talk) 23:58, 10 December 2016 (UTC)
@Sondra.kinsey: Sorry, but I'm still confused. But let me ask if I'm understanding one point correctly. My impression is that you are not suggesting removing the court rulings section from the AA article, right? I'm not sure what you mean by "a single authoritative source on the topic", but the information in the AA article seems to be adequately sourced. Regarding the other articles, I'm not sure if you are suggesting that the sections there should be removed from the current articles and moved to the AA article. It might be appropriate to make a brief mention of the information in the AA article, but I think it would be excessive to move it all to the AA article. I really don't have much opinion about the Pagans in Recovery, but I think the information in Rational Recovery should stay there (if properly sourced, I haven't look at the sourcing) because the group has been outspoken about required attendance at 12-step programs. I should also note that it seems to me that the focus is on 12-step programs in general, not just AA. If I have misunderstood something, please clarify. Thanks. Sundayclose (talk) 00:52, 11 December 2016 (UTC)
@Sundayclose: At a quick glance, it looked like there was more information in the Rational Recovery and Pagans in Recovery articles than there was here, but more careful review reveals that is not the case. Alcoholics Anonymous#United States Court rulings is clear, concise, and sufficient. I removed the Pagans in Recovery#First Amendment Violations, the Courts and 12 Step Recovery section completely, and am satisfied to close this discussion with no changes to this article, except the hatnote I already added. Sondra.kinsey (talk) 02:22, 11 December 2016 (UTC)

How do we achieve WP:NPOV?

There are two trains of thought when looking at Alcoholics Anonymous (AA):

  • There is the train of thought that AA does not work because only x% (usually 5%) of people who ever go to even one AA meeting stay sober. This line of thinking does not appear in recent peer-reviewed literature about AA's effectiveness, but it's a popular figure to quote in anti-AA polemics such as Dodes' "The Sober Truth" (it's not me calling "The Sober Truth" a Polemic -- it's the New York Times which called it that). I think this article has spent too much effort engaging in original research about what this percentage is -- the only sources which give out a percentage are anti-AA polemics.
  • Then there is the train of thinking that AA helps because x% of people who engage in AA/twelve step facilitation/12-step treatment get sober, where x can be as high as 75% (e.g. on page 197 of The Natural History of Alcoholism Revisited there is a chart showing that, of the chronic alcoholics who went to 300 or more AA meetings, 48% of people who had stable remission went to 300 or more meetings, while only 2% of the alcoholics still chronically drinking went to 300 or more meetings; it's easy but probably original research to run the math and find that, on this chart, 74% of the people who went to 300+ meetings had stable remission, 21% of the 300+ meetings attenders had intermittent alcoholism, and only 5% of people who went to 300 or more meetings were still chronic alcoholics -- numbers, that, interestingly enough, agree with the figures in the preface to the second edition of AA's own Big Book [50% got sober right away, 25% got sober after relapsing, and the rest showed improvement])

This article has had, over the years, numerous attempts to make this "The AA article which the Orange Papers wrote", which is not a neutral point of view. For us to be neutral, we need to represent both points of view in this article. For example, as I pointed out above, it may be OK to include Dodes' "The Sober Truth", but, if we do, we will also have to include the articles from reliable sources which disagree with Dodes' conclusions. Ditto with the Glaser article from last year.

Defendingaa (talk) 03:47, 8 March 2016 (UTC)

I'm afraid that I don't understand the arguments here (in the article, not in defendingaa's points) at all. The arguments against AA seem to suggest that it is no more effective than alternatives. But doesn't that say that it is as effective as alternatives? And if not, could this be explained? And aren't the (presumably institutional) alternatives all very expensive? As a member of this society, I happen to believe that even if x was only 5% and it is free, is that not a significant benefit to society? And finally, why is AA on trial? Rather than seeing the problem to be with AA, my view would be why the professionals, with the vast amount of public funding going into this, are unable (apparently) to produce results significantly higher than AA? --50.68.134.51 (talk) 20:06, 30 October 2016 (UTC)
Thanks for your comments, and I agree with Defendingaa that we need a balanced presentation with more than one point of view. I hope your comment "why is AA on trial", however, is not a suggestion that the Wikipedia article should not include balanced and well sourced comparisons of the effectiveness of AA and professional treatment. The views of us individual editors are irrelevant for the Wikipedia article (though not necessarily unimportant to each of us personally). We follow the sources and report what we find as objectively as we can. Sundayclose (talk) 21:18, 30 October 2016 (UTC)
My thought, for people looking at this in the archives: What the studies are discovering is that AA is a program for people who want it, not for people who need it. Studies show that, for the people who get serious about the program, going to one meeting a week or more, there is a high success rate: about 75% (Vaillant 1995; Fiorentine 1999; Moos and Moos 2006 shows that, of the people who were serious about AA their first year sober, 67% were still sober 16 years later; The 75% number is the one AA's Big Book gives for people serious about the program). However, most alcoholics do not get serious about AA, even when told they will die unless they get sober -- that's where the comparably low success rates (around 15% to 20%, as per Vaillant 1995, not 5% as argued by its critics using bad figures) come from. Since the people who get serious about AA have to be, because of the nature of AA's program, self selecting, there's the possibility that AA's success is merely "self selection bias." However, Humphreys 2014 makes a strong case that it's the actual AA program, and not just self selection, which is helping alcoholics gets better. Point being, doctors, when performing studies, have used the same methodologies used to measure the success of a chemical in treating an illness -- when they use those methods to try and measure AA success, they get inconsistent results, simply because most alcoholics exposed to AA do not do what is suggested: Go to meetings, get a sponsor, work the 12 steps as written in the first 164 pages of the Big Book. But that doesn't mean AA doesn't work. That just means most alcoholics don't work it, even if their life is on the line. Defendingaa (talk) 14:57, 10 December 2016 (UTC)
@Defendingaa: These are good points. I came to similar conclusions over the years of working on various other twelve-step and addiction recovery articles. I would point out, though, that only speaks to problems with the methodology of the studies. It's worth asking, "why didn't these people stay? why didn't they get a sponsor? why didn't they complete the steps?" The lazy answer and sanctimonious answer is "well, they didn't want it enough." This is lazy, because absent some surveys or something like that, you have no data to say why they weren't more engaged, so anything you're saying there is really just speculation. It's sanctimonious because it supports the view that there's nothing AA could do to change it.
Given that, at least two criticisms remain valid. (1) AA could do more to make it's program friendlier to a broader range of people. Of course, AA is under no obligation to do that. But if they were to take a data-driven approach to really understand why people don't get engaged in an authentic and granular way, and make some changes in response, maybe they could make that much more progress towards the primary purpose in helping other alcoholics to achieve sobriety. I'm not saying it would be easy, but it would be worth doing.
(2) AA could do more to encourage people to seek out alternatives if they're lukewarm on, or opposed to, AA. If they don't want AA, then maybe something else will help them. Maybe they would get engaged in some other group. Again, AA's primary purpose is to "stay sober and help other alcoholics to achieve sobriety." The evidence shows that there are groups other than AA that will help alcoholics achieve sobriety. That has to be acknowledged. - Scarpy (talk) 17:46, 10 December 2016 (UTC)
@Scarpy: I'm generally in agreement, although I will add that the well-established traditions of AA prohibit AA as an organization from recommending outside organizations or methods so as not to give the appearance of endorsement. That's not to say that individual AA members can't provide information about alternatives if done outside the official functioning of an AA group. Also, my understanding is that AA has never officially claimed that other methods have no effectiveness or that alcoholics should be discouraged from inquiring about other methods; I'm sure it happens among some individual members of AA, however. One more unrelated point about "research". Any reputable researcher, including social scientists, will quickly tell you that scientific research can never conclude that every condition that could affect results has been examined. Most researchers generally consider their conclusions to be tentative, always subject to modification if subsequent research puts forth alternative explanations based on unexamined or poorly examined conditions that can affect results. I suspect that the conclusions that "AA doesn't work" or "Other methods are better" come from people who don't fully understand the limitations of research. Sundayclose (talk) 19:45, 10 December 2016 (UTC)
To add to what other people said, yes there is a certain arrogance to the old school approach AA had where we flat out told people "If you don't like the program, the bottle is waiting for you" -- but that approach came from a time when AA was the only game in town. I don't know of that much research done on the question of "If AA doesn't work for alcoholic X, maybe they can get sober with program Y", but there is this reference in the LifeRing Secular Recovery article: Zemore, Sarah E.; Kaskutas, Lee Ann; Amy, Mericle; Hemberg, Jordana (2016). "Comparison of 12-Step groups to mutual help alternatives for AUD in a large, national study". Journal of Substance Abuse Treatment. 73: 16–26. doi:10.1016/j.jsat.2016.10.004. which shows promise to the idea that maybe an alcoholic who won't work AA might get sober via other means. Then again, that study says "LifeRing and SMART members were less likely to endorse the most stringent abstinence goal", even though LifeRing explicitly says complete abstinence is required. I'm not impressed with the track record of alcoholics who try moderate drinking again: Short-term self reporting studies claim success (Sobell, etc.), but long-term follow-ups show that problem drinking happens again (Again, the Sobell study is the most famous example of this, but there are others). AA itself is becoming more open to people who just can't accept the "God thing" which is a stumbling block for many. Defendingaa (talk) 22:41, 11 December 2016 (UTC)
Think the problem with this line of reasoning, simply put is that AA is not an organization as such, it does have a central office, but what it really is is a group of drunks who are getting sober, and you can't expect a group of people to know about all the latest science. That being said, I may or may not be a member, but I have a significant number of friends who are alcoholics, never once heard a single one say, "AA didn't work but I got this great shrink, started CBT/DBT and now voila I can drink like a gentleman, or voila I feel great haven't drunk once in three years." Not a single time have I heard this, and I used to live in LA and hear all sorts of wacky stuff, but never this. I've not even heard rumors of this. Other than the 12 steps, getting hand cuffed to a radiator, or dying I am not aware of any aware of any way to stay sober. But AA members are not doctors, or at least most aren't anyhow, and giving advice on medical issues is strongly discouraged. My understanding is you go to AA, members will help you work the steps, and be a member of the group, that is what AA is there for, it's not there as some sort of medical facility, nor does it ever claim to be. That aside, if you're worried about NPOV, then just take out the POV parts, problem solved. "This is what AA is, this is what AA does, these are the 12 steps." Bam your done, no toes stepped on, none of that; simply the facts and no conjecture. 85.57.175.24 (talk) 14:39, 14 April 2017 (UTC)

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Kownacki and Shadish 1999

A new user is making a lot of edits to this article and I'm one of the long-time editors trying to keep the article neutral.

That in mind, I have moved Kownacki and Shadish 1999 to Effectiveness of Alcoholics Anonymous because it's a pretty old study from last century; it used RCTs (Randomized controlled trials) to see how effective AA is, which have been shown to be pretty much ineffective when looking at AA effectiveness. Defendingaa (talk) 03:51, 12 October 2017 (UTC)

Canadian trials of AA's status as a religious organization

Multiple editors have removed this addition:

In Canada, the religious status of AA has not yet been resolved, and is currently being played out in provincial human rights tribunals.[ref]Wood v Vancouver Coastal Health Authority and others, 2016 BCHRT 91 https://www.canlii.org/en/bc/bchrt/doc/2016/2016bchrt91/2016bchrt91.html?autocompleteStr=wood%20v%20vancouver%20coastal&autocompletePos=1 [/ref][ref]A v Vleeming and another, 2016 BCHRT 171 https://www.canlii.org/en/bc/bchrt/doc/2016/2016bchrt171/2016bchrt171.html?autocompleteStr=a%20v%20vleeming%20a&autocompletePos=1[/ref][ref]Knight v AA World Services, Inc., 2016 HRTO 208 https://www.canlii.org/en/on/onhrt/doc/2016/2016hrto208/2016hrto208.html?resultIndex=2[/ref]

For us to add this information, we need consensus. If we can find reliable third party sources discussing these cases, it may be worthwhile to add it to the article; until then please do not try to add this to the article again. Defendingaa (talk) 04:12, 12 October 2017 (UTC)

Actually, the new user did find a third party reference to it ("After 3-year fight, AA backs down on "God or gone" stance". Globe and Mail Newspaper. February 6, 2017. https://beta.theglobeandmail.com/news/national/organizing-body-of-alcoholics-anonymous-in-gta-opens-doors-to-secular-groups/article33920196/?ref=http://www.theglobeandmail.com) so I think it can stay for now. I'm now sure "spirituality" is the right place for it, but that works for me. Defendingaa (talk) 04:29, 12 October 2017 (UTC)
Actually, on second thought, I think we should wait for more consensus before having this content about AA Canada's objections to secular meetings (something AA in the US does not share -- indeed, The Grapevine, AA's magazine, is soliciting the stories of agnostics or atheists who stay sober in AA) here. If anyone disagrees, please let us know. Defendingaa (talk) 03:47, 13 October 2017 (UTC)

@ByronWood: hoping you see the notification - you should really be discussing these edits on the talk page. Thanks. - Scarpy (talk) 06:48, 12 October 2017 (UTC)

What studies should we include here?

Right now, the guideline for including studies about AA effectiveness on this page is to generally only include studies from 2006 or later, since we summarize Cochrane 2006 and studies more recent than that. Anything that's older ends up in Effectiveness of Alcoholics Anonymous since anything predating Cochrane 2006 probably does not reflect current consensus about how well AA works for alcoholics.

This seems to be a pretty fair and objective guideline; does anyone think we should have a better rule of thumb for including or not including studies on this page? Sure, if a bunch of mainstream press articles came out that Brandsma 1980 somehow reflects the truth of how well AA works, we may have to ignore this guideline, just like we include an entire section on The Sober Truth because it got a lot of press attention.

Defendingaa (talk) 06:52, 8 January 2018 (UTC)

@Defendingaa: In this article, I'd rather just see a one paragraph summary of the Effectiveness of Alcoholics Anonymous article and a link to it. It's such a large, complicated topic I'm not sure addressing it at length here is worth it. - Scarpy (talk) 21:48, 8 January 2018 (UTC)
I am thinking a two paragraph summary, the first one with the general "studies go both ways" note, and the surgeon general statement (since I know at least one other editor favors having it here—I can not say who to protect their privacy) Defendingaa (talk) 01:18, 9 January 2018 (UTC)

I have removed most of the effectiveness section I agree with Scarpy here; let's just keep this out of the main article. "Does AA work?" is a controversial question with no clear answer in the relevant science. That in mind, I have put all the studies for and against in a sub-article, with only a two-paragraph summary. If we build consensus to restore it, I will gladly restore it. Defendingaa (talk) 01:23, 9 January 2018 (UTC)

How's the sub-article read? I wonder if we should consider having that linked for those who might come to the page wondering about AA's effectiveness, perhaps even looking for some studies that have been done so that they can weigh all the info for themselves. I like how the main page looks clean now, and gives just enough info to encourage one to research further. But I wonder if part of that research might be a linked up Wikipedia article? I'm kind of new here, and I'll have to re-read Wikipedia's criteria for splitting off articles, but I thought I'd put it out there and get people's thoughts on it at the same time. BudJillett (talk) 02:15, 9 January 2018 (UTC)
The sub-article is linked to at the top of the effectiveness section which has a whole bunch of research about AA effectiveness done. The main problem is that there have been so many scientific papers done studying AA, people can cherry pick studies to come up with pretty much any conclusion they want, so the best answer we can give is "it's complicated". Defendingaa (talk) 20:34, 9 January 2018 (UTC)

I have removed the paragraph about AA's effectiveness in the lead I feel a discussion about effectiveness is best done on a separate page (as per current rough consensus) and I think we need to come up with consensus about how we discuss the effectiveness before restoring content about effectiveness to the beginning of the article. Defendingaa (talk) 20:34, 9 January 2018 (UTC)

Surgeon general statement

I have added, from Effectiveness of Alcoholics Anonymous, the surgeon general (to be exact, the Surgeon General of the United States) statement that "Well-supported scientific evidence demonstrates the effectiveness of twelve-step mutual aid groups focused on alcohol and twelve-step facilitation interventions." This belongs here because:

  • It is a very recent statement, from just a couple of years ago
  • What the surgeon general says about something tends to be quite notable; the most famous example being the surgeon general warnings which have been on cigarette boxes for decades.

Defendingaa (talk) 23:21, 6 January 2018 (UTC)

@Defendingaa: I pretty strongly disagree here. In fact when it was added to the article it seemed dubious enough to me I was trying to think of what the best grounds to remove it would be. If you look at the page where this statement appears, there's very little context. It says "Well-supported scientific evidence demonstrates the effectiveness of 12-step mutual aid groups focused on alcohol and 12-step facilitation interventions." But this is very different than say, the Cochrane Review that details evidence evaluated and how it was evaluated, and that makes this much more dubious.
The Surgeon General is also a politically appointed office. I'm not sure how this squares with WP:RS, but my instincts tell me it hurts it more than it helps it (especially since they're not "showing their work" here). I know, at least in the past, this office has been subject to political pressures[3].
I think, at least, we should reduce the prominence of this statement. I don't see much substance behind it. - Scarpy (talk) 21:44, 8 January 2018 (UTC)
We have experimental studies which show AA effectiveness (in addition to getting more observational studies, which always show a correlation between AA attendance and successful sobriety) that are more recent than Cochrane 2006, and I think that's what the surgeon general is referring to. Note that, in terms of politics, this report was made during the Obama, not Trump administration. But, since it doesn't have a footnote pointing to why they believe that, I agree it may need to be less prominent. That said, since I was thanked by another editor for adding the information, I think there is some consensus it should stay in the article. Defendingaa (talk) 01:16, 9 January 2018 (UTC)
I think with less prominence it makes sense. I mention the Cochrane review because they set very clear criteria for inclusion (so you know what they looked at and what they didn't look at) and explain the analysis that was preformed and why is supports those conclusions. If similar documentation was available from the Surgeon General's office (or if it's there and I'm missing it) then I would have a different opinion. - Scarpy (talk) 03:14, 9 January 2018 (UTC)
The PDF report from the surgeon general goes in to more detail. Page 5-9 of the report states that "A substantial body of research indicates AA is an effective recovery resource; 61-65". The five linked studies are as follows:
* Emrick, C. D., Tonigan, J. S., Montgomery, H., & Little, L. (1993). Alcoholics Anonymous: What is currently known? In B. McCrady & W. Miller (Eds.), Research on Alcoholics Anonymous: Opportunities and alternatives. (pp. 41-77). New Brunswick, NJ: Rutgers Center of Alcohol Studies.
* 62. Kelly, J. F., & Yeterian, J. D. (2008). Mutual-help groups. In W. O’Donohue & J. R. Cunningham (Eds.), Evidence-based adjunctive treatments. (pp. 61-106). New York, NY: Elsevier.
* 63. Humphreys, K., Blodgett, J. C., & Wagner, T. H. (2014). Estimating the efficacy of Alcoholics Anonymous without self‐selection bias: An instrumental variables re‐analysis of randomized clinical trials. Alcoholism: Clinical and Experimental Research, 38 (11), 2688-2694
* 64. Ferri, M., Amato, L., & Davoli, M. (2006). Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database of Systematic Reviews, 3(3)
* 65. Kaskutas, L. A. (2009). Alcoholics Anonymous effectiveness: Faith meets science. Journal of Addictive Diseases, 28 (2), 145-157
I’m not familiar with items 61 and 62. Humpreys 2014 is a very key study showing that we have all that correlation between AA attendance and people getting sober because something about the AA program helps them (and it's not just self-selection bias). I would like to see more studies like this, but it shows a lot of promise. I don't know why they use Cochrane 2006 to argue that AA works, since all Cochrane 2006 says is that AA is no better and no worse than other treatment. Kaskutas 2009 makes a strong case that AA really works, and tears down the old studies most commonly brought out by people who try and prove AA doesn't help alcoholics.
Point being, the version we put on this page is the surgeon general's summary. The PDF file gives us the full monty linking to studies. I will update the reference to link to the PDF version so professionals can determine why the surgeon general is asserting that AA really works. Defendingaa (talk) 08:56, 9 January 2018 (UTC)
Thanks for the PDF. I have not read it yet, but will take a look when I can. Several years ago I emailed Keith Humphreys to see if he had interest in contributing to Wikipedia and he politely declined (too busy, something like that IIRC). I've been very impressed with him and William L. White, who I think I also emailed at one point and if memory serves I got a similar response. A bit of feedback, I think it's wise to follow inductive reasoning here. Too many people come to the discussion from the perspective of "AA works" or "AA doesn't work" and try to prove one point or the other (deductive reasoning). Or if we have to reason about it deductively, not asking "does AA work?" but "could AA work better?" - Scarpy (talk) 19:23, 9 January 2018 (UTC)
The degree to which AA helps keep people sober is a point of contention. It's a point of contention among the scientific community; it's a point of contention among the recovery community; it's a point of contention in the mainstream media. There's no simple answer to the question; it's very difficult to be objective (and I am not objective on the matter, but I do my best to keep my POV at the door when editing articles) and I think it's the right move to put the whole non-stop debate on AA's effectiveness on another page. Defendingaa (talk) 22:25, 9 January 2018 (UTC)
For sure, it's a point of contention. What I'm more getting at is that there are things that are lost in the research presented that focuses narrowly on the "does or does not help keep people sober" point. AA waffles on this point a bit too, and I mention it because I want to encourage one side of the waffle more than the other. For example if you read AA's Primary Purpose or Singleness of Purpose, you get one idea of what AA is about. But if you read more you might hear things like the alcoholism is just a symptom (allergy-like bodily reaction), it's really a condition of self-centeredness, and that's where "dry drunk" as a concept comes from. So, from that perspective, it's actually possible by another definition of AA's standards that someone could be sober, even sober in AA, and still could have "failed." On the other hand, think of AA's "goals" as larger than just sobriety, that means there's elements of it's effectiveness (say for example, reducing narcissism as mentioned in the Neurotics Anonymous article) that are going undiscussed. What about the Responsibility Declaration? Do AA members help others more than non-AA members?
There are also levels of nuance and granularity that are missed in specifically focusing on the "sober or not" criteria, it incorrectly paints AA and people's experience in it as if it's a very monolithic thing. What if some parts of the program are more useful then others? Or the way parts are executed have a strong effect on outcomes? Maybe the amount of time taken to complete a 4th and 5th step is important. Maybe having meetings within walking distance is important. Maybe the temperature of meeting rooms is important. Maybe mixed gender meetings are less effective than single gender meetings. Maybe the longer a sponsor has been sober the more of a positive effect it has, maybe the opposite is true and you get more benefit from a sponsor that's "closer to you" in terms of time. Maybe being coerced to attend a meeting effects outcome, maybe it doesn't. Maybe comorbid disorders effect outcomes, maybe they don't. Maybe people going to multiple types of groups or fellowships helps (e.g. going to AA and Al-Anon, or going to AA and LifeRing). Maybe there's a threshold of attendance that's important (as noted by McIntyre when he said previously when AA compiled statistics you were old considered to have "tried AA" if you went to 90 meetings). For sure, most of this has not been researched, but for sure some factors have been considered and we're light on including these in overall picture of how to optimize AA's effectiveness.
I can also tell you from editing Wikipedia for about a decade now, I've seen the feedback loop in publications that have been written after things I've written in articles. Overtime, the relationship between scholarly researchers and Wikipedia works less like a pipeline and more like a symphony. I can guarantee you things we put in here or gaps we point to will have influence over what researchers do in the future. We should keep that in mind. - Scarpy (talk) 20:48, 10 January 2018 (UTC)
I know some edits have been made since this discussion began, but I just checked the "Effectiveness" section and it reads pretty balanced by my eye at this writing. Scarpy makes some good points about the Surgeon General's office, but I tend to think most people consider these points when they see statements from the Surgeon General's office, or from any government office. Readers have the option to follow-through to the cited sources. Just my $0.02! BudJillett (talk) 02:04, 9 January 2018 (UTC)

The 13th step movie

I have removed this sentence for violating Wikipedia notability guidelines as well as being undue weight to include here:

"The 13th Step" is a 2016 documentary film [ref]The 13th Step. Documentary Film. Directed by Monica Richardson. 2016 http://www.imdb.com/title/tt3253040/[/ref] about the prevalence of sexual predators in Alcoholics Anonymous. The film advocates for secular, science based support groups as alternatives to AA.

We need to have mainstream reliable sources discussing the notability of this movie before it is notable enough to include anywhere, especially this article. Defendingaa (talk) 04:06, 12 October 2017 (UTC)

Just in case someone tries to bring up this movie again: Having a page in IMDB does not establish notability (nor reliability; there are movies and TV series which do not even exist in the IMDB). There is not a single review for this movie posted over at Rotten Tomatoes; it needs to be notable enough to have a Rotten Tomatoes page before we even consider adding it to this article. Defendingaa (talk) 16:48, 19 December 2017 (UTC)
I removed another reference to this non-notable movie which was added last March in this edit Defendingaa (talk) 09:43, 9 January 2018 (UTC)

Notability guidelines do not apply to content within an article but to whether a subject is notable enough to be subject of its own wikipedia page. This is repeated on the page about film notability.

Undue weight is a policy requiring appropriately weighting viewpoints in a description or summary of a disputed topic, and does not apply to mentioning the existence of a documentary film, or including it in a list of films about a particular topic. Bananaramadingdong (talk) 06:40, 19 February 2018 (UTC)

While the notability guidelines do not apply as strongly to the contents of an article as they do for a standalone article, the same principles apply for an article's contents. The policy on undue weight clearly states that "the views of tiny minorities should not be included at all" and that "in determining proper weight, we consider a viewpoint's prevalence in reliable sources."
The fact that this 13-step movie has no reviews at all on Rotten Tomatoes indicates that it's a movie which only has appeal to a tiny minority. That fact that there is no mention of this movie at all in reliable sources indicates that this movie should not be mentioned at all in this article. Defendingaa (talk) 18:16, 22 February 2018 (UTC)
"While the notability guidelines do not apply as strongly to the contents of an article as they do for a standalone article, the same principles apply for an article's contents."
The notability policy literally has a section titled "notability guidelines do not apply to content within an article." That is unambiguously in disagreement with your counter-claim, and you haven't provided a citation to back said counter-claim.
"The policy on undue weight clearly states that "the views of tiny minorities should not be included at all" and that "in determining proper weight, we consider a viewpoint's prevalence in reliable sources.""
As I said before: undue balance is about not giving undue balance to viewpoints, more specifically in regards to a contested topic. The edit you reverted was a factual statement of the existence of the film and a brief statement of its contents, that appears to be neutral. You haven't contested my assertion that the edit you removed isn't a viewpoint, nor have you asserted that the existence of the film is a disputed or controversial subject.
If I submit an edit that states the existence of the film, will you revert it or otherwise edit it out again, and under what specific grounds and policies? Presently (ie if the edit were done right now), in what context would you permit it to be included in the article? Bananaramadingdong (talk) 05:32, 23 February 2018 (UTC)
Existence of the film is not sufficient for us to mention it in this Wikipedia article; we need to have discussion about the film in third party reliable sources, which does not include self published sources (The Fix, for example, is a self-published source, as is medium.com). 06:16, 23 February 2018 (UTC) — Preceding unsigned comment added by Defendingaa (talk • contribs)

Not that surprising that this film does not have much coverage. The listed production company is "Inwood Girl ​Productions, LLC" (Buzzfile entry), an obscure Los Angeles-based company with few other credits. It was reportedly founded in 2013. Based on the information they give on themselves:

"Inwood Girl Productions is located in Los Angeles, California. This organization primarily operates in the Motion Picture and Tape Distribution business / industry within the Motion Pictures sector. This organization has been operating for approximately 5 years. Inwood Girl Productions is estimated to generate $142,488 in annual revenues, and employs approximately 8 people at this single location." Dimadick (talk) 18:44, 22 February 2018 (UTC)

Removed disguised advertisement for Practical Recovery

I have removed the contents of an edit which looks to be an advertisement for the "Practical Recovery" clinic. This edit is troublesome, for a number of reasons:

  • The edit makes a claim about AA's effectiveness. Those kinds of claims by and large do not belong in this article; they belong in Effectiveness of Alcoholics Anonymous. See The recent discussion on the talk page.
  • The edit appears to be an advertisement for this non-12-step Practical Recovery treatment center.
  • The article linked to in the edit uses a 1990 report congress made entitled "Alcohol and Health" This report is outdated, as per WP:MEDDATE
  • The linked article falsely claims that addiction research has not changed since 1990. We have a huge number of studies and conclusions done since then.
  • The editor, linking to this research, seems to have not noticed that, in 2016—some 16 years after that outdated report—the surgeon general has said that 12-steps approaches help a lot of people get and stay sober (that information was available for the editor to read in the article immediately above where they inappropriately put their questionable claims).

As a rule of thumb, edits discussing effectiveness of Alcoholics Anonymous will be removed from this page. We have a page for that: Effectiveness of Alcoholics Anonymous. Please discuss whether or not AA works there, not here.

Defendingaa (talk) 21:37, 26 February 2018 (UTC)

Alcoholics Anonymous FBI file

I have removed the following link from the external links: https://archive.org/details/AlcoholicsAnonymousFBIFile

The external link said there is a FBI file on Alcoholics Anonymous, but the actual file is not an investigation of the AA World Services or anything else relevant to AA as a whole, but a report of a criminal investigation of a 1978 Texas bombing where no one was injured.

If this link should be restored, please explain why here.

Defendingaa (talk) 17:28, 30 March 2018 (UTC)

Here is the diff which added this link. I will go to their user page and ask them why they added the link. Defendingaa (talk) 17:39, 30 March 2018 (UTC)

I have added a note to the user's talk page. Since they have not been active for over a year, I doubt they will reply. Defendingaa (talk) 17:43, 30 March 2018 (UTC)

Should we make the "effectiveness" section smaller.

I propose we make the effectiveness section shorter. Right now, here is the text:

Studies of AA's efficacy have produced inconsistent results. While some studies have suggested an association between AA attendance and increased abstinence or other positive outcomes,[65][66][67][68][69] other studies have not.[70][71][72]
The Surgeon General of the United States 2016 Report on Alcohol, Drugs, and Health states "Well-supported scientific evidence demonstrates the effectiveness of twelve-step mutual aid groups focused on alcohol and twelve-step facilitation interventions." [73]

I think we can reduce this to one sentence:

While there has been some scientific controversy about AA's efficacy, the Surgeon General of the United States 2016 Report on Alcohol, Drugs, and Health states "Well-supported scientific evidence demonstrates the effectiveness of twelve-step mutual aid groups focused on alcohol and twelve-step facilitation interventions." [73]

The rationale: The scientific consensus is finally shifting to addiction treatment experts seeing that referring alcoholics to AA (i.e. Twelve Step Facilitation) helps a significant subset of alcoholics get and stay sober. We have recent (read: Post Cochrane 2006) experimental studies showing this; longitudinal studies have shown this for a long time (Humphreys 2014 makes a strong case that it's AA, not self-selection, getting those people in the room); and the "science shows AA doesn't work" comes from really old studies (Brandsma 1980) or studies which made the same general mistakes as Brandsma 1980 (in Stahlbrandt, Henriettae; Johnsson, Kent O.; Berglund, Mats (2007). "Cluster Randomized Trial", "The TSI intervention was a 3-hour formal lecture, given by therapists trained in the 12-step method."; they didn’t see this helping alcoholics, but those lectures weren't AA meetings.)

Sure, a decade ago, saying "The science shows AA doesn't work" was a reasonable assertion (this was before we had experimental studies showing people randomly assigned to TSF doing better), but a lot has changed since the days of the Orange Papers motivated edits.

I won't make this change without consensus. Defendingaa (talk) 18:20, 21 July 2018 (UTC)

I have reverted a number of unsourced claims

An anonymous IP has made a number of unsourced claims:

  • They claimed that AA is a "patriarchal Christian fellowship" without a reference backing up their claim.
  • They claimed that AA is about finding one's place with "a male Christian God" without a reference, and counter to the AA Big Book's own claim that "When, therefore, we speak to you of God, we mean your own conception of God." (Alcoholics Anonymous, Page 47)
  • They claimed that AA's tolerance is "Christian" tolerance, again, without a reference.
  • The IP claimed that "Rudy and Greil argue that patriarchal Christian AA is best described as a quasi-religious organization". The reference at the end of the sentence ( https://doi.org/10.2307/3710917 ) does not have the word "patriarchal", "patriarch", or "patriarchy" anywhere in it.
  • "Meetings in the USA often end with a Christian Patriarchal prayer such as The Lord's Prayer (aka The Our Father)." While true for a relatively small number of meetings, this claim was, again, unsourced.
  • They revised the sentence "AA meetings do not exclude other alcoholics" to say "AA meetings exclude from membership other alcoholics who have no desire to stop drinking; the only qualification for membership is the desire to stop" which is unsourced and inaccurate.
  • "The research also found that AA was effective at helping agnostics and atheists become sober" became "The research also found that AA was effective at helping agnostics and atheists, and people who deny spirituality", which was more poorly worded.
  • A couple more needless references to "Christian patriarchal monotheism" and "Christian prayers" when describing agnostic meetings were made.
  • A paragraph about whether Alcoholism is a disease was revised to be more needlessly verbose and wordy. "More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."" became the more poorly worded "AA has equivocated about alcoholism being a disease, and has considered alcoholism as possibly an allergy, a type of mental illness, or as a spiritual malady. More informally than not, AA's membership has helped popularize the disease concept of alcoholism. In the 1930s, a founding member Dr. Bob Smith and Dr. William Silkworth hypothesized that alcoholism is a disease, their theory being preceded by earlier speculation which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", The Big Book defined alcoholism as a disease and 1973 conference-approved literature categorically stated that "we had the disease of alcoholism.""
  • A needless "He claimed" was added.
  • This paragraph was added: "Nevertheless the medical and scientific communities now confirm AA's early disease hypothesis and AA culture now accepts that alcoholism is indeed a disease. There are ten general scientific criteria to consider in classifying any health issue as a disease; alcoholism meets these criteria and is thus included in medical diagnostic manuals as "addictive disease" or "Alcohol Use Disorder, Severe, Moderate, or Mild". Beginning in 2000, work groups were formed to create a research agenda for the fifth major revision of DSM (DSM–5). These work groups generated hundreds of white papers, monographs, and journal articles, providing the field with a summary of the state of the science relevant to psychiatric diagnosis and letting it know where gaps existed in the current research, with hopes that more emphasis would be placed on research within those areas. In 2007, APA formed the DSM–5 Task Force to begin revising the manual as well as 13 work groups focusing on various disorder areas. DSM–5 was published in 2013. First, alcoholism is a Primary Illness not caused by other illnesses nor by personality or character defects; second, an addiction gene is part of its etiology; third, alcoholism has predictable symptoms; fourth, it is progressive, becoming more severe even after long periods of abstinence; fifth, it is chronic and incurable; sixth, alcoholic drinking (or other drug abuse) persists in spite of negative consequences and efforts to quit; seventh, brain chemistry and neural functions change so alcohol as perceived as necessary for survival; eighth, it produces physical dependence and life-threatening withdrawal; ninth, it is a terminal illness; tenth, alcoholism can be treated and can be kept in remission." Some of this may be worth keeping, but I want to see it actually referenced.

So, we see the IP made the wording needlessly verbose and added spurious claims. That in mind, I have reverted their changes.

Defendingaa (talk) 01:40, 1 November 2018 (UTC)

At this point, the editor is becoming disruptive. I have put a gentle disruptive editing warning on their talk page, as follows: As per the discussion in Teahouse, and the reverting of your changes by no less than three different editors, your edits do not reflect consensus. In particular, the claims that AA is "Patriarchal", "Monotheistic", and "Christian" are contentious, and need to be supported by references from reliable sources using the same terminology (the references have to use same words). To say that AA is "Patriarchal" because the Big Book uses male pronouns for God is original research, which goes against Wikipedia policy. The claims that Alcoholism is, in fact, a disease seems reasonably well referenced, although I would prefer a more definite reference (such as a webpage any editor can access, or a peer reviewed scientific paper) Defendingaa (talk) 23:08, 3 November 2018 (UTC)
I have done a little digging around to see what people say about AA being Patriarchal. A simple Google search shows that DOI 10.1080/15560350903543766 ("Acknowledging Gender in Women-Only Meetings of Alcoholics Anonymous", Jolene Sanders, 2010, Journal of Groups in Addiction & Recovery) actually claims the opposite, mentioning AA's "alleged patriarchal culture (Berenson, 1991; Kirkpatrick, 1986; Rapping, 1996; Tallen, 1995; Walters, 1995)" (those articles appear to, by Sanders's description of them, describe the issues women have in AA more than the "Patriarchal Christian" claims Vertapol keeps trying to add to this article) but contending that "AA has evolved in a dialectical fashion to become more accommodating to women.", that "Trevino identifies AA as a whole as encompassing a feminine ethic", and then discusses the experience of women in AA. So, the one reliable source I looked at seems to say the opposite of what Vestapol alleges: AA is not particularly patriarchal, it used to be a male culture, but that is changing, and it can be argued at AA is actually feminine, the opposite of patriarchal.
That in mind, if we're going to have a section about whether AA has been or currently is patriarchal (instead of sprinkling the claims throughout the article, without being well-referenced, as Vestapol has been trying to do), we're going to have to include Sanders 2010's claims to the contrary that AA actually accommodates women. Defendingaa (talk) 12:19, 4 November 2018 (UTC)
I have had to resort to reporting the disruptive editor. Defendingaa (talk) 02:15, 6 November 2018 (UTC)

AA Tradition and Culture

Thank you, defendingaa, for taking the time to carefully read and respond to my editions. As a brand new editor I have lots to learn beginning with the technical procedures for communicating with you and other editors. As I get those skills, I hope to work efficiently with you... and all of you... to protect the accuracy & quality of the AA page.

I'm a friend of Bill, loyal to AA, wanting passionately to enhance AA Unity which really is the integrity of AA culture. Enhanced Unity requires rigorous honesty confronting some minimization, rationalization, and a few sacred cows in the AA pasture. To keep each point of the discussion clear for all, I'm adding my comments in your text, defendingaa (DAA), using caps to help our readers:

DAA: They claimed that AA is a "patriarchal Christian fellowship" without a reference backing up their claim.

VESTAPOL: "PATRIARCHAL CHRISTIAN" SOUNDS HARSH, PERHAPS DISRUPTIVE, BUT IS JUDICIOUSLY BASED ON MINDFUL, INFORMED ASSESSMENT. WE'RE PRETTY CONFIDENT THE AA FOUNDERS DID NOT INTEND TO CREATE A PATRIARCHAL AA CULTURE, AREN'T WE?. BUT THEY WERE MEN WITHIN A RARELY-QUESTIONED PATRIARCHAL SOCIETY IN THE 1930s AND 1940s (ON INTO THE 1960s) UNABLE TO SEE THEIR ENABLING OF THE PATRIARCHY. THE EMPIRICAL FACTS ARE:

1. THAT AA HAS ROOTS IN THE EDUCATED WHITE, MALE, HETEROSEXUAL, CHRISTIAN OXFORD GROUP;

2. UNTIL THE BIG BOOK'S LAST EDITION, THE STORIES HAVE BEEN ABOUT MEN; THE NEW EDITION ADDED A WOMAN'S STORY AND A FEW MORE REFERENCES TO WOMEN, A SINCERE BUT SMALL STEP IN THE DIRECTION OF UNITY;

3. THE BB RELIABLY IF NOT ALWAYS REFERS TO ALCOHOLICS AS "HE", "HIM";

4. PATRIARCHY IMBEDDED IN AA SPIRITUALITY IS EMPIRICALLY EVIDENCED BY NUMEROUS REFERENCES TO ONE MALE GOD;

5. THE MUCH LESS FREQUENT REFERENCE TO "THE GOD OF YOUR UNDERSTANDING" IRONICALLY ASSUMES, AND IMPLIES, MONOTHEISM

(MY ANECDOTAL EVIDENCE SHOULD NOT BE CONFUSED WITH RESEARCH, BUT FOR WHAT IT'S WORTH, I JUST ATTENDED A 3-DAY AA CONFERENCE OF 2000 PEOPLE AND EVERY WORKSHOP BEGAN & ENDED WITH A CHRISTIAN PRAYER; EVERY SPEAKER REFERRED TO THE GOD AND USED THE MASCULINE PRONOUNS FOR THE GOD).

AS YOU KNOW, DAA, I ADDED A REFERENCE TO ORIGINAL RESEARCH, REGARDED AS A GOOD THING BY SCIENTISTS. IT'S UNCLEAR HOW THE QUANTITATIVE, DESCRIPTIVE STATISTICS I CITED (ABOUT THE FREQUENCY OF REFERENCES TO THE GOD IN THE BB) IS ANYTHING BUT INCONTROVERTIBLE. IN FACT THE STATISTICS USEFULLY POINT THE WAY TO ENHANCED AA UNITY. SO AA WILL NOT DE FACTO BE A PATRIARCHAL CHRISTIAN ORGANIZATION.

Original research is not allowed on the Wikipedia. We can link to research published by reliable sources, but we should not perform our own research and make our own conclusions. Especially with contentious words. For us to call AA "patriarchal" and "Christian", reliable sources have to call it that. If we find a reliable source (e.g. an article in a reliable publication) saying AA is "patriarchal" and "Christian", we need to balance that with the reliable source I found saying that AA is not "patriarchal". Defendingaa (talk) 02:25, 10 November 2018 (UTC)

DAA: They claimed that AA is about finding one's place with "a male Christian God" without a reference, and counter to the AA Big Book's own claim that "When, therefore, we speak to you of God, we mean your own conception of God." (Alcoholics Anonymous, Page 47)

VESTAPOL: THE BB QUOTE YOU CITE IS ITSELF EVIDENCE OF UNQUESTIONED PATRIARCHAL MONOTHEISM; BECAUSE "WE" IS THE WHITE CHRISTIAN MEN WHO HAD JUST WRITTEN THE BB (WITH THE ASSISTANCE OF ONE OR TWO WOMEN); AND BECAUSE "GOD" IS SINGULAR, AN ANTHROPOCENTRIC MONOTHEISTIC JUDEO-CHRISTIAN WORD. WE CAN ADD PAGE 47 AS A REFERENCE...(I'M BEING HALF FACETIOUS, HALF SERIOUS HERE).

Please be serious. I can not see how someone can read that line in the Big Book and conclude anything besides that the AA program, as outlined in its primary book, is open to many beliefs. Defendingaa (talk) 02:25, 10 November 2018 (UTC)

DAA: They claimed that AA's tolerance is "Christian" tolerance, again, without a reference. VESTAPOL: AS ABOVE.

DAA: The IP claimed that "Rudy and Greil argue that patriarchal Christian AA is best described as a quasi-religious organization". The reference at the end of the sentence ( https://doi.org/10.2307/3710917 ) does not have the word "patriarchal", "patriarch", or "patriarchy" anywhere in it. VESTAPOL:THIS IS NOT MY EDITING.

DAA: "Meetings in the USA often end with a Christian Patriarchal prayer such as The Lord's Prayer (aka The Our Father)." While true for a relatively small number of meetings, this claim was, again, unsourced.

VESTAPOL: DAA, THIS ONE'S YOURS TO REFERENCE, "While true for a relatively small number of meetings..." I WILL CERTAINLY CITE REFERENCES FOR PRAYER AT MOST AA MEETINGS.

DAA: They revised the sentence "AA meetings do not exclude other alcoholics" to say "AA meetings exclude from membership other alcoholics who have no desire to stop drinking; the only qualification for membership is the desire to stop" which is unsourced and inaccurate.

VESTAPOL: THE REFERENCE IS TRADITION THREE; I'LL ADD THAT. WE CAN CLARIFY THAT CLOSED MEETINGS ARE FOR MEMBERS ONLY AND OPEN MEETINGS MAY WELCOME "alcoholics who have no desire to stop drinking".

Again, this is an inference from something not there in the third tradition. It is, again, original research. Defendingaa (talk) 02:25, 10 November 2018 (UTC)

DAA: "The research also found that AA was effective at helping agnostics and atheists become sober" became "The research also found that AA was effective at helping agnostics and atheists, and people who deny spirituality", which was more poorly worded.

VESTAPOL: WHAT I'M TRYING TO GET AT, AWKWARDLY I'M AFRAID, IS TO CLARIFY THAT THERE ARE ATHEISTS IN AA WHO ARE SPIRITUAL AND THEY SHOULD BE DIFFERENTIATED FROM ATHEISTS IN AA WHO DECLINE SPIRITUALITY. MY CONCERN IS THAT IN PREDOMINANT CHRISTIAN CULTURES PEOPLE OFTEN ASSUME (SOMETIMES PREJUDICIALLY) "ATHEIST" MEANS REJECTION OF A SPIRITUAL FAITH SYSTEM; IT'S HARD FOR SOME TO IMAGINE A SPIRITUAL ATHEIST WHO HAS A FAITH SYSTEM. AGAIN, THIS IS NUDGING AA CULTURE TOWARDS THE INTEGRITY OF "AA UNITY".

This distinction can only be done if reliable sources make the distinction. To say something on the Wikipedia, it needs to be backed up with a reference to a reliable source, especially when the edit it contentious. Defendingaa (talk) 02:25, 10 November 2018 (UTC)

DAA: A couple more needless references to "Christian patriarchal monotheism" and "Christian prayers" when describing agnostic meetings were made. A paragraph about whether Alcoholism is a disease was revised to be more needlessly verbose and wordy. "More informally than not, AA's membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", in 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."" became the more poorly worded "AA has equivocated about alcoholism being a disease, and has considered alcoholism as possibly an allergy, a type of mental illness, or as a spiritual malady. More informally than not, AA's membership has helped popularize the disease concept of alcoholism. In the 1930s, a founding member Dr. Bob Smith and Dr. William Silkworth hypothesized that alcoholism is a disease, their theory being preceded by earlier speculation which had appeared as early as the late eighteenth century. Though AA initially avoided the term "disease", The Big Book defined alcoholism as a disease and 1973 conference-approved literature categorically stated that "we had the disease of alcoholism."" A needless "He claimed" was added.

This paragraph was added: "Nevertheless the medical and scientific communities now confirm AA's early disease hypothesis and AA culture now accepts that alcoholism is indeed a disease. There are ten general scientific criteria to consider in classifying any health issue as a disease; alcoholism meets these criteria and is thus included in medical diagnostic manuals as "addictive disease" or "Alcohol Use Disorder, Severe, Moderate, or Mild". Beginning in 2000, work groups were formed to create a research agenda for the fifth major revision of DSM (DSM–5). These work groups generated hundreds of white papers, monographs, and journal articles, providing the field with a summary of the state of the science relevant to psychiatric diagnosis and letting it know where gaps existed in the current research, with hopes that more emphasis would be placed on research within those areas. In 2007, APA formed the DSM–5 Task Force to begin revising the manual as well as 13 work groups focusing on various disorder areas. DSM–5 was published in 2013. First, alcoholism is a Primary Illness not caused by other illnesses nor by personality or character defects; second, an addiction gene is part of its etiology; third, alcoholism has predictable symptoms; fourth, it is progressive, becoming more severe even after long periods of abstinence; fifth, it is chronic and incurable; sixth, alcoholic drinking (or other drug abuse) persists in spite of negative consequences and efforts to quit; seventh, brain chemistry and neural functions change so alcohol as perceived as necessary for survival; eighth, it produces physical dependence and life-threatening withdrawal; ninth, it is a terminal illness; tenth, alcoholism can be treated and can be kept in remission." Some of this may be worth keeping, but I want to see it actually referenced. So, we see the IP made the wording needlessly verbose and added spurious claims. That in mind, I have reverted their changes.

VESTAPOL: WE EACH APPRECIATE SCIENCE, DAA, AND AGREE THAT INCLUDING THE DISEASE CRITERIA WILL BE USEFUL FOR THE GENERAL READERSHIP. THOUGHT I'D REFERENCED THAT BUT WILL MAKE SURE IT'S CITED WITH CARE.

Defendingaa (talk) 01:40, 1 November 2018 (UTC)

DAA: At this point, the editor is becoming disruptive. I have put a gentle disruptive editing warning on their talk page, as follows: As per the discussion in Teahouse, and the reverting of your changes by no less than three different editors, your edits do not reflect consensus. In particular, the claims that AA is "Patriarchal", "Monotheistic", and "Christian" are contentious, and need to be supported by references from reliable sources using the same terminology (the references have to use same words). To say that AA is "Patriarchal" because the Big Book uses male pronouns for God is original research, which goes against Wikipedia policy. The claims that Alcoholism is, in fact, a disease seems reasonably well referenced, although I would prefer a more definite reference (such as a webpage any editor can access, or a peer reviewed scientific paper) Defendingaa (talk) 23:08, 3 November 2018 (UTC) I have done a little digging around to see what people say about AA being Patriarchal. A simple Google search shows that DOI 10.1080/15560350903543766 ("Acknowledging Gender in Women-Only Meetings of Alcoholics Anonymous", Jolene Sanders, 2010, Journal of Groups in Addiction & Recovery) actually claims the opposite, mentioning AA's "alleged patriarchal culture (Berenson, 1991; Kirkpatrick, 1986; Rapping, 1996; Tallen, 1995; Walters, 1995)" (those articles appear to, by Sanders's description of them, describe the issues women have in AA more than the "Patriarchal Christian" claims Vertapol keeps trying to add to this article) but contending that "AA has evolved in a dialectical fashion to become more accommodating to women.", that "Trevino identifies AA as a whole as encompassing a feminine ethic", and then discusses the experience of women in AA. So, the one reliable source I looked at seems to say the opposite of what Vestapol alleges: AA is not particularly patriarchal, it used to be a male culture, but that is changing, and it can be argued at AA is actually feminine, the opposite of patriarchal.

VETSAPOL: AA HAS MADE GESTURES, AS YOU CITE ABOVE, IN THE DIRECTION OF IDENTIFYING PATRIARCHAL & CHRISTIAN ASSUMPTIONS & BIASES. AA IS SHIFTING SLOWLY TOWARD THE UNITY THAT HAS THE INTEGRITY OUR FOUNDERS INTENDED (BUT STRUGGLED TO FULLY IMAGINE). WITH SO MANY MEMBERS (AND FRIENDS OF AA) YET MINIMIZING OR BLIND TO THE PATRIARCHAL CHRISTIAN CULTURE OF AA, A RIGOROUSLY HONEST WIKIPEDIA PAGE CAN BE A VERY GOOD THING FOR ALL.

The article says that AA is not patriarchal. We should not infer something it does not say. Defendingaa (talk) 02:25, 10 November 2018 (UTC)

That in mind, if we're going to have a section about whether AA has been or currently is patriarchal (instead of sprinkling the claims throughout the article, without being well-referenced, as Vestapol has been trying to do), we're going to have to include Sanders 2010's claims to the contrary that AA actually accommodates women. Defendingaa (talk) 12:19, 4 November 2018 (UTC)

Vestapol (talk) 20:36, 8 November 2018 (UTC)VESTAPOLVestapol (talk) 20:36, 8 November 2018 (UTC)

I am hoping other editors can chime in and let us know their thoughts on these edits. Until they do, the consensus is to keep the article the way it was before, without the contentious claims. If you look at my edits, I have kept some of them (the paragraph on the disease model, and the claim about efficacy was put in Effectiveness of Alcoholics Anonymous; you do make valuable contributions. Defendingaa (talk) 02:25, 10 November 2018 (UTC)

Edits in Introduction undone by anonymous user

I am trying to find out why my edits were undone by an anonymous user on 4/23. Please let me know where they are factually inaccurate, not cited, or otherwise wrong so we can talk about them here. Thanks! Lwoodyiii (talk) 13:56, 23 April 2019 (UTC)

Just now reading them over, they appear a lot more vague than what was on the page before. Tom Reedy (talk) 04:31, 24 May 2019 (UTC)

Please do not edit Alcoholics_Anonymous#Effectiveness without getting consensus here on the talk page first

Since this has been a point of contention for a long time, please do not make any edits to the section on AA effectiveness in this article without first getting consensus here on the talk page. We went to a lot of effort to hammer out consensus, and that section should only be changed after we come to a new consensus about what exactly that section should contain. Defendingaa (talk) 05:40, 12 June 2019 (UTC)

I have changed my username

This is just a heads up that I have changed my username from "Defendingaa" to "SkylabField"; the reason I did this change is because the old username resulted in some other editors accusing me of editing in bad faith. SkylabField (talk) 11:44, 16 January 2020 (UTC)

Short description minor change

I think the short description would be more descriptive—and hopefully still concise—if it mentioned sobriety. Perhaps "sobriety focused mutual aid movement," "mutual aid sobriety fellowship."— motevets (talk) 03:16, 27 September 2020 (UTC)

Thanks for raising this issue. I prefer "sobriety focused mutual aid fellowship". Let's see if there are other comments. Sundayclose (talk) 03:31, 27 September 2020 (UTC)
It better explains the organization's aim than merely describing its mutual aid philosophy. Dimadick (talk) 09:57, 28 September 2020 (UTC)
I like that too, but I would hyphenate sobriety-focused, since we are essentially using it as an adjective. --FeldBum (talk) 22:19, 29 September 2020 (UTC)
If that's enough consensus, happy to make this edit. --FeldBum (talk) 04:36, 30 September 2020 (UTC)
@FeldBum: I, for one, and happy with any of the suggested phrasings. — motevets (talk) 13:54, 30 September 2020 (UTC)

 Done Sundayclose (talk) 14:20, 30 September 2020 (UTC)

The Big Book in the lead section

So in the lead section it reads that " Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered From Alcoholism [...] is now usually referred to as the Big Book." Should this be changed to say something along the lines of "is now usually referred to by members of the AA community as the Big Book"? Not this exact wording but something that indicates it is only referred to as the Big Book by those in the know (I wasn't). Xx78900 (talk) 18:50, 24 October 2020 (UTC)

Other 12-step groups refer to it as the Big Book. Many substance abuse professionals refer to it as the Big Book. I think your suggested change is misleading and not necessary. It's apparent that the informal title is used by those who are familiar with the book. Sundayclose (talk) 19:23, 24 October 2020 (UTC)

Substance and Form

"Although it neither originated nor promulgated the disease model of alcoholism, viewing it as an outside issue on which it has no opinion, AA members, acting independently, have done much for its popularization.[5] "

Right so you've just described AA as a mutual-aid, self supporting, and dare I paraphrase decentralised, primarily membership organisation. So given your structure, if AA members have played such a role in popularising such an understanding, and mixed that promulgation with their AA experience, decentralised branding and membership branding, and especially if AA have not acted to clamp down on it, it is linked to AA as a decentralised membership entity - that is a just bizarre proposition to make. As AA is not a natural person we logicians then have to impute states of mind to it based on the those involved which as you say as a mutual support membership organisation can of course bring into play the conduct of members of an organisation, under the AA branding, unless of course its made clear at the time that such activity and presentations do not form part of AA.

I mean I could draw a diagram if it would help.

Artificial entities can obviously not have opinions. That's is where we have to impute states of mind to them.

131.111.184.3 (talk) 09:59, 13 July 2021 (UTC)

Alex Shrugged (talk) 18:23, 16 August 2021 (UTC)Organizations have official opinions and present those opinions as belonging to the organization as a whole while individual members might not always agree. For example, "The White House said today...". Obviously houses of any color do not speak per se but the organization with the nickname "The White House" is often asked for an opinion by news people. The same with "The Congress", "The Senate," and "soccer moms" even though soccer moms are not an organization. The idea that they would speak with one voice seems ridiculous to me. That doesn't make it nonsensical though.

Added by another editor not Alex Shrugged:

AA, despite being an intentional non hierarchical anarchy, is not decentralized — so the paraphrasing, daring or not, was misleading. It has what is commonly called the Central Office. AA also explicitly says it has no opinions on outside issues as an organization. Obviously, as Alex Shrugged says so well, it is not impossible, in fact, quite common, and clearly sensical for an org to offer opinions as an org. Also obvious is that the agency of an org will differ from the agency of a person, but this difference has no bearing on the org’s opinions, it just defines the social context for those receiving the opinion.

Merger proposal

I propose merging Effectiveness of Alcoholics Anonymous into Alcoholics Anonymous. I think the content in the daughter article has a higher visibility and creates a single more robust article if merged. The parent article looks odd as coverage of effectiveness is minimal. The prose size of each (26kb and 10kb) lies comfortably within the ceiling prose size (50kb).Cas Liber (talk · contribs) 03:38, 30 September 2021 (UTC)

Support Here in 2021, I do not think the effectiveness of Alcoholics Anonymous needs the deep level of discussion it needed before the 2020 Cochrane Review of Alcoholics Anonymous was released. In particular, the studies which do not show any efficacy for AA are older studies which had methodological issues (or were studies where the “AA” treatment didn’t have AA’s fellowship aspect). The Lance Dodes stuff will continue to need to be addressed, because, even though the majority of treatment experts feel his figures are very inaccurate, those figures continue to be cited in social media. One issue with the merger is that Outpatient Treatment of Alcoholism may become an orphan. SkylabField (talk) 07:24, 30 September 2021 (UTC)
Both plublications are notable and discussion of them should be in main article - as I pointed out, a combine article is still comfortably under maximum article size Cas Liber (talk · contribs) 19:23, 1 October 2021 (UTC)
I support it being a combine article. Other editors may wish to trim some of the content, but “Does AA work?” is a big question asked, so having the entire current Effectiveness of Alcoholics Anonymous article would not be out of line. We should preserve the history of both articles, and keep the Talk:effectiveness of Alcoholics Anonymous page as a record of consensus already reached (e.g. only medically reliable sources, etc.) SkylabField (talk) 01:34, 2 October 2021 (UTC)
  • Support per Cas. Basically as stated neither article is too long and it is logical and easier for readers to have them both located here. It probably saves some duplication too. Tom (LT) (talk) 22:55, 1 October 2021 (UTC)
  • Support Yes, with the 2020 Cochrane Review out, we’re burying the lede somewhat. If a new wave of editors comes to challenge this, we can always re-evaluate. - Scarpy (talk) 05:51, 2 October 2021 (UTC)
  • Support - the article is long. It needs to cut to the chase. In each method and study it should simply lay out the facts, figures and methods, with any caveats. CaffeinAddict (talk) 01:44, 6 October 2021 (UTC)

Done. Since there is consensus to merge the two articles, and since it has been over a week, I have done a simple combine merge of Effectiveness of Alcoholics Anonymous in to this article. I moved all of the sub-sections one level down and added “Effectiveness:” to some of the sub-section titles, but otherwise kept the Effectiveness article as is. I am sure this section will be edited some more now that it is more visible, but this is an important start. History and contributers for this section is over at Effectiveness of Alcoholics Anonymous and discussion about content for effectiveness is over at Talk:Effectiveness of Alcoholics Anonymous. SkylabField (talk) 05:36, 6 October 2021 (UTC)

  • Oppose Too many issues with the Effectiveness article to do a full merge. I feel like its length is marginal for inclusion as a separate section, and it has been heavily edited to reflect a particular viewpoint. It's a complex discussion that if given full attention is almost certainly going to require a full article. — Preceding unsigned comment added by 12.221.138.134 (talk) 13:10, 6 October 2021 (UTC)
    General consensus is that the current full combine merge is within reason (but I sense it will be trimmed down in future edits); the alleged POV issues can be resolved by having that content here, where it’s more visible and where more people will edit it. SkylabField (talk) 14:32, 6 October 2021 (UTC)

Proposed taming of the lede

Propose eliminating paragraphs 2,3, and 4. In brief, the paragraphs covering AA history, and summarizing the Steps and Traditions. Suggesting these are better left to the body of the article as the 1st and last lede paragraphs are enough for the lede. 5ive9teen (talk) 16:05, 4 November 2021 (UTC)

See Wikipedia:Manual of Style/Lead section - the lead is supposed to be a summary of the most important information in the article. All material in the lead should be in greated detal in the body. I agree the lead is a little (but not too much) on the large side but it is a big article. Feel free to have a play with it Cas Liber (talk · contribs) 19:42, 4 November 2021 (UTC)

“so as” or “is”

We have been having an edit war about the correct grammatical form for this sentence:

That AA should have no opinions on other causes so as to avoid public controversy

Versus:

That AA should have no opinions on other causes is to avoid public controversy

Both are slightly sloppy wording. I propose something different:

AA should have no opinions on outside issues in order to avoid public controversy

Why:

  • “That” should not be at the beginning of a sentence; it’s uncommon to begin a sentence with a preposition
  • “outside issues” instead of “other causes” to be consistent with AA’s own traditions on the matter
  • “in order to” makes the bit about avoiding public controversy a subordinate clause

The sentence’s subject is “AA”; the verb is “should have” (two words, because English uses auxiliary verbs frequently); the object is “no opinions on outside issues”, where “on outside issues” is a prepositional phrase modifying “no opinions”. We then have a subordinate clause, “in order to”, which implicitly uses the same subject (“AA”), but has a different verb (“avoid”) and object with adjective (“public controversy”).

SkylabField (talk) 01:20, 18 December 2021 (UTC)

@SkylabField: I have a concern about your wording which I think can be resolved, but first: No one is edit warring, and to link my edit to suggest that I have edit warred is a personal attack, although I believe done unintentionally. I reverted once, with an appropriate edit summary. That's not edit warring. Please strike your comment.
Your suggested change is an improvement in that it is a complete sentence, as opposed to "That AA should have no opinions on other causes so as to avoid public controversy". That's not just sloppy wording, it's an incomplete sentence. The problem with your suggestion is that it puts AA's Tradition Ten in Wikipedia's voice. It is AA that is saying what should not be done. Your wording makes it sound as if Wikipedia is saying what AA should not do. Adding the phrase "According to Tradition Ten" would resolve the problem in your edit. But yours is not the only edit that does that; other similar edits referring the the Twelve Traditions also have worded it to speak in Wikipedia's voice. At this point I'm not sure how to resolve those. I need to give this some thought. Sundayclose (talk) 05:29, 18 December 2021 (UTC)
I will concede that one edit is not an edit war. That’s not what happening here. Four reverts in the same month means we should take it to talk to build consensus: [4] [5] [6] [7] Now, it’s not a question of who is right and who is wrong here, and I don’t see any reason to bring this up to WP:AN/I at this point, but we need to hammer out consensus on the talk page about the wording of that entire paragraph, and I’m offering a third opinion, not because I have any real interest in this matter, but because I want to see established consensus on this. So, let me outdent and go back to the paragraph:

Here’s the version of the paragraph in this revision:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. That AA should have no opinions on other causes to avoid public controversy. That members or groups should not use AA to gain wealth, prestige, or property. That dogma and hierarchies are to be avoided. That AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

Then, here’s the next revision:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. That AA should have no opinions on other causes is to avoid public controversy. That members or groups should not use AA to gain wealth, prestige, or property. That dogma and hierarchies are to be avoided. That AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

And then, this was reverted back; after going back and forth between these two versions, an IP chipped in and we got this version:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. That AA should have no opinions on other causes so as to avoid public controversy. That members or groups should not use AA to gain wealth, prestige, or property. That dogma and hierarchies are to be avoided. That AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

That got reverted back to this:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. That AA should have no opinions on other causes is to avoid public controversy. That members or groups should not use AA to gain wealth, prestige, or property. That dogma and hierarchies are to be avoided. That AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

So, I looked it over and made it look like this:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. AA should have no opinions on outside issues in order to avoid public controversy. AA members and groups should not use AA to gain wealth, prestige, or property. AA should avoid dogma and hierarchies. AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, AA members should remain anonymous in public media.

The second sentence in particular has resulted in four reverts this month. I will include all of the versions of it and my opinions:

  • Version 1: That AA should have no opinions on other causes to avoid public controversy.
  • Version 2: That AA should have no opinions on other causes is to avoid public controversy.
  • Version 3: That AA should have no opinions on other causes so as to avoid public controversy.
  • Version 4: AA should have no opinions on outside issues in order to avoid public controversy.

My thoughts:

  • Version 1: “That” is a bit sloppy. “AA should have no opinions on other causes to avoid public controversy.” is grammatical English (i.e. it’s a sentence a native English speaker will consider as one with correct grammar). A little more sloppy with “that”, but I will let it slide.
  • Version 2: “That AA should have no opinions on other causes is to avoid public controversy” would work better with a gerund: “AA having no opinions on other causes is to avoid public controversy”
  • Version 3: “That AA should have no opinions on other causes so as to avoid public controversy” works better than “That AA should have no opinions on other causes is to avoid public controversy” because the subordinate clause is more clearly marked.
  • Version 4: This is my version; I’m perfectly happy with another version as long as consensus can be reached so we stop having multiple reverts over the same sentence.

If we need to keep the “that”, perhaps “That AA, by having no opinions on other causes, avoids public controversy.” and the rest of the paragraph as is before I mucked with it. Here is my proposed version 5:

Besides requiring a member to only have at minimum a desire to stop drinking, the Twelve Traditions hold that helping others recover from alcoholism is AA's primary purpose. That AA, by having no opinions on other causes, avoids public controversy. That members or groups should not use AA to gain wealth, prestige, or property. That dogma and hierarchies are to be avoided. That AA groups are autonomous and self-supporting—declining outside contributions—but they are barred from lending the AA name to other entities. And, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

I personally am happy with version 3, version 4, or version 5. SkylabField (talk) 11:49, 18 December 2021 (UTC)

@SkylabField: I'll just address the "edit war" issue here and make any other comments later. My reversions over a period of one month do not constitute edit warring. And I also don't refer to who is right or wrong. In compliance of WP:BRD, I made a good faith effort to discuss the issue on the talk page of an editor who was repeatedly adding a grammatical error, and that editor eventually left it alone. If you don't feel you can strike the "edit war" comment, at the very least you can unlink my edit from the "edit war" phrase. Again, I don't think you have acted in bad faith, and the actual issue of how to word the disputed content is simply a matter of hammering out an agreement. But I did not edit war. I'll discuss the wording issue when I have more time. Sundayclose (talk) 15:06, 18 December 2021 (UTC)

Adding the word "that" again creates incomplete sentences. "That AA, by having no opinions on other causes, avoids public controversy" is an incomplete sentence. But this would be a complete sentence: "AA, by having no opinions on other causes, avoids public controversy"; but's it's a bit awkward. I recommend the following, which has no incomplete sentences:

The Twelve Traditions stipulate that: AA, by having no opinions on other causes, avoids public controversy; members or groups should not use AA to gain wealth, prestige, or property; dogma and hierarchies are to be avoided; AA groups are autonomous and self-supporting — declining outside contributions — but they are barred from lending the AA name to other entities; and, without threat of retribution or means of enforcement, members should remain anonymous in public media.

Or a slightly wordier version, but with no incomplete sentences:

The Twelve Traditions stipulate: That AA, by having no opinions on other causes, avoids public controversy; that members or groups should not use AA to gain wealth, prestige, or property; that dogma and hierarchies are to be avoided; that AA groups are autonomous and self-supporting — declining outside contributions — but they are barred from lending the AA name to other entities; and, without threat of retribution or means of enforcement, that members should remain anonymous in public media.

Sundayclose (talk) 17:27, 18 December 2021 (UTC)

I like the less wordy version. I have edited the article to make that the version in the article space, with two changes: 1) A sentence explaining what the traditions are 2) A MOS:DASH fix: Wikipedia uses the same em dash style as the Big Book—no spaces between the dash and words. SkylabField (talk) 18:09, 18 December 2021 (UTC)

For the record, I'll make one final comment and then move on: this edit is not edit warring, as described at WP:EW and WP:BRD and supported by this attempt at discussion. Sundayclose (talk) 20:30, 18 December 2021 (UTC)

Effectiveness of Alcoholics Anonymous

Now that effectiveness of Alcoholics Anonymous has been merged to the article I believe it is WP:UNDUE - it seems like a back and forth argument about whether it works or not, when it could simply be laid out as: "it works, for some people"... I think the further reading section was appropriate for a standalone article but not embedded in the current one. Sundayclose disagrees apparently. CaffeinAddict (talk) 02:50, 15 January 2022 (UTC)

My issue isn't whether AA is effective. It's your removal of the "Further reading" section, which you decided unilaterally with no discussion. Your edit summary said "further reading should be in external links". But you didn't put it in "External links". You removed it entirely. And it doesn't actually belong in "External links" because sometimes "Further reading" has items that are not external links. They are simply titles of publications. Look around at the thousands of articles that have "Further reading" sections. One example of those thousands is Narcotics Anonymous. You have provided no reasonable basis for removing "Further reading" or moving it to "External links" that would make this article the exception. Sundayclose (talk) 03:20, 15 January 2022 (UTC)
Realistically, in the context of an encyclopedia article, why do we need further reading on the subject that could be more succinctly summarized? I feel like all the major studies and media pieces about it are presented there, no? The list also seems to be an arbitrary collection of articles and books. CaffeinAddict (talk) 04:22, 15 January 2022 (UTC)
Upon review this I would suggest losing Impact evaluation and Program evaluation from the article and adding Project MATCH to see also. I would also propose removing the list of further reading altogether as a distraction from this article. Some of those can be used as fantastic sources for the article and this section in particular. However, the section remains WP:UNDUE in it's weight. I would almost, despite my previous vote to merge the former article into this larger one be in favour of breaking it off to prevent it from WP:BLOATing too much. CaffeinAddict (talk) 04:32, 15 January 2022 (UTC)
You still have not provided a reasonable basis for treating this article as an exception to the standard practice on Wikipedia of having a "Further reading" section. Further reading is not a "distraction", and I have no idea how you came up with that strange notion. "Further reading" sections usually have useful information for the reader interested in pursuing the topic more fully. I strongly oppose removing "Further reading". Unless there is a new consensus, that section remains as the WP:IMPLICITCONSENSUS. Don't again decide unilaterally to remove it. Sundayclose (talk) 04:42, 15 January 2022 (UTC)
I look forward to other editor's comments on the matter. I will happily continue to do BOLD edits on wikipedia where I see fit and will never be intimidated by others (including you). Again, looking forward to other opinions and hopefully you will not decide to WP:OWN this article. :) CaffeinAddict (talk) 04:45, 15 January 2022 (UTC)
You don't have to be intimidated. You just have to respect consensus. And while you're at it, stop throwing around false accusations of WP:OWN. If that's done sufficiently, it's a personal attack. You and I are finished here unless others weigh in. Sundayclose (talk) 04:49, 15 January 2022 (UTC)
WP:COOL ;) CaffeinAddict (talk) 04:52, 15 January 2022 (UTC)

I support trimming the “further reading” of the effectiveness sub-section. I also support removing most of the studies from this section; Cochrane 2020 is a pretty good summary (42% success rate among people serious enough to sit in a room with a therapist to talk about their drinking problem). That The Sober Truth discussion should remain, simply because people on social media still use this outdated (and, quite frankly, never accurate) book to incorrectly claim AA has a “5% success rate”. Maybe also have a brief section pointing to the refutation of the old “The AA 1990 triennial survey shows a 5% success rate” chestnut, because I saw that one brought out of the woodwork in the last three years. I am a bit worried about Outpatient Treatment of Alcoholism becoming an orphan, so we should briefly mention it; that is yet another old chestnut the people trying to claim AA doesn’t work love to bring up. SkylabField (talk) 08:31, 16 January 2022 (UTC)

SkylabField what are your thoughts on the subsection "Effectiveness: See also"? CaffeinAddict (talk) 00:21, 18 January 2022 (UTC)
I think we can get rid of it. Project MATCH is already linked, and the other two items seem superfluous. I also think we can get rid of the back-and-forth style of the writing, which reflects what was going on in the popular press in the mid-2010s (e.g. the popular press would have a bunch of summaries of The Sober Truth, claiming AA essentially doesn’t work, then articles saying but AA really works would pop up); the current consensus, even in the common press, is to concede AA really works for some and really helps some because of Cochrane 2020. SkylabField (talk) 10:06, 18 January 2022 (UTC)
I'm going to glaze it over at some point and suggest some fine-tuning. CaffeinAddict (talk) 16:07, 18 January 2022 (UTC)
I’ve gone to the liberty of trimming down the entire back-and-forth comparing different studies from the 1990s or 2000s. Consensus among scientists is that AA works for some, and the arguments that AA doesn’t work are based on older papers (or, in the majority of cases, not even a scientific study: Neither the 1990 Triennial Survey nor the book The Sober Truth were peer-reviewed) which have been superseded. SkylabField (talk) 13:54, 20 January 2022 (UTC)

Adding sentence on effectiveness to the lead

​​​​​​​​​Now that Cochrane 2020 has been around for a couple of years, do other editors feel it’s OK to add a one sentence mention of effectiveness to the lead? I’m thinking “A 2020 Cochrane Library review of Alcoholics Anonymous concludes that AA participation significantly increases sobriety.” Thoughts? If you have gotten a notification, that’s because this section inlucdes a hiddent ping of people who have chimed in about AA effectiveness over the years. SkylabField (talk) 18:32, 22 January 2022 (UTC)

My question is how important is the argument about effectiveness to the article in the first place? My view is it continues to have WP:UNDUE weight due to it being ported over from it's own article. A sentence or two would suffice however - as time moves on it seems the basic principle is it works if you let it. CaffeinAddict (talk) 19:11, 22 January 2022 (UTC)
When you say “A sentence or two would suffice however”, do you mean a sentence or two in the lead, or in the article as a whole? SkylabField (talk) 19:19, 22 January 2022 (UTC)
In the lede. CaffeinAddict (talk) 21:00, 22 January 2022 (UTC)
My view is effectiveness is central to the effort of AA. So, yes, a sentence in the lead is highly appropriate. The Cochrane review is a massive development in that respect. Scarpy (talk) 19:15, 22 January 2022 (UTC)
Three thoughts:
  • While "it helps, on average" is a perfectly good thing to put in the lead, this long sentence about where the cited source is from, what year it was published in, what kind of study it was, etc., is inappropriate. See MEDMOS on citing sources – citing the sources for the facts they contain, not talking about the sources so that everyone has to slog through a long description. The Cochrane review could be used to support "AA participation increases sobriety". Leave out the other 75% of the words in the tentatively suggested sentence. Or re-write it into simple English: "People in AA are more likely to stay sober than people who do nothing."
  • PMID 32628263 might be helpful in writing about efficacy. Notice their useful comparison: "similar benefits to other treatments". There are no magic treatments in this field.
  • The whole efficacy section needs a major re-write. Encyclopedia articles summarize overall facts. They do not provide detailed literature reviews. They especially do not repeat the same statistic about 42% abstinence three times in the same section.
WhatamIdoing (talk) 02:57, 23 January 2022 (UTC)
I appreciate the feedback and ideas. It’s important to take in account a very key part of PMID 32628263: “AA/TSF interventions produce similar benefits to other treatments on all drinking-related outcomes except for continuous abstinence and remission, where AA/TSF is superior. AA/TSF also reduces healthcare costs”. Cochrane 2020 doesn’t conclude that AA is better than nothing -- we’ve known that since Brandsma 1980 -- but it concludes that AA has higher abstinence rates than other treatments, costs less than other treatments, and is in other ways as effective as other treatments. I can word it in the lead as AA results in higher abstinent rates and costs less than other treatments. The effectiveness section is its own can of worms, but that’s another discussion for another day. SkylabField (talk) 03:59, 23 January 2022 (UTC)
I think it's worth mentioning while there have been some clinical studies on AA as a whole, it was not historically very well studied (probably due to the anonymity of the fellowship) until the most recent 2020 cochrane review. I would suggest something along the lines of: The effectiveness of AA (compared to other methods and treatments) has been challenged throughout the years. According to clinical studies (most recently a 2020 Cochrane review), AA results in higher abstinent rates and costs less than other treatments. CaffeinAddict (talk) 06:42, 23 January 2022 (UTC)
That's far too much detail for the lead. WhatamIdoing (talk) 06:58, 23 January 2022 (UTC)
Other programs don't have a goal of abstinence, so that may be an unfair comparison. Therefore I wouldn't emphasize it, especially in the lead, where there is no room to explain the context.
I would be hesitant to say that it "costs less", because it doesn't "cost less": it "costs the healthcare system less". The calculation they're using excludes the costs to the participants (e.g., time, travel, lost work, childcare, educational materials), the mentors (ditto, plus extra expenses for training), the local hosts (e.g., heating and cleaning costs for the building), the national organization (about US$15M per year, if memory serves), etc.
It is the same problem as the Kegel exercise, which is "free" but costs 30 minutes a day of the woman's time and attention, for a minimum of several months, but a woman's time and attention is always free, right? And breastfeeding is nearly free, except a little extra food – and hours and hours of the woman's time, every day, even round the clock, for months on end. For most disabilities, the biggest economic cost is lost time and wages, not the cost of seeing a doctor or buying a drug. This seems to be no different. The ~90 minutes spent getting to each meeting, participating in the meeting, and getting back to your home or work would normally be valued at about $40 per US participant per meeting (approximately $15K per year for a person attending one meeting each day). AA is popular with the US criminal justice system because the costs are not borne (directly) by taxpayers, not because any decent economist would say that it's actually free. WhatamIdoing (talk) 06:58, 23 January 2022 (UTC)
The concept of costing was from one of the actual studies. It was individual cost, compared to say therapy, rehab, etc. CaffeinAddict (talk) 07:01, 23 January 2022 (UTC)
The reason why I brought up AA costing less is because that’s what medical reliable sources say about the matter; that may be contentious, but I would like to see the contention backed by medically reliable sources first. I agree a two or three sentence summary is probably too long for the lead, which is why I prefer the one sentence “AA results in higher abstinent rates and costs less than other treatments” summary in the lead, and go in to this more extensively in the body. The way we describe AA efficacy in the body is less than ideal, and it’s that way because it was by and largely written around 10 years ago when there scientific consensus was a lot more murky (hence a lot more attribution for claims of efficacy than is normally done in the Wikipedia, because it’s not Wikipedia’s place to declare a given scientific consensus when there actually wasn’t a really clear one a decade ago), but that’s another issue altogether. I’ll keep the comments here in mind when and if we go over how we should rewrite the section on efficacy. SkylabField (talk) 10:38, 23 January 2022 (UTC)
I’ve added a one-sentence summary of AA effectiveness to the lead and have made some improvements to the effectiveness section in the body as per the discussion here. Also, while WP:NOTAFORUM, to get in to the entire discussion of cost, the issues with transportation to AA meetings and with parents needing child care to make it to a meeting were real issues two years ago. Here in the COVID 2020s, there are a lot more online meetings, so these problems are no longer the problems they were before. SkylabField (talk) 11:39, 23 January 2022 (UTC)
Skylab, "AA...costs less" exactly what the sources don't say. Here are exact quotations:
  • Healthcare cost offset studies were also included.
  • higher health care cost savings
  • reduces healthcare costs
  • healthcare cost offsets
  • total medical care costs
  • substantial healthcare cost savings
None of this is talking about the program's actual "costs". If you are trying to control Medicaid's budget, then rejoice: AA participation doesn't come out of the Medicaid budget. But that's not "costs"; that's only the costs paid by the healthcare system, ignoring and excluding all other non-healthcare costs, even though we know they are significant. WhatamIdoing (talk) 00:28, 24 January 2022 (UTC)
AA may have originated in the US - but it is a worldwide program. You're being narrowly US-centric. CaffeinAddict (talk) 03:04, 24 January 2022 (UTC)
The Cochrane review included 27 studies. Out of those, only three were outside the US. That's 89% from the US, so, yes, this is mostly about AA/TSF in the US.
About those three: The Canadian one concluded that both Relapse prevention and AA/TSF attendance probably helped, but there were other significant factors; it does not mention costs. The UK one concluded that if you're doing in-patient detox, then you might join a 12-step program afterwards anyway, but the odds are higher if your doctors tells you to go, and even higher if an AA peer recommends it; no matter how you get there, if you show up faithfully, your short-term abstinence rate goes up from 40% to 60%. It does not mention costs. The Norwegian one was mostly measuring how to get people to attend 12-step meetings after they're released from in-person detox; half of them got a "motivational intervention" and the rest were simply advised to join a 12-step group. It, too, did not mention costs.
Since none of the three studies outside the US mention costs, then all the information in this study about costs is about US healthcare costs. If recognizing that there is no information about non-US costs in this study is "narrowly US-centric", then your complaint is with the source, not with me. WhatamIdoing (talk) 03:36, 24 January 2022 (UTC)
No my complaint is with you. I don't quite know what you're getting at to be honest. CaffeinAddict (talk) 04:52, 24 January 2022 (UTC)
If we write – as someone did – that AA "costs less than other treatments", we are misrepresenting the source. The source does not say that it "costs less". The source says "reduces healthcare costs". "Costs" and "healthcare costs" are not interchangeable terms.
You appear to have accused me of being US-centric because I (accurately) pointed out that the source only looked at data for healthcare costs in the US. I'm not sure why you posted that. WhatamIdoing (talk) 06:03, 24 January 2022 (UTC)
Because when you start ranting about Medicaid assuming everyone even knows what that is (I vaguely do as a Canadian) - it makes one wonder if you have your blinders on. CaffeinAddict (talk) 06:24, 24 January 2022 (UTC)
I think it’s important, even though we have differences of opinion, to respect each other as people (or, as we used to say, “men and women”). Principles before personalities. I’m OK with having the article clarify it’s healthcare costs (I am also willing to concede that the US doesn’t respect the difficulties of being poor or being a parent enough, but those are, for the purposes of this page, outside issues), but, on a personal level, the prevalence of online (Zoom, etc.) meetings post-COVID has made this much less of an issue than it was. SkylabField (talk) 13:13, 24 January 2022 (UTC)

Non-US coverage

I think we’re bringing up a legitimate point in the previous section: The coverage we have, in particular w.r.t. AA efficacy, is quite US-centric. When Nick Heather brought up the issue with the studies used in Cochrane 2020 being too US-centric, John Kelley and Alexandra Abry conceded this is an issue, flatly saying we need more non-US research on AA’s efficacy, but that most studies are done in the US so they had to work with what they had.

That said, it would be good to have some more international information. I recently unfortunately had to remove a section about AA in the UK, because the information was based on a 17-year-old survey and appeared to be biased. It would be good to have a more international perspective on AA in this article. SkylabField (talk) 13:03, 24 January 2022 (UTC)

One of the things that struck me in looking at the three non-US sources above was that they were downplaying AA as a specific organization and using generic descriptions like "12-step self-help groups". I have always assumed that AA (=the specific corporation described in this article, not any/all Twelve-step program focused on alcohol) was by far the most popular, but perhaps that's not true everywhere. WhatamIdoing (talk) 17:24, 24 January 2022 (UTC)

Lance Dodes and the Cochrane 2020 review

Since one reliable source has linked Lance Dodes to the Cochrane 2020 review of AA, it's fair to link him to that review in the section about his book criticizing AA. In particular, here is what the reliable source in question said after Cochrane 2020 was published about Dodes:

The review won't likely change the minds of 12-step opponents, like Dr. Lance Dodes, a retired assistant psychiatry professor at Harvard. Dodes hadn't yet read the new Cochrane Review, but said in an interview that he is opposed to the fundamental idea of AA — that fellowship and social connections are needed to deal with substance use disorders. Dodes has written books arguing against AA as the primary treatment for addiction.
"What does spirituality or morality or a good feeling toward others have to do with addiction? Zero. It has nothing to do with it. Addiction isn't about that. It's a psychological symptom to help you get through feelings of being overwhelmed," Dodes said. "The problem is that 90% or more of all the people who are referred to AA do not do well, and many of them are harmed."

I would summarize this as follows:

  • Dodes didn't at the time read the 2020 Cochrane Review on AA
  • Dodes continues to believe under 10% of people referred to AA "do well" after being asked about the 2020 Cochrane Review of AA.

Here is how I summarized those two paragraphs in the Wikipedia:

Dodes has not, as of March 2020, read the 2020 Cochrane review showing AA efficacy.

Because of the WP:BLP concerns, I want to make the post-Cocheane 2020 update to Dodes's claims as neutral and fact based as possible.

But this sentence got reverted.

I think a Dodes-Cochrane link belongs in the article; the Cochrane 2020 review was widely reported in many reliable sources, is a pretty good up to date scientific consensus on the effectiveness of AA, and its conclusion is a pretty significant contrast to Dodes's views on AA's effectiveness. More to the point, it has been noted and discussed in one reliable source (WBUR-FM).

SkylabField (talk) 09:05, 29 March 2022 (UTC)

I have restored the quote, but added some more of Dodes's ideas as reported by a reliable source. Here is the current wording "Dodes has not, as of March 2020, read the 2020 Cochrane review showing AA efficacy, but opposes the idea that a social network is needed to overcome substance abuse". Since there are WP:BLP concerns here, and since this entire AA efficacy debate is very contentious, I am being very careful to closely match the intention of what the reliable source says without any interpretation which could be considered original research of any form. SkylabField (talk) 09:14, 29 March 2022 (UTC)
Since Dodes is a subject matter expert in addiction, I have linked to a rebuttal to some of the criticism published in his blog. It’s allowed as per WP:BLOG. SkylabField (talk) 06:20, 20 April 2022 (UTC)

Editing Suggested to separate the summary from the content

As currently written the summary goes on at length, and includes paragraphs which seem to belong in the section on 12 Steps and 12 Traditions.

It’s a bigger task than I can take on at present.

NorieNC (talk) 21:33, 2 July 2022 (UTC)

The Irrationality of Alcoholics Anonymous

As per WP:RSPRIMARY, we should summarize “The Irrationality of Alcoholics Anonymous” by Glaser based on what secondary reliable sources have to say about it. An editor claimed, in an edit summary that “Its reference to The Sober Truth was very minor and didn't affect the content of the article”, but this claim is original research and directly contradicts what reliable secondary sources have to say about Glaser’s article. To wit:

Her argument also leans too heavily on the work of Lance Dodes, a former Harvard Medical School psychiatrist. He has estimated, as Glaser puts it, that “AA’s actual success rate [is] somewhere between 5 and 8 percent,” but this is a very controversial figure among addiction researchers.

Source: Singal, Jesse. "Why Alcoholics Anonymous Works". New York. Retrieved 2022-08-05. {{cite magazine}}: Cite magazine requires |magazine= (help)

That in mind, I have reduced the summary of this article. Here is the summary before I edited it:

In a 2015 article for The Atlantic, Gabrielle Glaser criticized the dominance of AA in the treatment of addiction in the United States due to its lack of evidence-based care, unproven assertions of high efficacy rates, and claim that its path is the only solution for recovery, despite the existence and increasing number of alternatives, including therapies, counseling, and prescription drugs, that are based on modern science and proven to be effective. Of particular note are cases where treating mental health issues by a professional results in reduced addictive behavior, which AA may not be equipped to handle.

And here is what I have trimmed that down to:

In a 2015 article for The Atlantic, Gabrielle Glaser criticized the dominance of AA in the treatment of addiction in the United States. Her article uses Lance Dodes's figures and an outdated Cochrane report to claim that AA has a low success rate, but those figures have been criticized by experts in the addiction treatment field.

The older summary gives undue weight by uncritically accepting the article’s own claims while ignoring secondary sources which contradict Glaser’s claims. SkylabField (talk) 05:36, 6 August 2022 (UTC)

I’m looking around for other secondary reliable sources discussing the article. So far
Most of the sources are from 2015, when the article was published. The WBUR article does link to other criticism on blogs about the article; the Chicago Tribune article is an opinion piece, and the 2020 medically reliable peer-reviewed article criticizes Glaser’s perception of AA. Perhaps we should flesh out this section using those sources, but we should do so with the utmost of caution: As per WP:MEDRS and WP:MEDDATE, and because a lot of the claims in this seven-year-old article have been subsequently preempted by the 2020 Cochrane report, we should be very careful about uncritically accepting the claims this article makes and we should not be parroting its claims in Wikipedia’s voice. I would lean heavily on the 2020 article if expanding it, simply because that is a medically reliable source, and because it’s relatively recent. SkylabField (talk) 06:00, 6 August 2022 (UTC)
I’ve added a sentence based on the 2020 peer-reviewed scientific article which footnotes Glaser’s article: “The Glaser article criticizes 12-step programs for being "faith-based", but 12-step programs allow for a very wide diversity of spiritual beliefs, and there are a growing number of secular 12-step meetings.” SkylabField (talk) 06:25, 6 August 2022 (UTC)
Also added: “The Glaser article says that "nothing about the 12-step approach draws on modern science", but a large amount of scientific research has been done with AA, showing that AA increases abstinence rates.”, using the Emrick 2016 as a reference. I understand this reference is behind a paywall, but I am using it because it’s a medically reliable source (as per WP:MEDRS) and because the article specifically uses over two pages of text to address and refute Glaser’s claims. I will, in the interests of commentary and criticism, quote some of its text here:
Contrary to Ms. Glaser’s (2015) sweeping statements about the lack of science concerning AA, a significant body of research has been conducted on this organization and its impact on drinking and other variables. [...] [Humphreys 2014 shows that] those who increased AA attendance due to the effects of AAFIs [AA Facilitation Interventions] (not personal motivation) had significantly more days of abstinence than those getting alternative treatments who did not go to AA. To clarify, involvement in AA was the variable that led to better drinking outcome, not receipt of AAFIs per se.
SkylabField (talk) 16:37, 6 August 2022 (UTC)

Origin

"AA sprang from the Oxford Group"

Before changing this I'd like to discuss it a bit. I think it is possibly misleading, but I don't know the history that well. At the time when Bill and Bob first met, what sort of association did each have with the Oxford group? I guess if both were direct participants at that time, the quoted statement is correct. I tried to have a look at the citation, but I was only able to read two pages. Ike9898 (talk) 16:41, 3 August 2022 (UTC)

http://prestongroup.org/aa_docs/Bill_Wilson_Oxford_Group.pdf 66.60.170.151 (talk) 17:33, 4 August 2022 (UTC)
The article shared is certainly interesting, but does not address my specifc area of concern - At the time when Bill and Bob first met, what sort of association did each have with the Oxford group? Ike9898 (talk) 20:08, 6 August 2022 (UTC)
Now, having read the cited section of ''My name is Bill W" and continuing through page 136, I can see that both men were clearly members of the Oxford Group at the time of their meeting, thus I don't see any problem with the statement that AA "sprang from" the Oxford Group. I do think a reader could misunderstand and think that the OG actively created AA, but you can't get too specific in a 3 paragraph section. The one change I'm going to make is to change the citation to include the page range I had to read to verify these facts. Ike9898 (talk) 20:45, 6 August 2022 (UTC)

Mutual help vs Mutual aid

Similar to discussion on Twelve-step program, I've updated the lead paragraph to read "mutual help" in place of "mutual aid"(linked to mutual aid (organization theory). The citation(Mäkelä 1996) is about AA as a mutual help program, as opposed to a mutual aid one, and includes discussion differentiating it from mutual aid. I'm not sure why this got translated to "mutual aid", but none of the other citations for this section mention mutual aid, so I think this is a better representation of the source.

The 2020 cochrane review refers to AA/TSF as a "peer to peer support" programme, which may be a better substitute if we wish to avoid these subtle differentiations, and is both recent and very reliable as a source- maybe we should use that? Adacable (talk) 18:00, 30 August 2022 (UTC)

“Mutual-help” is how Cochrane 2020 describes AA, so I think that wording is more apt than “mutual aid”. SkylabField (talk) 14:22, 31 August 2022 (UTC)

Bill Wilson openly acknowledged Kropotkin’s book Mutual Aid as extremely influential to him. Also, AA is an intentional anarchy due to Wilson’s devotion to the Kropotkin’s anarchist ideology. Mutual self help conveys none of that as essential. Mutual aide is the most descriptively appropriate and most historically relevant descriptor. Finally, as a movement, as far as I can tell, mutual self help has no standing in comparison to mutual aid. It is a generic and anodyne term, which is probably why some academics like it, with no wiki page to be found. — Preceding unsigned comment added by 66.60.170.151 (talk) 03:58, 1 September 2022 (UTC)

Additional note: AA can be argued to the most prominent, representative and successful example of the Mutual aide movement. — Preceding unsigned comment added by 66.60.170.151 (talk) 15:37, 1 September 2022 (UTC)

One more thing: That AA is an anarchy to its very core is so poorly understood and appreciated results in off the money edits by well intentioned good faith editors. Fair play, no harm no foul, but we’re here to keep the record straight. — Preceding unsigned comment added by 66.60.170.151 (talk) 07:00, 2 September 2022 (UTC)

People in TSF treatment are not always actively engaged in AA

Since 66.60.170.151 has started an edit war by reverting my edit correcting what the 2020 Cochrane Report actually says, let me clear things up.

Here is the wording the IP editor wants:

Regarding its effectiveness, a recent scientific review has shown that when engaged with AA through clinically delivered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.

Here is my wording correcting the record:

Regarding its effectiveness, a recent scientific review has shown that when actively directed to go to AA through clinically administered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.

Here is what the source document says:

The evidence suggests that compared to other well‐established treatments, clinical linkage using well‐articulated Twelve‐Step Facilitation (TSF) manualized interventions intended to increase Alcoholics Anonymous (AA) participation during and following alcohol use disorder (AUD) treatment probably will lead to enhanced abstinence outcomes over the next few months and for up to three years.
[...]
Thus, a relatively brief clinical intervention (AA/TSF) can help people with AUD to become engaged in a long‐term, freely available, community‐based, recovery support resource that can help them sustain ongoing remission.

Point being, the IP’s wording implies that it’s only with people actively engaged in AA who have better outcomes than other treatments, but, according to Cochrane 2020, it’s the entire sample of subjects who went through treatment “intended to increase Alcoholics Anonymous (AA) participation” who did better compared subjects going through other treatments.

When we compare the people actively engaged in 12-step programs to people who weren’t engaged with 12 step programs, as was done in Moos and Moos 2006, we get even better results than what Cochrane found (Cochrane 2020 saw a 42% abstinence rate one year after treatment; Moos and Moos 2006 saw 67% 16 years after treatment) but there’s the thorny issue with self selection bias which Cochrane 2020 doesn’t have.

SkylabField (talk) 16:24, 12 September 2022 (UTC)

That unfortunate accusation of edit warring has no basis since it was about a good faith edit—not a revert—given a good explanation is never a commencement of an edit war. An apology is due me an actually reverting editor is encouraged to become familiar with wiki’s page edit warring.
You’re edit warring:
SkylabField (talk) 19:31, 12 September 2022 (UTC)
As for the edit itself, per the source, as noted above, engagement with AA is what results in long term remission. The editor thinks the previous wording had excluded TSF/AA:
No, I thought the wording you recently added in this edit misrepresents what the Cochrane 2020 review actually says. SkylabField (talk) 19:59, 12 September 2022 (UTC)
In that editor’s words, “the IP’s [myself] wording implies that it’s only with people actively engaged in AA who have better outcomes than other treatments”
per the actual edit objected to for excluding TSF/AA
“Regarding its effectiveness, a recent scientific review has shown that when engaged with AA through clinically delivered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.”
Explicity the offending edit does not excluded TSF/AA and in no way suggests that AA alone would have result in likewise outcomes. In fact, when the edit was made, my editor’s note said that AA alone could as beneficial, but that was beyond the scope of the review and should be avoided.
Cochrane 2020 does not compare AA by itself to other treatments, but uses TSF because one can not effectively randomize for AA alone. See Kaskutas 2009 or the popular press article In Defense Of 12 Steps: What Science Really Tells Us About Addiction for further information. SkylabField (talk) 19:59, 12 September 2022 (UTC)
Essentially we do and have agree, and have both made edits that TSF/AA is the sole context of the review. A better and less careless reading of the objected to edit would have ben preferred. 66.60.170.151 (talk) 17:03, 12 September 2022 (UTC)
The difference may seem subtle to people not familiar with how medical studies are performed, but it’s a very important distinction for people familiar with how medical studies strongly suggest that AA itself helps keep alcoholics sober. As per Moos and Moos 2006 (linked above), we’ve known for a long time that people actively engaged in AA are more likely to stay sober. However, we still didn’t know back in 2006 if this was correlation (people who have the type of personality to go to AA meetings on a regular basis also happen to have the type of personality to stay sober) or causation (AA itself helps keep alcoholics sober). By using the word “engage”, we’re implying that we still don’t know if it’s correlation or causation. We now know that simply being encouraged (“directed”, whatever) to engage in AA results in more people being sober, since people randomly assigned to a treatment which doesn’t mention AA are less likely to stay sober compared to people randomly assigned to treatment which encourages going to AA. The wording in the lede should make this distinction clear. SkylabField (talk) 19:30, 12 September 2022 (UTC)

The editor is also encouraged to know the difference between a scientific study and a scientific study and to thereby learn the inadvisability of making a very recent review, which I will presume acknowledged and accounted for Moos study, subordinate to a 18 year old study. — Preceding unsigned comment added by 66.60.170.151 (talk) 17:12, 12 September 2022 (UTC)

Please become more familiar with Wikipedia’s policies, in particular WP:MEDDATE SkylabField (talk) 19:30, 12 September 2022 (UTC)

The editor insists on a distinction that makes no difference. To engage with through TSF/AA and to be directed to AA by AA/TSF have exactly the same meaning, hence a distinction with no difference. Unfortunately the editor in this case also prefers bad writing. Since there is no real difference and the insisted upon edit misleads or will confuse no one, I will make a concession to bad writing since the editor is so bent on taking the article hostage for this silly issue of their manufacture. It is hoped for all of our sakes the editor now knows the difference between a single study as opposed to a comprehensive review that takes account for that study as well as other relevant studies — Preceding unsigned comment added by 66.60.170.151 (talk • contribs) 21:18, 12 September 2022 (UTC)

I have already explained how “directed to” (told by a doctor to go to AA) and “engaged” (actively going to AA) are very different above. I feel no need to repeat myself. I should also point out that I am well aware that Moos and Moos 2006 is a single study and Cochrane 2020 is a comprehensive review, and my edits have been to have the article correctly reflect what the comprehensive review Cochrane 2020 has to say about AA efficacy (Moos and Moos 2006 is mentioned but given much less prominence in the article). More to the point, this is a formal warning to 66.60.170.151: You have been warned by multiple editors that your pattern of edit warring goes against Wikipedia policy and violates Wikipedia’s guidelines. Since you have erased those warnings from your talk page we can safely assume you understand that you have been given multiple warnings from multiple editors about your behavior. Should a pattern of reverting other editor’s contributions continue, you may have your editing privileges on the Wikipedia revoked. SkylabField (talk) 22:07, 12 September 2022 (UTC)
That was unlettered, and and unnecessary flex (oddly and inappropriately energetic and out of touch with forms of courtesy regarded as ideal from wiki editors), and all in the face of a concession. The word graceless comes to mind.
I’m reminded of how many times my mom directed me to do something, you know like clean my room, and, well, never mind. The suggestion in the editors’s mind is that everyone told by a doctor, or similar professional, to become active in AA did so—if it were only that simple—and this is the actual population the Cochrane review was concerned with. This is atoundoundly incorrect. In fact, the Cochrane review carefully focused on the much much smaller population of those actually engaged with AA (again, engaged is their their defining behavioral descriptor). But if the editor must, It’s on that editor if they wish to insist on perpetrating the indefensible error, but one that will lead to no harm since despite the faulty logic, the reader will know well enough what is meant. Nonetheless, if the editor does now realize what defines a scientific review, some good will have been done. A return to civility might even be possible, and I will be glad to join the editor towards that end going forward. 66.60.170.151 (talk) 22:35, 12 September 2022 (UTC)

Actively directed to AA vs actively directed and actually do go

To say the Cochrane Study’s populations are only those told to go—actively directed— to AA is to say the populations include both those told to go and didn’t along with those who are directed and do engage. The review explicitly eliminates those told to go but who don’t. If only telling folks to go to AA was what it took to get the superiors results attributed to TSF/AA clinical interventions. This is sadly not the case and the additional qualifier “and actually do go to AA” was not removed for any good reason but to instigate an officious wasting of time that seems obstinate more than anything else since the truth of who makes up the populations is clarified up and a falsehood is left in it’s place. 66.60.170.151 (talk) 03:08, 13 September 2022 (UTC)

Show me where the review eliminates people who were told to go but do not. Please quote the exact part of the the Cochrane 2020 review where it “eliminates those told to go but who don’t”. The qualifier “and actually do go to AA” was removed because Cochrane 2020 does not measure sobriety rates among people who actually go to AA. It measures sobriety rates among people directed to go to AA, because we can not effectively randomize for people who actually go to AA because of self-selection bias issues, and proper randomization is very important with these kinds of high quality reviews. SkylabField (talk) 12:21, 14 September 2022 (UTC)
  • "The review explicitly eliminates those told to go but who don’t." - That is not accurate. The TSF studies compare one treatment intervention, Twelve-Step Facilitation, to other established interventions, e.g., MET or CBT. Each treatment group has individuals who do not follow recommendations, e.g., for TSF, participants are encouraged to go to AA meetings but some don't, and for CBT, participants are encouraged to, for example, record their activities and corresponding mood and mastery ratings, but some participants never or rarely do such therapeutic homework. Mark D Worthen PsyD (talk) [he/him] 06:28, 15 September 2022 (UTC)

Edits to improve coverage of the Cochrane review

I made some edits to improve accuracy, clarity, conciseness, and concordance with what the Cochrane review actually says (diff). Mark D Worthen PsyD (talk) [he/him] 06:28, 15 September 2022 (UTC)

I’m thinking we should maybe restore a description of Humphreys 2014, which uses instrument modelling to show less severe negative consequences w.r.t. alcohol for people who went to more AA meetings as determined by randomization (drinking days per week, as I recall). Perhaps more in-depth discussion of the strong correlation between self-selected AA attendance and better outcomes for alcoholics from the older longitudinal studies we have. The big point of Cochrane 2020 is that if we carefully only use studies with good randomization, we get better results with treatments which should make people more likely to attend AA meetings. But, things look pretty good and are rigorously accurate right now. SkylabField (talk) 08:23, 15 September 2022 (UTC)
Another thing to keep in mind is, when we added the Cochrane information to the lead, the consensus at the time was to make the summary a short one-sentence summary. See Talk:Alcoholics_Anonymous/Archive_9#Adding_sentence_on_effectiveness_to_the_lead
Right now, the summary is “Regarding its effectiveness, a recent scientific review indicated that manualized Twelve-Step Facilitation (TSF) interventions designed to increase AA participation are more effective than other clinical interventions as measured by abstinence from alcohol, and are likely more cost-effective as well”, which, yes, is one sentence, but a bit wordy. I would reduce it to “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in more sobriety than other interventions”, but will not edit it without consensus at this point because of edit warring over the wording. SkylabField (talk) 14:58, 15 September 2022 (UTC)

Good point. I would replace "sobriety" with "higher abstinence rates" or similar. I know what you mean by "sobriety", but the word has various denotations. Mark D Worthen PsyD (talk) [he/him] 17:21, 15 September 2022 (UTC)

How about “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions” SkylabField (talk) 22:57, 15 September 2022 (UTC)
Perfect. :0) Mark D Worthen PsyD (talk) [he/him] 22:45, 18 September 2022 (UTC)

Continuing edit warring from 66.60.170.151

After a discussion on the talk page (see above), consensus is the following wording for AA's effectiveness in the lead:

Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions

Despite being given warnings by other editors, and despite consensus to the contrary, 66.60.170.151 continues to edit war, restoring their wording which goes against consensus in a series of edits. I have warned the editor, but since they have blanked other warnings, should the edit warring continue, it is time to escalate this to WP:AN/I as per the discussion we had at the 3 revert noticeboard. This is a final warning. SkylabField (talk) 19:57, 24 September 2022 (UTC)

This is specious edit war charge made by an aggressive and contentious editor who is given themselves to edit warring and then running to the wiki police. The editor did file an edit warring charge which the last charge was closed as unfounded. The editor just did the first revert of a good faith edit for no reason than apparent animosity. The editor seems to be unconcerned with the merits of an edit and instead seeks ownership of the article through police actions.The edits of mine, however, were duly noted noted as clarifications and changed noting but remove vague wording that did not clearly convey what the review actually said. What was objectionable about the edit besides the editor?
The main unfortunate outcome of the revert at issue:
The review only concerns itself with only the AA/TSF interventions while the edit, as it now stands, categorically includes the much broader realm of all interventions. Why the insist on the falsehood remaining? If there is no substantial reply, an edit warring charge can be submitted for that editor. Do, really need to do that over a clear and simple factual matter that should be easy to resolve? 66.60.170.151 (talk) 20:25, 24 September 2022 (UTC)
Please be aware it is not a single editor who you disagree with. You have been reverted multiple times by multiple other editors. Multiple editors have asked you to seek consensus on the wording, and you have been told your proposed wording is inaccurate by another editor. Consensus has been established by multiple editors, and your continuing to edit against consensus goes against Wikipedia policy. The only reason Daniel Case marked it no violation is because, at the time, you stopped your reverting and edit warring. Since you have since reverted again, that changes things. SkylabField (talk) 20:37, 24 September 2022 (UTC)
I expected a legalistic response and got one.
So, why do we leave in place a revert grossly misstating the scope of Cochrane review as covering all intervention, and not the much more narrower and truthful fact that it was limited to TSF/AA clinical interventions. This will be second time this has been asked. 66.60.170.151 (talk) 20:55, 24 September 2022 (UTC)
We use the current wording because that is the wording which we decided upon via consensus with multiple editors. To change the wording requires discussing it on the talk page, and, this is very key: Since an edit war has been done over the wording of that sentence, other editors must agree to the new wording here on the talk page before editing it in the article. You are the only editor which desires different wording than “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions”, so that is the wording that remains until multiple editors agree on another wording. Please review and understand WP:CONSENSUS. SkylabField (talk) 21:01, 24 September 2022 (UTC)
Great, lets get your opinion.
Do you insist on letting the article say all AUD interventions are the scope of the review? No answer will taken as an abstention on the matter. 66.60.170.151 (talk) 21:10, 24 September 2022 (UTC)
A non-response from another editor does not mean they agree with your edits. Again, other editors must agree to the new wording here on the talk page before editing it in the article. For them to agree with a given wording, they have to make an edit on the page saying words to the effect of “I agree with the wording”. SkylabField (talk) 21:17, 24 September 2022 (UTC)
This is evasive. Since the edit is up for discussion, do you, and you only, agree with or not and why in either case? 66.60.170.151 (talk) 21:23, 24 September 2022 (UTC)
That claim is incorrect. Multiple editors have agreed on the current wording. It is not just one editor. Consensus has been established. This will be my last reply to the IP in this discussion; should the IP attempt to revert the sentence again in the article without consensus from other editors, they may be reported. It does not matter if they revert the sentence today or revert in the future. SkylabField (talk) 21:29, 24 September 2022 (UTC)
Since my edit does not contradict but only clarify, why do you, and you only, have issue with it? 66.60.170.151 (talk) 21:33, 24 September 2022 (UTC)
This is a flex and a flex only to keep an article in poor shape. 66.60.170.151 (talk) 21:35, 24 September 2022 (UTC)
The IP editor is now blocked for engaging in disruptive editing. Yes, being argumentative and engaging in personal attacks on talk pages is disruptive editing. Hopefully they have learned their lesson, and will learn to work better with other editors. If not, then this matter will be escalated. SkylabField (talk) 02:33, 25 September 2022 (UTC)
That’s a misleading overstatement. The block was for 24 hours only while Skylab is apparently content to let the conflation that all interventions, including non clinical ones, are what the Cochrane review only addresses clinical interventions having no argument accept that is the consensus and has persistently refused to materially address and correct the clear falsehood. This is a second known instance suggesting that Skylab may be habitually given to making or supporting misleading declarations. That with a predilection towards the fallacy of authority makes me profoundly doubt that editor’s judgement. Though the article suffers badly for that, oh well, it’s not for lack of one editor trying to fix the error. 66.60.170.151 (talk) 21:03, 29 October 2022 (UTC)
I think it would be best if you dropped this matter. You have already been blocked once. SkylabField (talk) 01:34, 30 October 2022 (UTC)
Here’s the problem. Sadly as it stands, a casual reader would think an informally orchestrated intervention of family and friends would be just as effective as any clinical intervention. That can have disastrous, possibly fatal, in fact, consequences for those who actually need a clinical intervention and because incorrect and misleading information is left to remain. Skylab May wish to hope no harm will be a direct result. Unfortunately, this is only a hope buttressed by no scientific review and ethically unsound to buy into. 66.60.170.151 (talk) 21:03, 29 October 2022 (UTC)
This matter has been escalated: Wikipedia:Administrators'_noticeboard/Incidents#Continued_disruptive_behavior_from_66.60.170.151 SkylabField (talk) 02:31, 30 October 2022 (UTC)
And this will matter how? The dangerously incorrect lede remains unchanged due to an inexplicable resistance to adding “clinically aided” to “interventions”. Think about what it takes to disregard what harm that might cause. I simply don’t otherwise care. 66.60.170.151 (talk) 03:26, 30 October 2022 (UTC)
The IP account has been blocked again for continued disruptive editing. I really, really hope that they will learn a lesson with this second block and will stop their disruptive editing. Constructive edits, as always, are welcome. SkylabField (talk) 12:33, 30 October 2022 (UTC)
The page has been updated to accurately reflect the effectiveness of AA. This will prevent the harm of the previously insisted upon and potentially dangerous misleading edit might have caused. Oddly, the correction was done in the exact manner which had been so strongly objected to, meaning unilaterally without any discussion subsequent to the one where it was seemingly agreed that clinical should be left out. That is perplexingly inconsistent and suggestive of privilege while only delaying the installation of the objected to accurate edit. Not sure what lesson is to be drawn from that except sometimes compelling and ethically sound arguments can get through to even those who will not dialogue on the matter. Why that might be and as hard as that is to understand, it is no longer a concern. All’s well that ends truthfully. 5ive9teen (talk) 04:07, 1 November 2022 (UTC)
Here’s what happened:
- We had a version which said treatment which encourages AA participation is more effective than no treatment, using Brandsma 1980 as the reference backing that up.
- A disruptive editor re-worded the summary to incorrectly imply that Cochrane 2020 compares people actively engaged in AA to people not actively engaged in AA.
- When explained this is inaccurate, by two other editors, the IP became very combative and disruptive, reverting multiple times and posting personal insults on talk pages, until they were blocked.
- At the same time, as the IP’s poor behavior is escalating, @Markworthen comes in at my request and rewords everything to be pedantically accurate, including the use of the word “clinical”, but without “and no treatment” (which comes from Brandsma 1980, not the Cochrane review, and yes that’s really old but I don’t know offhand more recent studies comparing AA to no treatment) at the end of the sentence.
- We hammer out consensus of having a shorter summary without the word “clinical”
- While the IP stops reverting multiple times after being blocked, the continue to be disruptive on talk pages, and gets blocked again.
- After the IP is blocked, I restore the word “clinical” since @Markworthen added the word but I removed it when we were hammering out consensus.
- The “and no treatment” wording has been restored, which I don’t object to, but that conclusion doesn’t come from the Cochrane 2020 study. Since we have been referencing the Brandsma 1980 study, the wording can stay (but see below)
SkylabField (talk) 14:22, 1 November 2022 (UTC)
The huge delay between that discussion and the much delayed addition of clinical by the editor who objecting to its inclusion—citing that very same discussion now used to induce a contrary consensus—strongly suggests an unilateral edit. On a more positive note, that editor now seems eager to open a dialogue on a recent revert of theirs. A lesson may have been learned. 5ive9teen (talk) 15:29, 1 November 2022 (UTC)

Placing “and no treatment” and “clinical” in the lead summary of AA efficacy

@Markworthen, Sundayclose, 5ive9teen, and Gråbergs Gråa Sång: since this was brought up above, here is yet another discussion of the wording of AA effectiveness in the lead.

@Markworthen used this wording:

Regarding its effectiveness, a recent scientific review indicated that manualized Twelve-Step Facilitation (TSF) interventions designed to increase AA participation are more effective than other clinical interventions as measured by abstinence from alcohol, and are likely more cost-effective as well.

As per discussion and consensus above, I made that shorter:

Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions.

@Gråbergs Gråa Sång then made the dating absolute (changes in bold):

Regarding its effectiveness, a 2020 scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions.

This is objectively correct and better wording.

I restored the word clinical as per Markworthen’s version:

Regarding its effectiveness, a 2020 scientific review saw clinical interventions encouraging increased AA participation resulting in higher abstinence rates than other clinical interventions.

Then @5ive9teen adds the following:

Regarding its effectiveness, a 2020 scientific review saw clinical interventions encouraging increased AA participation resulting in higher abstinence rates than other clinical interventions or no treatment

Now, I am well aware the 2020 Cochrane review of AA doesn’t have high-quality evidence comparing AA to no treatment. However, Brandsma 1980 does, so I am about to make it the following:

Regarding its effectiveness, AA is more effective than no treatment[Brandsma 1980 reference] and a 2020 scientific review saw clinical interventions encouraging increased AA participation resulting in higher abstinence rates than other clinical interventions.[Cochrane 2020 reference]

If anyone objects to this wording, please explain why. Also, it would be nice to have something more recent and with better methodology than Brandsma 1980 giving us the “AA is better than nothing” conclusion.

References:

SkylabField (talk) 14:43, 1 November 2022 (UTC)

No problem with leaving out no treatment but the economic benefits of AA/TSF are prominently listed in the review’s conclusion as a main benefit. So, following the current apparent protocol, that has been added to the lede without soliciting for a new consensus. 5ive9teen (talk) 15:44, 1 November 2022 (UTC)
Protocols change when an editor engages in disruptive behavior to the point of being blocked not once but two times. People who edit war to the point of violating WP:3RR and attacking editors with personal insults when asked to seek consensus are treated differently than other editors. Since that editor is now blocked, we can make edits to the article as long as a consensus building process is in place at the same time.
All that aside, I don’t object to the economic benefits being mentioned, except to point out the sentence is starting to get really wordy (but that’s not a big enough objection to revert over, and I’ll bow to consensus). SkylabField (talk) 17:45, 1 November 2022 (UTC)
As per the above comment, I have removed the phrase saying AA is better than no treatment. This is widely considered to be true; see this article from over 11 years ago for discussion, but the sentence is getting too long and we really need something better and more recent than Brandsma 1980 to back up the assertion (the linked article might work, since it does have a DOI, probably making it a WP:MEDRS, but I’ll only add it if consensus feels it’s worth adding as a reference) SkylabField (talk) 17:50, 1 November 2022 (UTC)

South Park in the "AA in media" section

The 14th episode of the ninth season - Bloody Mary - is plot-wise entirely based around AA and the effect it has on some people. South Park is one of the biggest shows in the world - and it has been for decades - and I think a skeptical or satiric take on a subject as big as this should be pointed out and referenced in an un-biased way as it would be on any another topic. This is important. Carnelust (talk) 09:33, 7 November 2022 (UTC)

There are a lot of TV/Movie plots that use AA as a trope: It brings disparate and vulnerable people together in dramatic and changing situations where soliloquies are easily constructed and dispensed with. Probably best to make a separate article out of them since their proliferation is unlikely to end. Whether or not to include mention of the South Park episode, it’s inclusion is probably not best for the article but not objectionable enough to want to vociferously argue, let alone act, against it. BTW, I’ve yet to see one 12 step meeting well portrayed. SNL set it up as group therapy session. Served the skit well, but that’s neither here nor there except maybe in a sub article. 5ive9teen (talk) 23:06, 7 November 2022 (UTC)
Then I insist that such a sub article should be made and have it linked to by the AA Wikipedia page under "AA in media" section. Carnelust (talk) 23:47, 8 November 2022 (UTC)
@Carnelust: In a few days and with a few more edits, you'll be able to create articles. Then you won't have to "insist" that others do it. Read H:FIRST and WP:HOW for information about creating an article. You can also seek help here and by placing {{helpme}} on your talk page. Sundayclose (talk) 02:32, 9 November 2022 (UTC)

Copy edit

Removed an extraneous 'h' from the beginning of the article lead; add the word 'with' to the sentence "AA is often associated with"(emphasis mine to show addition). Let me know if I made any mistakes! Thanks! King keudo (talk) 16:42, 14 January 2023 (UTC)

Effectiveness change

I additionally reverted what appeared to be a good faith edit regarding the descriptive effectiveness of AA under the 'effectiveness' section. The sources cited all seem to indicate that other programs, not tied to and expressly independent of AA, were showing to be just as effective as AA. This is why I reverted the change. Please feel free to correct me if I have intruded upon an improvement to this article! King keudo (talk) 16:58, 14 January 2023 (UTC)

I agree with your reversion. Cochrane 2020 shows that AA is more effective (but only w.r.t. abstinence) compared to psychological treatments (cognitive behavior therapy, etc.). Cochrane 2020, unlike Zemore 2018, does not compare AA to other peer support groups. As far as we can tell, other peer support groups are just as effective, as long as the goal is abstinence (controlled drinking doesn’t seem to work for alcoholics), but with only Zemore 2018—which is a longitudinal study—to go on, the conclusion is preliminary (there may be self-selection effects, etc.). SkylabField (talk) 04:25, 15 January 2023 (UTC)
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