Dr. Bankole Johnson, a justly respected addiction researcher, published an op-ed in the Washington Post last week that lambasted 12-step mutual help organizations such as AA. In the Washington Post today, I correct Johnson’s assertion that there are no randomized clinical trials supporting 12-step interventions. The amount of benefit to addicted patients in the trials I mention (One published by Christine Timko and colleagues in Addiction, the other by Leonard Jason and colleagues in American Journal of Public Health) not incidentally surpasses that found in most studies of the alcoholism medications for which Johnson advocates. We have some promising developments in terms of medications, but we clearly don’t have a blockbuster drug yet and certainly don’t have a basis for saying that we don’t need the 12-step approach anymore.
What I didn’t have space to say in a 200-word letter I will say here: I agree with Dr. Johnson’s questioning of the value for money from $50,000/month day-spa-with-massage-rehabs for addicted movie stars in Southern California, but am mystified that he lumped a free, non-profit mutual help organization together with such boondoggles. My research with Professor Rudolf Moos on these organizations shows that they take an enormous financial burden off of society because they substantially lower health care utilization. That means lower tax burden and reduced insurance premiums for the rest of us while at the same time saving livesâ€¦..which as a cost-benefit arrangement is the other end of the world from Malibu rehab inc.