Medical Community Needs Better Understanding of Power of AA: Expert

Many doctors, even those who specialize in addiction treatment, do not have a good understanding of Alcoholics Anonymous (AA) and its benefits for people struggling to give up drinking, says Marc Galanter, M.D., Founding Director of the Division of Alcoholism and Drug Abuse at NYU Langone Medical Center.

“Doctors don’t necessarily know about the 12 Steps and how going to AA can be useful to patients,” says Dr. Galanter, a former president of the American Society of Addiction Medicine and the American Academy of Addiction Psychiatry. “They need to know how valuable it can be for people to go to meetings and meet people who have achieved abstinence, and learn how the program helped them.”

Of the more than 3,400 addiction treatment programs in the United States, many use the AA model, but half don’t have any relationship with a physician, Dr. Galanter notes. “It’s essential to bridge the gap between the medical and rehab communities,” he says.

Although it began in the 1930s, AA still has an important place in addiction treatment today, in an era when people tend to look to medications as the answer to solving everything, Dr. Galanter says.

“I can tell them as their doctor that they need to stop drinking, but if they go to AA meetings and meet other people with the same problem, it can mean more to them in terms of recovery,” says Dr. Galanter, author of What is Alcoholics Anonymous? A Path from Addiction to Recovery (Oxford).

Last year, Dr. Galanter published a study that looked at the effect of prayer on the brains of 20 long-term AA members, as measured by MRI. The twelfth step in AA involves “spiritual awakening,” an important part of the AA experience that can be interpreted in different ways. For many people spiritual awakening is related to prayer and meditation, which helps them stay sober, Dr. Galanter explains. “We wanted to see if there is a physiologic basis for prayer and meditation having a role in keeping people sober,” he said.

The participants were placed in an MRI scanner and then shown either pictures of alcoholic drinks or people drinking. The pictures were presented twice: first after asking the participant to read neutral material from a newspaper, and again after the participant recited an AA prayer promoting abstinence from alcohol.

Dr. Galanter found members who recited an AA prayer after viewing drinking-related images reported less craving for alcohol after praying than after reading a newspaper. The reduced cravings in people who prayed corresponded to increased activity in brain regions responsible for attention and emotion.

He said the findings suggest that AA has a physiologic effect on the brain, and doesn’t just lead to a general change in attitude about drinking. “A lot of people don’t appreciate that AA isn’t just a sort of club. It actually changes how people think and how their brains work,” Dr. Galanter said.