Letter: Twelve helpful steps that can also hinder

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URSULA Kenny's criticisms of Alcoholics Anonymous and "12-step" addiction treatment will not surprise academics ("Cult or cure", Real Life, 10 May). As a self-help organisation, AA needs no defending. I often encourage patients to try it but many find it unhelpful. Criticisms include excessive religiosity, boredom from hearing the same stories, false claims of sobriety, and brain-washing.

In the sole scientific study of 12-step in-patient treatment, only 14 per cent of patients abstained throughout the first year, and 20 per cent were controlled drinkers. Patients treated in more traditional units fared no worse. A recent American publication shows that combining 12- step methods with Antabuse (which deters drinking by causing an unpleasant reaction with alcohol) gives better results than 12-step treatment alone. However, most AA groups reject medication, often claiming that theirs is the only effective approach.

Many alcoholics recover without treatment. Those who need help should be offered a range of methods. In the US alternative self-help groups exist with less doctrinaire attitudes, such as Smart Recovery. If anyone wants to start a group in Britain, the e-mail contact is srmail@aol.com

Colin Brewer

Stapleford Centre, London SW1

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