Regardless of the merits of AA specifically, it seems to me that if such a person can acquire the humility to accept help that would be the key to breaking the underlying emotional impasse. This could be characterized as "learned helplessness" or as a recognition that not everything is within our power and that external help is OK.
I guess what I'm saying is that for some alcoholics the desire for an impossible level of self-control is the source of the problem and, ironically, leads to this uncontrolled behaviour.
It's really frustrating to read healthy people criticize a method of treatment for sick people that was created by other sick people out of desperation.
Look, as far as I'm concerned, as long as you're not hurting anyone (and that's asking a lot because addiction hurts more people than just the addict) you can seek out any nonsense therapy you want. Wave a chicken, swallow some sugar pills and pray the gay away.
But the second your ghost healing clinic becomes the industry standard and courts send people their under threat of punishment it's no longer fun and games. Those people could be helped if they received proper treatment but instead they get to waste their time (and worsen their health) by sitting through a so-called treatment that actually makes them less likely to succeed in overcoming their addiction.
Here's a web page that nicely summarises the problems with AA and its effectiveness: https://www.orange-papers.info/orange-effectiveness.html
Yes, the first step in beating any addiction is to recognise that you have an addiction and to decide that you want to get rid of it. But that's true for any other psychology problem: if someone's clinically depressed but refuses to cooperate with their therapist, they're not going to get better.
The thing is that with normal secular therapy you learn to control yourself. You learn to reflect on your thoughts and why you might have them. If you're depressed, you don't really want to kill yourself, you just think you do because you can't imagine things will ever be any different. If you're addicted, you think you need the drug because it's the only way to feel better but of course it isn't.
That said, the bigger problem is that addictions are rarely isolated problems. There's usually something that started it and something that sustains it. Frequently addiction starts out as a coping strategy (I'd say for many adults nicotine and caffeine are obvious coping strategies although they become inefficient on a chemical level fairly quickly).
I'm not seeing addicts should avoid therapy and simply will themselves out of their addiction. This works for some people but obviously not universally (again, consider how giving up nicotine is so challenging it has become a widely known trope in Western media). But those people who can't do it on their own should instead seek actual help, not the AA.
For all we know, the small group of people who actually managed to overcome their addiction while attending AA would have been able to do it on their own, whereas those who failed would have benefited from actual fact-based therapy.
You wouldn't suggest a treatment as the go-to default solution if its viability was never tested and there are easier and more reliable treatments that have a scientific basis and have been proven to work.
The great thing about the Sinclair Method is that it works both if you do it yourself or with supervision. You don't have to will yourself to stay sober, you just have to will yourself to take the pills and your body does the rest. Sure, that in itself is a feat of willpower but that's why actual therapy is a thing that exists.
Disclaimer: am shareholder in manufacturer. Feel there is a massive lack of emphasis on novel pharmaceutical interventions in drug and alcohol rehabilitation.
Hadn't heard of nalmefene, thanks for the reference. Naltrexone is also useful in much lower doses than the standard 50mg tablets, as "low-dose naltrexone" (1-5mg).
I will say that drinking while taking Naltrexone was an odd experience because I felt none of the europhoria that typically comes with drinking.
Some people, when I tell them that, respond with "well, what did you expect? that's drinking" and some with "that can't be, perhaps your vodka was watered down". Your comment reminded me of that.
Having experienced both versions (euphoric and non euphoric), do you have any insight about the difference, how much of it is physiological vs. psychological?
I would encourage anyone who wants to stop drinking and doesn't feel well served by AA to try to find a doc willing to prescribe Naltrexone and give it a try.