I dunno, sounds pretty objective to me:
> Out of the 20 patients the Sobell study claimed were moderately drinking, only one arguably was still moderately drinking a decade later.
Of course, to conclude from a 20 person study that moderate drinking can never work is another thing. But simply ignoring the study can't be the solution either.
> What does help however is "housing first"
This is probably true, but you didn't give any empirical evidence for that either. Also, not all alcoholics are homeless.
The current science shows that Alcoholics Anonymous is an incredibly effective treatment for many alcoholics. Indeed, the 2020 Cochrane Review on AA shows that Alcoholics Anonymous is more effective then other treatments in getting alcoholics abstinent. See https://www.nytimes.com/2020/03/11/upshot/alcoholics-anonymo... or https://www.wbur.org/commonhealth/2020/03/11/medical-science...
Keep in mind that Cochrane reviews are the golden standard for high quality meta analysis of science, as pointed out at https://en.wikipedia.org/wiki/Wikipedia:MEDDATE
The part about helping others is a big factor. It gives a reason other than self, which seems to be a big factor.
It's hard to say what makes it "work" for certain. The Oxford Group, the predecessor of AA, lacked the helping others aspect and did not see widespread success. This is what AA itself considers to be their unique magic.
Or maybe it's all the sayings! God, there are so many sayings.
Despite being very hostile initially, I got a lot of benefit from 12 step programs. It is not something I have stayed formally involved with, but I got a lot of helpful insight.
I don't think any one thing did it for me, it was a long and difficult process. The fact I'm alive and stable today is a small miracle. Most people in the state I was aren't so lucky.
I know what doesn't work though: Shame. I had to stop shaming myself before I could get well.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
It will become non-paywalled (or should I say, non-semi-paywalled) come March over at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065341/
What about alcoholics who already have a home? "Housing first" won't help them, while AA arguably would.
https://www.nice.org.uk/guidance/cg115
The evidence tab is useful to see what information they used to make the decision: https://www.nice.org.uk/guidance/cg115/evidence
Looking over at that Nice website, it looks like the Nice reports haven’t taken the information the 2020 Cochrane review on AA used in to account yet.
The truth? Especially in anything related to alcohol/substance abuse, there most often is no objective "truth", as there are a lot of religious / moralizing standpoints involved. Alcoholics Anonymous, for example, has been shown to be more morals than science: https://www.theatlantic.com/magazine/archive/2015/04/the-irr...
What does help however is "housing first": https://www.samhsa.gov/homelessness-programs-resources/hpr-r...
Kinda makes sense, given that many people on the streets basically self-medicate either existing untreated mental health problems or the (enormous) stress that comes with living on the streets.