To extend this, there have been programs that have attempted to fix the problems of alcohol addiction but not require patients to remain sober. The core concept being that there is an underlying cause to the alcohol problem and the alcoholism is an expression of that problem, not itself a root. Thus once the root cause is fixed, the alcohol is no longer a trigger.

Another form allows participants to drink but uses a medicine which induces unpleasant effects from alcohol. Thus participants self train an avoidance pattern and break the positive feedback loop.

These should not be seen as contrary to the AA abstinance approach. For some people that appears to be the most effective means. For many other people, AA is not.

I suspect as we advance our understanding we'll come to find distinct subdiagnoses in alcoholism and alcohol abuse that suggest different treatment strategies. Right now our understanding feels very rudimentary.