Alcoholics and narcotics anonymous: A radical movement under threat

Abstract

In recent decades, the considerable proliferation of the self-help groups (especially those of the Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)) has attracted the interest of those engaged in the social sciences as well as of those responsible for mapping out health policies. This article is based on the 10-year involvement of the authors in a participatory action research project for the promotion of self-help groups in Greece as well as to an extensive literature review of the AA and NA movements. Based on this methodology, the objective of this article is twofold. First, it identifies the radical perspective of self-help groups, as the main source for their effectiveness, while it attempts an assessment of their effect on traditional professional attitudes. Second, it raises concerns over the radical perspective of these initiatives in the framework of their transition from an alternative stance towards their integration in formal Health Systems. This transition process is manifested in the following developments: (1) the constantly increasing number of old members who quit the role of the volunteer sponsor and undertake the financially beneficial role of (para-) professional addiction counselor; (2) the instrumentalization of 12 steps; (3) the increasing number of members who adopt the nosological perspective of addiction 4. The various adverse effects of dominant culture on the internal working of the groups are studied. Moreover, this article attempts a comparative assessment of the produced experience with the AA and NA movements in Greece and abroad.

• Alcoholics anonymous
• narcotics anonymous
• self-help groups
• addiction

Notes

Notes

1. The AA and NA groups urge members to visit specialists for the treatment of mental and physical health problems.

2. It is customary to refer to former addicts (now being paid for assisting with therapy) as ‘para-professionals’, while those who have gone on to acquire official, accredited, professional training are described as ‘professionals’. At present, the vast majority of the professionalized ΑΑ and AN members in Greece do not have accredited training and are, therefore, classified as ‘para-professionals’.

3. The concept governing the operation of these centres is based on the utilization of the 12-step method, within a professional environment, which is either residential or out-patient, and which is determined by mental health professionals or ex-addicts, who are members of self-help groups, and act as professional counsellors. These centres use the Minnesota model, a system for treatment of users of psychoactive substances that is based on the AA and NA principles (Anderson, McGovern, & Dupont, 1999). The debate on the emerging threat of professionalization is largely linked to the commercial exploitation of this model and the reactions it provokes. It should be noted that the concerns outlined in this article are based on international experience, but are mainly derived from observation of the reality here in Greece, where the private centres that have been created draw their fundamental concept from the Minnesota model, but without having constructed a coherent proposal based on it.