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This is a wild take about 12 step programs. Are you suggesting its similar to a pyramid scheme because one if its practices is to take a new member under ones wing and do step work?
AA and similar programs are, medically speaking, indistinguishable from telling someone "just quit" or walking into a church and asking the liturgist for guidance.
It's great that they work for some, and I'd hate to suggest anyone to give up on what works for them. But AA is historically cult-like with how they talk about their success rate and that is a major issue.
One of my closest friends had a drinking problem, crappy insurance, and was referred to AA. I went as silent support to his first meeting, but the program absolutely did not take and the net result of time spent was disillusioning him from getting any help at all. He went back to the bottle and died a few years later, yet to hear AA describe it his death was because he "failed the program" and not at all because the program failed to help him.
If your 12 step program helps you and gives you a chance to help others that's a great and wonderful thing. But AA was founded by a drunk who invented a new label for "drinks too much", and there are people who would have loved longer and healthier lives if their take was less "this is the one way for all" and more "this is one way that happened to work for us".
Its not meant to be on par with medical methods for treatment though. Its not fair to set that as the bar for what we consider effective or not. This is a really nuanced conversation I sadly do not have time to have right now but the influence that program has had on society puts it easily within the top 10 of most positive impacts in the previous century. Millions have found recovery through various 12 step programs (and their spinoffs).
In no universe does any group purporting to help people get to measure itself by a different standard than everyone else. If AA is at all worthwhile they should neither fear medical research into their efficacy nor protest when the measured result is sufficiently lower than their own unprofessional claims.
Let me re-state and expand my complaint : the way AA sells itself does more harm than good. Peer support groups with or without religious overtones are definitely helpful to those they work for, and their fiscal efficiency does make them a great first-try resource for anyone seeking to reduce alcohol consumption. But they do not work for everyone, and the way AA asserts that this failure is always a moral fault of the individual discourages some from seeking other forms of treatment.
I am not even questioning the efficacy of the program for regular adherents, as was done before the 2020 NIH meta-study. My chief and sole complaint is that the way AA portrays itself specifically and "alcoholics" in general can and does lead some adults suffering from alcohol abuse to abandon any hope of cessation rather than seeking alternative forms of assistance that appear at least as successful for those who continue treatment.
No, I elaborated in another comment but I don't think 12 step or similar recovery programs are cults themselves. However, there are cults and scam operations that use recovery groups as recruiting grounds, sometimes hosting their own meetings masquerading as recovery programs in order to ensnare new members, as is described in the article.