Will My Insurance Pay for Rehab?
A disproportionate amount of convicted sex and violent offenders are court ordered to 12-step meetings. My concern is not their presence at meetings, but rather that they are combined with the general population—including minors and member's children—without regard for anyone's safety. (AA has no safety policies and although this is known, the meetings are recommended by trauma counselors seemingly without second thought.)
In my case, both the county and state dropped the ball, and I did too, after I submitted several written statements to the police without an attorney present. I naively trusted that the justice system wouldn't convict a person stealing under threat from her abuser. Twelve years later, my assailant was finally convicted of assaulting me, a conviction which, if it had happened over a decade earlier, would have helped my case. Instead, I became one of many domestic violence victims funneled into the criminal justice system, court-ordered to AA in the same way as perpetrators of sex and violent crimes.
We know at least four crucial facts about female convicts, abuse and addiction, and Alcoholics Anonymous' role in court mandates:
1. They can be charged for crimes committed under duress, or immediate threat including living under constant abuse.
2. Both abusers and their victims can have substance abuse problems.
3. Women in-and-out of prison were often convicted as accessories to a criminal, or abusive, partner's crimes.
4. AA cooperates and facilitates their involvement in court-ordered attendance.
The AA organization claims it cooperates, doesn't affiliate, with the courts though their official guidelines explicitly state in minute detail: The "cooperating group has a sheet, furnished by the court, that the Secretary announced is available for court-ordered newcomers," and, "Once two or three of you might visit with a local court official. Take along AA information, such as the pamphlets 'If You Are a Professional' and 'A Brief Guide to AA,' along with 'AA as a Resource for Drug & Alcohol Court Professionals,' and offer to take the court administrators to an 'open' AA meeting." We, the ordinary readers, are to believe furnishing this information to the courts is not "promotion," or that the courts, by associating with AA, are not thereby "affiliating" with the organization.
Yet, a court or rehab's recommendation of AA does come across as their endorsement. The fact that the majority only promote AA comes across as affiliation, where AA has the monopoly. It would appear less one-sided, more impartial, for both AA and professionals to mention other supports (SMART Recovery, Secular Organizations for Sobriety, Women for Sobriety, Moderation Management, or HAMS) because mentioning this would actually reflect cooperation, and AA could repeatedly state their being mentioned does not equal endorsement.
Informed consent isn't happening. Instead, the professionals outside of AA are coercing—or forcing—mandatory 12-step attendance and forcing people to affiliate with one organization. We can all agree AA is not paying professionals to recruit for them, however, it's hard not to get the impression AA benefits and other organizations do not.
Those who research options, or have the luck of being told non-12 step options exist, stand a better chance at rehabilitation. If one treatment fails, they can find one that works. By AA not listing options, which does not mean endorsement, they are not cooperating with professionals who recognize, for example, that SMART may work when AA does not.
The other options a typical AA member will commonly hear are these:
1. "Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it."
2."To be doomed to an alcoholic death or to live on a spiritual basis are not always easy alternatives to face."
I can only cite from the AA literature, the choice between joining AA or death from drinking (controlled drinking means you never were addicted, even if this outcome is refuted by the FDA and NIAAA). Granted, when the Big Book was published in 1939 treatment options were few. But the last edition, from 2001, has not corrected the fact that today other programs can help if AA doesn't. Non-AA professionals can't call recommending 12 steps a part of informed consent if those consenting aren't informed that AA contains religious topics, that only 5% stay in AA, or other programs exist; we don't have patients choosing AA when they had no choice.
Anyone for whom AA didn't work are told they didn't give it a chance, no matter how long they attended, and are discouraged from discussing reasons why the steps didn't help them. I often hear: "Leave AA alone!" or "Discuss other options that do work." On the last note, I want professionals in medicine and criminal justice to discuss options too, instead of offering 12 steps or punishment. When did the worthy idea of rehabilitation turn into a monopolistic relationship with 12-step fellowships?
The solution isn't complicated: Keep AA a program of choice which is what AA's own traditions demand. Also, do not further marginalize or stigmatize court-ordered participants (some are not dangers to others) by segregating them, but instead apply safety rules to all participants. Many go to support groups, or AA, or SMART to recover from abuse issues as they relate to addiction, and none of them should have their safety jeopardized by seeking help.
Juliet Elisabeth is a writer and artist. She is also a former court mandated attendee of Alcoholics Anonymous. Her activist cause for 12-step alternatives in Ohio is the AARMED with Facts blog.