US of AA

Book excerpt: In the aftermath of Prohibition, America's top scientists joined forces with AA members and put their clout behind a campaign to convince the nation that alcoholism is a disease. They had no proof, but they hoped to find it once research money came pouring in. The campaign spanned decades, and from it grew a multimillion-dollar treatment industry and a new government agency devoted to alcoholism. But scientists' research showed that problem drinking is not a singular disease but a complex phenomenon requiring an array of strategies. There's less scientific evidence for the effectiveness of AA than there is for most other treatments, including self-enforced moderation, therapy and counseling, and targeted medications; AA's own surveys show that it doesn't work for the overwhelming majority of problem drinkers. Five years in the making, Joe Miller's brilliant, in-depth investigative reporting into the history, politics, and science of alcoholism shows exactly how AA became our nation's de facto treatment policy, even as evidence accumulated for more effective remedies—and how, as a result, those who suffer the most often go untreated. US of AA is a character-driven, beautifully written exposÉ, full of secrecy, irony, liquor industry money, the shrillest of scare tactics, and, at its center, a grand deception. In the tradition of Crazy by Pete Earley and David Goldhill's Catastrophic Care, US of AA shines a much-needed spotlight on the addiction treatment industry. It will forever change the way we think about the entire enterprise.