The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry [NOOK Book]


An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.
AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, ...
See more details below
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry

Available on NOOK devices and apps  
  • NOOK Devices
  • Samsung Galaxy Tab 4 NOOK 7.0
  • Samsung Galaxy Tab 4 NOOK 10.1
  • NOOK HD Tablet
  • NOOK HD+ Tablet
  • NOOK eReaders
  • NOOK Color
  • NOOK Tablet
  • Tablet/Phone
  • NOOK for Windows 8 Tablet
  • NOOK for iOS
  • NOOK for Android
  • NOOK Kids for iPad
  • PC/Mac
  • NOOK for Windows 8
  • NOOK for PC
  • NOOK for Mac
  • NOOK for Web

Want a NOOK? Explore Now

NOOK Book (eBook)
$14.99 price
(Save 44%)$26.95 List Price


An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.
AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors, employers, and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model.
In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program’s overall success.
But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA’s rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.
The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of clinical practice, as well as firsthand accounts submitted by addicts through an open invitation on the Psychology Today website. These stories vividly reveal the experience of walking the steps and attending some of the nation’s most famous rehabilitation centers.
The Sober Truth builds a powerful response to the monopoly of the 12-step program and explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem. 

From the Hardcover edition.
Read More Show Less

Editorial Reviews

From the Publisher
“A searing critique of the rehab industry.”
—Psychotherapy Networker

“As always, Dr. Dodes offers a humane, science-based, global view of addiction. The Sober Truth is an essential, bracing critique of the rehab industry and its ideological foundations that we have much to learn from.”
—Gabor Maté M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

“Like Breaking Addiction and The Heart of Addiction, The Sober Truth makes an important contribution to the field by raising central questions about how treatment and self-help programs operate and whether commonly used treatments for addiction are effective. Dodes and Dodes thoughtfully and rigorously trace the history of alcohol treatment and the role of such treatment within the “rehab” setting. Perhaps most importantly, The Sober Truth examines the failure of science to provide answers to fundamental questions about addiction treatment. People struggling with addiction deserve more than science has provided, and The Sober Truth should stimulate a fundamental dialogue that can move the field forward. Finally, and not to be missed, this book also serves as a treatment guide for anyone seeking help with their own or a loved one’s alcohol use.”
—Howard J. Shaffer, Ph.D., Associate Professor, Harvard Medical School; Director, Division on Addiction, The Cambridge Health Alliance

“Lance Dodes and Zachary Dodes have the guts to take on clearly, perceptively, and with solid scientific grounding the nude king of American addiction treatment: AA and the 12 steps. Not only do these shibboleths yield no benefit for the mass of alcoholics and addicts in America, they leave cold—even harm—far more people than they help. Read this book!”
—Stanton Peele, Ph.D., author of Recover!

“Provocative, illuminating, persuasive, and lucid, The Sober Truth will enrage some, reassure others, but inform all. The Dodes's write beautifully (so rare in this field), and they also hold fast to common sense (also rare) while backing up their contrarian statements with utterly convincing evidence. Read this book before committing to any 12-step course of treatment, then decide for yourself.”
—Edward Hallowell, M.D., author of Answers to Distraction and Superparenting for ADD 

From the Hardcover edition.

Read More Show Less

Product Details

  • ISBN-13: 9780807033166
  • Publisher: Beacon Press
  • Publication date: 3/25/2014
  • Sold by: Barnes & Noble
  • Format: eBook
  • Pages: 192
  • Sales rank: 222,024
  • File size: 3 MB

Meet the Author

Lance Dodes, MD, has been treating people with addictions for more than three decades. He is the author of The Heart of Addiction and Breaking Addiction. He is a Training and Supervising analyst emeritus with the Boston Psychoanalytic Society and Institute and recently retired assistant clinical professor of psychiatry at Harvard Medical School. He lives in Southern California.

Zachary Dodes is a freelance writer based in Southern California. He earned a BA from Yale University and an MFA from the University of Southern California.

From the Hardcover edition.
Read More Show Less

Read an Excerpt


MYTHS HAVE A WAY of coming to resemble facts through repetition alone. This is as true in science and psychology as in politics and history. Today few areas of public health are more riven with unsubstantiated claims than the field of addiction.

Alcoholics Anonymous has been instrumental in the widespread adoption of many such myths. The organization’s Twelve Steps, its expressions, and unique lexicon have found their way into the public discourse in a way that few other “brands” could ever match. So ingrained are these ideas, in fact, that many Americans would be hard-pressed to identify which came from AA and which from scientific investigation.

The unfortunate part of this cultural penetration is that many addiction myths are
harmful or even destructive, perpetuating false ideas about who addicts are, what addiction is, and what is needed to quit for good. In this chapter, I’d like to take a look at a few of these myths and examine some of the ways they impair efforts at adopting a more effective approach.


This common myth essentially says that an addict needs to reach a point of absolute loss or despair before he or she can begin to climb back toward a safe and productive life.

The most common objection to this myth is simple logic: nobody can possibly know where their “bottom” is until they identify it in retrospect. One person’s lowest point could be a night on the street, while another’s could be a bad day at work or even a small personal humiliation. It’s not unusual for one “bottom” to make way for another following a relapse. Without a clear definition, this is a concept that could be useful only in hindsight, if it is useful at all.

A bigger problem with this notion is the idea that addiction is in some fundamental way just a matter of stubbornness or stupidity— that is, addicts cannot recover until they are shown the consequences of their actions in a forceful enough way. This is a dressed-up version of the idea that addiction is a conscious choice and that stopping is a matter of recognizing the damage it causes. I have said it before, but it bears repeating: if consequences alone were enough to make someone stop repeating an addictive behavior, there would be no addicts. One of the defining agonies of addiction is that people can’t stop despite being well aware of the devastating consequences. That millions of people who have lost their jobs, marriages, and families are still unable to quit should be a clear indication that loss and despair, even in overwhelming quantities, aren’t enough to cure addiction. Conversely, many addicts stop their behavior at a point where they have not hit bottom in any sense.

There is a moralistic subtext at work here as well. The notion that addicts have to hit bottom suggests that they are too selfish to quit until they have paid a steep enough personal price. Once again we get an echo of the medieval notion of penance here: through suffering comes purity. Addicts no more need to experience devastating personal loss than does anyone else with a problem. Yes, it can be useful when a single moment helps to crystallize that one has a problem, but the fantasy that this moment must be especially painful is simply nonsensical.

Finally, the dogmatic insistence that addicts hit bottom is often used to excuse poor treatment. Treaters who are unable to help often scold addicts by telling them that they just aren’t ready yet and that they should come back once they’ve hit bottom and become ready to do the work. This is little more than a convenient dodge for ineffectual care, and a needless burden to place on the shoulders of addicts.


Here we have another pillar of the Oxford Group, AA’s theological forerunner, which preached salvation through surrender to God. In Alcoholics Anonymous, this idea is implied, if not expressly stated, in steps 1 and 3, which respectively recommend admitting powerlessness and making a decision “to turn our will and our lives over to the care of God as we understood God.”

The first problem with this idea is its overt religious flavor. I have covered the many ways that addiction is a problem of the mind and not of the spiritual soul. “Surrendering,” in the sense that addiction organizations commonly understand it, means abdicating power to a presence greater than oneself to attain guidance. It’s not surprising that many addicts chafe at this notion, not least because it requires a belief system that may not jibe with their own.

A bigger problem is that surrendering is tantamount to agreeing that one is incapable of managing one’s own life. AA’s literature ties this idea once again to a moralistic adage: “Our whole trouble had been the misuse of will power.”1 Surrendering becomes a way to toss out a useful sense of selfhood or agency precisely when it’s needed most.

And of course the very notion of surrender is problematic when viewed through the prism of a more psychologically sophisticated understanding of addiction. As I outlined in chapter 5, the emotion that precipitates addiction is helplessness. Addicts find certain forms of helplessness utterly intolerable, and the addiction is an effort to reverse that. Asking them to surrender their free will in response to this problem is diametrically opposed to what they need to do: feel empowered. As we saw in the first-person accounts in chapter 6, the dissonance created by this emphasis on surrender is one of the big reasons so many addicts don’t get better in AA.

From the Hardcover edition.
Read More Show Less

Table of Contents

The Problem
The Rise of AA
Does AA Work?
The Business of Rehab and the
Broken Promise of “AA-Plus”
So, What Does Work to Treat Addiction?
What the Addicts Say
Why Does AA Work When It Does?
The Myths of AA
The Failure of Addiction Research and Designing the Perfect Study

Read More Show Less

Customer Reviews

Be the first to write a review
( 0 )
Rating Distribution

5 Star


4 Star


3 Star


2 Star


1 Star


Your Rating:

Your Name: Create a Pen Name or

Barnes & Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation


  • - By submitting a review, you grant to Barnes & and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Terms of Use.
  • - Barnes & reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously

    If you find inappropriate content, please report it to Barnes & Noble
    Why is this product inappropriate?
    Comments (optional)