Substance abuse and theological perspectives

Substance abuse and theology: The controversy over the role of religion in AA (Alcoholics Anonymous) and NA (Narcotics Anonymous)

To recover from an addiction, must you believe in God? For many people, this is not simply a theoretical question, but also a legal one. Many addicts are required to attend regular treatment programs, but some of the major therapeutic approaches, such as AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) require the addict to surrender his or her will to a higher power. Atheists and even some believers reject this idea. The U.S. courts have agreed: in 2007 a federal appeals court ruled that NA "has enough religious overtones that a parolee can't be ordered to attend its meetings as a condition of staying out of prison" (Egelko 2007).

Although the organization is not explicitly Christian, both AA and NA state in their 12 steps that participants must acknowledge that only "a power greater than ourselves could restore us to sanity" and make a promise to "turn our will and our lives over to the care of God as we understood Him" while offering prayers and meditations upon sobriety (Egelko 2007). Also, AA and NA demand strict adherence to their credos -- individuals cannot pick and choose which of the 12 steps they would like to perform, and in what order. Although the organization is accepting of people who 'fall off the wagon,' it demands a commitment to trying to achieve all 12 steps -- a commitment many atheists and agnostics refuse to give and allege is a violation of their constitutional rights. In the case of the 2007 decision, a Buddhist "objected to religiously oriented drug treatment in prison, sued state officials over the issue and told Hawaii parole authorities just before his release that he would object to any condition that included a treatment program with religious content" (Egelko 2007). Merely because a citizen is convicted of a crime does not mean that they forgo their rights to freedom of religion: a Jewish person could not be compelled to go to an evangelical Christian church as a condition of his release, for example.

Covert participant anthropological observations of AA and NA meetings indicate that in practice the use of theological components of the program is even more explicit than the 12 steps might indicate. During the meeting the members hold "each other's hands, and lead the membership into a recitation of the Lord's Prayer. Affixed to the Lord's Prayer is an AA ending: 'Keep coming back; it works'" (Alexander & Rollins, 1984, p.7). Anthropologists and critics alike have commented upon the 'cult-like' nature of AA and NA: new adherents are encouraged to leave their jobs and cut family ties to facilitate their path to sobriety; there is a ritualistic aspect to the group's meetings; a demand for purity on the part of the membership; and required adherence to all of the group's rules (Alexander & Rollins, 1984, p.8). The emphasis on the need to confess and tell one's stories, the need to prioritize doctrine over family relations, and the substitution of family relationships for group members have all troubled some observers (Alexander & Rollins, 1984, pp.8-9).