Alcoholics Anonymous: The Libertarian Ideal

In a previous post on zoning, I wrote that one reason why libertarianism is such a hard sell is that we have no political experience with any set of institutional arrangements other than the nanny/regulatory/welfare state. Accordingly, it is difficult for voters to imagine how a polity built on laissez faire principles would address the various social problems that may arise in a modern society.

I go on to argue there that for a variety of reasons, including the continuing viability of the tort of nuisance, “there is no reason to believe that the repeal of zoning would have disastrous consequences. In fact, there are at least as good grounds for supposing that there would be net benefits.” However, since zoning has been the norm from the 1950s onward, most of us are unfamiliar with any other approach. Houston is now the lone major holdout.[1]

In my view this unfortunate ignorance regarding potential voluntary/free market solutions to social problems obstructs our political vision in many important areas of public policy. As described in Libertarian Philosophy in the Real World, these include protection against unsafe and dangerous products (chapter 5), “free banking” (chapter 6), poverty relief (chapter 7), public education (chapter 8), and health care (chapter 9). Accordingly, it may be useful to highlight one remaining and important private sector initiative that has not yet been regulated to death or displaced by the state. I am referring here to Alcoholics Anonymous and other 12-step programs modeled after it.

AA (founded in 1935) describes itself as an “an international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere.” AA does not accept government subsidies or charge membership fees of any sort, and it costs nothing to attend its meetings. Participation is entirely voluntary.[2]

This organization has a central office that accepts donations, disseminates information and literature about the program, and that’s about it. Everything else is highly decentralized, with scheduled meetings arranged and conducted by unpaid local volunteers. The organization has over two million members worldwide. They share experiences at their meetings, and mentor and encourage each other.

AA does not claim to be superior to other forms of treatment, and does not discourage other therapies, including supplemental medications. While this is a controversial claim, the Surgeon General of the United States reported in 2016 that, “Well-supported scientific evidence demonstrates the effectiveness of 12-step mutual aid groups focused on alcohol and 12-step facilitation interventions.”[3]  However, the best evidence of efficacy is the members’ willingness to attend meetings, mentor other participants, make donations, etc. As individualists, we should trust that competent adults generally know what is in their own best interests.

The 80-year track record of AA should remind us of the power of people to manage their own affairs and build vibrant communities without state “assistance,” as should the contributions of service organizations like Kiwanis, Lions, Rotary International, and the countless small-scale charitable foundations established by ordinary Americans. Unlike governmental programs, no one is compelled to join these organizations, or to support them financially.

As indicted above, I believe that voluntary solutions would emerge in almost every other area of unmet social need if the state would just get out of the way. But one thing seems certain: we should exhaust private sector options before we resort to heavy handed governmental coercion. Unfortunately, this principle was abandoned long ago.

EDIT (3/20/20):  This NYT story supports the effectiveness of AA on various objective measures, in addition to the participants’ subjective conclusion, evidenced by their voluntary attendance:

An updated systematic review published Wednesday by the Cochrane Collaboration found that A.A. leads to increased rates and lengths of abstinence compared with other common treatments. On other measures, like drinks per day, it performs as well as approaches provided by individual therapists or doctors who don’t rely on A.A.’s peer connections.

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[1] For a much more detailed critique of zoning ordinances, see Chapter 3 of my Libertarian Philosophy in the Real World.

[2] Some persons are forced to participate in 12-step programs by courts as part of a criminal sentence or as a condition of probation. Arguably, such steps may violate the defendant’s freedom of conscience because an inherent part of 12-step programs is the recognition that assistance must be sought from a “higher power.” However, AA does not initiate or encourage such orders, and so is not responsible for any injustice that arises thereby.

[3] The absence of a scientific consensus of the “effectiveness” of 12-step programs is not surprising. In addition to the typical challenges present in designing and conducting social science research (hurdles apparently so formidable that most of it can’t be replicated), there is the added complication of defining “effective” in a manner that is both meaningful and quantifiable. For example, if a successful outcome is defined in terms of strict abstinence for some specified period, this would treat important reductions in the severity of the drinking problem as a “failure.” The SG’s Report acknowledges this in commenting that “recovery goes beyond the remission of symptoms to include a positive change in the whole person.”

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6 Responses to Alcoholics Anonymous: The Libertarian Ideal

  1. “As individualists, we should trust that competent adults generally know what is in their own best interests.”

    Are alcoholics competent adults?

    More generally, the principle seems either false or too narrow. A person who is deceiving himself may well not know what is in his own best interests. Does a self-deceiver qualify as a competent adult? If yes, the principke is false. If no, then, given the extent of self-deception, the principle applies to relatively few people.

    As you may remember, I prefer to speak of people having the right to direct their own lives because fulfilment depends upon self-discovery, and self-discovery depends upon learning from mistakes.

    • Mark Friedman says:

      Hi Danny:
      Thanks for the comment. I think you may be reading more into this sentence than was intended or implied. Absent fraud or serious deception, libertarians don’t generally wish to set aside transactions between competent adults on paternalistic grounds (i.e. cigarettes, booze, prostitution, etc.). We assume that both parties benefit by their own lights, and so we respect such transactions, even if we personally would act differently. There are no doubt various degrees of self-deception, some of which would falsify the above conclusion, but I disagree with the claim that any degree of self-deception disqualifies one as a “competent adult.” Accordingly, I think that almost all alcoholics are competent adults in that whatever self-deception is present does not give us cause to doubt that they know what is in their own best interests, especially in light of the evidence I cite that AA “works” in some objective sense.

      The criminal law seems to make the same judgment, as having a drinking problem does not excuse criminal conduct. Nor does actual intoxication, although being blind drunk might be relevant for sentencing purposes. Thus, the law presupposes that alcoholics have sufficient control over themselves to be responsible for their decisions.

      Your theory of rights may be superior to mine, but I don’t see this as decisive in terms of determining whether alcoholics derive a benefit from participation in AA. Let me know if I have missed something (always possible).

  2. Hi Mark,

    Actually, I was not connecting alcoholism with self-deception: the latter was intended as a separate point. But now that you make the connection, I think there is something in it!

    I have lately been struck by the prevalence of self-deception. Someone acting under self-deception may think he is acting in his best interests when he is not (and when he would discover that he is not, if only he would stop averting his eyes from the truth). I agree that he is entitled to act as he does; but if he is engaged in a transaction, he does not benefit by it. Does he benefit by his own lights? That is a difficult one. Even if he does not benefit, and “at some level” recognises that he does not benefit, he may deceive himself that he does. So if we do think he is entitled to act as he does (as I think we should), we ought not to ground that entitlement in his acting in a way that seems to him to be beneficial (since it may be doubtful whether that is true).

    • Mark Friedman says:

      Hi Danny:
      As I think you would agree, the weight we accord to potential self-deception in grounding rights is a thorny issue. As you know, I accept Nozick’s idea that rights are grounded in rational agency: essentially possession of moral agency coupled with the capacity to plan and life our lives in accord with our own conception of the good. Clearly, a person may be suffering from such a degree of self-deception that they no longer qualify as a rational agent (e.g. members of extreme cults), so that their rights might be suspended. Nevertheless, since we are all I think self-deceivers to some extent, I wouldn’t like to say that only perfectly rational people are entitled to have their choices respected.

      Further, I would say that we should presume that rational agents do “benefit” from their choices, even they are also self-deceivers to some degree. I have no taste at all for such risky endeavors as sky-diving, base-jumping, or mountain climbing, but many people seek them out. For them, the risk/reward trade-off is favorable. They may not have accurately calculated the exact risk they are assuming, but they know that there are serious risks, and proceed anyway. So, they have concluded that whatever the exact danger may be, the thrill or sense of accomplishment is worth it to them. Since we’re dealing with a subjective experience, I’m not sure what better evidence there could be of a benefit.

      I’m not sure how grounding rights in an entitlement to fulfillment based on self-discovery paints a clearer picture. Whether we regard persons as rational agents or self-discoverers (and I think the two things are closely related), they are equally vulnerable to self-deception. A person may be fool himself about what experiences will produce personal growth (sky-diving, etc.), and may deceive himself in the interpretation of his experiences (“it has made me a better person”), etc. I assume that you would hold that rights are not obviated by such self-deception because on balance this process is still intrinsically valuable and thus entitled to non-interference. Am I missing something?

  3. Hi Mark,

    Let me go back to the beginning.

    “As individualists, we should trust that competent adults generally know what is in their own best interests.”

    I reject that. People are often wrong about their own best interests. Sometimes it is due to ordinary error. For instance, they have been brought up to believe that they will find fulfilment in a particular way (e.g. being a family man/woman, or being a butcher like past generations of the family, etc.). If the belief is wrong, they will eventually discover that it is and correct it and, if they can, make changes to their lives. However, sometimes the error is not an ordinary one because it is due to self-deception. In that case they will not easily learn that they are in error because they deceive themselves about the feedback they are getting (“yes, I am really enjoying this”, they lie to themselves, etc.).

    As you may recall, I argued for freedom on the ground that it enables people to discover for themselves what fulfils them. I denied that people generally know what is best for them; but I said that freedom enables them to find that out. And I said that the verdict on whether a particular kind of life fulfils a person has to be given by that person, not by others; so no paternalism. But the prevalence of self-deception (which had not occurred to me at the time I wrote) means that my argument needs more careful statement. I do not think it allows a loophole for paternalism because the paternalist might be deceiving himself too.

    I think I have been rambling a bit. I am thinking out loud. But I need to revisit the whole issue. I hope these thoughts help you, too.

    Incidentally, I thought the rest of your post was fine!

    • Mark Friedman says:

      Hi Danny:
      You may be rambling, but I think you are on to something. When I wrote the sentence you quote, I was not focused specifically on self-deception or what you call “ordinary error,” but simply had in mind that people are fallible. Thus, I tried to hedge my bet by the use of “generally.” My sense is that people may often be wrong regarding their own “best interests,” but that this difficulty will be more pronounced in some types of cases than others. I would suppose that choices involving consequences that will unfold over a long time are the most problematic, e.g. going to law school v. graduate school in philosophy or some other field. Or accepting one job offer v. continuing the possibly futile search for a better one. Decisions with more immediate and obvious feedback may be easier.

      I think it is worth noting that this sentence was tied to the previous one: “However, the best evidence of efficacy is the members’ willingness to attend meetings, mentor other participants, make donations, etc.” So, I was not attempting some sort of universal judgment about the quality of people’s self-awareness, but rather their ability to judge the value of AA for them. In other words, the issue is whether they are capable of accurately assessing whether AA is meeting their goal of greater sobriety, relative to the other options they had before them. And while I believe that they (generally) are, I have no good evidence to back this up. Thus, perhaps I shouldn’t have said that their participation is the “best” evidence of AA’s efficacy, but something like “the empirical evidence cited by the Surgeon General combined with the willingness of members to participate in AA on a long-term basis strongly suggests that they benefit from it.”

      In any case, you have given me something to think about.

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