Survivorship Bias and Addiction Treatment

Let’s put aside the topic of addiction treatment for a moment and talk about something much more interesting.

I want to share a secret with you that could possibly help you to make a lot of money. You are not going to believe that this has been hiding from you in plain sight all these years. Sit down, I am about to reveal a trick that could possibly change your life and make all of your dreams come true.

Every day, thousands of people win the lottery.

I’m not talking about the big jackpots. The odds against winning the lotto and powerball are far too great. To see where the winning is really happening for a lot of people, take a look at scratch-off tickets. These flashy little cards at the convenience store counter can be bought for as little as one dollar each.

And yes, thousands upon thousands of people scratch their way to winnings each and every day. A winning scratch-off can net a payoff of up to thousands of dollars. Some even offer the possibility of income for life.

Imagine if you bought ten tickets every day.

If each ticket won only $5, you would be profiting $40 per day. That is an additional $1200 per month income for just a few minutes of work each day.

Before get started, scratching your way to riches, I hope that you see the flaw in my logic. Even though thousands of winning tickets are scratched off each day, there are also millions of losing tickets. The deck is stacked against you. In fact, if you try the plan I just described for even a few days, it is unlikely that you will come out ahead, let alone get returns of 500% or more.

This is a ridiculous example of survivorship bias. Survivorship bias happens when we only focus on the successes and disregard the failures.

Another example is what happens when you walk into a new gym.

When you look around, you see people in incredibly good shape working out hard. Imagine that you walk up to a man with large, bulging muscles and almost no body fat. You ask him how he does it. “I just show up every day and do my routine. Anyone can do it.” You are inspired. But, is it true? Can anyone do it?

Yes, most of the men and women working out in the gym look great. But, before you sign up for a membership, think about the people you don’t see. How many hundreds, or even thousands of people have walked into this gym, signed up, and never achieved the results they had hoped for?

Why do gyms fail these people?

Did they just not work out hard enough? Did they not want it bad enough? The key to understanding success in the gym might be found in studying the failures more than the successes. Is it possible that genetics or upbringing or both affect personality and physical potential in such a way that some people are able to thrive in the gym and attain pro-level results? To promote gyms as successful vehicles for all people to develop near-perfect physiques is an example of survivorship bias.

Now, let’s get back to survivorship bias and addiction treatment.

There are spiritual fellowship programs that provide support and guidance in getting clean from drugs and alcohol. These programs employ a version of the 12 steps, originally developed by Alcoholics Anonymous. There are weekly and daily meetings in many communities.

You can find meetings of the major programs, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in nearly every city and town in the U.S. and around the world.

Attending 12-step meetings are people with varying amounts of sober or clean time.

Often, a successful member will talk for the first half of the meeting. They discuss how they achieved success in accumulating clean time. The remainder of the meeting is open for other individuals in the group to speak.

12-step meetings can be inspirational, but can also, at times, sound like an extended infomercial. If you ask a group member after the meeting how to achieve success, they will recommend that you find a sponsor and work the steps.

When you listen to speakers at meetings, one thing you will not hear about is failure.

They may describe failures in their early attempts to get clean, but at some point, the speaker found success and stayed clean for over a year. How did they do it? Was it the 12-steps? Was it showing up to meetings every day?

While these activities may have contributed, the real reason that all speakers at a 12-step meeting have had success in staying clean for over a year is that the requirement for speaking is to have at least one year clean. That rule nearly guarantees that newcomers will only see success at the front of the room at every single meeting. It is just like the gym. Success appears to be the rule, not the exception.

If you have sat through many 12-step meetings over a period of years, you will notice that you get to know the successful people really well. You will get to know all of their names. In fact, they all fit easily in one room. Most likely, they don’t take up more than the first row of chairs. The rest of the people in the room are strangers. They come and go. Sometimes, they come around to the meeting for days, weeks or months, but eventually, they are gone and soon forgotten. Other newcomers take their place. Why didn’t it work for them?

They say that the failures did not want it badly enough.

Or, they were not ready yet.  Some try, but they were not willing to work the program thoroughly.There are many reasons given for the failures. And, long-term group members will point to the overwhelming success of the program. Look around at all of the clean time in the room.

Yes, the level of success among the successful is high.

The ones who make it make it. The program works for the ones for whom it works. Is it possible that the people who do well in 12-step programs are predisposed to success in this particular environment?

Could it be that the people who enjoy speaking out loud and hearing the sound of their own voice have an advantage? What about people who like writing and exploring their self inventory, shortcomings and defects? There could be a great many variables involved. Is it possible that it takes a very specific type of person to quit drugs, go to a 12-step program, and achieve many years of clean time? For every success, how many don’t make it? It’s hard to say. No one is counting the failures.

Does this mean that if 12-step programs don’t work for you that you should just give up? Of course not.

There is more than one path to success. Some people find success through the practice of their religion. Others do well with medical treatment. Some people reach a point in their life where they have an awakening to the fact that there is no safety net and they stay clean no matter what. Everyone is different.

In conclusion, consider the possibility of survivorship bias when you hear people promoting their success with a particular program. Ask if there is any real data. Have scientific studies been done to support their claims? Find studies, if they exist, and review them for yourself. And, if something isn’t working for you, consider trying something else.

This Post Has 40 Comments

  1. I attend twelve step meetings and I do agree that they can sound like infomercials at times, but I disagree with a couple other points you make. First of all, beginners meetings actually require that you have LESS than one year of sobriety in order to share. Those back of the room babies are like our spiritual children. Some of us like to listen, not just talk. Secondly, we talk A LOT about failure. It’s one of the main reasons we identify with each other. Those of us who have strung together a few years are not saints on pedestals. We get angry, fart, relapse, and sometimes still cry at meetings. If I never heard anything but success stories I would have never come back. I have other aspects of my personal program, like exercise and attending the church of the God of my understanding, and I realize that my 12 step program isn’t for everyone. But it is the one place where I can be honest about my failures. And I’m not worried about data when I see the miracles of lives being transformed.

  2. My brother is attending the 12-step meetings and has recently started doing it. We are all concerned about him in every sense. But, he has a great willpower and it gives us inner strength to believe that he will come out of it with flying colours. Thanks for sharing this.

    1. I hope that this article does not discourage anyone from going to 12-step meetings. While it is not easy and not everyone finds success, meetings are excellent places to meet friends who are dedicated to staying clean. Building a network of support is important. Just like in my example of going to the gym, just because you can’t be a world class body builder does not mean that going to the gym is a waste of time. However, it is also important to not discount medical treatment. There have been some great advances in the medical treatment of certain substance use disorders. I recommend seeing a doctor for the medical condition of addiction or substance use disorder.

  3. There are so many paths people can take to recover, they just have to find what works for them. The main thing is to be aware of your problem and commit to getting better. Your solution is out there you just have to find it. Great article!

  4. The AA program is a new way of life. The steps are a continuous, lifelong practice that you have to be willing to commit to. It’s never finished unless You are. Anyone that I have seen fail, did so because they stopped working the steps, quit calling their sponsor, and stopped going to meetings. Sometimes people, places and things need to be reevaluated. Is this the best thing for me?
    Trust God Clean house Help others

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