It is extremely difficult, maybe impossible, to get statistics to answer questions like, "What is the suicide rate among A.A. and N.A. members?"

There is little doubt that membership in A.A. or N.A. will affect the suicide rate of members, but who knows which way, or what the rate is? The enthusiastic members will probably insist that membership makes the suicide rate go down by instilling hope of recovery in people. On the other hand, critics of 12-step programs suspect that

• the induction of feelings of guilt, self-doubt and hopelessness,
• the constant self-criticism and confessions,
• the practice of having to "stuff your feelings"
• and the advice to not take doctor-prescribed medications

Nobody collects such vital statistics. There are no toe tags attached to the dead bodies in the morgues, identifying the cadavers as A.A. or N.A. members, and those members do not usually get tatoos which could identify them as members.

And group secretaries do not collect such statistics. When someone disappears, they just disappear. Usually, people disappear because they just stop coming to meetings. The group secretary usually has no way of even knowing why the person is no longer there. Did they just get tired of meetings, or did they return to drinking or drugging, or did they die? Nobody knows. There is almost never an announcement by anyone at a meeting that so-and-so relapsed and died drunk. And I've never, not once, heard an announcement of a member's suicide. But we know that they die. I hear through the grapevine about the casualties. (One very old old-timer told me about one — an actual announcement at a meeting that another old-timer in good standing had just offed himself, but that is just one announcement in the whole country.)

The whole issue of membership complicates the issue. Anyone can become a member by coming to a few meetings and saying that he is a member. But it is also possible for him to go to meetings and still declare that he doesn't feel like he is a member yet. Likewise, almost no one ever says that he is quitting, and terminating his membership. People just walk out and don't come back.

If someone disappears, and it turns out that he isn't attending meetings because he committed suicide, then that would appear to count as the suicide of a member. But what if someone stops coming to meetings, and then commits suicide a year later? That would not seem to be the suicide of a member. Most people would agree that he quit the group long before committing suicide. But where do we draw the line? How long must a person be absent from meetings before he isn't a member when he commits suicide? One day? That is obviously too short of a period of time, of course he was still a member. How about a week? Still too short. One month? Too short. Three months? Now that is getting hazy... Six months? Maybe sounds like he had quit, and was an ex-member... A year? He had quit.

This brings up a parallel question: "How long does the A.A. or N.A. program effect last?" That is, if we assume that going to such meetings and working the Twelve Steps has some effect, either positive or negative (which it had better, or else a lot of people are wasting a lot of their time going to meetings and working steps), how long does the effect last before it wears off?

Can attending meetings have such a positive effect that people still abstain from drink or drugs months or years after attending their last meeting? Members would like to think so, even though they will also tell you that you should attend at least one meeting a week, and missing meetings is dangerous. Can attending meetings and doing the Twelve Steps have such a depressing effect that people can still commit suicide months or years after their last meeting? Critics suspect that that is true. (Experts on cults say that the negative effects of cults can last for months or years after people leave the cults.)

The question among critics is, "How long does it take to deprogram from A.A.?" If people get some false information in A.A., and continue to believe it, then the negative effects of "12-step therapy" could last a long time. If people believe that the A.A. program is the only way to recover from alcoholism, but they find the bombastic religiosity and cultish behavior of the A.A. members to be depressing and unacceptable, then the A.A. program could cause people to commit suicide out of despair. Or they could simply refuse to try another treatment program, arguing, "I already tried that," and end up dying. Or it could cause them to decide that they would rather drink themselves to death than become a dogmatic, narrow-minded, brainwashed A.A. member. And those deaths could occur months or years after quitting A.A..

Again, no group secretaries are collecting such statistics. The secretary is unlikely to even know that someone who quit coming to meetings a few months earlier just committed suicide. How could he or she know, unless there just happens to be a friend of the dead person who is still coming to the meetings, who tells the secretary?

Since directly measuring or counting the suicides among A.A. or N.A. members is nearly impossible, perhaps we could indirectly measure the rate. Many cities have drug and alcohol rehabilitation housing, where low-income recovering people are housed. Almost all of the inhabitants of such housing are members of A.A. or N.A.; it is almost a requirement. Attendance at some kind of treatment program or recovery group usually is a requirement for such housing. However, since so many State Supreme Court judges, and Federal District Court judges and Federal Appeals Court judges have ruled that A.A. is a religion, people cannot be forced to attend 12-step meetings as a condition of housing — not "officially". Some people could be attending Rational Recovery, SMART, or some other secular recovery group meetings. In practice, though, that number of people is still very small, just a fraction of one percent of the whole group, because the 12-steppers who manage such substance abuse programs go out of their way to pressure newcomers to join their 12-step religion, even if such actions are illegal. So almost everyone in such housing is a member of a 12-step group.

Nevertheless, even though it would be much easier to measure the suicide rate among such people, the statistics would still be very skewed and biased.

• Are we measuring the suicide rate among new A.A. and N.A. members, or the suicide rate among recently-detoxed and newly-recovering people housed in some treatment program's low-class cheap housing?
• Or are we measuring the suicide rate among dead-broke, down-and-out people who recently failed in life, and crashed and burned?
• Or are we measuring the suicide rate among people who have despaired of life, and think that the situation is hopeless and that they will never be able to quit?
• Or are we measuring the suicide rate among people who have despaired of life because they are in so much mental or physical pain, and who turned to drugs and alcohol — and then to suicide — just to end their pain?

And how many "relapses" and fatal drug over-doses were really accidental deaths, and how many were really deliberate or "sort of deliberate" deaths — consciously or unconsciously deliberate? When somebody insists on taking a large dose of something that might kill him, you have to ask whether he really wants to live.

True answers to those questions are very hard to come by. Keep this in mind the next time you hear someone boasting about how many people the 12-step programs are helping, or what kind of fantastic success rates they have. "Rarely have we seen a person fail who has thoroughly followed our path."

They don't know that. They don't even know how many people they are losing because of suicide.