AA's foundational notion that addiction is a form of spiritual corruption is in conflict with contemporary scientific understanding of addiction as neurophysiological disease.

To be consistent, AA chapters must discourage use of SSRI's, opioid receptor antagonists, bupropion, or other possible pharmacological remedies. Many chapters and many individual sponsors do.

AA's problematic is idealist; the contemporary scientific conceptualization of addiction is materialist.

AA's success rate is said to be around 5%. Long term success rates of contemporary pharmacological approaches are not yet known.

Will AA's leadership allow its core principles to be updated as scientific knowledge matures?