Sobriety startups shaking up the 12-step model • Hacker News Board

Re: Sobriety startups shaking up the 12-step model

#151

Post by turingcompeteme » Fri, Jan 04, 2019, 9:42 PM UTC

empath75 wrote: post #38

Most people with substance abuse problems “grow out of it” with no outside help at all. https://www.google.com/amp/s/www.psychologytoday.com/us/arti... Just from personal experience partying with lots of drugs and drinking in the rave scene when I was in my 20s and djing and promoting, the vast vast majority of people just got tired of it one day and quit — or it interferes with their jobs or their families and they…

These articles are silly, and don't understand alcoholism. They give a few examples of successful ways that people have quit on their own, and since lots of people did it that way, then it must be more effective than treatment.

They miss the blindingly obvious point that every single person in treatment has already tried and failed those "self-help" ways. Treatment is a final, desperate, step for alcoholics, once all those self treatment methods have failed. You can't compare the two, and the first treatment has already failed for the second group.

It's like saying Tylenol is a more effective treatment than going to the hospital, because more people get better that way. Of course they do - because they have a less serious problem.

Re: Sobriety startups shaking up the 12-step model

#152

Post by gammateam » Fri, Jan 04, 2019, 9:57 PM UTC

The AA 12-step program was so strange when I accompanied my friend to one

I had no idea it was so religious

I found this to be a bug, not a feature

It is interesting to see other methods being tried instead of masquarading the 12-step programs longevity as absolute validation

Re: Sobriety startups shaking up the 12-step model

#153

Post by taurath » Fri, Jan 04, 2019, 10:08 PM UTC

whiddershins wrote: post #130

mgamache wrote: post #60

If you consider addiction as a psychological and physical dependence on a chemical what healthcare professional would design a program like AA? Seven of the 12 steps involve God. It also reinforces the 'moral failure' stigma attached to the person. You drink too much for a reason, not because you are a bad person. It's likely due to genetic and environmental factors. ohh and you can die from withdrawal (unlike most o…

There are any number of persistent myths attached to the popular conception of 12 step programs. I am in no way an expert on AA, but I have researched various addiction treatment methods fairly extensively and am close to people who work professionally in recovery programs. The idea that AA reinforces the "moral failing" aspect of addiction seems contrary to everything I've ever read, heard, or seen in regards to AA.…

> The idea that AA reinforces the "moral failing" aspect of addiction seems contrary to everything I've ever read, heard, or seen in regards to AA.

The entire insistence on the belief in a higher power, along with insistence that one is "powerless over your addiction" is intrinsically talking about a moral failing, and more specifically adherence to a christian-worldview where all from birth are morally failed.

They are offering a solution, in the form of rewiring your entire worldview (and deeply held beliefs) to the idea that you are powerless, there's an all powerful deity, and all good things are because of said deity. Step 4 is literally "Made a searching and fearless moral inventory of ourselves." [1] It may be effective for some, and some may have issues or resistance to such a thing.

Having a conversation about the methodologies is impossible without potentially discouraging someone from seeking help - but we should not hide the negatives, or else there'll be no way to actually get to better solutions. My feeling is that religion and giving up to a higher power can work for some people, but for others it can be a betrayal of their deeply held principles and values - my fear is that places like AA in an effort to evangelize their own principles and values take people who are rock bottom and offer up theirs as a solution rather than something that might work well for the person.

1: https://12step.org/the-12-steps/

Re: Sobriety startups shaking up the 12-step model

#154

Post by rajacombinator » Fri, Jan 04, 2019, 10:09 PM UTC

jcims wrote: post #40

Quequau wrote: post #11

After years and years of struggling with alcoholism and AA, I got sober with naltrexone using the "Sinclair Method". I followed the treatment plan for a few weeks and at the end quitting drinking was easy and obvious. That was just over ten years ago and I haven't had a drink or gone to any meetings since. I'm only one person and I'm fully aware that the plural of anecdote isn't data. However, the experience was so d…

First congrats on finding something that works for you and making it stick! From that perspective, I can see why you would not like folks that insist on AA being a monopoly, but I'm curious about that position. I've seen a lot of people that hate AA and a lot of people that think it saved their lives, but I've never seen anyone say that AA must be the only way to sobriety. What's the angle?

You may have encountered these people casually in passing but not read anything from AA proponents. Basically every AA proponent I’ve ever read from tows the party line that it is the only viable treatment. Many of them disparage and suppress alternatives like the Sinclair method.

Re: Sobriety startups shaking up the 12-step model

#155

Post by dillondoyle » Fri, Jan 04, 2019, 10:12 PM UTC

graeme wrote: post #74

Quequau wrote: post #11

After years and years of struggling with alcoholism and AA, I got sober with naltrexone using the "Sinclair Method". I followed the treatment plan for a few weeks and at the end quitting drinking was easy and obvious. That was just over ten years ago and I haven't had a drink or gone to any meetings since. I'm only one person and I'm fully aware that the plural of anecdote isn't data. However, the experience was so d…

Does this only work for alcoholism, or does naltrexone work for any compulsive behaviour?

Commonly used to treat opiate dependence, often a combo of buprenorphine + naltrexone

Re: Sobriety startups shaking up the 12-step model

#156

Post by vorpalhex » Fri, Jan 04, 2019, 10:14 PM UTC

cwkoss wrote: post #136

jyriand wrote: post #122

Earlier quoted context omitted.

Anyone know if there is something similar to quit smoking? Tried to quit cold turkey 20 times at least, usually can’t get past the first day.

Juul has helped a few friends quit smoking, but some still use the juul. Nicotine salts in their juice make it feel stronger than cigarettes, so its easier to switch than standard nicotine-base juices.

I've known several people in my life who went from being 2-pack a day smokers to, well, vapors on a low nicotine dose. Juul is sort of an overpriced unit and really they're trying to run a subscription model on their dumb pods - but in general vaping can help in smoking cessation (though not necessarily nicotine addiction!)

Re: Sobriety startups shaking up the 12-step model

#157

Post by taurath » Fri, Jan 04, 2019, 10:15 PM UTC

coleifer wrote: post #123

mgamache wrote: post #60

If you consider addiction as a psychological and physical dependence on a chemical what healthcare professional would design a program like AA? Seven of the 12 steps involve God. It also reinforces the 'moral failure' stigma attached to the person. You drink too much for a reason, not because you are a bad person. It's likely due to genetic and environmental factors. ohh and you can die from withdrawal (unlike most o…

> You drink too much for a reason I don't think that's right. More than anywhere else, it seems like on HN there's an idea of the infallibility of human rationality. Would anyone in their right mind a) shoot dirty dope filtered through a cigarette butt, b) gamble themselves into debt with the mafia, c) overeat to the point they can't leave the house, d) play videogames compulsively for days on end, etc?

A reason doesn't mean from a rational perspective. A reason someone wouldn't go in an elevator might be an irrational fear of heights. A few reasons someone might continue drinking even though its slowly destroying their lives and relationships:

* Undealt with trauma/abuse

* Lack of skills to express themselves emotionally, and experience that it is a "socially acceptable outlet" (for a while)

* Depression and lack of self worth (sometimes brought on by excess drinking, in a cycle/loop)

* Neurochemical or biological imbalance - note that the rates of ASD spectrum or bipolar alcoholism is much higher than neurotypical, for example

* Cultural enforcement of drinking (frequently being around people with other of these issues)

* Others

Or most frequently

* Multiple of above

Re: Sobriety startups shaking up the 12-step model

#158

Post by [deleted] » Fri, Jan 04, 2019, 10:26 PM UTC

DoreenMichele wrote: post #150

derefr wrote: post #113

Earlier quoted context omitted.

The AA steps were constructed in a culturally-Christian environment, for people who are also culturally-Christian, even if they’re atheists. (I.e., they are people who were taught Christian messages and then maybe rejected them, and who also have a mostly-Christian community around them.) Thus, they have to be read through this lens. Basically, if you want to “translate” the AA steps for the modern era where things a…

The AA steps were constructed in a culturally-Christian environment I've read the origin story. It was constructed by a group of people who had been terrible, hard core alcoholics for decades who had failed all efforts to get off the alcohol and were still drinking even though it was literally killing them. "Giving it up to God" helped these folks get sober when nothing else had. Now, we call every college kid who go…

[deleted]

Re: Sobriety startups shaking up the 12-step model

#159

Post by scott_s » Fri, Jan 04, 2019, 10:39 PM UTC

stronglikedan wrote: post #87

PakG1 wrote: post #75

Earlier quoted context omitted.

The unfortunate thing is how much people actually buy into it. I remember once in university, I was at a national entrepreneurship conference for student entrepreneurs. One night, there was a party at a club type of venue. I was sitting with a pretty female friend from my university when she asked me to get her water. So I went and got her a bottle of water. This jerk from another university walks up to us and incred…

> how much did that guy...and how much was that guy... Neither. It's a common joke used when people get water when there's a bar close by. Nothing more, nothing less. It doesn't have to be believed, and one does not have to be a "scared kid inside" to say it. I think you just read way too much into it, perhaps since it was your first encounter with said joke.

It's a common joke because drinking water at a bar is seen as wimpy or uncool. Put another way, the only way the joke works is if we all agree that there's something wrong with drinking water instead of alcohol. I agree with PakG1's reading.

Re: Sobriety startups shaking up the 12-step model

#160

Post by scott_s » Fri, Jan 04, 2019, 10:41 PM UTC

superpermutat0r wrote: post #34

randomacct3847 wrote: post #24

Earlier quoted context omitted.

New findings show there’s no such thing as a “safe amount of alcohol” https://www.npr.org/2018/08/24/641618937/no-amount-of-alcoho...

Well, the increased risks from 1 glass of wine per day is abysmal. Even 2 glasses of wine.

Yes, but that's not important takeaway. What's important is that with better, recent methodology, we're discovering that the "moderate drinking is beneficial" effect vanishes.