Alcoholics Anonymous vs. other approaches: the evidence is now in • Hacker News Board

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#111

Post by fat_cam » Wed, Mar 11, 2020, 8:56 PM UTC

bbunix wrote: post #29

xfitm3 wrote: post #11

Earlier quoted context omitted.

Doing it virtually makes it hard to retain the "anonymous" part of AA.

Anonymous is at the level of press, radio and films...

^^ Tradition 11. Tradition 12 states:

"Anonymity is the spiritual foundation of all our Traditions, ever reminding us to place principles before personalities."

While it is easy to take the word anonymity at face value, in my opinion as an alcoholic active in AA, anonymity as it is mentioned here in tradition 12 deals more with ego and pride. When you walk into a meeting, you leave "what you are" at the door and walk in as "who you are." This translates into practices of not using honorifics. A judge isn't "Your Honor" at a meeting. A priest isn't "Father." All are equal, and all are just one drink away from being drunk. Thus, placing AA's principals before our own personalities.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#112

Post by neonate » Wed, Mar 11, 2020, 8:57 PM UTC

JamesBarney wrote: post #97

The studies in this space are notoriously bad(AA has a lot of true believers, which can lead to publication bias, and psychotherapy research in general is pretty poor). And one the best and largest studies(MATCH) on the topic show that pretty much every non-pharmacological treatment is the same. For a different take on the literature look at https://slatestarcodex.com/2014/10/26/alcoholics-anonymous-m...

But Cochrane reviews are notoriously good. They're always spoken of as the standard in meta-analysis. What's interesting here is that new research is contradicting previous findings.

According to https://www.nytimes.com/2020/03/11/upshot/alcoholics-anonymo..., the weak studies they weeded out were ones that had found against AA, not in favor of it.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#113

Post by celdon25 » Wed, Mar 11, 2020, 9:01 PM UTC

celdon25 wrote: post #34

NicolasGorden wrote: post #13

I completely agree with the message that people-helping people is super effective. But I'd like to point out that one of the core tenants of AA is to surrender to a higher power. I'm not advocating in favor of religion. But rather highlighting that maybe people who accept 'surrender' of their own will are more likely to get better. There's something to the concept that seems powerful. Anecdotally, I've known someone…

I'm not saying whether this is a good or a bad thing, but religion has done a lot over the millenia to teach people how to be productive in society. Religion is first and foremost a tool to keep people in line. The fact that part of it happens to incorporate a belief in the afterlife is an implementation detail. Sure, it might be obsolete now, but if someone is in bad enough shape (such as an alcoholic), even an obso…

Feel free to downvote, but the results of this meta-analysis of 145 scientists and 10,080 participants speaks for itself. Sometimes the outcome doesn't match your worldview and that should be okay.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#114

Post by neonate » Wed, Mar 11, 2020, 9:06 PM UTC

olliej wrote: post #52

I’m unsure about this meta analysis because it’s presumably based on AA publications. The thing is That numerous prior AA publications have treated “falling off the wagon” or missing one of the steps to mean that you weren’t doing AA properly, and so they dont report it as a failure . Essentially they end up getting close to just filtering out all the treatment failures, which inflates their success rate.

Based on the OP and two other articles (see below), I believe your presumption is mistaken. It's hard to say for sure, because the list of studies included in the meta-analysis hasn't been published yet (that I can find). (Edit: it looks like the study is available at https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...) But the articles make it clear that this was a rigorous meta-analysis done by qualified researchers. Surely they didn't just toss in AA publications uncritically. What they're saying is that, after careful review, the studies that have been popularized in the past as showing that AA was less effective are the ones that turn out to be wrong. From the NYT link:

The 2006 Cochrane Collaboration review was based on just eight studies, and ended with a call for more research to assess the program’s efficacy. In the intervening years, researchers answered the call. The newer review also applied standards that weeded out some weaker studies that drove earlier findings.

In the last decade or so, researchers have published a number of very high-quality randomized trials and quasi-experiments. Of the 27 studies in the new review, 21 have randomized designs. Together, these flip the conclusion.

https://www.nytimes.com/2020/03/11/upshot/alcoholics-anonymo...

https://eu.usatoday.com/story/news/health/2020/03/11/alcohol...

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#115

Post by elixanchor » Wed, Mar 11, 2020, 9:07 PM UTC

recovering addict here. some words for those who may be struggling.

i tried a number of things over many years (life coach, therapy, meditation retreats, ayahuasca, ibogaine, etc).

i reached a bottom, and nothing i had tried really worked or stuck. kept relapsing after a few months of sobriety at most.

ultimately it was going to AA that i largely credit to my successful transformation into a happy life of sobriety.

if you're not sure if it's right for you and struggling with addiction, i highly recommend having an open mind, and trying 90 meetings and 90 days. see how you feel after. it's the daily practice that is transformative.

there is something powerful about being focused on a purpose with a group of similarly motivated people.

the people in the rooms of AA understand the challenge you're facing in a way that friends and family often don't.

you quickly realize that the 'higher power' thing is a pretty easy to move beyond, regardless of your religious orientation. a 'higher power' can even be a conceptual device - e.g. the wisdom of the people in your meeting who have achieved a life of sobriety.

it's also not to say that AA in itself is a savior. it's a healthy component to integrate as part of a balanced recovery of body, mind, and spirit.

eating well, exercising often, and finding ways to be helpful are other important pillars to incorporate along your journey.

good luck, be well.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#116

Post by thrownaway954 » Wed, Mar 11, 2020, 9:10 PM UTC

just remember everyone that there are other 12 step and recovery focused programs and out there. so adventure out, explore, meet people, find where you fit and heal :)

https://aa.org/pages/en_US/meeting-guide Alcoholics Anonymous - for those who have a desire to stop drinking alcohol.

https://www.na.org/meetingsearch/ Narcotics Anonymous - for those who have a desire to stop using drugs.

https://secularaa.org/meetings/ Secular AA - same thing as AA except they don't pray nor require a belief in a higher power (no God stuff)

https://whitebison.org/WellBriety.aspx Wellbriety - Wellbriety means to be sober and well. Wellbriety teaches that we must find sobriety from addictions to alcohol and other drugs and recover from the harmful effects of drugs and alcohol on individuals, families and whole communities. The ‘Well’ part of Wellbriety is the inspiration to go on beyond sobriety and recovery, committing to a life of wellness and healing everyday.

https://heroinanonymous.org/meetings/ Heroin Anonymous - for those who have a desire to stop using herion (basically like NA only herion focused.)

https://crystalmeth.org/cma-meetings/cma-meetings-directory.... Crystal Meth - for those who have a desire to stop using crystal meth (basically like NA only crystal meth focused. the meetings are off the charts)

https://www.smartrecoverytest.org/local/ SMART Recovery - Self-Management And Recovery Training (SMART) is a global community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction (to drugs or alcohol or to activities such as gambling or over-eating). Participants find and develop the power within themselves to change and lead fulfilling and balanced lives guided by our science-based and sensible 4-Point Program®.

If you know or attend other group, please list :)

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#117

Post by par » Wed, Mar 11, 2020, 9:10 PM UTC

sgift wrote: post #103

keiferski wrote: post #94

Earlier quoted context omitted.

People often get hung up on the contemporary Western conception of a higher power, not realizing that the personal, anthropomorphic God is but one flavor of the concept. Scientific laws or forces are in some sense, a "higher power" - clearly we all surrender to the power of gravity every day. https://en.wikipedia.org/wiki/Panentheism https://en.wikipedia.org/wiki/Pantheism https://en.wikipedia.org/wiki/Personal_god

The various results for "atheists removed from AA" or "atheists kicked out of AA" on Google tell me AA works with the personal god version, not the others ones.

Google results can drum up anything you like. I've never personally or through second hand seen or heard of any AA group that would kick out an atheist.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#118

Post by JamesBarney » Wed, Mar 11, 2020, 9:10 PM UTC

neonate wrote: post #112

JamesBarney wrote: post #97

The studies in this space are notoriously bad(AA has a lot of true believers, which can lead to publication bias, and psychotherapy research in general is pretty poor). And one the best and largest studies(MATCH) on the topic show that pretty much every non-pharmacological treatment is the same. For a different take on the literature look at https://slatestarcodex.com/2014/10/26/alcoholics-anonymous-m...

But Cochrane reviews are notoriously good. They're always spoken of as the standard in meta-analysis. What's interesting here is that new research is contradicting previous findings. According to https://www.nytimes.com/2020/03/11/upshot/alcoholics-anonymo... , the weak studies they weeded out were ones that had found against AA, not in favor of it.

It is, but even if the review is done really well garbage in/garbage out.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#119

Post by c3534l » Wed, Mar 11, 2020, 9:15 PM UTC

Interesting. I was never a fan of AA and I was very critical in the lack of science and rigor in addiction treatment, and actually for mental health in general. I always felt there were better treatments, but CBT-based group therapy / 12-step alternatives are pretty rare. All you really need to start a chapter of AA is to not have one nearby and a place to host it. It's comforting that AA at least doesn't make things worse, on average, even if its not amazing. I'm still not comfortable with the fact that the government will require people to attend what is essentially a religious service as criminal punishment, and there are certain aspects of AA that they should probably at least de-emphasize.

Re: Alcoholics Anonymous vs. other approaches: the evidence is now in

#120

Post by ajross » Wed, Mar 11, 2020, 9:17 PM UTC

NicolasGorden wrote: post #13

I completely agree with the message that people-helping people is super effective. But I'd like to point out that one of the core tenants of AA is to surrender to a higher power. I'm not advocating in favor of religion. But rather highlighting that maybe people who accept 'surrender' of their own will are more likely to get better. There's something to the concept that seems powerful. Anecdotally, I've known someone…

> But rather highlighting that maybe people who accept 'surrender' of their own will are more likely to get better.

There's a correlation/causation trap here. It can be very reasonably hypothesized in the opposite direction: people comfortable with surrender to higher power are more likely to respond to AA as a treatment.