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

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

#311

Post by Broken_Hippo » Thu, Mar 12, 2020, 12:26 PM UTC

3fe9a03ccd14ca5 wrote: post #159

C19is20 wrote: post #144

Earlier quoted context omitted.

After 15yrs of a-abuse, 4 bottles of alcover (sodium oxibate? i believe available - prescription only - only in one country) cured me. I bought 2 cases of xtra-strong beer 'just in case', have had 2 cans on my desk for months now. 0 interest in drinking.

Why in the world would you tempt yourself like that?

I can't speak on alcohol and think any alcohol addiction is more difficult to quit, but: I quit smoking and nicotine a year and a half ago. I still have ecigs about: I kept them in case I just couldn't. Just in case. For peace of mind. I never really saw it as temptation. I don't mind getting rid of them now, mind you, I'm just lazy and they are stored away.

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

#312

Post by dang » Thu, Mar 12, 2020, 12:30 PM UTC

thulecitizen wrote: post #306

prawn wrote: post #267

Earlier quoted context omitted.

I've always assumed that some top level posts are elevated based on the quality/upvotes of their best replies.

Yeah I think it works like that too. Yet at the same time I think dang has the ability to move any post up or down/re-prioritizing or re-ranking based on his intellect, instead of a natural, organic ranking. It becomes a forced therapy session by dang. We also cannot know if this happens, since those moves would be invisible to everyone else on the site (except to other admins/moderators). I do not think it’s far fet…

We're not in every thread moving things up and down, but HN is a curated site, and that involves judgment and interpretation. For example, if there's an offtopic comment, especially a generic one [1] sitting at the top of a thread collecting upvotes as they tend to do, it's a standard moderation move to downweight it.

The idea of HN is intellectual curiosity. Sadly, upvotes alone don't optimize for that; the voting system optimizes for indignation and repetition. Countervailing mechanisms, such as software and moderation, are needed. We use software to do what we know how to automate and humans to do what we don't know how to automate—though I wish we did, because most of the human intervention at this level is tedious.

Today is a good moment to illustrate this, actually. If humans weren't curating HN, we wouldn't have had https://news.ycombinator.com/item?id=22545878 or https://news.ycombinator.com/item?id=22548217, and probably not even the current thread about AA. It would have been all coronavirus stories, or almost all.

[1] https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...

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

#313

Post by [deleted] » Thu, Mar 12, 2020, 12:34 PM UTC

athrowaway69 wrote: post #263

iateanapple wrote: post #205

Earlier quoted context omitted.

> When I moved, the meetings I encountered were extremely hostile to atheists. In my experience there are two types of atheists who go to AA: those for whom religion “isn’t their thing” and those who are actively hostile to religion. I think the latter group should find an alternative to AA.

Nice. Blaming the victim and implying I was the hostile one. I'm respectful of others' religions. It's a private matter. I made friends, ostensibly, until they found out I was an atheist. So fuck right off with your pseudo-righteous bullshit, okay?

[deleted]

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

#314

Post by gammadens » Thu, Mar 12, 2020, 12:40 PM UTC

dang wrote: post #190

So far the comments have been about people's prior experiences with the topic (which is great), or prior opinions about the topic (which is ok). But the more interesting story is being overlooked: this is heavy-duty new research that overturns previous conclusions, including the prior expectations of at least one of the lead authors. It would be good to discuss the specifics of the article and the new study.

This meta-analysis isn't ground breaking. What has been known for awhile is that AA works very well for some, but not at all for others. This has always been the dilemma with AA in research as well as clinically. It won't affect treatment because no one was ever discouraged from trying it at least in my experience.

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

#315

Post by Broken_Hippo » Thu, Mar 12, 2020, 12:42 PM UTC

handedness wrote: post #214

kwhitefoot wrote: post #68

This is probably not going to be a popular thing to say but total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for. Just as those who over eat want to control their appetite for food rather than simply stop eating so do some who have a drink or drugs problem. In many cases the drink is a symptom not a cause. Remove the cause and for some people at least the drink problem wi…

Great comment, except the first line is only true of some recovering alcoholics. It is not at all true for a great many of them, and for them that is downright dangerous advice.

Just because it isn't true for all doesn't mean we should eshew it. Yes, some folks find out they can't drink at all, ever. Others will do just fine being without for a bit, then learning how to drink moderately. It isn't dangerous advice, merely truthful and we can be honest about it not being right for everyone.

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

#316

Post by raxxorrax » Thu, Mar 12, 2020, 12:54 PM UTC

apatters wrote: post #265

elixanchor wrote: post #115

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. i…

AA's 12 Steps use the word God four times. They also refer to "Him" three times, to a higher "Power," a "spiritual awakening," and prayer. Nearly every step has a reference to spirituality of some kind and most of them are laced with Christian undertones. More generally the idea behind the 12 steps is to place yourself in the hands of this higher power and allow it to guide you. Basically it requires a belief in pray…

You can take God as an euphemism for nature or more general something beyond your control. If he exists he probably wouldn't hold it against you. You don't have to deceive yourself to a degree to believe it. You probably can watch a Batman movie without believing in Batman.

I would be skeptical too and it can certainly have a negative impact on addiction groups. Although I would think these negative factors to be worse for people actually believing it. Some people classify them as a sect, but I wouldn't go that far to be honest.

But if it doesn't work for you, I think there are other groups or those that set the focus elsewhere.

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

#317

Post by abyssin » Thu, Mar 12, 2020, 12:56 PM UTC

kilroy123 wrote: post #153

sbilstein wrote: post #125

I didn’t do AA but did AlAnon for children of alcoholics recovering from trauma. Despite what people think, the 12 step program is super light on the spirituality stuff and very atheist friendly. As a recovery group AlAnon was super useful for getting some closure on the hell my parents dragged me through and just leaving that stuff behind. Edit:I guess I should have qualified that I’ve only done support groups in SF…

I, too, went to AlAnon meetings when I was a teen. I honestly don't think I would be where I'm at today without going when I was younger.

Can you share about how it helped you?

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

#318

Post by runawaybottle » Thu, Mar 12, 2020, 1:18 PM UTC

kwhitefoot wrote: post #68

This is probably not going to be a popular thing to say but total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for. Just as those who over eat want to control their appetite for food rather than simply stop eating so do some who have a drink or drugs problem. In many cases the drink is a symptom not a cause. Remove the cause and for some people at least the drink problem wi…

Sure, and I’ll add that one understated strategy in dealing with addiction is harm-reduction. Relapses basically occur when you pull the rug out from under you and just go full abstinence. Phasing down the dosage can be an effective strategy. If you drink 500ml of Vodka a day, could you go for 350ml for awhile? Crazy thing to suggest because at those levels you’re dealing with a full blown alcoholic, but it is definitely a strategy.

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

#319

Post by jaybeeayyy » Thu, Mar 12, 2020, 1:23 PM UTC

How is it even possible to study AA meetings when they can vary so much everywhere in the world? Some have been horrible with horrible people while others were fine...some were good. I just never saw actual consistency even in the same meetings.

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

#320

Post by formeruser » Thu, Mar 12, 2020, 1:24 PM UTC

addict_throwawa wrote: post #252

formeruser wrote: post #161

Earlier quoted context omitted.

I tapered off of my Suboxone prescription gradually over a long period of time. By the end of it, I was taking very tiny pieces of the film. They were small enough that at some point, it was probably more mental than anything. I wish you all the best! After getting off of it, the hardest part for me was still maintaining a clean lifestyle while avoiding the types of people and behaviors that lead to scoring or abusin…

How long of a taper did you do? im not on a very high dose but was still thinking about like 3 months. but I also am 50/50 like I'm worried about the after effects you have - this is working so well now I see very little downside to long term use and the upside is really big imho - except probably harder to eventually taper off the longer I'm on.

By not high, do you mean around 2-4 mgs? If so, 3 months is probably a good timeline for taking a 25%-50% reduction every 1-2 weeks or so. I might have even taken longer for the last few doses. I think the big thing is not to rush it and take a pace you're comfortable with. Like you say, taking buprenorphine is much preferable to turning to alternatives.

My first experience with a taper was at rehab as they were pushing me out the door. They rushed it, and I was dopesick as I left. You can imagine that didn't turn out well.

Another thing I credit my recovery to is having strong support along the process. Also, building new lifestyle habits like going to the gym helped me improve my self-image. I don't know how much making that sort of change would apply to you but thought I'd mention it.