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Alcoholics Anonymous vs. other approaches: the evidence is now in
341–350 of 366 posts
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#342Earlier quoted context omitted.
Why should they find an alternate group? I thought the purpose was to address alcohol addiction. And to what group should they go?
The AA treatment has a component that many atheists may interpret as religious or spiritual. If that's your interpretation, and you are actively hostile to that belief, then your own world view is not compatible with either the treatment path or the social group you will encounter. That is not going to be a high probability scenario for recovery, and it may interfere with others' recovery, and that's why you should f…
What I'm hearing is if you are hostile and rude, you should not participate (not trying to put words in your mouth). I agree.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#343What's more interesting is since "The Irrationality of Alcoholics Anonymous" (2015)[1] HN thinks they are experts in how AA doesn't work. These meme bugs that infect people are the on ongoing issue you see a lot here. They make no sense, but that's why the meme works. AA is free and you talk to people about your issues, it's hard to see why it's wrong, which is why people love the meme. Throw in some other regulars -…
> They make no sense, but that's why the meme works. AA is free and you talk to people about your issues, it's hard to see why it's wrong, which is why people love the meme.
this isn't a very charitable take. there are a lot of legitimate reasons to be skeptical about AA. to an outsider, the tone and content of the twelve steps can seem pretty weird. why abstinence only, and why don't coffee and cigarettes count? why are people prohibited from identifying themselves as a drug addict in some AA meetings (as if alcohol is not itself a drug)? why does AA itself collect essentially no data that could be used to determine the efficacy of the program? why do courts mandate attending AA but not other similar support groups?
the old adage "it's hard to beat free" certainly applies here, but I wouldn't casually discount all the negative stories in this thread from addicts that tried AA.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#344recovering 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…
I had other experiences. The friendships I had in AA were superficial. Once, when I was struggling and needed help and people to talk to, I was completely ignored by the people around me. They didn't want to help the struggling - just to have this toxic positivity that nothing is wrong. I later moved out of state. I came back to visit family, and went back to a meeting to find out that there were rumors that I had re…
sorry that you had these experiences, i can relate to aspects of them as well.
each meeting can be quite different. i had to try 10-20 of them in my city to find a few that were on my wavelength.
i don't attend aa meetings as often as i used to in early sobriety, but i still go if i have a friend that's struggling and want to open this resource to them.
at every meeting, there are things that people say that resonate and things that are cringe-worthy or even inflammatory.
part of the meditation and process is being able to be hear and react to everyone's words with equanimity.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#345Someone else mentioned this and I agree wholeheartedly. I think unless you have a physical addiction to something, you just need to discard it and "forget" about it.
For drinking, I think the new Heineken 0.0 is a game changer. You can go out to a bar and hold one and drink, get the placebo effect.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#346I find it frustrating that the subheading says “less expensive.” No, it’s FREE. Absolutely free. Donations optional. To me, it sounded like the editor of the piece didn’t want it to sound promotional, which made it less true.
No-cost-to-member, and overall cost, are two different notions. bAs are financial and nonfinancial costs, e.g., time, travel or transport, facilitator, meeting space, training or. materials.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#347Earlier quoted context omitted.
Do you think you could elaborate why you believe this is "heavy-duty" new research (or even new research at all, rather than a new meta-analytic synthesis of old research)? My quick read of the study suggests that they examined several outcomes, got null or low powered results on most of them, and chose to highlight the single result which did show a significantly positive effect on recovery; that result was based on…
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Would love to chat about hiring research analysts. I seem to be in the same position as you. Email is info@koanmail.com.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#348The AA way was described in The Power of Habit as one of the examples of successful habit change. Basically: keep the habit's cue(e.g. feeling depressesed) and the reward(social interaction) but replace the bad habit(drinking) with a better one(meeting with the sponsor).
My alcoholism (if it can be called that - it is a spectrum) is driven in part by the social interaction of fellow drinkers. The predictability of seeing each other at the bar, of hanging out and not worrying about the day.
I've talked to one or two of them about doing tea on Tuesdays, or some other thing that could get us from drinking 3-7 stouts a night.
That book may be worth a read.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#349So 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.
Do you think you could elaborate why you believe this is "heavy-duty" new research (or even new research at all, rather than a new meta-analytic synthesis of old research)? My quick read of the study suggests that they examined several outcomes, got null or low powered results on most of them, and chose to highlight the single result which did show a significantly positive effect on recovery; that result was based on…
This reply will probably be ignored, since it has been two days and ycombinator has a pretty short attention span, but I have skimmed over the full study.
There are about 10 findings, and the only “high” quality finding is that there appears to be a significant increase in abstinence, especially long term abstinence from people who get treatments which get them in the rooms of AA (“TSF” treatments).
We can dive down in to the details about this finding (percent abstinent) on pages 88 and 89 of the report. They actually use six different studies, but only two of them provide information at the one-year follow-up, so only those two get listed in the summary on page 4 of the report.
Considering that they compared a number of things, and only percentage of subjects abstinent showed, with high confidence, a difference between AA/TSF and other treatments, I’m a little worried we may be seeing a multiple comparison fallacy. Then again, this is unlikely: They are seeing P values of 0.02 and 0.03 (1-in-30 to 1-in-50) for the abstinent numbers, but only look at about 10 factors.
Humphreys 2014, another meta-analysis of multiple studies, showed AA effectiveness which can not be attributed to self-selection, but it saw something different: A fairly small but significant increase in the percentage of days abstinent. While they did see in the 2020 Cochrane review, they did not see it with a high level of confidence (see pages 89-90).
Percentage days heavy drinking — I don’t have a copy of Brandsma 1980 handy, but I think that’s what the “Brandsma 1980 shows that AA results in increased binge drinking!!!111!!!!!” claim parroted by the usual anti-AA crowd talks about — might be increased in the short term after starting AA treatment, based on the one study which has 6-month follow-up figures for this; Brandsma 1980 only saw it at the 3-month follow-up and not later. Then again, the Cochrane study of those numbers show a pretty high P value (0.79, just glancing at those figures), which means we still don’t really know if Brandsma 1980 actually saw something. Scott Alexander dismisses it as an example of a multiple comparison fallacy, and the P values for it in Cochrane 2020 means we probably didn’t actually see something, but this may merit additional investigation.
Cochrane 2020, of course, didn’t look at the longitudinal studies showing really high abstinence rates for people who self-select to go to a lot of AA meetings, but even using only randomized studies, we are seeing a significant increase in number of subjects who get and stay sober when they engage in treatment which encourages AA attendance.
Another thing: There are no recent high-quality studies comparing AA to no treatment (“spontaneous remission”, an expression I see used mainly by people with a pretty strong anti-AA bias) because it’s been established for a long time that AA (or any other treatment you can think of) is better than no treatment. Even Brandsma 1980 saw that going to their AA-like meetings was significantly better than getting no treatment at all.
In summary, with some caveats, we are seeing solid scientific evidence that AA really helps alcoholics get sober and stay sober. Ten years ago, someone could still say “AA does not have a higher success rate than no treatment” with a straight face; today, to claim something like that requires ignoring a lot of scientific evidence.
Re: Alcoholics Anonymous vs. other approaches: the evidence is now in
#350Earlier quoted context omitted.
Do you think you could elaborate why you believe this is "heavy-duty" new research (or even new research at all, rather than a new meta-analytic synthesis of old research)? My quick read of the study suggests that they examined several outcomes, got null or low powered results on most of them, and chose to highlight the single result which did show a significantly positive effect on recovery; that result was based on…
> And for "rates of continuous abstinence" they found a positive effect. It’s been a while since I reviewed the literature for substance abuse disorder, but if I remember correctly it was highly disputed whether complete abstinence was necessary (or even beneficial) for treatment. Has this changed? The argument was that by focusing on abstinence you are setting a significant part of your patience up for failure with…
I am very skeptical about claims that heavy alcoholics can ever moderately drink over a significant period of time again. There are a lot of studies showing successful moderate drinking over the short term, but the studies are always short-term studies using self-reporting data.
Active alcoholics are downright dishonest about how bad their alcoholic drinking is; they will claim it is moderate drinking to anyone who asks them (including scientists making a study) and lie about the amount of alcohol they actually consume.
The most famous study refuting the claims that alcoholics can moderately drink again is probably Pendery 1982, which showed that people who were reported as successfully moderately drinking in an early 1970s study were, a decade later, either not drinking at all, engaging in out of control drinking, or dead from alcohol-related complications.
Some more discussion about it is here: