A drug that cures alcoholism may be the next anti-anxiety medication • Hacker News Board

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#101

Post by zafka » Sat, Apr 16, 2022, 2:54 PM UTC

ChrisMarshallNY wrote: post #91

ransom1538 wrote: post #68

Earlier quoted context omitted.

"Also anecdote: the easiest way to quit alcohol is with xanax." Ugh. Replacing addiction with addiction. Go this route if you have extreme medical conditions requiring it. EG. You are an alcoholic with serious liver issues, then by all means substitue xanax. Rehabs are full of people with xanax issues.

But we seem to have no issue, with Suboxone. That is, quite literally, replacing one addiction with another. Opiate/oid withdrawal is pretty awful. You feel like you will die, but that seldom happens (unless you have other issues). Withdrawal from alcohol, on the other hand, is, quite frequently, deadly (that's why medical alcohol detox is recommended). Benzo withdrawals make alcohol withdrawals look like a case of t…

Benzos are often given short term- 3-5 days on a taper schedule to someone in detox. It is not recommended to give a script to an alky. Benzos are not as dangerous to withdraw from as alcohol but are horrible to detox from as they are fat soluble.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#102

Post by hilbert42 » Sat, Apr 16, 2022, 2:56 PM UTC

Quequau wrote: post #7

Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect that alcohol abuse cessation treatment using it relies on, it is my belief that the treatment is unconscionable and inhumane. I quit drinking after more than 25 years of problematic drinking using naltrexone (The Sinclair Method) and, given my experience with alc…

"...it is my belief that the treatment is unconscionable and inhumane."

Likewise. Fortunately, I'm not an alcoholic nor have I ever been one but it's always been my understanding that disulfiram was a pretty brutal way of dealing with the problem. I've seen pharmacology texts written in the 1960s warn of the dangers of disulfiram (I had the impression that by the end of the 1950s it was already recognized as a brute force method that was not that effective).

Moreover, as disulfiram inhibits acetaldehyde dehydrogenase, the build up of acetaldehyde in the body alone is pretty nasty and ought to be avoided (there's nothing subtle about this chemical. (I hesitate to use the word 'drug' even though it may have effective uses in completely different areas of medicine.)

Making someone feel ill by essentially 'pickling' - or should that be 'poisoning' - him/her from the inside strikes me as a treatment that should have gone out with Galen.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#103

Post by photochemsyn » Sat, Apr 16, 2022, 3:00 PM UTC

giraffe_lady wrote: post #95

photochemsyn wrote: post #93

Earlier quoted context omitted.

Are you saying that AA promotes discredited scientific claims because of a belief among their members that such claims have utility in helping their members quit drinking and stay off alcohol? Why even have the quasi-scientific patina then? Just go back to purely religious-era thinking, things like 'You'll burn in hell for all eternity if you don't get off the booze right now". The problem with groups like AA is that…

Yeah that's exactly what I'm saying. And if the burn-in-hell model was demonstrably more effective than a medical model I would endorse it. Wouldn't you? What's the value in pushing a scientific model if it isn't actually more practically effective at helping the people who are asking for help? And look, I'm not saying the medical model isn't more effective. But "new evidence" isn't always easy to apply even when it…

What I object to is religious types trying to use bad science to back up their agenda. Science is not a matter of faith, and it's a complete perversion of the basic concept of scientific inquiry to promote false claims simply because of their claimed utility. That's a dishonest and manipulative strategy at best, and I doubt any good will come of it.

Of course, science provides no ultimate answers of the type religious fundamentalists (a group which includes the dogmatic atheist IMO) seem to be seeking. For example, it's impossible to use science to test the 'simulation hypothesis', i.e. the notion that we're all living in a perfect VR sim.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#104

Post by zafka » Sat, Apr 16, 2022, 3:07 PM UTC

giraffe_lady wrote: post #88

gitfan86 wrote: post #65

Earlier quoted context omitted.

No. Allergic reactions are the immune system responding to a substance in a hypersensitive way[1]. There is however a genetic component to how people respond to alcohol. Some people after having 1 drink have a strong desire to continue drinking to blackout levels. Others are more likely to feel sick or sleepy after 2 drinks and have a desire to stop. It isn't an immune system reaction, but it is a reaction. The AA co…

I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some models are useful" situations with the allergy thing. Most individuals either find that model sufficiently useful that they don't need to expand it. Or, they're more or less fully aware of the gaps but still find that model useful. Or they don't find it useful and…

Great post! I have been a long term member myself, and you described my feelings about AA pretty well. It was fun to read what Charlie Munger ( Warren Buffet's partner) wrote about AA. He says that AA uses a number of natural psychological tendencies together to create a "Lollapalooza effect" that helps people to stay stopped, once they quit drinking.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#105

Post by giraffe_lady » Sat, Apr 16, 2022, 3:14 PM UTC

photochemsyn wrote: post #103

giraffe_lady wrote: post #95

Earlier quoted context omitted.

Yeah that's exactly what I'm saying. And if the burn-in-hell model was demonstrably more effective than a medical model I would endorse it. Wouldn't you? What's the value in pushing a scientific model if it isn't actually more practically effective at helping the people who are asking for help? And look, I'm not saying the medical model isn't more effective. But "new evidence" isn't always easy to apply even when it…

What I object to is religious types trying to use bad science to back up their agenda. Science is not a matter of faith, and it's a complete perversion of the basic concept of scientific inquiry to promote false claims simply because of their claimed utility. That's a dishonest and manipulative strategy at best, and I doubt any good will come of it. Of course, science provides no ultimate answers of the type religiou…

Well, in this case "their agenda" is helping people out of deep addiction. What do you gain by opposing that? We aren't disinterested third parties here pushing an agenda on other people, this is US, working for ourselves. Who are you?

Expecting people to abandon a belief that they can plausibly claim has saved their life because it isn't scientifically true is a radical ideology.

Very much good has come from it, true or not. If you think you can do better then pick up a shovel man, and get to work. Because one of the other things AA provides is practical advice on how to work with people you don't understand or like, towards the shared goal of healing and sobriety.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#106

Post by staticautomatic » Sat, Apr 16, 2022, 3:15 PM UTC

hilbert42 wrote: post #102

Quequau wrote: post #7

Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect that alcohol abuse cessation treatment using it relies on, it is my belief that the treatment is unconscionable and inhumane. I quit drinking after more than 25 years of problematic drinking using naltrexone (The Sinclair Method) and, given my experience with alc…

"...it is my belief that the treatment is unconscionable and inhumane." Likewise. Fortunately, I'm not an alcoholic nor have I ever been one but it's always been my understanding that disulfiram was a pretty brutal way of dealing with the problem. I've seen pharmacology texts written in the 1960s warn of the dangers of disulfiram (I had the impression that by the end of the 1950s it was already recognized as a brute…

My recollection is that accumulation of aldehyde is also the danger of consuming methanol.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#107

Post by [deleted] » Sat, Apr 16, 2022, 3:17 PM UTC

anon9001 wrote: post #41

xanaxagoras wrote: post #36

Earlier quoted context omitted.

Xanax is about the worst choice for this because the half life is so short. Most often people receive ativan or librium for the taper you describe.

Any of them work, and it probably depends how deep you're in. If you can't fall asleep without a drink, xanax would be a good choice. If you need a drink in your hand all day, I'd guess librium. If you're drinking from shift end until you pass out, probably ativan. Alcoholism takes a lot of different forms, and obviously a doctor should come up with a taper plan. But I think the reason these drugs (which actually wor…

[deleted]

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#108

Post by xanaxagoras » Sat, Apr 16, 2022, 3:20 PM UTC

cue_the_strings wrote: post #73

anon9001 wrote: post #31

Earlier quoted context omitted.

Quoted post unavailable.

I knew a guy who swapped his World of Warcraft addiction with heroin. It worked surprisingly well, he never played WoW again. Last time I saw him, he tried 'borrowing' some money from me for 'medicine for his mom'.

There's a case to be made that he's better off.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#109

Post by QuantumYeti » Sat, Apr 16, 2022, 3:51 PM UTC

throwaway20382 wrote: post #53

Quequau wrote: post #7

Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect that alcohol abuse cessation treatment using it relies on, it is my belief that the treatment is unconscionable and inhumane. I quit drinking after more than 25 years of problematic drinking using naltrexone (The Sinclair Method) and, given my experience with alc…

"I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous" I urge people to see an addiction specialist first. Do not see AA first. See a doctor asap. This disease is serious and has a high fatality rate. AA meetings are like a club after you have it under control (EG. don't attend drunk). Disulfiram: An old military drug. Thi…

Another problem with AA is you don't know who is there voluntarily trying to get better, and who is there because they're a physically abusive alcoholic that was court-ordered to be there.

There was also an uncomfortable amount of "thirteenth stepping" going on in my groups, where the single males running them ended up in relationships with women in the groups.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#110

Post by photochemsyn » Sat, Apr 16, 2022, 3:54 PM UTC

giraffe_lady wrote: post #105

photochemsyn wrote: post #103

Earlier quoted context omitted.

What I object to is religious types trying to use bad science to back up their agenda. Science is not a matter of faith, and it's a complete perversion of the basic concept of scientific inquiry to promote false claims simply because of their claimed utility. That's a dishonest and manipulative strategy at best, and I doubt any good will come of it. Of course, science provides no ultimate answers of the type religiou…

Well, in this case "their agenda" is helping people out of deep addiction. What do you gain by opposing that? We aren't disinterested third parties here pushing an agenda on other people, this is US, working for ourselves. Who are you? Expecting people to abandon a belief that they can plausibly claim has saved their life because it isn't scientifically true is a radical ideology . Very much good has come from it, tr…

Could it be that one of AA's goals is the creation of a population of donors to keep their organization funded, just like any other organized religious group? This would explain the reluctance to admit that alcohol addiction is not a 'lifelong disease' that requires lifetime committment to AA, wouldn't it?

Regardless, promoting bogus scientific claims in the name of social good does actual harm to people. It's one of the reasons for the whole anti-vax thing, and the resulting measles outbreaks, for example.