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With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

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Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#81

Post by ChrisMarshallNY »

sgent wrote: post #80
ChrisMarshallNY wrote: post #72

Earlier quoted context omitted.

If you are looking at raw numbers, lots of things. MAT (Medically Assisted Treatment) is considered more effective, numbers-wise. There's a huge amount of money being made in the field. Also, AA and NA don't collect much, in the way of data. It's actually hard to tell how truly effective they are. Something to do with the second "A," I would guess... That brings up another point that people have been avoiding, here:…

The fight I witnessed because someone bought the "expensive" Bic pens instead of the 1c/pen less expensive.

Sounds like grounds for a duel (or a cage match).

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#82

Post by MissionInfl »

vorpalhex wrote: post #79
Eisenstein wrote: post #53

Earlier quoted context omitted.

> Another form allows participants to drink but uses a medicine which induces unpleasant effects from alcohol. Actually, the successful medical method doesn't introduce unpleasant effects, but removes the pleasant ones and introduces 'extinction'. The medication is naltraxone. Look up 'Sinclair method'.

> To avoid strong side effects such as nausea and vomiting, practitioners typically wait until after the alcohol detox process before administering naltrexone. If you take one or two drinks, yeah it will just be not good. If you binge, you be puking your guts out.

This is not true. I have had ~15 drinks on Naltrexone which definitely qualifies as a binge although I never "truly" binged as I never blacked out after starting treatment via The Sinclair Method. It wasn't a great time especially the next morning but I didn't get sick at all.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#83

Post by labrador »

ChrisMarshallNY wrote: post #30
labrador wrote: post #3

I'm a recovering alcoholic who has worked the 12 steps. To get this out the way, I agree that courts should not be sending people to AA. It's no good for anyone. The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves; it has to do with the camaraderie. I agree with the second half of the that sentence, but the reason the reason many people including researchers don'…

I like that breakdown. Stealing it...

Great! I was talking to a friend about it and came up with a couple additional thoughts:

I always felt hesitant about rewriting Bill Wilson, because he's a Saint to some people, but knew I would someday. I'm aware he's just a guy like me and if he were alive today he'd see the need for it.

I think Bill W put too much emphasis on his steps causing a "spiritual awakening" because it set the bar too high. My feeling is that if people quit drinking or drugging or whatever it is that has captured them and do the work of getting better then they will naturally be in better spirits, which is a good enough spiritual awakening. Some will go further and have a Bill Wilson spiritual awakening. All the better.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#84

Post by hughw »

jedberg wrote: post #34

I have a friend in AA. I'm not sure how to measure if she's been "successful" or not. After completing the steps the first time, she relapsed after a few months. After the second time, she went a bit longer, but didn't quite make a year. She's on her 3rd time now. It's been over a year since she last drank. She's made significant positive life changes and this time feels different. The last two times she constantly t…

If you relapse after 10 years, you had 10 good years. Win.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#85

Post by lazyasciiart »

readthenotes1 wrote: post #61
emacsen wrote: post #56

Earlier quoted context omitted.

No one is saying that 12 step doesn't have any successes, but: 1. The data is somewhat overwhelming that the rates of success aren't 25-30% as you said, but closer to 7%.[1] This puts it in roughly the same category as no 2. No one is dismissing the idea of doing 12 steps, but 12 steps is often court mandated. 3. 12 Step has more than passing connections to "faith-based" treatments. This is a problem when it's court…

"But unlike AA, I would never claim that what I've suggested is right for everybody. But ... let's say I had nothing better to offer: It wouldn't matter — we still need to change the system as it is because we are harming 90 percent of the people." It is difficult to tell if those are the words of the NPR author or Lance dodes who wrote the book, but it directly contradicts your statement "2. No one is dismissing the…

Changing the system doesn't have to mean getting rid of the 12 steps: it would change the system to make other options equally accessible and respectable.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#86

Post by KingMob »

phs318u wrote: post #13
KingMob wrote: post #9

Earlier quoted context omitted.

> The 12-step view is that there isn’t a “once and done” cure. If I were to use an analogy it’s more like having lifelong diabetes. You gotta keep taking that insulin. It’s the continuity that forestalls the disease/ keeps you in remission. This is actually one of the things that many psychologists are dubious about. It's entirely possible that self-labeling as an alcoholic forever makes it harder, not easier, for so…

Identifying as an alcoholic or gambling addict or drug addict etc, is no different than saying "I'm a diabetic". It's the label of a chronic disease. Applying that label to self is about acceptance of that as a fact of life that you can then work with. If you've ever been unfortunate enough to see e.g. a diabetic who did not accept the reality of their illness - it's not pretty. Acceptance is the price of vigilance.…

I think I understand your point of view just fine. I have friends, family, and exes in AA and NA. I just disagree that the best way to treat addiction is a settled matter.

What I think is still up for debate is whether AA's framings are a net benefit, due to the lack of good research.

Your comment brings up standard AA doctrine, and I'm glad it's worked for you. But by your own admission, a lot of people fall off the wagon. You blame it on being court-mandated, but it doesn't seem to occur to you that another program may have worked better, court-ordered or not.

There's no consideration in your comment for survivorship bias in who remains in AA. Perhaps AA works great for a small subset of people, who stick with it, but is worse for a larger majority, who would be better served in a different program.

> Fundamentally though, the evidence is pretty clear that there's a neurological basis to most addictions

Uh, I'm not disagreeing. Not sure why you think I was? I used to chat about this stuff with Dr. Carl Hart, who studied meth addiction, when I was in grad school. He was also of the opinion that AA's efficacy was a black box, and said that he'd recommend Scandinavian outpatient facilities over AA, based on the research he'd seen.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#87

Post by mistercheph »

KingMob wrote: post #86
phs318u wrote: post #13

Earlier quoted context omitted.

Identifying as an alcoholic or gambling addict or drug addict etc, is no different than saying "I'm a diabetic". It's the label of a chronic disease. Applying that label to self is about acceptance of that as a fact of life that you can then work with. If you've ever been unfortunate enough to see e.g. a diabetic who did not accept the reality of their illness - it's not pretty. Acceptance is the price of vigilance.…

I think I understand your point of view just fine. I have friends, family, and exes in AA and NA. I just disagree that the best way to treat addiction is a settled matter. What I think is still up for debate is whether AA's framings are a net benefit, due to the lack of good research. Your comment brings up standard AA doctrine, and I'm glad it's worked for you. But by your own admission, a lot of people fall off the…

Yes, the one thing we can do that we will surely bring us closer to curing alcoholism, is researching it extensively and coming up with a massive body of literature, and defining a system of taxonomic subclassifications of various alcoholism diseases.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#88

Post by red-iron-pine »

AlbertCory wrote: post #50

Disclosure: not an alcoholic, not married to one, either. This is not a debunking. There are "support groups" for almost everything (watch Fight Club to see examples of that). >The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves; it has to do with the camaraderie. It's a supportive organization with people who are on the whole kind to you, and it gives you a stru…

Harmed in the sense there is little reason to think this approach will work for them, and in choosing it (or being forced upon it, i.e. via a court order), we're not using more effective methods. Or just doing nothing.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#89

Post by AlbertCory »

red-iron-pine wrote: post #88
AlbertCory wrote: post #50

Disclosure: not an alcoholic, not married to one, either. This is not a debunking. There are "support groups" for almost everything (watch Fight Club to see examples of that). >The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves; it has to do with the camaraderie. It's a supportive organization with people who are on the whole kind to you, and it gives you a stru…

Harmed in the sense there is little reason to think this approach will work for them, and in choosing it (or being forced upon it, i.e. via a court order), we're not using more effective methods. Or just doing nothing.

the court order: you're right.

Otherwise, "more effective methods" are yet to be identified, AFAIK.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#90

Post by P_I_Staker »

ChrisMarshallNY wrote: post #72
readthenotes1 wrote: post #64

Earlier quoted context omitted.

What is more effective than AA?

If you are looking at raw numbers, lots of things. MAT (Medically Assisted Treatment) is considered more effective, numbers-wise. There's a huge amount of money being made in the field. Also, AA and NA don't collect much, in the way of data. It's actually hard to tell how truly effective they are. Something to do with the second "A," I would guess... That brings up another point that people have been avoiding, here:…

This is also true with psychiatry. Many people with ADHD being bilked out of 10s of thousands of dollars with useless, sometimes harmful medications, while there's something effective on the shelf.
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