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

nytimes.com

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

#101

Post by matwood »

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…

> The reasonable man adapts himself to the world, the unreasonable man adapts the world to himself, therefore all progress is due to the unreasonable man.

Yes and no. There is value in recognizing the things that can't be changed (at least at the time).

From Musashi:

"What a fool I’ve been,” he exclaimed aloud. “I tried to make the water flow where I thought it should and force the dirt to stay where I thought it ought to be. But it didn’t work. How could it? Water’s water, dirt’s dirt. I can’t change their nature. What I’ve got to do is learn to be a servant to the water and a protector of the land."

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

#102

Post by RookyNumbas »

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…

> total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for

I guess you're technically right. But statements like these make me chuckle. They are very common, and a dead giveaway that you are not very familiar with addiction. Switch out drinking for shooting heroine or smoking crack, and see if the statement still makes sense.

The rest of your comment is dead on though. The studies are very bad at making any sort of distinctions like you mentioned. They also ignore the astounding costs of some of these other programs, whether a person is there by choice or not, whether they are trying to quit for the first time or 20th, types and severity of relapses, and many other factors.

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

#103

Post by sgift »

keiferski wrote: post #94
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…

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.

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

#104

Post by addict_throwawa »

Pigo wrote: post #74
addict_throwawa wrote: post #72

throwaway account obviously. this got long but here's my (five) cents. I'm an addict in recovery. In the past alcohol and then switched to opiates (sadly all to common story of getting pills from MD unnecessarily). I haven't faced many consequences and have been still successful in tech. still not 'out' about opiates to work or friends, just my peers in recovery. I have found the underlying hypothesis of this - group…

I've heard that part of the motivation for the escalation of opiate strength (fentanyl and carfentanil) is because so many people have begun seeing success with these new therapies. The illegal marketplace has probably been losing profits. Maybe replacement therapy isn't perfect, but I've seen it help a lot of people who are in a bad place. I wish there was more motivation for finding exit strategies, but there doesn…

my dr mentioned that he's had success with the sub cutaneous thing. it lasts a month and it seems like it's a good way to slowly taper down. and he said the bupe stays in your body for a LONG time when doing that - longer than a month after the 30 day period

it's really hard to taper down! it takes a lot of willpower not to just take more since you have it sitting around. i wonder if would be more successful with like a 1 month taper for in patient program.

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

#105

Post by dang »

snurfer wrote: post #50
sfkdjf9j3j wrote: post #45

Earlier quoted context omitted.

Modern medicine treats alcohol abuse and addiction as similar to other chemical dependencies. I don't know what to tell you. Your callous dismissal of the seriousness of alcohol dependency is an ideological position, not one based on reason or science.

Excuse me, but I offer a rational alternative to the religion of Alcoholics Anonymous. Would you say AA is the bastion of reason and science?

Please stop doing flamewar on Hacker News.

https://news.ycombinator.com/newsguidelines.html

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

#106

Post by _jal »

mullingitover wrote: post #44

Trying to find sources to confirm this, but I've repeatedly heard that cognitive behavioral therapy dominated AA in effectiveness. I would take this more as an indictment of psychotherapy than an endorsement of AA. Edit: I found a review of Project MATCH[1]. > Background > Project MATCH was the largest and most expensive alcoholism treatment trial ever conducted. The results were disappointing. There were essentially…

It makes sense to take a lot of these numbers with a healthy amount of skepticism.

That second 'A' means something. AA has no membership, no census, no graduation. Additionally, I doubt the people who stay involved are a random sample, so identifiable 12-steppers are going to be a skewed distribution.

I'm sure at least some of that can be controlled, but claims about their efficacy have been all over the map, I think, because of this.

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

#107

Post by thrownaway954 »

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…

if all the God and higher power stuff bothers you can always go to a secular meeting. the best thing about aa is that there is a group that fits you :)

https://secularaa.org/

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

#108

Post by neonate »

a_c_s wrote: post #91

That doesn't make sense: AA is not very effective at all. "Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent." https://www.theatlantic.com/magazine/archive/2015/04/the-irr...

The Cochrane meta-analysis has arrived at opposite results to that debunking, based on 21 recent randomized studies. It's interesting how many comments in this thread are pointing to the older results as if they debunk the newer ones.

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

#109

Post by neonate »

mullingitover wrote: post #44

Trying to find sources to confirm this, but I've repeatedly heard that cognitive behavioral therapy dominated AA in effectiveness. I would take this more as an indictment of psychotherapy than an endorsement of AA. Edit: I found a review of Project MATCH[1]. > Background > Project MATCH was the largest and most expensive alcoholism treatment trial ever conducted. The results were disappointing. There were essentially…

Cognitive behavioral therapy is a form of psychotherapy obviously, so if the article is representing the Cochrane analysis accurately, it contradicts what you've repeatedly heard.

Edit: https://eu.usatoday.com/story/news/health/2020/03/11/alcohol... specifically mentions CBT as one of the psychotherapies found to be less effective by this new meta-study. and the NYT article now linked at the top goes into this.

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

#110

Post by keiferski »

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.

A study found an association between an increase in attendance to AA meetings with increased spirituality and a decrease in the frequency and intensity of alcohol use. The research also found that AA was effective at helping agnostics and atheists become sober. The authors concluded that though spirituality was an important mechanism of behavioral change for some alcoholics, it was not the only effective mechanism.[54] Since the mid-1970s, a number of 'agnostic' or 'no-prayer' AA groups have begun across the U.S., Canada, and other parts of the world, which hold meetings that adhere to a tradition allowing alcoholics to freely express their doubts or disbelief that spirituality will help their recovery, and these meetings forgo use of opening or closing prayers.[55][56] There are online resources listing AA meetings for atheists and agnostics.

That doesn’t seem to be the case.

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