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

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

#71

Post by derefr » Wed, Mar 11, 2020, 6:42 PM UTC

shoes_for_thee wrote: post #51

simion314 wrote: post #39

Earlier quoted context omitted.

>The point is surrendering to something "bigger" than yourself. Don't get tied up in militant atheist perspectives. There are people that can just say "from tomorrow I will believe in God/afterlife/spirits etc. It would be so easy to live knowing that your loved ones are not gone or that if you are good enough your problems will be solved soon but for some people(like me) it is like trying to convince me that 2+2=5 a…

Sometimes I think that spirituality is something people either "get" or they don't. For me, to consider the very fact of existence rather than non-existence, the beauty and order of it, the people around me who have somehow manifested as conscious beings from chaos... (and on and on)... none of those things require a supreme being or intelligent creator, but the sense of awe after giving sufficient consideration is d…

> but the sense of awe after giving sufficient consideration is difficult to differentiate from feeling god

Do you think that, in a universe with a proven-real, interventionist diety—picture, say, the Architect in the Matrix—that "feeling god" would really be a feeling of awe?

I'd personally expect it to be mostly a feeling of fear, at how insignificant and easy-to-accidentally-kill you are.

Imagine the feeling of being made aware of an entire galaxy, one containing quadrillions of lifeforms, getting sucked into a black hole.

Imagine the feeling of knowing that if you ask a question, a million consciousnesses might be created and then destroyed in order to answer it.

In short, imagine the feeling of someone else having an omnipotent magical genie.

Feeling at one with the flow of the universe is, to me, the exact opposite of "feeling god." It's feeling that we're operating in a system with a static set of rules; a feeling that nobody has the capacity to declare humanity forfeit by fiat (but instead has to "work for it" through regular physics, in a way that we might be able to defend against through other physics); etc. It's a feeling that the universe is a fair game rather than a rigged one, at least on the quantum-chromodynamics level.

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

#72

Post by addict_throwawa » Wed, Mar 11, 2020, 6:44 PM UTC

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 support - has been a really big help for me. I found a group for those in recovery that participate in sports (the Phoenix) which has a double punch of great community and also physical activity which is super beneficial.

For me, I think this has been the second biggest contributor to success.

But my #1 - with opiates in particular - is medicine replacement therapy. I tried so many times to get off myself. I finally got on buprenorphine which has been a lifesaver and successful to date on first try [one year!]. There are also some drugs now for alcoholism but unfortunately stimulants seem to not have great options.

It seems a shockingly low amount of rehabs use replacement therapy [1] [2] or even know about it (or even as a short term withdrawal taper tool). There are also a scary amount of overdoses from relapse post rehab.

I think the science is pretty convincing - there are studies showing even if relapse after maintenance therapy the period of abstinence before relapse is longer [3] - and also just seems like MUCH higher success rate [4].

BUT this is still an opiate! My doctor has patients who have been on for years. A lot struggle to get off. I personally don't have a problem with very long term use - personally I see parallels with SSRIs/SNRIs where many users report problems getting off and withdrawal, but obviously who would say you should get off something like prozac - a mind altering drug that has clear benefit?

The most FU part of this for me - it still takes a special license to dispense buprenorphine replacement therapy, patient numbers are capped per MD, and there is a ton of stigma all around even at pharmacies who dont blink twice doling out opiates. Pisses me off when looking at how most MDs can dole out opiates with far less training/license requirements. also pharma definitely profits - though there are now generics. i've found at least for the strips it's basically the same price. The pills without naloxone are cheaper - but for addicts struggling that gets rid of the back stop and overdose preventer.

Plus having only a few Drs in many states (or none) that charge cash or medicare only makes it in-accesible for many of the downest and out addicts. It should be free (or covered by the worst pharma co s) and FAR more MDs should be able to write script.

[1] https://www.samhsa.gov/data/sites/default/files/N-SSATS%20Rp...

[2] https://www.rehabs.com/pro-talk/opioid-addiction-treatment-w...

[3] https://www.ncbi.nlm.nih.gov/pubmed/30094695

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874458/

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

#73

Post by [deleted] » Wed, Mar 11, 2020, 6:55 PM UTC

derefr wrote: post #71

shoes_for_thee wrote: post #51

Earlier quoted context omitted.

Sometimes I think that spirituality is something people either "get" or they don't. For me, to consider the very fact of existence rather than non-existence, the beauty and order of it, the people around me who have somehow manifested as conscious beings from chaos... (and on and on)... none of those things require a supreme being or intelligent creator, but the sense of awe after giving sufficient consideration is d…

> but the sense of awe after giving sufficient consideration is difficult to differentiate from feeling god Do you think that, in a universe with a proven-real, interventionist diety—picture, say, the Architect in the Matrix—that "feeling god" would really be a feeling of awe ? I'd personally expect it to be mostly a feeling of fear, at how insignificant and easy-to-accidentally-kill you are. Imagine the feeling of b…

[deleted]

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

#74

Post by Pigo » Wed, Mar 11, 2020, 7:02 PM UTC

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't seem to be any profit in that.

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

#75

Post by pozdnyshev » Wed, Mar 11, 2020, 7:04 PM UTC

luckylion wrote: post #63

riyadparvez wrote: post #59

Earlier quoted context omitted.

As someone who is been in psychotherapy and an arm-chair psychology enthusiast, not every kind of therapy will be effective for everyone. This also goes for psychiatric medications. CBT is often oversold as a cure for every kind of mental health issues. New meta-research has found that the effectiveness of CBT has been decreasing for quite some time and long-term effectiveness of CBT is arguable. Regarding effectiven…

> not every kind of therapy will be effective for everyone That's pretty problematic though, isn't it? At some point, you're dropping below placebos, not everything works for everyone, but should we still put weight on it? Homeopathy and intense praying works for some as well, but we don't say "I guess it's not effective for everyone". Psychotherapy (not the behavior therapy kind) gets a pass for some reason.

Ultimately it's a matter of finding a provider of an evidence-based practice like CBT. CBT is shown to be effective for some DSM diagnoses, but there's a realistic question of whether they can be provided that care, as many insurance companies won't cover intensive CBT sessions, and you may not have a trained CBT professional in your community. Psychotherapy then may be a better option.

Also, psychotherapy would likely be recommended over CBT for someone if their behavior is related to adverse childhood experiences or having trouble with housing/money(poor ppl). Of course its not total black/white as even some CBT practitioners can incorporate elements from psychotherapy.

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

#76

Post by bones6 » Wed, Mar 11, 2020, 7:05 PM UTC

snurfer wrote: post #60

alexilliamson wrote: post #31

Earlier quoted context omitted.

It's also great for people who have alcoholism

Almost certainly, anyone who calls themselves "alcoholic" should probably give Alcoholics Anonymous a try. However, alcoholism is not a disease and AA isn't the only answer.

You left out the phrase "in my opinion" from your very strong opinion statement that alcoholism is not a disease. You could qualify your opinion, such as "in my professional opinion as a psychologist", or "in my layperson opinion through my experience with people who believe they are alcoholics". Or even better perhaps "in my opinion as someone who thought I was addicted, I solved my problem this way...".

Try harder.

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

#77

Post by daseiner1 » Wed, Mar 11, 2020, 7:10 PM UTC

jl2718 wrote: post #69

alexilliamson wrote: post #31

Earlier quoted context omitted.

It's also great for people who have alcoholism

I don’t agree with either of these characterizations. It is not a disease because the cure comes instantly by a decision from within. It is not a moral failing because the substance subverts moral reasoning. I am not religious, but I find the religious view to be accurate: a good soul fallen, that needs to be saved. Source: a lifetime of addiction in my family and loved ones. Some made it out. That transformation is…

I'm sorry, but I sincerely question your understanding of addiction, the program, those closest to you if you genuinely believe "the cure comes instantly by a decision from within." If this were true then chronic short term sobriety followed by relapse wouldn't be so common.

My impression is reinforced with, imo, your trite "we're ALL addicts" platitude. Yeah, we all get distracted sometimes and get hung up on the bit of cleaning. That doesn't mean we all have ADHD and OCD. There are ways to establish a middle ground without downplaying legitimate disorders.

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

#78

Post by daseiner1 » Wed, Mar 11, 2020, 7:16 PM UTC

snurfer wrote: post #47

tanseydavid wrote: post #27

Earlier quoted context omitted.

Do you have a link or citation for that? Is this just your impression that you are relating?

No citation, but consider this: before the creation of AA (1930-something), are we to believe no one ever stopped drinking successfully?

Are you aware that you're arguing in bad faith throughout this thread, or do you think these are strong points you're making? "Someone must've quitted drinking before AA existed" => "the silent majority of quitters do so via self-help" is nowhere close to a valid conclusion. Particularly for someone who's prided themself on their rationality elsewhere..

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

#79

Post by [deleted] » Wed, Mar 11, 2020, 7:17 PM UTC

reggieband wrote: post #56

beefok wrote: post #43

Earlier quoted context omitted.

Please describe a 'militant' atheist perspective unironically. :) When you contrast it to any other type of 'militant', there is typically violence involved.. However, personally, I think the closest thing I could believe in is a "best self". Not that anyone chooses their beliefs, but the rest would be pretty hard to digest for any good reasons. Honestly, I just think giving up on the idea that you can do this by you…

> Please describe a 'militant' atheist perspective unironically. :) I think of militant as unyielding and confrontational. This isn't some pejorative assigned to others, it is a term forwarded and embraced by proponents of that ideology. For an unironic perspective I suggest this New Yorker article "All Scientists Should be Militant Atheists" by Lawrence Krauss [1]. 1. https://www.newyorker.com/news/news-desk/all-sci…

[deleted]

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

#80

Post by xamuel » Wed, Mar 11, 2020, 7:20 PM UTC

simion314 wrote: post #39

saberience wrote: post #20

Earlier quoted context omitted.

I think there's a major understanding of this part of AA. This DOES NOT mean acknowledging that you believe there is a god. The concept of a "higher power" can mean anything you want it to mean. You can imagine your higher power is Gandalf, Sauron, elves at the bottom of the garden, or even some aspect of your "best self." You could imagine it to be the spirits of your ancestors or even something like the energy of t…

>The point is surrendering to something "bigger" than yourself. Don't get tied up in militant atheist perspectives. There are people that can just say "from tomorrow I will believe in God/afterlife/spirits etc. It would be so easy to live knowing that your loved ones are not gone or that if you are good enough your problems will be solved soon but for some people(like me) it is like trying to convince me that 2+2=5 a…

Suppose you had brain damage and a doctor prescribed some tongue-twisters for you to recite in order to exercise specific parts of your brain. Would you object based on the semantic content of the tongue-twisters? If one of the tongue-twisters was "Our father who art in heaven, hallowed be thy name", would you object to reciting it because you disagree with what it means? What if clinical trials had found that particular phrase to cause the necessary brain exercise, and no-one had discovered any alternative ways to achieve the same exercise?