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Old 3rd July 2019, 02:37 PM   #201
Thor 2
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Originally Posted by Safe-Keeper View Post
You mean like the millions of people who got better after bloodletting, homeopathy, or exorcism?


Of course not. Nor would I recommend something I didn't believe had any effect.

"It's gotta be better than doing nothing" has been used to justify all sorts of ineffective or destructive "help" throughout history. I prefer finding out what works, and taking action based on that.

Well one could argue that it's worse than doing nothing if one considers the following extract from the Harvard Mental Health Letter, from The Harvard Medical School.


Quote:
On their own
There is a high rate of recovery among alcoholics and addicts, treated and untreated. According to one estimate, heroin addicts break the habit in an average of 11 years. Another estimate is that at least 50% of alcoholics eventually free themselves although only 10% are ever treated. One recent study found that 80% of all alcoholics who recover for a year or more do so on their own, some after being unsuccessfully treated. When a group of these self-treated alcoholics was interviewed, 57% said they simply decided that alcohol was bad for them. Twenty-nine percent said health problems, frightening experiences, accidents, or blackouts persuaded them to quit. Others used such phrases as "Things were building up" or "I was sick and tired of it." Support from a husband or wife was important in sustaining the resolution.

So if as many as 50% manage to cure themselves without treatment, and the "treatment" of AA secures a much lesser % of success, it can be argued that the afflicted would be better off not going to AA meetings.
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Old 3rd July 2019, 03:28 PM   #202
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Originally Posted by Safe-Keeper View Post
You mean like the millions of people who got better after bloodletting, homeopathy, or exorcism?
What I mean is that there is both scientific and anecdotal evidence to support the effectiveness of AA. I've provided numerous links to the scientific literature. Here's one:
https://www.ncbi.nlm.nih.gov/pubmed/19340677

Originally Posted by Safe-Keeper View Post
Of course not. Nor would I recommend something I didn't believe had any effect.

"It's gotta be better than doing nothing" has been used to justify all sorts of ineffective or destructive "help" throughout history. I prefer finding out what works, and taking action based on that.
You are of course entitled to your beliefs. There are lots of folks who believe vaccinations are not beneficial or even harmful. I am wondering if you have any evidence to support your beliefs.
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Old 3rd July 2019, 03:33 PM   #203
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Originally Posted by Thor 2 View Post
Well one could argue that it's worse than doing nothing if one considers the following extract from the Harvard Mental Health Letter, from The Harvard Medical School.





So if as many as 50% manage to cure themselves without treatment, and the "treatment" of AA secures a much lesser % of success, it can be argued that the afflicted would be better off not going to AA meetings.
Here's what the Harvard Mental Health Letter has to say about AA:
Quote:
Since 1935 new treatments, including drugs and behavioral therapies, have been introduced for alcoholism. But it often still resists conquest, and Alcoholics Anonymous — ubiquitous and nearly cost-free — still offers the best hope to many. Researchers have begun to consider systematically how and why the AA approach to addiction succeeds or fails, and their discoveries may improve the prospects for treating all substance abusers.
Quote:
There is more to be learned about which problem drinkers are best served by AA, which are most likely to participate, and how long and intensely they need to be involved. But it may always be difficult to tell which features of AA account for its success because it means different things to different people. Today we know that alcoholism and other addictions are chronic illnesses, like diabetes or cardiovascular disease, which require long-term self-management — pervasive and consistent changes in the way a person lives. The discipline and fellowship of AA are valuable for many alcoholics because they fulfill that function in a way no other treatment can.
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Old 3rd July 2019, 03:45 PM   #204
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Originally Posted by Minoosh View Post
What makes you think it hasn't?

AA explicitly discourages debate in one specific area - the internal debate by alcoholics who argue that they are "not that bad." Its literature even encourages people to self-diagnose by trying controlled drinking over time.

By the time people voluntarily get to AA they have probably had this internal debate multiple times, which is why "How It Works" can elicit such a sometimes humorous response by people who have tried all these things.

Nevertheless, I agree the excerpt from "How It Works" may very well be obsolete and I have suggested measures to acknowledge and address this issue. It might not be obsolete if one is talking about self-selected folks who have had no success with other measures, which is AA's original audience. I suspect, but do not know, that these points have been brought up multiple times within AA. I would not conclude on the basis of evidence that "AA" has not considered these arguments.

I may have other responses to other posts but may address only one point at a time for personal reasons.
Where are AA's studies of their effectiveness? They avoid it like the plague. It is like an alcoholic refusing to examine their drinking. Which is why we are stuck debating nonsensical anecdotes, and not actual studies on the people doing AA and the effectiveness of same.
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Old 3rd July 2019, 04:17 PM   #205
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Originally Posted by whoanellie View Post
Here's what the Harvard Mental Health Letter has to say about AA:

Interesting that I post a letter from the Harvard and you post one directly contradicting mine. Maybe someone in that institution is on the bottle.


That to one side here is an article of interest from The Atlantic:

https://www.theatlantic.com/magazine...nymous/386255/

Excerpt 1:

Quote:
The Big Book includes an assertion first made in the second edition, which was published in 1955: that AA has worked for 75 percent of people who have gone to meetings and “really tried.” It says that 50 percent got sober right away, and another 25 percent struggled for a while but eventually recovered. According to AA, these figures are based on members’ experiences
A grand success rate claimed here and given there are no surveys quoted perhaps a little dubious.

Excerpt 2:

Quote:
In his recent book, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Lance Dodes, a retired psychiatry professor from Harvard Medical School, looked at Alcoholics Anonymous’s retention rates along with studies on sobriety and rates of active involvement (attending meetings regularly and working the program) among AA members. Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent. That is just a rough estimate, but it’s the most precise one I’ve been able to find.
Well, given that a professor is the source of the data gives it some credibility I suppose. The contrast between 75% and 5 - 8% is rather stark.
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Old 3rd July 2019, 04:38 PM   #206
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Originally Posted by The Greater Fool View Post
Where are AA's studies of their effectiveness? They avoid it like the plague. It is like an alcoholic refusing to examine their drinking. Which is why we are stuck debating nonsensical anecdotes, and not actual studies on the people doing AA and the effectiveness of same.
AA is not going to withhold AA from people in order to create a control group.

AA is not going to ask its members if they're still drinking.

It's not going to look up people who stopped attending and find out why, and if they are still drinking. It does not ask for names and contact information.

It's not going to ask if you were court-ordered into AA.

However, third parties research these variable with some frequency. The studies of effectiveness of AA are mixed. See the Scientific American article and "Alcoholics Anonymous Effectiveness: Faith Meets Science." (It's not really about faith, if the title turns you off). These have been linked to, by name, in this thread.

Meanwhile, perhaps AA's best-known detractor, "Agent Orange," puts together some decent information, but he is so prone to hyperbole and sometimes venom that he's frankly unreliable. The studies themselves often have serious flaws - and this includes some that support the effectiveness of AA. For example, it's very difficult to tease out the variables that make it "work" or not work.

Quantitative studies IMO should be taken pretty universally with a grain of salt, which is why we're left with anecdotes. I disagree that they are "nonsensical" but I think I understand where you're coming from.
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Old 3rd July 2019, 05:26 PM   #207
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Originally Posted by Thor 2 View Post
Interesting that I post a letter from the Harvard and you post one directly contradicting mine. Maybe someone in that institution is on the bottle.


That to one side here is an article of interest from The Atlantic:

https://www.theatlantic.com/magazine...nymous/386255/

Excerpt 1:



A grand success rate claimed here and given there are no surveys quoted perhaps a little dubious.

Excerpt 2:



Well, given that a professor is the source of the data gives it some credibility I suppose. The contrast between 75% and 5 - 8% is rather stark.
1) The Glaser article in The Atlantic was highly critical of AA. My understanding it was based, at least in part on the Dodes book. A good rebuttal to Glaser's article can be found here:
https://thepointmag.com/2016/examine...he-insane-idea

If it were up to me AA would never have made any statements about its success rate. That's my personal opinion. It's important to remember that to a large extent you are judging what AA wrote in 1935 - 1955 by today's medical standards. AA was developed in part as a response to the failure of medicine at that time to help alcoholics. The article I cite above gives discusses the state of medical treatment of alcoholism at that time.

The Dodes book has been criticized and rebutted. See the following:
from the journal "Alcoholism Treatment Quaterly"
Quote:
Our review of the studies cited by Dodes and Dodes reveals that long-term abstinence rates for actively involved members of AA and other 12-Step groups are impressively high.
https://www.tandfonline.com/doi/full...eedAccess=true

an extensive critique from "Psychology Today" written by two Harvard professors
Quote:
It turns out that rather than support Dr. Dodes’ position, the science actually supports the exact opposite – AA and 12-step treatments are some of the most effective and cost-effective treatment approaches for addiction.
https://www.psychologytoday.com/us/b...ment-addiction

from the NYT book review by a professor of clinical psychiatry at Weill Cornell Medical College

Quote:
Enormously popular with the public and the medical establishment, A.A. became the gold standard for treating alcoholism.....
Even if one grants that A.A. and 12-step programs are helpful only to those patients who adhere to them, surely that is better than nothing. But the Dodeses’ indictment goes much further: They tell readers that the public has been misinformed by the biological research community, and that addiction cannot be understood in terms of altered neurobiology, but as a pure psychological compulsion that helps addicts deal with feelings of helplessness......
“The Sober Truth” asserts that addiction can be treated with psychodynamic psychotherapy, which focuses on unconscious feelings and thoughts. But while there is some scientific data for cognitive behavior therapy in addiction, there is little to no evidence that psychodynamic therapy is effective for any type of drug abuse. The authors’ blanket claim of efficacy for their own cherished treatment, in the absence of credible data, is the very flaw for which they harshly criticize A.A.
https://www.nytimes.com/2014/05/06/h...ehab.html?_r=3

from "Wikipedia"
Quote:
The Sober Truth
Dodes, in The Sober Truth, argues that most people who have experienced AA have not achieved long-term sobriety, making the controversial argument[12] that research indicates that only 5 to 8 percent of the people who go to one or more AA meetings achieve sobriety for longer than one year.[13] Gabrielle Glaser used Dodes' figures to argue that AA has a low success rate in a 2015 article for The Atlantic, which argues that better alternatives than Alcoholics Anonymous for alcohol treatment are available.[14]

The 5–8% figure put forward by Dodes is controversial; Thomas Beresford, MD. says that the book uses "three separate, questionable, calculations that arrive at the 5–8% figure."[44][45] The New York Times calls The Sober Truth a "polemical and deeply flawed book".[46] John Kelly and Gene Beresin state that the book's conclusion that "[12-step] approaches are almost completely ineffective and even harmful in treating substance use disorders" is wrong (Dodes responded by pointing out that "I have never said that AA is harmful in general"), noting that "studies published in prestigious peer-reviewed scientific journals have found that 12-step treatments that facilitate engagement with AA post-discharge [...] produce about one third higher continuous abstinence rates."[11][47] Jeffrey D. Roth and Edward J. Khantzian, in their review of The Sober Truth, called Dodes' reasoning against AA success a "pseudostatistical polemic."[48]
Dodes views are hardly mainstream medicine/science.

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Old 3rd July 2019, 05:55 PM   #208
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Originally Posted by Thor 2 View Post
A grand success rate claimed here and given there are no surveys quoted perhaps a little dubious.
And that is a valid argument. Bill Wilson wrote most of the Big Book's first section and he was prone to exaggeration. He went through dozens if not hundreds of his own failures (as he acknowledges) and initially based his success claims on fewer than 100 people, most of them low-bottom white Protestant men, all of them volunteers. At one point he envisioned a chain of for-profit treatment centers. He was not a naturally humble person, but he knew how to listen and took advice seriously.

However, IMO, people who attend open meetings with regular newcomers can probably see for themselves that it's not a magic formula. A lot of 24-hour chips are given out, often to people who have been in AA before. However, that's based strictly on my own experience in midsize to large cities, where disagreements within one group often spur the creation of new meetings.

IIRC "How It Works" ("Rarely have we seen a person fail who has thoroughly followed our path. ...)" has been read in all of them. Its message to me is hopeful, not scolding. Not everyone agrees. Nor should they, IMO.
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Old 3rd July 2019, 06:16 PM   #209
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Originally Posted by Safe-Keeper View Post
If I as a hospital administrator or mayor have the choice between doing nothing, and having 5% of alcoholics recover, and funding and staffing AA meetings, and having 5% recover, the latter seems like a waste of money.
Just a small disclaimer: Funding and staffing AA meetings is moot. All you need is an empty room.

You can counter this argument if you want, and you can probably find evidence against it. Perhaps the VA does spend money; I don't know.
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Old 3rd July 2019, 07:11 PM   #210
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Originally Posted by The Greater Fool View Post
Where are AA's studies of their effectiveness? They avoid it like the plague. It is like an alcoholic refusing to examine their drinking. Which is why we are stuck debating nonsensical anecdotes, and not actual studies on the people doing AA and the effectiveness of same.
AA's tradition discourage any active promotion of AA. AA makes no pretense of being a scientifically or medically based approach to alcoholism. AA has no one on staff to conduct such research and no mechanism for funding research. It's not what they do. I've posted numerous links to scientific/medical research on the effectiveness of AA. I'm happy to discuss that research with any one here.
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Old 5th July 2019, 09:48 AM   #211
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Originally Posted by whoanellie View Post
What I mean is that there is both scientific and anecdotal evidence to support the effectiveness of AA. I've provided numerous links to the scientific literature. Here's one:
https://www.ncbi.nlm.nih.gov/pubmed/19340677
That study that says
"However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. "
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Old 5th July 2019, 11:26 AM   #212
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Originally Posted by 8enotto View Post
I quit drinking heavy by just not drinking booze. No bibles or babble from groups. I was powerful enough to just stop because I wanted to.
If only addiction were so simple that being 'powerful enough' was what you needed to quit.

Try 'just not drinking booze' when you've got a full blown physical dependency on alcohol. For some people (like myself), quitting drinking without help simply is not possible (alcohol withdrawal is potentially fatal if you've got a bad enough dependency).

Having said that, I think AA is ********.
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Old 5th July 2019, 12:21 PM   #213
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Originally Posted by Dancing David View Post
That study that says

"However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. "
And the major problem is that apparently there are no standards that one can assume all AA meets follow. Therefore you can't compare different AA meets as they are all likely to be different to one another.
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Old 5th July 2019, 12:35 PM   #214
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Originally Posted by Dancing David View Post
That study that says
"However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. "
That is a small part of what the author writes. Arguably, AA and TSF are not the same thing. We'd have to dig deeper to look at exactly what those 4 studies were looking at. The author does discuss some of the problems with the negative/null studies in her conclusions.
Quote:
One reason that several of the other trials may not have found positive effects for AA/ TSF is because many individuals randomized to the non-AA/non-TSF conditions also attended AA; thus, the AA or TSF condition ended up being compared to a condition consisting of an alternative treatment plus AA. This was the case in Walsh’s hospital inpatient treatment vs. AA study [23] and in the aftercare arm of Project MATCH [22], and arose because the patients in the non-AA/non-TSF conditions also had attended 12-step-based inpatient treatment, which in turn engendered strong participation in AA. Thus, AA attendance levels were high in the inpatient hospital condition in the former study, and in the CBT and MET conditions among the Project MATCH aftercare subjects. In fact, CBT and MET aftercare patients attended more meetings than the TSF outpatients, and the aftercare patients overall attended twice the number of meetings at every follow-up compared to the outpatients [22, see pp.191–192].

There are other concerns with the Brandsma trial [25] which call its experimental results into question. The control condition allowed for participation in actual AA meetings, while those in the AA condition attended a weekly AA-like meeting administered by the study (that was not an actual AA meeting). The description of the AA condition states that the steps were used for discussion content, the group focused on newcomers, and they told patients about sponsors [25, p.34], but it is not clear whether the meetings were led by AA members, whether crosstalk was allowed, whether the meeting leader shared their story as part of the meeting, or whether the meeting format was what one would encounter at an actual AA meeting. The meetings may not have been open to other AA members in the community, and not been listed in the AA meeting directory, which would mean that a potentially important therapeutic ingredient of AA--the experience of longer-term members--would not have been present in the AA condition. This is of special concern because the control condition did allow for attendance at such meetings.
My point is, of course, that it has not been scientifically established that AA is not effective or has a negative effect and that there is some evidence for the effectiveness of AA.
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Old 5th July 2019, 01:00 PM   #215
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This thread is not simply an academic discussion for me - Thread I started in 2013:

http://www.internationalskeptics.com...d.php?t=267785

I've watched this women I love go from relapse to relapse and just about every negative consequence noted for alcoholic/addicted persons. AA did not help her...because...not religious...she wasn't like the other alcoholics...she made over 100K a year and had a custom house! you name the excuse, she had/has it. In-patient rehabs worked for just about as long as she'd be an in-patient. Last go-round with acute alcoholic pancreatitis got her two weeks in the hospital, and because she was discovered by her neighbors unconscious on her front steps they gave her an MRI as a precaution. It wasn't good, but she's unwilling to go along with medical advice.

I wouldn't gas if she became a nun if it worked to beat her alcoholism.

Discussion about what some other person in different circumstances did to kick/get sober has little effect and so does formal counseling. People either get clean and sober or they don't, and arguing about the methodology of their approach to getting there doesn't do anything to make the process better, easier, or more effective.
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Old 5th July 2019, 01:29 PM   #216
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Originally Posted by whoanellie View Post
That is a small part of what the author writes. Arguably, AA and TSF are not the same thing. We'd have to dig deeper to look at exactly what those 4 studies were looking at. The author does discuss some of the problems with the negative/null studies in her conclusions.


My point is, of course, that it has not been scientifically established that AA is not effective or has a negative effect and that there is some evidence for the effectiveness of AA.
Sorry to keep beating this drum but according to the proponents for AA in this thread there isn't an AA, therefore each AA meet has to be assessed on its own success rate, therefore you can't extrapolate the results from one AA meet to a group of AA meets.
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Old 5th July 2019, 01:42 PM   #217
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Originally Posted by BStrong View Post
This thread is not simply an academic discussion for me - Thread I started in 2013:

http://www.internationalskeptics.com...d.php?t=267785

I've watched this women I love go from relapse to relapse and just about every negative consequence noted for alcoholic/addicted persons. AA did not help her...because...not religious...she wasn't like the other alcoholics...she made over 100K a year and had a custom house! you name the excuse, she had/has it. In-patient rehabs worked for just about as long as she'd be an in-patient. Last go-round with acute alcoholic pancreatitis got her two weeks in the hospital, and because she was discovered by her neighbors unconscious on her front steps they gave her an MRI as a precaution. It wasn't good, but she's unwilling to go along with medical advice.

I wouldn't gas if she became a nun if it worked to beat her alcoholism.

Discussion about what some other person in different circumstances did to kick/get sober has little effect and so does formal counseling. People either get clean and sober or they don't, and arguing about the methodology of their approach to getting there doesn't do anything to make the process better, easier, or more effective.
I thought the thread's purpose was to discuss the court mandating of programs with religious language and/or overtones. Everyone has different thoughts, opinions, and experiences regarding whether or not these programs work. They work differently for different people. But whether they work or not, my stance is that courts have no business mandating anything with even a whiff of religion. My mind can't be changed on that account because I am a severe stickler about separation of church and state.

I sort of feel bad about the direction the thread has taken, and I fear that my comments may have aided the derail. I think people should do whatever works for them. I simply object n the strongest possible terms to these programs being used in court-ordered settings, whether outpatient or ESPECIALLY inpatient.

I really hope that something ends up working for your girlfriend. It's terrible to watch these things happen to people you love.
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Old 5th July 2019, 01:49 PM   #218
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Originally Posted by Darat View Post
Sorry to keep beating this drum but according to the proponents for AA in this thread there isn't an AA, therefore each AA meet has to be assessed on its own success rate, therefore you can't extrapolate the results from one AA meet to a group of AA meets.
True.

The whole is AA a religion debate focuses on the idea that in the 12 steps you can replace god / higher power with whatever you want. This, of course, is a red herring. The 12 steps are statement of faith. Alcoholism is a moral failure that requires a spiritual awakening. How is that NOT religion?

Not even AA cares if it's effective, though. Well, no more than any religion cares about how effective it's teachings are. Like any religion they have rules and make claims and the faithful will follow.

AA doesn't want studies. Why would it? It's not like the results of any study is going to actually change anything. We all know this a hallmark of religion, nothing changes. The dogma is the dogma, period.

If AA is helpful to anyone, that is a happy coincidence.
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Old 5th July 2019, 01:58 PM   #219
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Originally Posted by JesseCuster View Post
If only addiction were so simple that being 'powerful enough' was what you needed to quit.

Try 'just not drinking booze' when you've got a full blown physical dependency on alcohol. For some people (like myself), quitting drinking without help simply is not possible (alcohol withdrawal is potentially fatal if you've got a bad enough dependency).

Having said that, I think AA is ********.
Actually that is the basis of sobriety, any thing else is just to help you DFD (Don't ******* Drink)

As a recovering addict I know how agonizing a choice it is but it really is the only choice, the rest is just to help cope

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Old 5th July 2019, 01:59 PM   #220
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Originally Posted by BStrong View Post
This thread is not simply an academic discussion for me -
It is real life for many in this thread
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Old 5th July 2019, 02:03 PM   #221
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Originally Posted by Dancing David View Post
Actually that is the basis of sobriety, any thing else is just to help you DFD (Don't ******* Drink)

As a recovering addict I know how agonizing a choice it is but it really is the only choice, the rest is just to help cope

I think he's referring to addicts who have a physical dependence. Alcohol withdrawal, if the dependence is serious enough, can be fatal. In those kinds of cases, ceasing drinking isn't enough. Medical intervention (usually including hospitalization) is needed.

Of course, once the detox is complete, everything comes down to coping mechanisms.
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Old 5th July 2019, 02:13 PM   #222
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The courts are faced with a simple fact that unfortunately sets the stage for sentencing an addict/alcoholic to a program that features religious belief as one of the core principles.

There are no proven approaches to "curing" addictions and no court anywhere is going to surrender it's authority just because the program of choice isn't proven effective and invokes the name of god.

Even post-conviction in-custody therapy is usually 12 step based.
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Old 5th July 2019, 02:14 PM   #223
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Originally Posted by The Greater Fool View Post
True.

The whole is AA a religion debate focuses on the idea that in the 12 steps you can replace god / higher power with whatever you want. This, of course, is a red herring.
Quote:
The 12 steps are statement of faith.
Alcoholism is a moral failure that requires a spiritual awakening. How is that NOT religion?

Not even AA cares if it's effective, though. Well, no more than any religion cares about how effective it's teachings are. Like any religion they have rules and make claims and the faithful will follow.

AA doesn't want studies. Why would it? It's not like the results of any study is going to actually change anything. We all know this a hallmark of religion, nothing changes. The dogma is the dogma, period.

If AA is helpful to anyone, that is a happy coincidence.

Yes of course they are, and when you try to replace the faith/God bits with something secular, it all becomes wishy washy and somewhat meaningless, as illustrated in my post #137.
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Old 5th July 2019, 02:23 PM   #224
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Originally Posted by BStrong View Post
The courts are faced with a simple fact that unfortunately sets the stage for sentencing an addict/alcoholic to a program that features religious belief as one of the core principles.

There are no proven approaches to "curing" addictions and no court anywhere is going to surrender it's authority just because the program of choice isn't proven effective and invokes the name of god.

Even post-conviction in-custody therapy is usually 12 step based.
But there are tons of secular alternatives. They're just not as well-known because they haven't been around as long.

Furthermore, there's no reason that the programs couldn't be tweaked to remove the most overt religiosity, especially in inpatient settings. It is so detrimental to recovery to force an atheist who is already at the end of their rope to recite the Lord's Prayer (for example) at the end of every group meeting like a child at religious boarding school. Not everyone will appreciate that because not everyone ******* hates religion with a passion, but many of the people committed to rehab DO.

They already lose so many of their rights by virtue of being in there, then it's just like an extra kick in the face. Especially when places lie about it. "Oh no, no religion here!" Then the people get there, and they're locked in, and they're not allowed to make phone calls for at least a week, and oh whaddaya know? Prayer time, every day, multiple times a day. Don't like it? We'll tell the judge you were being uncooperative.

Everyone has their berserk buttons, and this is one of mine. I see it as extremely shady and disrespectful, and it was the main reason I quit my old job (at that particular kind of center). That is where my objection comes from, and like I said, I'm completely intractable about it. Courts need to update their list of options.

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Old 5th July 2019, 03:48 PM   #225
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Originally Posted by Thor 2 View Post
Yes of course they are, and when you try to replace the faith/God bits with something secular, it all becomes wishy washy and somewhat meaningless, as illustrated in my post #137.
This sounds like a gish-gallop or moving of the goalposts to me. "Well, the steps invoke God!"

When directed to a secular version, "That's too wishy-washy."

We could argue all day about whether support groups actually help, or whether addiction is really a disease, or what powerless really means. What AA calls spiritual growth could probably also be termed emotional growth or just growth. Why is there even a list of steps? Maybe just because people like lists.

If someone can do it with willpower that's perfectly OK. You don't need a checklist. Just stop. Or if moderation is your thing, just cut down. You don't need a group or anything. If that's not working for you, try something else. You can even go to AA and state that you don't believe in God and that you are planning to stop at a liquor store on the way home, or even that you're actually drunk. I don't think anyone would bat an eye, unless you were raising a ruckus. The might chip in for an Uber though.
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Old 5th July 2019, 04:15 PM   #226
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Originally Posted by Minoosh View Post
This sounds like a gish-gallop or moving of the goalposts to me. "Well, the steps invoke God!"

When directed to a secular version, "That's too wishy-washy."

We could argue all day about whether support groups actually help, or whether addiction is really a disease, or what powerless really means. What AA calls spiritual growth could probably also be termed emotional growth or just growth. Why is there even a list of steps? Maybe just because people like lists.

If someone can do it with willpower that's perfectly OK. You don't need a checklist. Just stop. Or if moderation is your thing, just cut down. You don't need a group or anything. If that's not working for you, try something else. You can even go to AA and state that you don't believe in God and that you are planning to stop at a liquor store on the way home, or even that you're actually drunk. I don't think anyone would bat an eye, unless you were raising a ruckus. The might chip in for an Uber though.

You seem to be all over the place here, and you call what I posted gish-gallop.

Well we have argued "all day" about the help that support groups may give. The evidence for and against the effectiveness of AA is most contradictory it seems. Given there is some confusion about defining what is an authentic AA group, as pointed out by others, this is hardly surprising.
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Old 5th July 2019, 04:18 PM   #227
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Originally Posted by isissxn View Post
But there are tons of secular alternatives. They're just not as well-known because they haven't been around as long.

Furthermore, there's no reason that the programs couldn't be tweaked to remove the most overt religiosity, especially in inpatient settings. It is so detrimental to recovery to force an atheist who is already at the end of their rope to recite the Lord's Prayer (for example) at the end of every group meeting like a child at religious boarding school. Not everyone will appreciate that because not everyone ******* hates religion with a passion, but many of the people committed to rehab DO.

They already lose so many of their rights by virtue of being in there, then it's just like an extra kick in the face. Especially when places lie about it. "Oh no, no religion here!" Then the people get there, and they're locked in, and they're not allowed to make phone calls for at least a week, and oh whaddaya know? Prayer time, every day, multiple times a day. Don't like it? We'll tell the judge you were being uncooperative.

Everyone has their berserk buttons, and this is one of mine. I see it as extremely shady and disrespectful, and it was the main reason I quit my old job (at that particular kind of center). That is where my objection comes from, and like I said, I'm completely intractable about it. Courts need to update their list of options.
Re: the highlighted:

1. AA won't tell the judge squat.
2. Agreed. I thought they already had, at least in the U.S.

My boonta button is people conflating treatment centers with AA. AA won't lock you in, search your room or take away your phone. It doesn't report to judges or probation officers. When you say "it" and "this" I'm afraid people will think AA does these things. It's not coercive. And there are groups who use secular versions of the steps. These are available in Vancouver but I don't know if the BC Board of Nursing or whoever accepts this for rehabilitation. IMO it should. From what I've heard meetings in Canada are more secular than those in the U.S. as are meetings in the UK and Australia.
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Old 5th July 2019, 05:27 PM   #228
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AA helps some but not others. Saying it helps no one actually harms those who would be helped.
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Old 5th July 2019, 05:51 PM   #229
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Originally Posted by theprestige View Post
AA helps some but not others. Saying it helps no one actually harms those who would be helped.
Exactly. Whether you agree with AA methods/philosophy/spirituality or not, it has helped a lot of people recover from a miserable condition. To deny that strikes me as in some way cruel.

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Old 5th July 2019, 05:56 PM   #230
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Originally Posted by Darat View Post
Sorry to keep beating this drum but according to the proponents for AA in this thread there isn't an AA, therefore each AA meet has to be assessed on its own success rate, therefore you can't extrapolate the results from one AA meet to a group of AA meets.
AA does not conform to your notion of what an organization should look like. AA's success - whatever it is - depends in large part on the very qualities which you find so perplexing.

Yes, there is a lot of variability between meetings and that is one factor that would make AA difficult to study scientifically. To add to the confusion, many of the studies that have been done are not studies of AA but of a Twelve-Step Facilitation approach. To a greater or lesser extent therapists will try to replicate AA in a clinical setting and may or may not encourage patients to attend actual AA meetings. The TSF group may be compared to control group which may be attending AA on their own. It's a mess.

Last edited by whoanellie; 5th July 2019 at 06:18 PM. Reason: add 2nd paragraph
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Old 5th July 2019, 06:05 PM   #231
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Originally Posted by The Greater Fool View Post
True.

The whole is AA a religion debate focuses on the idea that in the 12 steps you can replace god / higher power with whatever you want. This, of course, is a red herring. The 12 steps are statement of faith. Alcoholism is a moral failure that requires a spiritual awakening. How is that NOT religion?
If AA stands for anything, it is that alcoholism is not simply a "moral failure".
Originally Posted by The Greater Fool View Post
Not even AA cares if it's effective, though. Well, no more than any religion cares about how effective it's teachings are. Like any religion they have rules and make claims and the faithful will follow.

AA doesn't want studies. Why would it? It's not like the results of any study is going to actually change anything. We all know this a hallmark of religion, nothing changes. The dogma is the dogma, period.

If AA is helpful to anyone, that is a happy coincidence.
I'm going to quote from the Gabrielle Glaser article in The Atlantic that is critical of AA:
"As an organization, Alcoholics Anonymous has no real central authority—each AA meeting functions more or less autonomously—and it declines to take positions on issues beyond the scope of the 12 steps. (When I asked to speak with someone from the General Service Office, AA’s administrative headquarters, regarding AA’s stance on other treatment methods, I received an e-mail stating: “Alcoholics Anonymous neither endorses nor opposes other approaches, and we cooperate widely with the medical profession.” The office also declined to comment on whether AA’s efficacy has been proved.)"

Imagine if AA did conduct or fund studies of its effectiveness? Would you trust those studies. Couldn't it be argued that those studies were biased? To those who attend AA meetings, the proof of its success is their own sobriety and that of those around them.
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Old 5th July 2019, 06:27 PM   #232
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Originally Posted by Thor 2 View Post
You seem to be all over the place here, and you call what I posted gish-gallop.
Because the conversation keeps changing. Yes, I do perceive that if one objection is addressed another will rush in, but they're not all coming from you.

What I'd like to know is, why did you find the secular 12 steps "wishy-washy" and "meaningless"? Can you be more specific? Do you have suggestions for improvement? What if there was a group that had applied those steps to their own lives, and could help others do the same?

Originally Posted by Thor 2 View Post
Well we have argued "all day" about the help that support groups may give.
Not all in one day, fortunately.

Originally Posted by Thor 2 View Post
The evidence for and against the effectiveness of AA is most contradictory it seems.
Yes.

Originally Posted by Thor 2 View Post
Given there is some confusion about defining what is an authentic AA group, as pointed out by others, this is hardly surprising.
Speaking of that:

The Brandsma study purporting to show increased binge drinking in the "AA" cohort (at 90 days, but not at one year) wasn't actually referring people to AA. Instead, they were in a group set up specifically for that study to simulate an "AA condition." The thing is, a static group is going to be a different experience than a community meeting where people come and go. Trying to standardize AA changes its nature. For people who don't like AA that's a bug. For people who do, it's a feature.
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Old 5th July 2019, 06:34 PM   #233
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Originally Posted by whoanellie View Post
AA does not conform to your notion of what an organization should look like. AA's success - whatever it is - depends in large part on the very qualities which you find so perplexing.

Yes, there is a lot of variability between meetings and that is one factor that would make AA difficult to study scientifically. To add to the confusion, many of the studies that have been done are not studies of AA but of a Twelve-Step Facilitation approach. To a greater or lesser extent therapists will try to replicate AA in a clinical setting and may or may not encourage patients to attend actual AA meetings. The TSF group may be compared to control group which may be attending AA on their own. It's a mess.
If there is a common denominator in all this variability that enables recovery it would be in the interest of all AA members to conduct studies to determine what it is. Once known the meetings could concentrate on that aspect and significantly increase the recovery rate.

If there is no common denominator then the meetings and attendees are effectively stumbling around in the dark hoping to encounter the important aspect by accident. As you say, it’s a mess.
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Old 5th July 2019, 07:28 PM   #234
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Originally Posted by whoanellie View Post
If AA stands for anything, it is that alcoholism is not simply a "moral failure".
In fact it was a leader in proposing that alcoholism was a disease - and it's been attacked for that as well.

Originally Posted by whoanellie View Post
Imagine if AA did conduct or fund studies of its effectiveness? Would you trust those studies. Couldn't it be argued that those studies were biased?
I can't even envision a realistic scenario where it could do anything resembling a head-to-head comparison with other methods - what's it going to do, forbid people to attend AA? Also I'm not sure there's any one superior method - perhaps a combination works best.

Medical and nursing boards usually require action on multiple fronts. They're not trying to be mean; they want their practitioners back.
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Old 5th July 2019, 08:30 PM   #235
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Originally Posted by Steve View Post
If there is a common denominator in all this variability that enables recovery it would be in the interest of all AA members to conduct studies to determine what it is. Once known the meetings could concentrate on that aspect and significantly increase the recovery rate.
And why is it the job of a drop-in social club for drunks to do that research? Fundamentally that's all AA is. It's not a research institution equipped to do longitudinal studies with placebos and control groups. How would that even work in an organization that doesn't collect personal information? It's not going to withhold AA from anybody, so that's out. It's not going to hound people who want nothing to do with AA.

AA's mission is not to save the world. It's to be there for people who want it. And unfortunately people who don't want it are sometimes forced to go there.

Originally Posted by Steve View Post
If there is no common denominator then the meetings and attendees are effectively stumbling around in the dark hoping to encounter the important aspect by accident.
Within AA there is a common denominator: the steps. But even if you never work any of them, you're still learning new behavior - how to relate to people without drugs and alcohol. That's another common denominator.

Re: highlighted. I don't think there is a single important aspect. If someone finds something that works for everyone, they'll probably get rich.

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Old 6th July 2019, 04:18 AM   #236
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Originally Posted by Dancing David View Post
Actually that is the basis of sobriety, any thing else is just to help you DFD (Don't ******* Drink)

As a recovering addict I know how agonizing a choice it is but it really is the only choice, the rest is just to help cope
I made the decision to quit drinking, but I definitely did not do what 8enotto suggested worked for him, which was that he was 'powerful enough' to 'simply not drink booze'.

For lots of alcoholics, to 'simply not drink booze' will end badly. No amount of willpower and being 'powerful enough' is going to prevent or get you through the DTs. I don't think it's helpful to imply that addiction just needs willpower to beat it. I wonder whether or not 8enotto had an actual addiction to alcohol or just drank too much.
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Old 6th July 2019, 05:43 AM   #237
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Originally Posted by theprestige View Post
AA helps some but not others. Saying it helps no one actually harms those who would be helped.
Acupuncture helps some but not others. Saying it helps no one actually harms those who would be helped.
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Old 6th July 2019, 06:21 AM   #238
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Originally Posted by theprestige View Post
AA helps some but not others. Saying it helps no one actually harms those who would be helped.
Being as generous as possible the best reading of the evidence at the moment seems to be that a particular meet of AA may have helped some people attending that meet with a slightly higher success rate than the spontaneous remission rate of some alcoholics. But we don't know which meet that was, what that meet does to help people. (According to the proponents of AA in this thread. )
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Old 6th July 2019, 06:26 AM   #239
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Originally Posted by whoanellie View Post
AA does not conform to your notion of what an organization should look like. AA's success - whatever it is - depends in large part on the very qualities which you find so perplexing.

Yes, there is a lot of variability between meetings and that is one factor that would make AA difficult to study scientifically. To add to the confusion, many of the studies that have been done are not studies of AA but of a Twelve-Step Facilitation approach. To a greater or lesser extent therapists will try to replicate AA in a clinical setting and may or may not encourage patients to attend actual AA meetings. The TSF group may be compared to control group which may be attending AA on their own. It's a mess.
I have no views of what an organisation that treats alcoholics "should look like". All I am pointing out is if your and others description of AA meets are accurate then you cannot extrapolate a success rate from one study of one AA meet to any other.

In other words there is no evidence that AA "works" any better than any other approach. In my opinion the state should not be mandating non evidence based treatment.
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Old 6th July 2019, 06:30 AM   #240
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Originally Posted by Minoosh View Post
And why is it the job of a drop-in social club for drunks to do that research? Fundamentally that's all AA is. It's not a research institution equipped to do longitudinal studies with placebos and control groups. How would that even work in an organization that doesn't collect personal information? It's not going to withhold AA from anybody, so that's out. It's not going to hound people who want nothing to do with AA.

AA's mission is not to save the world. It's to be there for people who want it. And unfortunately people who don't want it are sometimes forced to go there.

Within AA there is a common denominator: the steps. But even if you never work any of them, you're still learning new behavior - how to relate to people without drugs and alcohol. That's another common denominator.

Re: highlighted. I don't think there is a single important aspect. If someone finds something that works for everyone, they'll probably get rich.
As I said above unfortunately AA is not being treated by the state as a drop-in social club for drunks, it is being treated by the state as if it was a treatment for alcoholism, which you and its other proponents in this thread also claim.

Problem is that such claims are not evidence based.
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