Alcoholics Anonymous and Drug Addiction

[AceBoogie]

And while many medical organizations may call something a disease, is their opinion absolute truth?

Is being a bad driver a disease? What if bad driving habits are genetic? What if the anxiety that is related to bad driving is genetic? I am not a medical professional but regardless I can say that the disease model for addiction does not make sense to me. Beyond that I have no say because the medical professionals that have come to this conclusion know more than me.

But it makes more sense to me that addiction is a SYMPTOM of a much larger psychological and possibly physiological issue... but does that make it a disease??? I don't know, all I can say is it makes no sense to me.

Your medical training is ... ?

Your definition of a disease is ... ?

loll as I very obviously admitted that medical professions obviously know more than me, I will ignore your childish, condescending attitude.

And I will repeat that while I don't argue that many medical associations and professionals may consider addiction a disease (and others don't) the concept simply does not make sense to me.

With that being said I believe addiction is a serious issue that needs to be dealt with as seriously as possible.

Believe it or not as humans we don't have to agree with everything that 'society' or some organization says. You are allowed to be you're own person and have your own ideas. And if that means that not 100% of my ideas make sense, I'll live with it. It just doesn't make sense to me. And I'll leave it at that. Thanks.

[Aractus]

Drich, where did your figures come from?

Did you pull them out of ur fat red-neck ass?

I referenced leading-edge treatment that suggests that peer-support is not the best model for anorexic treatment, you referenced nothing - nada - and claim that peer support is important?

Where is your evidence?

[Chas]

Your medical training is ... ?

Your definition of a disease is ... ?

loll as I very obviously admitted that medical professions obviously know more than me, I will ignore your childish, condescending attitude.

And I will repeat that while I don't argue that many medical associations and professionals may consider addiction a disease (and others don't) the concept simply does not make sense to me.

With that being said I believe addiction is a serious issue that needs to be dealt with as seriously as possible.

Believe it or not as humans we don't have to agree with everything that 'society' or some organization says. You are allowed to be you're own person and have your own ideas. And if that means that not 100% of my ideas make sense, I'll live with it. It just doesn't make sense to me. And I'll leave it at that. Thanks.

If it doesn't make sense to you, then you must have some definition of what a disease is. What is that?

[John V]

[Aractus]

[John V]

No it isn't. Your study is invalid because it's not a controlled trial, nor is it looking at real data from AA.

The study found for their cohorts that 12 weeks of AA was as effective as CBT - that doesn't surprise me. That's only 12 weeks, and it doesn't count people that drop out of the program, or that are excommunicated from 12-step programs, and I know someone who was excommunicated from a 12-step program.

First, I only quoted a part of the article, as I believe that's the preferred practice here. The study I quoted went on to one-year results. The next study cited in the article looked at 16-year rates:

Other research suggests that AA is quite a bit better than receiving no help. In 2006 psychologist Rudolf H. Moos of the Department of Veterans Affairs and Stanford University and Bernice S. Moos published results from a 16-year study of problem drinkers who had tried to quit on their own or who had sought help from AA, professional therapists or, in some cases, both. Of those who attended at least 27 weeks of AA meetings during the first year, 67 percent were abstinent at the 16-year follow-up, compared with 34 percent of those who did not participate in AA. Of the subjects who got therapy for the same time period, 56 percent were abstinent versus 39 percent of those who did not see a therapist—an indication that seeing a professional is also beneficial.

Second, it's a little odd that you bitch about the validity of a Scientific American article, but also bitch about a single friend who was booted out of a group. As AA doesn't keep records of names much less share them among groups, he was only booted from one group, and can go to others if he chooses. Why was he booted? I've got to think he was disruptive in some way.

AA has been around for 70 years and has never been updated. CBT has been around maybe 20 years and is constantly being updated. CBT can be delivered in group settings or individually - and when done by a qualified psychologist the individual treatment plan is designed specifically for that patient, unlike AA which is the same for everyone. In fact, they also design group CBT for specific groups of people as well, e.g. people with a particular mental illness, or other associated issue.

If noting else, AA is outdated because it has never been improved upon.

If it ain't broke...

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Right so it's probably true for anorexia nervosa, it's certainly true for gambling disorder, thus it's quite likely to also be true for alcoholism.

Sorry, but that conclusion isn't supported.

Again, I find it odd that you complain about methodology in opposing studies, but you feel free to make unwarranted leaps from one condition to another yourself, or to cite anecdotes (your one friend who was booted oout).

[Chas]

No it isn't. Your study is invalid because it's not a controlled trial, nor is it looking at real data from AA.

AA doesn't maintain, publish, or provide any data.

The study found for their cohorts that 12 weeks of AA was as effective as CBT - that doesn't surprise me. That's only 12 weeks, and it doesn't count people that drop out of the program, or that are excommunicated from 12-step programs, and I know someone who was excommunicated from a 12-step program.

No one is 'ex-communicated' from a 12-step program. Some groups have told trouble-makers not to return. There is no central authority or official membership.

You give an impression of ignorance of what 12-step programs actually are.

If noting else, AA is outdated because it has never been improved upon.

That doesn't necessarily follow.

[Aractus]

Okay, I just checked Moos & Moos's study - it's not a controlled trial. Participants were not told whether to attend AA or not, and those that did attend AA were people who decided to seek out treatment for themselves. Nevertheless they did find AA essentially equally effective to professional treatment with effectiveness most associated with the length of time spent in either professional treatment or AA (and 27 weeks was the magic number). They also found that people who attended both professional treatment and AA had significantly better results, which indicates that AA can work in parallel to professional treatment rather than replace it.

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Also, they were comparing it to therapy available in 1990. CBT was developed later in the 90's. So it doesn't compare it to the better therapies available today, which would be expected to out perform AA over the same period of treatment (e.g. 27 weeks).

[John V]

Okay, I just checked Moos & Moos's study - it's not a controlled trial. Participants were not told whether to attend AA or not, and those that did attend AA were people who decided to seek out treatment for themselves. Nevertheless they did find AA essentially equally effective to professional treatment with effectiveness most associated with the length of time spent in either professional treatment or AA (and 27 weeks was the magic number). They also found that people who attended both professional treatment and AA had significantly better results, which indicates that AA can work in parallel to professional treatment rather than replace it.

IMO you're downplaying the importance of AA. The study said:

Consistent with prior studies (Fiorentine, 1999; Fiorentine & Hillhouse, 2000; Moos et al., 2001; Ritsher, McKellar, et al., 2002; Ritsher, Moos, & Finney, 2002), longer participation in AA made a positive contribution to alcohol-related, self-efficacy, and social functioning outcomes, over and above the contribution of treatment. An initial episode of professional treatment may have a beneficial influence on alcohol-related functioning; however, continued participation in a community-based self-help program, such as AA, appears to be a more important determinant of long-term outcomes.

Also, they were comparing it to therapy available in 1990. CBT was developed later in the 90's. So it doesn't compare it to the better therapies available today, which would be expected to out perform AA over the same period of treatment (e.g. 27 weeks).

Do you have data comparing AA to newer therapies?

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Here's a study on group v. individual therapy in substance abuse (rather than anorexia or gambling). The abstract:

Most substance abuse treatment programs employ various models of group therapy. Empirical evidence, however, of the benefits of group vs. individual treatment is scarce. This study examined the impact of type of treatment, defined as individual or group counseling, on treatment performance, as measured by treatment completion and goal achievement. Data on clients treated in publicly funded substance abuse outpatient treatment programs were drawn from the Massachusetts Substance Abuse Information System. A larger proportion of group to individual therapy was strongly and positively associated with increased likelihood for improved measures of treatment performance. State data systems can provide useful insights into the development and application of performance measurement.

[John V]

Since I found nothing to really work for my sobriety, accept myself, I am actually turning back to an extremely unpopular point of view that has been discarded long ago by the addiction culture: willpower and self-control. It has become simply accepted that willpower does nothing and has no effect on any addictive behavior, when in fact self-control is a major ingredient in most successful endeavors. Why not for addiction recovery? Advancements in neuroscience are just now beginning to make psychologists rethink treatment methods for many things. Most addicts need to realize that there is nothing unusual about ending up where you are: jobless, broke, jail, prison, homeless, or whatever. The particular brew of brain chemicals and combination of life circumstances has put you where you are with no degree of surprise. And it's no surprise that willpower and self control failed people. Somewhere somehow someone is working on mindfullness methods or a pill that will increase self-control and willpower, so we can all take our lives back and not be slaves to our own biochemicals, free from meetings and churches and grasping at straw methods to overcome the seemingly impossible. Ha! Maybe I'm delusional....

Er, I'm gonna go out on a limb here and suggest that most everyone who makes it to AA, rehab or therapy tried willpower and self control multiple times without success. That's why they end up in those places.

If you can control your drinking through willpower and self control, then you're not an alcoholic. My brother is a heavy drinker, but he can stop whenever he needs to. He's not an alcoholic.