Alcoholics Anonymous and Drug Addiction

[Aractus]

[Dorian Gray]

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.

I spent years in AA, and almost a year in an intensive Christian rehab, and 2 other secular rehabs before that. I’ve been hospitalized 9 times for alcohol overdose, spent dozens of weeks cumulatively in detox, spent and lost over $200,000 in booze and losses inflicted thereof. Had 3 DUIs, lost all my friends and my family due to my drinking, and have been told by several doctors that my next drink could kill me. I’ve lived on the streets, slept in alleys, under bridges, AND went out and drank a half gallon a day for years after being told I would die. I’m 43 years old.

Uh, yeah I think I MIGHT be an alcoholic.

I used to say “prayer is the last resort of the truly damned.” Since I am still alive, and basically left with no “help,” I guess my new slogan is “I am the last resort of the truly damned.”

What I mean to say, is that I believe that the old and much maligned concepts of willpower and self control may become the only thing you can rely on when addicts like me find that AA, church, and rehabs (as we know them today) don’t work very well. Advances in neuroscience have proven such concepts as “ego depletion” and “decision fatigue” that addicts in particular suffer from. Diet also plays an enormous part in decision making and clear thinking. It’s no surprise that willpower and self control alone do not work for addicts given the mountain of stress, bodily damage and poor diets that they inflict on themselves. BUT, once these things are normalized, self control, which has been fatigued by overuse, can be strengthened like a muscle. There is too much on the topic to go into here, but I honestly believe it best for all addicts to not discount themselves as a major element in sobriety. I used to say AA is a good start – it can get you in a place where people understand and some shoulders to cry on, but when you go home at night (if you have one) you are always alone with your thoughts.

I’m going on a year soon, and I won’t get a chip, go to church, or celebrate in any way, except do some mindfulness exercise, make sure I’ve got plenty of glucose in my system at all times, and get plenty of rest.

[FatAndFaithless]

Yikes Dorian, I'm glad you're doing so much better now, that's some scary shit.

[AceBoogie]

I would argue that regardless of whether or not someone attends AA meetings, we cannot know exactly WHAT IT IS that is 'keeping someone sober.' One could argue that willpower and a decision to simply stop ruining one's own life and that attending AA is simply a byproduct of that decision.

I would have to favor CBT over AA personally because it is based on real science and is updated as new information is discovered. And SMART Recovery provides CBT based techniques and practices to help people stay sober and it is completely free, so that point is moot.

If one really cares to do some research, you will find that most claim that AA is just as effective as any other method of staying sober. And in these studies I would argue that willpower and a decision to stop destroying one's own life is more of a factor than anything, hence the consistency of 'success' in individuals despite the method used to obtain sobriety. At least that's what makes sense to me.

I do believe AA is great for those who can make it work for them. And while some people I know who are atheist have found success in AA, others I know have also claimed that there are many logical loopholes to jump through in order for them to make sense of AA. I suppose it's up to the individual.

[Aractus]

[John V]

[Aractus]

No, that quoted section - you're right I was wrong that it wasn't in the paper - clearly contradicts the rest of the paper. The most important determinant for success was completing 27 weeks either in outpatient-treatment or in AA in the first year. This is made very clear elsewhere in the paper. Continued involvement in AA lead to further long-term improvements, but it wasn't at all "the most important determinant for success".

And that's just going on their data, and their own claims elsewhere in the paper.

The fact is that treatment is effective and doesn't lose its effectiveness the way that AA appears to. Even the program they used in 1990 for 27 weeks produced results that could not be improved upon at that time (i.e., a patient receiving 28 or more weeks of professional treatment saw no further benefit). This is good, this is what we want from treatment, we want it to be finite - if it's 27 weeks or whatever the length, there should be a cut off time that the benefit has been delivered by.

With AA this was not the case. Thus you could argue that AA has more to offer but is unable to offer it within the same time period. And that's compared to 1990's treatment.

Compared to today's CBT outpatient programs it would probably not do anywhere near as well as it did in 1990 against a more primitive form of treatment. Today we have treatment programs that as I said seem to be expected to last between 3 to 6 months, which is a lot faster than 27 weeks to deliver that long-term benefit. You also have to remember treatment is generally once a week, whereas AA can be up to three meetings per week, so although they both delivered the same long-term benefit after 27 weeks, it takes more relative effort for those attending AA than for those attending treatment.

Most importantly of all, as I said before, patients who received both professional treatment and attended AA had the best chance of success. So again, AA does not replace therapy, but it can work in parallel to deliver further benefit and further chance of success. My advice to any alcoholic would be to try both CBT (outpatient care) by a qualified therapist, and AA, and based on the study to attend AA for at least 27 weeks, and to attend the CBT treatment plan for the duration requested by the therapist.

[Drich]

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?

Life. My experience with loved one who drank and used heavy drugs.

[John V]

No, that quoted section - you're right I was wrong that it wasn't in the paper - clearly contradicts the rest of the paper. The most important determinant for success was completing 27 weeks either in outpatient-treatment or in AA in the first year. This is made very clear elsewhere in the paper. Continued involvement in AA lead to further long-term improvements, but it wasn't at all "the most important determinant for success".

Ah, so you're a better interpreter of the data than the authors of the published paper. Got it!

[Aractus]

The authors of the published paper contradicted themselves there, this is clear.

Compared to individuals who did not enter treatment in the first year after they sought help, individuals who obtained treatment for 27 weeks or more experienced better 16-year alcohol-related outcomes. Individuals who participated in AA for 27 weeks or more in the first year, and in years 2 and 3, had better 16-year outcomes than did individuals who did not participate in AA. Some of the contribution of treatment reflected participation in AA, whereas the contribution of AA was essentially independent of the contribution of treatment.