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The Science of 12-Step Programs 330

Posted by timothy
from the your-brain-on-steps dept.
Hugh Pickens DOT Com writes "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists. But there is an interesting read at National Geographic where Jarret Liotta writes that new research shows that the success of the 12-step approach may ultimately be explained through medical science and psychology. According to Marvin Seppala, chief medical officer at Hazelden and sober 37 years, attending 12-step meetings does more than give an addict warm, fuzzy feelings. The unconscious neurological pull of addiction undermines healthy survival drives, causing individuals to make disastrous choices, he says. "People will regularly risk their lives—risk everything—to continue use of a substance." Addicts don't want to engage in these behaviors, but they can't control themselves. "The only way to truly treat it is with something more powerful," like the 12 steps, that can change patterns in the brain. Philip Flores, author of Addiction as an Attachment Disorder, says the human need for social interaction is a physiological one, linked to the well-being of the nervous system. When someone becomes addicted, Flores says, mechanisms for healthy attachment are "hijacked," resulting in dependence on addictive substances or behaviors. Some believe that addicts, even before their disease kicks in, struggle with knowing how to form emotional bonds that connect them to other people. Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that.""
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The Science of 12-Step Programs

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  • Gotta have a plan (Score:5, Interesting)

    by maroberts (15852) on Sunday August 11, 2013 @05:18AM (#44534551) Homepage Journal

    I would suspect that programs such as these do work, because they provide a means of seeking help, support and resisting temptation, instead of having no direction to go but down.

    • People suspect that many things work and sometimes they are wrong.

      "'no experimental studies unequivocally demonstrated the effectiveness of AA" in treating alcoholism." (https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous#Clinical_studies)

      Well controlled scientific studies are great at answering these questions.

      • by arkenian (1560563)

        People suspect that many things work and sometimes they are wrong.

        "'no experimental studies unequivocally demonstrated the effectiveness of AA" in treating alcoholism." (https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous#Clinical_studies)

        Well controlled scientific studies are great at answering these questions.

        and for some things, its very hard to set up an ethical and moral controlled scientific study. In a case like this the best you can do is try to study people who have already elected for various treatments. And the 'anonymous' part of AA (and various other programs) just complicates it all. "Unequivocally demonstrated" is a difficult bar to meet when its not actually legal to set up a properly controlled experiment. Don't get me wrong, I haven't reviewed the literature either way, and don't have an opin

      • Re:Gotta have a plan (Score:5, Interesting)

        by Zero__Kelvin (151819) on Sunday August 11, 2013 @11:18AM (#44535805) Homepage
        This 100 times over. AA "works" for those whom it works for because they are committed to staying clean. Going to meetings is merely a manifestation of that commitment. Unfortunately, I am an expert on AA, having had to become one while trying to make sense of it all, before I could reject it without being accused of "contempt prior to investigation." (Yes, AA advocates: I had sponsors and worked the steps several times, but was non-plussed since I already worked step 10 (without knowing it) even when I was drinking, and I don't have an imaginary friend anymore)

        If you are a logical person and want to feel your circuits frying go to a meeting and listen to the cognitive distortion-fest. If you stay away from alcohol it worked. If you don't then you failed, not AA. It is akin to a twist on Lisa Simpson's Tiger Repelling rock: It keeps away tigers. If you get mauled by a tiger then you weren't using it correctly.

        In AA you need to be open minded, which means believing what they believe. If you don't believe what they believe, then you aren't open minded!

        You need to get a "Higher Power" which, despite the claims to the contrary, is clearly and unquestionably the Christian God if you bother to read the literature. (e.g.. Tradition 2: "For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience ..."). My favorite (these two statements are usually separated by lots of double think first, but if you remove the interim content you get: "AA is a spiritual, not a religious program ... now lets end the meeting as we do with all meeting, with the Lord's Prayer ."

        Don't get me wrong, I'm friends with lots of "AAs" (as they call themselves in the literature, etc.) but one thing is for sure: Their imaginary friend did not restore them to sanity (see step 2).

        These people almost killed me, and I am estranged from parts of my family to this day even though I turned to more powerful paradigms and overcame my issues once I finally rejected it and sought them (i.e. Yoga, Kundalini Meditation, and other spiritual but non-religious pursuits such as playing the guitar and listening to music, surrounding myself with non-drinkers, etc.) My family was told that if I wasn't in AA then I wasn't commited to overcoming my addiction, so in their minds I haven't changed so there is no sense in talking to me.

        Luckily I am strong willed enough to have finally rejected their philosophy. As far as I am concerned AA may well have helped a lot of people, but it killed a lot them as well. The jury is still out as to which way the meter's needle sways.
    • by frovingslosh (582462) on Sunday August 11, 2013 @12:32PM (#44536191)
      You say that you suspect that they work. But there is no data to support that. In fact, most 12 steppers fail, and the success rate for 12 steppers is as low as the success rate for people just deciding to quit without using the 12 step program. Penn and Teller did an episode of their show "Bullshit" that talked about 12 step programs and gave some interesting data on its success. I'll suggest that you may want to see it before telling more people why you think 12 step programs work. They do not. You can usually find copyright infringing episodes of this show on You Tube. This supposed report is just more Bullshit.
  • by Anonymous Coward on Sunday August 11, 2013 @05:18AM (#44534553)

    in order to get back to the healthy, socially expected addiction to people. Makes sense.

  • quit drinking (Score:4, Insightful)

    by gl4ss (559668) on Sunday August 11, 2013 @05:28AM (#44534567) Homepage Journal

    had to quit it due to pancreatitis. fuck twelve steps, fuck the AA, fuck the higher power, fuck the addiction treatment industry.

    you see what's wrong with for example the AA 12 steps? 8 of the steps are "whee I'm a christian now and can't be judged for raping my cousin" and the rest are pretty much "It's not my fault I am/was an asshole". it's bullshit.

    not fucking one of the steps is to ACTUALLY STOP DRINKING! and half of the steps are practically just setting up that it's not their fault if they drink!

    here's my two step program.
    1) stop drinking.
    2) try to fill the time with something to make things feel as fun as when drinking.

    step two is hard, because, hey, drinking is highly enjoyable.

    (* due to having stopped drinking, I find myself unable to stop posting obnoxious poorly spelled comments to slashdot, but hey, it works. btw if you drink, don't be an asshole. AA is geared for people who are so big assholes they can't even go to the corner shop sober because they know they're such dicks when they drink, which makes for a sorry loop).

    • Re:quit drinking (Score:5, Insightful)

      by Idimmu Xul (204345) on Sunday August 11, 2013 @05:50AM (#44534609) Homepage Journal

      You didn't just 'actually stop drinking' you got pancreatitis, which then motivated you to stop, your 2 step program is missing a couple.

      Alcohol abuse is so socially acceptable most people don't even recognise it as abuse and it can take a massive upheaval of your social life to simply "stop drinking", as well as taking time to spot patterns of behaviour and triggers and then change them.

      I do dislike the AA though, they say that if you stop drinking, you're just a dry drunk, so in their eyes even of 10 years sobriety you're still branded as an alcoholic, you still have to announce that you're an alcoholic, and that just reinforces the idea that you're weak, that you may slip up and that you need AA meetings to get by.

      • Re:quit drinking (Score:5, Interesting)

        by Sycraft-fu (314770) on Sunday August 11, 2013 @06:08AM (#44534645)

        Well their terminology may be a bit off but the idea is actually correct: You can't, at this point, be "cured" of alcoholism. You can stop drinking and that is what you need to do, but the addictive nature is still there. If you start again, you'll overdo it and spiral down the addict path. If your brain/body is such that it will get addicted to alcohol, then it will always be that way, and no amount of time will change that.

        That's really what they are saying and it is correct. You don't cure an addiction, as in become such that you won't get addicted to the substance, you just stop taking the substance.

        As an example take a look at nicotine. There actually are people who do not become addicted to it, my mother is one of them, they are just very rare. Most people, if you use it more than a little bit you WILL get addicted. We all understand that, so those of us that don't wish to get addicted avoid it. Also once you've quit smoking, you recognize that you can't start again, you can't do it "just a little bit," you'll get hooked again.

        Well for alcoholics, that is how alcohol works. Most people, 90%ish, aren't like that. They do not get addicted. However for alcoholics it works like nicotine, they do get addicted. So the only answer is avoidance. There's no amount of time after which you are "cured" and can no safely drink, you just need to stay away.

        Same thing goes for any addiction. You are never "cured" you just stop taking the substance. You can't ever go back to taking it, or you'll head down the path of addiction again.

        • Re:quit drinking (Score:5, Insightful)

          by Trepidity (597) <delirium-slashdot@h a c k i sh.org> on Sunday August 11, 2013 @07:54AM (#44534895)

          You can stop drinking and that is what you need to do, but the addictive nature is still there. If you start again, you'll overdo it and spiral down the addict path. If your brain/body is such that it will get addicted to alcohol, then it will always be that way, and no amount of time will change that.

          That's commonly true, although alcohol is a strange drug because of how it figures in so many social situations. There's a segment of what you might call "problem drinkers" who do successfully change from drinking excessively to drinking moderately, mostly caused by a significant change in their social setting. For example they change cities and have a different group of friends with different activities.

          This strongly depends on the person and the nature of their excessive alcohol use, though. It's "easier" in a sense to be cured if it has a large socially situated psychological component, such as people who drink too much basically because their social life revolves around spending 5-6 hours each evening at the pub, and drinking is what you do at the pub. In that case, a change in social setting can significantly cut down on the amount they drink. But you could argue that these people were not truly addicted; rather they were drinking more than they wanted to because of social/peer/environmental pressure to do so, and then stopped doing so when the external pressure disappeared.

        • by alphatel (1450715) *

          As an example take a look at nicotine. There actually are people who do not become addicted to it, my mother is one of them, they are just very rare. Most people, if you use it more than a little bit you WILL get addicted. We all understand that, so those of us that don't wish to get addicted avoid it. Also once you've quit smoking, you recognize that you can't start again, you can't do it "just a little bit," you'll get hooked again.

          I was a smoker for 10 years and quit 10 years ago. I still smoke, but only when on vacation (which is so rare nowadays it might as well be retirement). I do not suffer any lingering after-effects. Even though in theory I shouldn't be able to kick the habit after smoking for a week or two in some summer retreat, it does not fail. Honestly by the time the vacation is over I am tired of the smoking ritual and its effects. The people I leave behind in those places, they don't stop smoking.

          Non-sequitur break:

        • > If you start again, you'll overdo it and spiral down the addict path.

          That's the problem with these programs - they teach people that they are helpless to their "addiction" which actually encourages addiction. If you are a permanent addict then if you have a drink well you are fucked so in for a penny in for a pound.

          • by raymorris (2726007) on Sunday August 11, 2013 @12:17PM (#44536077)
            When you lose your license to practice law behind drinking, but feel compelled to drink again the next day, you start to suspect there may be a problem. A year later, when you lose your wife and kids to drinking despite doing all you can to try to stop, you suspect it might be serious. Two years later, when you find yourself in the bar after your dialysis appointment, you KNOW you're screwed. Nobody has to tell you that. At AA you'll find people who tell you "yes, I was just as powerless, I found myself in the same situations."

            If you personally haven't been through that, I'm sure it's hard to comprehend. The fact is, for a real alcoholic, it's like diabetes - it'll always be part of your makeup, though it can be controlled with daily vigilance. That's fundamentally different from someone who simply has a sugar crash from eating too many sweets, or a hangover from too many drinks.
        • "Well their terminology may be a bit off but the idea is actually correct: You can't, at this point, be "cured" of alcoholism."

          I disagree. I'm not a fan of the disease model (it's pretty broken), but it has some uses. Framed in that paradigm addiction to a substance is like a curable STD. You can get rid of it and it stays gone unless you sleep with another infected partner (pick up the substance again.)

          " You can stop drinking and that is what you need to do, but the addictive nature is still there."

          If y

      • Re:quit drinking (Score:4, Interesting)

        by gl4ss (559668) on Sunday August 11, 2013 @07:30AM (#44534833) Homepage Journal

        3/4th of people don't quit drinking after getting alcohol induced pancreatitis locally here, probably a big part of it is the shitty education on the subject - they're one of the biggest money drains on public health care over here, every intensive care ward has someone dying from symptoms caused by reoccurances of it. the education for it given? a fucking brochure about dangers of drinking and then you're sent home with a weeks dose of opiates.

        I'm not an advocate for all people to stop drinking totally, just for people for whom it will cause serious medical problems that are not offset by the benefits of drinking and for those who are just so big douches when they drink that it causes them massive problems, that they view as massive problems(thus, again, damages outweighing benefits of fun) - in which case the solution is the same two step. however those douches are actually a minority, but you notice them much easier.

        Of course if you have no reason to stop drinking - why would you embark on even one step program to quit drinking?

        AA system sucks, hard. and that for most substances the society has built artificial damages for "abuses" of many substances - so they become a serious hamper on your life much, much before they become an actual problem on your functionality as a person or a problem on your health and that's stupid - with alcohol it'll for most people become a hamper on the health long before it becomes a problem socially.

    • Re:quit drinking (Score:4, Insightful)

      by AK Marc (707885) on Sunday August 11, 2013 @05:50AM (#44534613)
      The difference is that an alcoholic would drink themselves to death despite pancreatitis. So you weren't an alcoholic. How do I know that an alcoholic would drink themselves to death, knowing the next drink would kill them, and doing it anyway? Because my uncle died that way.

      Step 0.5 is to stop drinking. They won't let you in if you are actively drinking at the moment, so they assume you have quit, even if it's one day sober (while not sober).

      You had a need to stop, you did stop. That proves you are not an alcoholic. So your views on it are irrelevant.

      And they are all giving power to a higher power because the addicted can't stop themselves. So having an imaginary friend who's always there looking over your shoulder gives you some accountability when you'd otherwise have none. There's surprisingly little God in it, despite it being Christian God-based. It's psychological, giving help when needed.
      • Re:quit drinking (Score:5, Informative)

        by dcollins117 (1267462) on Sunday August 11, 2013 @07:01AM (#44534767)

        Step 0.5 is to stop drinking. They won't let you in if you are actively drinking at the moment, so they assume you have quit, even if it's one day sober (while not sober).

        The only requirement for A.A. membership is a desire to stop drinking. Anyone can go to meetings, sober or drunk, doesn't matter.

        • True enough, but your mistake is in thinking that the AA program is about going to meetings. Not only is that untrue bullshit regularly spewed forth in meetings, I can prove it. Read the AA "Big Book" section that describes the program (first 168 pages or so IIRC) and you will see that it isn't mentioned at all until pg. 159 [whytehouse.com], and then they are not described as a part of the actual program, but merely as a weekly get together to discuss the actual program.
      • Re:quit drinking (Score:5, Insightful)

        by cnaumann (466328) on Sunday August 11, 2013 @07:49AM (#44534873)

        You are defining an alcoholic as someone that can only stop drinking if they use the 12 step program. Someone who is able to stop for any other reason is not a true alcoholic.Therefore, Only the 12 step program can keep a true alcoholic sober. And the views of anyone who was not a true alcoholic and was able to stop drinking without using the 12 step program views are irrelevant. I think data obtained with these criteria will be somewhat biased.

        Surprisingly little God in them? Have you actually read them? (http://en.wikipedia.org/wiki/Twelve-step_program) The OP is essentially correct in his summery.

        • You are defining an alcoholic as someone that can only stop drinking if they use the 12 step program.

          No, he's defining an alcoholic as someone who cannot stop drinking without great difficulty, even if there are strong rational reasons for doing so. That's called addiction, and it's a well documented phenomenon. By contrast you offer no definition of alcoholism. Furthermore, all the OP said about AA is why it might help some of the people who have that problem.

      • The difference is that an alcoholic would drink themselves to death despite pancreatitis.

        NO. An alcoholic would WANT to continue drinking but whether or not they actually do so is a separate matter. Addiction is about the urge. Some can conquer the urge, some ultimately cannot.

        You had a need to stop, you did stop. That proves you are not an alcoholic.

        Which shows you do not understand addiction. If the person stops but the urge remains then they ARE an alcoholic whether or not they ever drink again. For some the urge is too difficult to overcome. I have an employee who is an alcoholic. A condition of his employment was that he stay sober but he always has the u

      • The difference is that an alcoholic would drink themselves to death despite pancreatitis. So you weren't an alcoholic.
        ...
        You had a need to stop, you did stop. That proves you are not an alcoholic. So your views on it are irrelevant.

        Your views are not based on empirical evidence. You have no right or research to support your definition of alcoholism in such terms. You assume that it is an incurable disease and speak in absolutes. Fuck Your Anecdotal Bullshit.

        Life is not black and white. If you can not comprehend this, then you can get bent, hard. You're doing more harm than good by creating self fulfilling prophesies whereby, "once an alcoholic, always an alcoholic".

        And they are all giving power to a higher power because the addicted can't stop themselves. So having an imaginary friend who's always there looking over your shoulder gives you some accountability when you'd otherwise have none. It's psychological, giving help when needed.

        Requiring belief in non-existent higher powers as a conditio

      • "The difference is that an alcoholic would drink themselves to death despite pancreatitis. So you weren't an alcoholic."

        Actually, the world is full of "Alcoholics"* who stopped well before dying from pancreatitis. Go read the DSM [wikipedia.org] and then get back to us on that one. In the meantime, it would be best if you accepted that you don't actually know what you are talking about and refrain from doing so on this subject. Thanks in advance.

        * An alcoholic is just an addict who hasn't figured out they are an addict

    • Re:quit drinking (Score:5, Insightful)

      by Hadlock (143607) on Sunday August 11, 2013 @06:45AM (#44534721) Homepage Journal

      Having watched a close friend spiral downwards and end up in a sober living home after a trip through the state mental hospital + inpatient rehab, the 12 step program is a system that is flexible and allows you to modify (although not fix, for a lot of people) some deep rooted behavioral problems so that when they go off the rails, it's a one or two day bender, not a two week "I haven't showered in 9 days and are these even my pants? where am i hey can i have some money i lost my wallet letsgogetsomebeermanthatsoundsgreat" binge that only stops because their liver has shut down and they end up detoxing in the hospital.
       
      I'm glad for you it's not a big problem and you had something more pressing to get you off of alcohol, but for a lot of people a day job is a great excuse to drink. Go hang out at an AA or NA meeting center some time, listen to their stories about how alcohol has been a lifelong struggle. For a lot of those people, the 12 steps is the only thing they have going for them, and they're grateful for what they have. It's a very well designed program for a certain subsection of people, and if you aren't one of them, you shouldn't knock it, because it doesn't apply to you.

    • Re:quit drinking (Score:5, Insightful)

      by m00sh (2538182) on Sunday August 11, 2013 @06:45AM (#44534723)

      Gah, the point of the article is that what is in the 12 steps don't matter. The steps could be "impersonate an orangutan in heat". What works is that people hang out together and fulfill a social need.

    • Re:quit drinking (Score:5, Interesting)

      by Anonymous Coward on Sunday August 11, 2013 @07:49AM (#44534879)

      Why is this modded down?

      If you type "is AA" into Google, Autocomplete will give "is AA a cult" as the first suggestion. Their success rates are abysmal.

      "Trying to fill the time" is an enormously important part of quitting the booze. The physical alcohol dependency quickly disappears, but your brains desire to kill some time by getting drunk never goes away.

      It's very annoying when the best posts on Slashdot get nuked, while somebody theorizing (poorly) about quitting alcohol can get modded up to +5. When I don't have an expert opinion on a topic, I let other people do the talking ...

    • "not fucking one of the steps is to ACTUALLY STOP DRINKING! "

      While I am definitely not a 12 step advocate [slashdot.org], your comment reflects an ignorance of the program. Step 1 as laid out in the big book (not the one liner, the whole enchilada) makes it clear that not drinking and staying stopped is key and that the remaining steps, when taken as a whole, are a means to that end. In other words, no single step is stop drinking and stay stopped just as no single step of fixing a car is 1) fix the car.

      Please leave

  • It works? (Score:2, Insightful)

    by Anonymous Coward

    It's been said in the comments on the NGS web site, but it's worth repeating here: The article starts from the presumption that 12 step programs are effective, based on the fact that they are popular. The actual science on twelve step programs says something else entirely.

    http://www.nytimes.com/2006/07/25/health/25drin.html?_r=1&

    http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/abstract

    Coming up with a "scientific explanation" for how AA "works" without any demonstration that it actuall

    • The article starts from the presumption that 12 step programs are effective, based on the fact that they are popular. The actual science on twelve step programs says something else entirely.

      Read your own fine article. From the NYT link:

      no data showed that 12-step interventions were any more — or any less — successful in increasing the number of people who stayed in treatment or reducing the number who relapsed after being sober ... None of the studies compared A.A. with no treatment at all

      It doesn't even pretend to address the point you're trying to make.

    • The study you linked to says AA works as well as other types of treatments. It also quotes several researches who say AA is effective.
  • by Anonymous Coward

    If there's anyone who wants to quit but doesn't like AA for whatever reason, I can recommend Naltrexone and the "Sinclair Method".

    • Re: (Score:3, Interesting)

      by Anonymous Coward

      There's also another alternative. LSD. It makes the person who takes it think more clearly and see their problems in a whole new light and make them accept that they have a problem as well as give them the will to stop.

      I'm not an alcoholic, but I stopped smoking cigarettes after taking acid once. It suddenly made smoking seem so stupid. I already knew that it was stupid, but somehow the acid made me really think about how cigarettes hurt me and that gave me the willpower to stop. And that wasn't even the re

  • by ThatAblaze (1723456) on Sunday August 11, 2013 @05:41AM (#44534589)
    The problem with 12 step programs isn't the people who they work for, the problem is that so often they are presented as the only option. Not everyone who has ever used any addictive substance has no control over themselves.Some people used them for different reasons, and those people are often forcefully pushed into these 12 step programs right along side the people who need them.

    Most schools are trying to come to terms with the fact that people learn differently, when will treatment programs come to terms with the fact that people recover differently?
    • Re: (Score:2, Troll)

      by silas_moeckel (234313)

      12 step programs success rate is the same as the spontaneous success rate. AKA it is not effective. It is a pseudo religious cult that the government forces people to got to. I'm sure addicts can use help dealing with there addiction but that costs real money not just free use of a church basement, coffee, and a doughnut spread.

      • 12 step programs success rate is the same as the spontaneous success rate.

        If you believe the naive application of that statistic settles the issue, then you don't understand the difficulties of studying the treatment of psychological problems, as regards choosing a random control group and making a study (double)blind. It's a far more difficult problem than say, studying the effectiveness of a drug for treating arthritis via the conventional double blind study with a placebo for a randomly chosen control group.

        the government forces people to got to

        That may be part of the problem. Historically it was based on people w

    • The problem with 12 step programs isn't the people who they work for, the problem is that so often they are presented as the only option.

      When? By whom? I've no doubt that some people say this, but I've never noticed it as a widespread problem.

      Not everyone who has ever used any addictive substance has no control over themselves.

      "No control over themselves" is getting seriously judgmental and/or philosophical. If they had no control over themselves then, absent permanent physical restraint, how did they stop? I'm a pragmatist. If it helps some people stop their destructive behavior, then it's a Good Thing (tm).

  • "attending 12-step meetings does more than give an addict warm, fuzzy feelings."

    "the human need for social interaction is a physiological one"

    I'm sure there's some scientific value in quantifying the effect, but that's what people mean by "warm, fuzzy feelings" - it wasn't a mystery.

  • by Bob_Who (926234) <Bob@@@who...net> on Sunday August 11, 2013 @07:02AM (#44534771) Homepage Journal

    I am a strong advocate of whatever works.

    It doesn't matter who is right or if its the best way or stupid or God or placebo effect. I think the issue is that human beings effect one another and that people with problems of any kind do have an affect on the people around them. These problems may be the result of their experience of the people around them. Whether or not addiction is a choice or a disease or a spiritual or a social disorder really does not matter. What matters is that those who may be afflicted with this dilemma attempt to engage with society in a way that will help to resolve behavior that is inevitably harmful to the self and to the people around them. I don't mean to judge others, each individual can make that determination for themselves. But if it seems that there is wreckage and damage to themselves and to others, and if it is difficult to ascertain how to get a handle on the situation, then its a pretty good bet that engaging with other human beings might be a good starting place.

    While it is also true that 12 step programs derive from a spiritual, albeit even Christian flavored template, that in no way limits an individuals personal approach or beliefs. Its just a social venue in which to engage with fellow addicts. And yes there are all kinds of people out there, from the weird to the mundane. Some with "fight club" agendas and some working on a date for Saturday night. Many are addicted to 12 step groups and some are stoned and court mandated to attend. Whatever. It doesn't matter. Its like the rest of the world - there are all kinds. But if you try to do SOMETHING, try to engage with others in a way conducive to new behavior, or another perspective, then its a good place to start.

    Why a 12 step? Because its all around, in pretty much every town in the western world. It is anonymous. It is inclusive of anyone who can just be present and listen. It costs nothing. You can leave at any time. If you don't like the kooks or freaks or holy rollers or drunks then just go and find a group that is normal like you. Or blow it off. Nobody will stand in your way. Just know that it is available to you, even if its not particularly useful or interesting to you, it remains an option. And the possibilities are as varied as the human beings that comprise our world. Some are even Scientologists lurking in narc-anon.

    Like most things you get out of it what you put into it. If you spend more time drinking you'll spend more time dealing with those consequences, whatever they are. For some, it just means better wine, for others its a DUI or health concerns or anything else you can imagine. If you spend a lot of times doing something else instead, then you will get other results. It may not make you happy or solve your problems, but it will take time away from drinking or gambling or eating a gallon of ice cream or it doesn't matter what else.

    My point is perhaps best stated by the immortal Tom Leher. He once said,

    "Life is like a sewer.... What you get out of it depends on what you put into it"

    And as with most things that goes for the 12 or 13 steps as well. Let the farce be with you.

    • It doesn't matter who is right or if its the best way or stupid or God or placebo effect.

      If it is the placebo effect then by definition the treatment is ineffective. In principle I agree with you. It something works then keep with it. The problem is that there is very poor evidence supporting the effectiveness of AA or other twelve step programs. If someone can show me a study that *definitively* says "yep, AA helps 10% more people than a control group" or then I will say go ahead with AA and try to figure out who it helps best. I'm even willing to go along with AA continuing while they do

  • by Anonymous Coward on Sunday August 11, 2013 @07:04AM (#44534775)

    My father managed to get out of several decades of drug and alcohol abuse (and criminality) via the 12 step. He got an education in treating addicts and now work since a number of years treating others with the 12 step. It works (but that's not news).

    Seeing this pretty close and talking to my father about many details, I can state this with absolute certainty that it is 100% exactly the same as any "mind-controlling" cult, but for a different purpose. It works the same, looks the same, everything - and it even has a lot of "god" in it, although many people choose to interpret that in other ways. Especially it is formed to teach you that you are powerless and must trust whatever higher power. It turns the addicts into addicts for meetings instead of drugs.

    I have many many problems with the treatment as it is done today, especially since it forms a life-long dependency on something new (this is the trick!) instead of the drug, and the breaking down of the mind. But, on the other hand, it's better than the alternative. I just can't help thinking that there must be a better way than switch addiction for addiction. My father disagrees, of course, simply because for him, this is not how he views it, he sees himself as free from addiction, but he gets all jittery if he can't go to a meeting for a few days...

    If we are gonna reprogram humans (it's similar to NLP?), I'm sure it would be possible to reprogram them in a better way than this.

    • by JPLemme (106723) on Sunday August 11, 2013 @08:28AM (#44535005)
      My AA story...

      In college, I attended an AA meeting as a requirement for a Psychology class. I wan't an alcoholic or even on the path to alcoholism; I just needed to fulfill the requirement and "attend an AA meeting" was the easiest way to do that.

      The first thing I noticed was that all the people in the meeeting (there were maybe 40 attendees) had replaced alcohol with coffee and cigarettes. The second thing was that all of these people seemed to care about each other. A lot. It wasn't anything explicit or obvious; it just seemed to radiate from everybody and it generated this vibe that was incredibly warm and fuzzy. I didn't announce why I was there, so unless they asked me the other attendees just treated me like another anonymous alcoholic. And they treated me like I was their son or their brother. It felt really, really comfortable and nice. At one point, I actually thought to myself "it's too bad I'm not an alcoholic, because it would be great to hang out with these people every week."

      I left that meeting on an emotional high. The only way I can describe it is that it was like finding out you had a whole branch of your family that been searching for you for years, and now you've been reunited and your new family just accepts you with -- not just open arms -- but with a tangible joy that you've finally joined them. It was awesome! And then I got about 50 feet out the door and said to myself "You just got hooked by a cult!"

      I was shocked because I had always assumed that I was 100% absolutely immune to cults. I had read stories about people who were brainwashed into joining them and thought that I -- with my intelligence and my skepticism and my stable family life -- could never fall for something like that. But I had only been there for two hours and they had hooked me. Had I been less intelligent or cynical or more lonely maybe I wouldn't ever have realized what was happening.

      But more importantly (at least for the report I had to write for my Psychology class), I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people, and then uses that control to help them conquer their addiction demons. It's atomic fission harnessed to light up a city rather than to destroy it. And it works because we're social animals and our brains normally respond to social cues at a level far beneath our concious thought. Unless we're actively guarding against it, we can all be manipulated this way. Even you.

      Please note, I'm not in any way claiming that AA is bad or that they use social power to do anything other than try to help people. People's need for social interaction is just a fact, and AA uses this knowledge as the starting point to help people stop drinking. Knowing that you have several dozen people who care about you, who would be disappointed if you had a relapse, who look to you as an example of success, or who would be happy to talk to you if you just need help resisting the urge; that knowledge might make the difference between you giving in to your addiction and you staying sober for another day. That's a good thing and if AA works for somebody then that's great.

      So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
      • I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people ... So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.

        "Cult" is a very imprecise term. By your broad definition, your family is also a cult (you're the one who likened the meeting to a family reunion). For that matter, our entire society (and I suspect all societies) are cults by that definition. Families and societies are extremely strong means of controlling people.

  • "Success" of AA? (Score:2, Informative)

    by Anonymous Coward

    AA's own internal figures show that only 5% of people who start AA are not drinking one year later.
    The spontaneous remission rate is also 5%.

    So the ones who are stopping were going to stop anyway (and kudos to them).

    But what about the 95% who don't stop? Other studies show that when groups of alcoholics were randomly assigned to court ordered AA, no treatment, or a therapy program, the AA group was FIVE TIMES as likely to engage in subsequent episodes of severe binge drinking as the no treatment group, and

    • AA's own internal figures show that only 5% of people who start AA are not drinking one year later ... So the ones who are stopping were going to stop anyway

      Your logic doesn't follow - it's just a guess on your part.

      Other studies show that when groups of alcoholics were randomly assigned to court ordered AA

      How did the courts determine that these people were alcoholics? It's now common practice to order anyone who gets a DWI to go to AA, and I suspect that's a mistake. Doing a stupid thing like driving while drunk doesn't necessarily mean you're an alcoholic. People will also, on legal advice, start going to AA before a DWI court date. "Gosh your honor, I'm repentant, be lenient!".

      Historically people went to AA because they chose to, not because they w

    • by Dcnjoe60 (682885)

      AA's own internal figures show that only 5% of people who start AA are not drinking one year later.
      The spontaneous remission rate is also 5%.

      So the ones who are stopping were going to stop anyway (and kudos to them).

      But what about the 95% who don't stop? Other studies show that when groups of alcoholics were randomly assigned to court ordered AA, no treatment, or a therapy program, the AA group was FIVE TIMES as likely to engage in subsequent episodes of severe binge drinking as the no treatment group, and nine times more likely than the therapy group.

      Here's a sampler:
      http://www.thefix.com/content/the-real-statistics-of-aa7301 [thefix.com]
      http://www.orange-papers.org/orange-effectiveness.html [orange-papers.org]
      http://www.youtube.com/watch?v=Z0DSEdLCAUg [youtube.com]

      Why don't you sue the statistics from AA of those that complete the 12 step program? Many more start than finish, just like college. Success rates, independently verified for success rates for those who complete AA is 40%. That's not as high as going to a private therapist which is 55%, but then that number doesn't include all the people who start therapy and don't continue, either.

      Your whole premise is based on the orange papers which even states that it is "One man's analysis." It is not a scientifically

  • I think before we start analyzing why 12 step programs work, maybe we should determine if they work. While everyone just assumes 12 step programs are the answers, there is very little scientific evidence and studies on whether they work better than anything else. It is a hard subject to study, but I think something that should be done since the state is sentencing people to 12 step programs. Before we force people to go into programs (especially one that force people to accept that there is a "higher powe

    • by Dcnjoe60 (682885)

      I think before we start analyzing why 12 step programs work, maybe we should determine if they work. While everyone just assumes 12 step programs are the answers, there is very little scientific evidence and studies on whether they work better than anything else. It is a hard subject to study, but I think something that should be done since the state is sentencing people to 12 step programs. Before we force people to go into programs (especially one that force people to accept that there is a "higher power") I think there should be strong studies done to show that these programs work better than other programs or at least better than a person just deciding to stop.

      Actually, there are numerous studies on the effectiveness of 12 step programs and their success rate is around 40% versus 55% for dedicated therapy with a psychologist and less than 5% for self-treatment. I don't remember the issue, but in 2011 Scientific American had an article about it and listed several recent studies.

      As for forcing people into accepting their is a higher power, nobody is forced into AA or other 12 step programs, it is totally voluntary and there are other options for therapy. As the SA

      • by dirk (87083)

        Actually, often part of a person's court sentence is to attend AA. Yes, I guess they instead accept jail time, but that seems like a false comparison. And yes, it is often mandated that it be AA, not alcohol treatment in general. People have actually tried to attend other, non-AA, non-religious treatments and been told no, you must attend AA.

        • by Dcnjoe60 (682885)

          Actually, often part of a person's court sentence is to attend AA. Yes, I guess they instead accept jail time, but that seems like a false comparison. And yes, it is often mandated that it be AA, not alcohol treatment in general. People have actually tried to attend other, non-AA, non-religious treatments and been told no, you must attend AA.

          In the cities I have worked with substance abuse, the courts always give an option. However, AA is the one most often chosen because of costs. But maybe other communities mandate it. I thought the ACLU had a case they won against mandating AA, but maybe it didn't cover the entire country.

        • by Swampash (1131503)

          Actually, often part of a person's court sentence is to attend AA. Yes, I guess they instead accept jail time, but that seems like a false comparison. And yes, it is often mandated that it be AA, not alcohol treatment in general. People have actually tried to attend other, non-AA, non-religious treatments and been told no, you must attend AA.

          And that's illegal.

          In April 1999 the U.S. Court of Appeals for the Second Circuit ruled that a court cannot require someone to attend Alcoholics Anonymous because doing

        • To the extent what you say does occur, it's a problem with the courts, not AA. It's not as though AA does anything to influence the courts' behavior in these issues (AFAIK that would be a major violation of AA's principles).

  • How it works (Score:5, Insightful)

    by DaveV1.0 (203135) on Sunday August 11, 2013 @08:12AM (#44534957) Journal
    It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
    • Re:How it works (Score:5, Interesting)

      by rwyoder (759998) on Sunday August 11, 2013 @08:57AM (#44535123)

      It trades one addiction for others: religion, caffeine, and nicotine.
      It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.

      There is an athiest/agnostic sub-group of AA, but judging by things found on their FB page, they are having an uphill battle with the powers-that-be in AA.

      https://www.facebook.com/pages/Agnostics-and-Atheists-in-AA/168374259840358 [facebook.com]

      http://www.aa-atheists.com/ [aa-atheists.com]

      • There is an athiest/agnostic sub-group of AA, but judging by things found on their FB page, they are having an uphill battle with the powers-that-be in AA.

        As far as I understand TPTB in AA, they don't have much power. Certainly the athiest/agnostic sub-group is free to create its own organization. In fact I believe it has been done.

    • by Dcnjoe60 (682885)

      It trades one addiction for others: religion, caffeine, and nicotine.
      It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.

      Maybe, but I would rather a person who believes in a higher power get behind the wheel of a car than an alcoholic. Just saying.

    • It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.

      As opposed to those who have a religious fervor for clinging to the belief that they are completely in control of themselves. Free will, determinism, blah, blah, blah. The important thing that religious evangelists and evangelical atheists have in common is that they love to debate this. Personally it bores me to tears. What I do know is that AA helps some people stop drinking and that I find stepping over drunks annoying. AA also doesn't cost me a penny. Therefore I think it's a Good Thing (tm).

    • by Fubari (196373) on Sunday August 11, 2013 @01:34PM (#44536521)

      It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.

      Quite glib; your implied point is "it" is worthless because it just swaps addictions.

      I haven't seen a definition of addiction yet, so I'll suggest this:
      Someone is addicted if they repeatedly make damage-causing choices, to the point where normal life is unsustainable (e.g. cant hold a job, arrested, or maybe death).

      Now instead of a question of "Addiction" it becomes a question of Sustainability: how long can somebody carry on?
      Some people carry on for a full lifetime with whatever. No problem, I'd say they're not addicted.
      Other people have trouble sustaining after a while.

      As for "trading one addiction for another", think of it as damage control.
      Different behaviors have different time frames to their consequences.

      Some things, like meth or heroin, can lead to severe consequences quickly (think Trainspotting).
      Alcohol tends to be longer-term maintainable; often drinkers can sustain for years, possibly even decades. Eventually health issues (like liver damage, possibly fatal), judgement issues (drunk driving, possibly fatal), and other "consequences" (getting fired, divorced, passing out in risky situations) tend to make life unsustainable.
      Marijuana is perhaps more sustainable than alcohol and other drugs.

      Now, let's talk about some of the other "addictions" that you're concerned about.
      Coffee? (Oh noes, they iz addixted to caffeen!!) WTF! Coffee is arguably completely sustainable, it doesn't cause damage to the user or to others.
      Cigarettes? *shrug* I don't know about that one but damage-wise, but it is probably safer for somebody to smoke than to routinely make poor decisions because they're blackout drunk.
      Sex? (Oh noes, they are sleepn roundz!) This is pretty sustainable; arguably healthier than lots of alcohol / chemical "entertainment" options. Do actually you have a problem with people engaging in sex?

      Look... whatever behavior you're thinking about, try thinking of it in terms of sustainability. Maybe some of these things are "just" substitute addictions"... but is that really so bad?

  • by Jah-Wren Ryel (80510) on Sunday August 11, 2013 @08:17AM (#44534979)

    There is a lot of evidence to suggest that 12-step programs are nothing more than window-dressing. That they take credit for spontaneous remission - the percentage of people who just quit on their own.

    For example, alcoholics have a spontaneous remission rate of roughly 5% - so if an AA program has a 5% success rate (including the people who give up on the program - the AA people don't like to count them) then AA is just a no-op.

    Here's one of many analyses making the argument that 12-steppers are just bad at math.

    http://www.orange-papers.org/orange-effectiveness.html [orange-papers.org]

    • by Dcnjoe60 (682885) on Sunday August 11, 2013 @09:00AM (#44535137)

      There is a lot of evidence to suggest that 12-step programs are nothing more than window-dressing. That they take credit for spontaneous remission - the percentage of people who just quit on their own.

      For example, alcoholics have a spontaneous remission rate of roughly 5% - so if an AA program has a 5% success rate (including the people who give up on the program - the AA people don't like to count them) then AA is just a no-op.

      Here's one of many analyses making the argument that 12-steppers are just bad at math.

      http://www.orange-papers.org/orange-effectiveness.html [orange-papers.org]

      An article in Scientific American in 2011 (sorry I don't have the direct reference) showed AA had a 40% success rate. Dedicated therapy something like 55% and people going cold turkey or self-treating less than 5%.

      I'm not sure why there is a discrepency between the link you quoted and the article in Scientific American. If I recall, the SA article quoted numeous statistically valid independant studies that corroborated their reported findings. Maybe the paper you referenced wasn't a statistically valid sample? I don't know, but given the plethora of studies that show otherwise, while not as successful as dedicated therapy, 12 step programs are universally recognized and accepted as being successful.

      • Do you mean this one? [scientificamerican.com] Where they didn't count the people who dropped out early on?

        • by Dcnjoe60 (682885) on Sunday August 11, 2013 @09:56AM (#44535401)

          Do you mean this one? [scientificamerican.com] Where they didn't count the people who dropped out early on?

          Yes, because in evaluating the efficacy of substance abuse programs the national standard when looking at recidivism is to look at those who have completed the program. Drop out rates are reported, but they don't impact the recidivism rate. That can only be measure once somebody completes the program. That is the same methodology used for private counselling related to substance abuse, too. So, when they say 40% for AA and 56% for private counselling, they are comparing apples with apples and only talking about those who completed therapy. The dropout rate for both is very high, which is why when court ordered, there is regular reporting back to the courts on attendance.

          This isn't unique to substance abuse, most medical treatments follow this practice. If somebody starts chemo for cancer and drops out, it does not count against the effectiveness of that type of chemo for that type of cancer. It does get reported so that doctors are aware of what the dropout rate is so they can help the patient through it.

          Put differently, when evaluating the effectiveness of any treatment, you need to look at patients who actually completed the treatment. It is important to know how many did not complete the treatment and why they didn't, but that doesn't change the effectiveness for those who do complete the treatment.

          • Yes, because in evaluating the efficacy of substance abuse programs the national standard when looking at recidivism is to look at those who have completed the program.

            Which is meaningless when comparing program success rates to spontaneous remission rates. I would even go so far as to say it is a bias that enormously skews the comparisons in favor of "doing something."

            • by Dcnjoe60 (682885)

              Yes, because in evaluating the efficacy of substance abuse programs the national standard when looking at recidivism is to look at those who have completed the program.

              Which is meaningless when comparing program success rates to spontaneous remission rates. I would even go so far as to say it is a bias that enormously skews the comparisons in favor of "doing something."

              Well, that is the established norm for pretty much all medical research, so either the medical community is all in on it or it is the best model they have. As for introducing bias in favour of doing something, well, that is not the case logically. At best it would introduce bias against doing nothing, which is not the same thing. To be fair, unless we know what the people did who dropped out of AA or private therapy or institutional therapy, we don't actually know their ultimate outcome. Likewise, for thos

          • by strack (1051390)
            Id sure like to know how you can drop out of the "quitting cold turkey program" and thusly not be counted in the study. then you might have a fair comparison of AA with the baseline of quitting cold turkey. And your analogy with a chemo study is disingenuous, it would be a fair comparison if all the people with really bad cancer self selected to drop out of the trial, inflating the chemo success rates over a control group baseline, just as all the people who went back to drinking self selected to not go thr
            • by Dcnjoe60 (682885)

              Id sure like to know how you can drop out of the "quitting cold turkey program" and thusly not be counted in the study. then you might have a fair comparison of AA with the baseline of quitting cold turkey. And your analogy with a chemo study is disingenuous, it would be a fair comparison if all the people with really bad cancer self selected to drop out of the trial, inflating the chemo success rates over a control group baseline, just as all the people who went back to drinking self selected to not go through a humiliating and somewhat public admission of failure at a AA meeting and dropped out of the program instead, inflating the AA success rate over a control group baseline.

              You know what, if you don't like the way medical research is conducted, then take it up with the medical community. But the whole purpose is to have a controlled group. Obviously, you cannot "drop out" of a cold turkey program. On the other hand, real studies are about the recidivism of those who complete the program, not of those who fail to complete the program. It doesn't matter whether it is AA, regular therapy, or even chemo. Success rates are reported based on those who complete the treatment.

              Again,

  • "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists.

    12 step programs do not claim to cure anything. If an alcoholic enters AA, even if they refrain from alcohol for years, they are still an alcholic. Nothing is cured, they have only developed ways to deal with the alcoholism. Same is true for other addicitons treated through 12 step programs.

    Maybe if scientists viewed 12 step programs as behavior modification programs, they wouldn't be so perplexed.

  • by HangingChad (677530) on Sunday August 11, 2013 @09:06AM (#44535155) Homepage

    AAs success rate varies between 5 and 8 percent, about the same success rate you'd expect from no treatment.

    If you can't beat the control group then it's junk science at best to try and derive meaningful conclusions from the few success stories and lends undeserved credibility to a program that is a massive statistical failure by almost any measure that means anything.

    • If you can't beat the control group then it's junk science

      It's junk science to pretend that a randomly chosen group is a meaningful control group when studying something like this. The key issue is explained here [wikipedia.org] and here [nih.gov].

      limitations are widely acknowledged in obtaining acceptable data due to the difficulty in applying experimental controls to clinical analyses of AA, such as adequate placebo control

      It's a notorious problem with studying the efficacy of psychological treatments. In many cases the whole issue is ignored so someone can claim to study it in a meaningful way and get more grant money.

  • by VortexCortex (1117377) <(VortexCortex) ( ... -retrograde.com)> on Sunday August 11, 2013 @09:39AM (#44535293)

    There was an AA meeting group in the civic center I volunteered at. A loved one and friend of mine also attended AA meetings.

    Though I am an atheist without a drinking problem I helped set up and clean up, and became tangentially involved with 12 step programs over the years.

    One major compulsion to attend AA and other 12 step addiction programs, especially for teen and young adult members, is the unwritten "13th Step": Sex and/or relapse into addiction with other members. Some have related to me that they were introduced to hard drugs or "milder" drugs like cigarettes and caffeine via AA... When I asked if trading one vice for another wasn't just as bad (smoking packs of cigarettes a day is very bad and severely addictive), "One addiction at a time," they would say. One need only look at the coffee expenses nearly all AA meetings have to realize the effectiveness at combating addictions are quite subjective... A cyberneticist might even say: They have changed from sating their tendency via physiological addiction into sociological addictions, either can be severely harmful; Please enjoy addictions responsibly; Everything flows, moderation is the key.

    I can believe that addictive personalties may favor a certain substance or habitual activity above others (drug of choice), but I can also acknowledge that there is no such binary as "AA works" -- It's more like: AA has some success and a lot of failures: Success more likely only if you've "Hit Rock Bottom" first however, which I find quite ridiculous. Either it does or doesn't work, the belief in AA that a cathartic event that nearly destroys a person be practically a prerequisite for recovery is dangerous, reckless, and foolish -- Not based in empirical study, for certain; Only anecdote.

    There was a teen 12 step program my friend was in, "Lifeway", and "PDAP", before that. These were largely modeled after AA's 12 steps, but Lifeway mushed the "you believe in a higher power" in with some other step so that it could squeeze in a step about abandoning your friends since they will cause you to fall back into addiction again... Even abandoning me because I wasn't "a winner" in life enough to help my friend "work a program". This is a common cult tactic.

    The safety net gone, when my friend could not "work a program" due to being as atheist and thus incompatible with the "higher power" step, my friend's parents (upon advice from the parent meetings they attended) kicked my friend out of the house. They said the other families wouldn't let them stay with them, even though such was the apparent practice, and instead they were shown, "Tough Love". My friend became a 16 year old homeless person and flunked out of high school. My friend said they still attended the meetings, because they were too ashamed and afraid to contact an old friend like me -- they said that if the group, family, or "sponsor" found out about the contact it could mean prolonging the homelessness. Though they had been without drugs while failing to "work a program" for over a year, they started using drugs again once on the street... Of course! That was my friend's first encounter with harder drugs... This before the 3rd step of the program could even be attempted, they said.

    AA and other 12 step programs do not provide the housing aspect a teenage kid requires to survive, so they were of no help, "Keep coming back, it works if you work it," is the literally ignorant motto. After months of homelessness and abject prostration before the parents of Lifeway my friend was allowed to stay with another family, but not their own family; It was more "Tough Love" they said. I saw my friend with the new family around town and was quite puzzled because they'd never hung out before, and I was given the cold shoulder when I tried to say Hi.

    Later, my friend had said they had to earn back the right to live in their home, and couldn't take any chances... Meanwhile they were instructed to attend "outpatient" meetings, which my friend described as exp

  • this article cites a few studies on dopamine receptors and fucking brain waves, and tries to link those with 12 step programs, does a bad job of it, and does not cite any study of the actual success rate of AA vs quitting cold turkey. Probably because those studies show that AA has at best, no effect on relapse rates for addiction. and AA isnt grassroots. its sneaky religious indoctrination that judges can order alcoholics to attend in lieu of time in jail. and thats probably unconstitutional.
  • by almechist (1366403) on Sunday August 11, 2013 @12:41PM (#44536229)

    The article is propaganda, plain and simple. In the first few sentences the author is already using words like “success” and “a miracle” to describe 12-step programs. I was interested in the article at first because the headline seemed to promise coverage of a genuine scientific assessment into the efficacy of the 12-step approach, something that is badly needed here in the USA where the 12-steps are frequently treated as The One True Religion by the established addiction treatment community. But the piece is just fluff, apparently written by a true believer who seems only interested in research aimed at retroactively determining just how 12-step programs accomplish such great things... The greatness is just assumed to already be a settled matter. The fact that AA and especially NA don’t work for the overwhelming majority of addicts is something that is just glossed over.

    And that’s really too bad, because AFAIK most studies find only marginally better outcomes when evaluating 12-step program performance, on the order of a couple of percentage points when compared with alternative treatment methods, particularly over the long term where the numbers are barely statistically significant. The sad fact is that something like 99% of the addicts who walk in to a NA meeting for the first time will relapse in a matter of weeks or even days, and often just hours. As for the long term outlook, there are studies showing no measurable difference in sobriety levels after 5 years of NA versus no treatment at all. Even when the 12-step rules are scrupulously adhered to and all meetings are faithfully attended by the recovering addict, it remains a method of dealing with addiction that works only for very, very few people, although admittedly when it does work it can be a godsend. The question that needs to be asked in the USA, a country still obsessed with the patently un-winnable War On Drugs, is this: why is a program with such abysmal success rates still considered the gold standard in addiction therapy by treatment providers? Too bad you won‘t find any such question in the article.

  • by PPH (736903) on Sunday August 11, 2013 @01:58PM (#44536647)

    ... is quite often the religious component.

    There is a lot of logic in taking people who have broken self control mechanisms and telling them that they need to rely on some external source of judgment. Fine. When they craving for a drink, teach them to call a sponsor or other group member to talk me down. Because their brain is too broken to make correct decisions in this area. But that should be the end of it. If this becomes a foot in the door to sell a story of some invisible guy up in the sky who is all powerful, well they may not be that screwed up. And attempting to make this sales pitch is often caught, even by people lacking excellent judgment as a con. Eventually, they see through the BS and reject not only the imaginary guy with the beard, but the useful support structure keeping them away from abusing substances.

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