>“Well,” he told me, “it’s 2,000 euros.” That’s about $2,500—a fraction of the cost of inpatient rehab in the United States, which routinely runs in the tens of thousands of dollars for a 28-day stay.
>I didn’t mention that some bare-bones facilities charge as much as $40,000 a month and offer no treatment beyond AA sessions led by minimally qualified counselors.
I'd have to guess that even the Finnish model would be vastly more expensive the US – it seems to be the rule when it comes to health care costs.
After all we also have AA-style treatments, and while I can't comment on their features, a quick Google-Fu reveals that the cost for month's inpatient rehab is 6500 €. (It's a fully private enterprise, and not a part of the public health care.)
One thing I've heard AA does right is asking attendees to talk about each their recent drinking acts and what preceded them. This forces some to realize their patterns and triggers for the first time.
On the other hand, it provides opportunities for new relationships that are even more toxic than those the attendees arrived with, since frequently this group has (or would have, if they were examined by a competent doctor) multiple diagnoses.
It is the windows 10 of treatments. It is cheap. It is often forced upon those in need. It only "works" if one buys into a theology. It suggests that there are no alternatives and actively seeks to weeken those that appear. Many of its lauded features are of little utility to most users. And it is american.
> He told me that for years he had drunk to excess, sometimes having as many as 20 drinks at a time
Hmmmm that's not a lot when your talking problem drinking as an addiction. That'd be typical in a frat house.
There's a lot wrong with the article and a lot right. Pick carefully.
There's no reason you can't go to AA and do the Sinclair Method. AA is full of Atheists the god bit is misleading.
I'm not sure why they are putting down AA when AA is not against the Sinclair Method. AA has found their way works for some people. It's also cheap councling. Not everyone can afford well paid doctors.
If your drinking is that bad you need a pill to stop it wouldn't hurt to talk to others about the problem as well. And AA is a meme/cult/religion that allows that except they don't go to war and fight others over oil and resources.
>> […] sometimes having as many as 20 drinks at a time
> Hmmmm that's not a lot when your talking problem drinking as an addiction.
Twenty drinks at a time is not a lot? Don't most people draw the line way before that? In the Netherlands drinking more than three drinks a day is considered problematic drinking (for men); I wager that this won't differ that much around the globe.
20 drinks at one sitting is a lot, and it's firmly in the problem and harmful drinking end of risky alcohol use.
People with alcoholism can drink a lot more than that.
A UK unit of alcohol is 10 ml of pure alcohol. You'd consider inpatient residential rehab for someone drinking 30 units per day. There are roughly 40 units in a litre of spirits in the UK.
And just to be clear, it's rare that what people call "a drink" is only one unit. What someone casually counts as "20 drinks" could easily be 50+ units.
There a difference between healthy living or occasional dangerous behaviour compared to an addiction that needs individual medical intervention.
I find it a strange case for a male person with an addiction problem (which is what we are talking, AA style intervention) thinking 'sometimes as many as' 20 drinks to be a statement of supprise.
The $350/hr. Psychiatrist said, "You need to go to AA---"
Me, but that doesn't work? There's this study done by the Rand Group. The Rand Group is this think tank, and they--
The Psychiatist cut me off immediately, to tell me, she knows all about the Rand Corporation. She didn't like to be told anything. I like her, but she does have an anger problem.
She then catches herself. I'm not sure if she ever liked me. She than said, "I have never been to a meeting."
Silence.
I told her I could quit on my own. She than said, "Don't stop on your own. You could die. Even two weeks later, you could get the delirium tremors." (She was being helpful. And if your drinking a lot, don't try to stop one your own. In my case he just gave me a reason to continue.)
Psychiatrist, "What don't you like about the meetings. It's the religion thing?" Me, "No--that's fine. I just don't relate to the other drinkers. I'm not doing the stuff they claim they did when they are on stage, and they seem to love those crazy stories?"
Psychiatrist, "Well why are you drinking a bottle of wine a day?"
Me, "Because I need it. I'm not nearly medicated enough."
Psychiatrist, "Your drinking because your life is terrible."
Me, I'll just agree. There's just no use in arguing, and if the tables were turned, I'm not sure if I would up my patients dose of dubious drugs.(benzodiazepines--long half life.)
Moral of story. If your drinking a lot of hard alcohol, don't even think about stopping without medical oversight. Dying is real. Then again, if your poor, like me, and don't have a fancy insurance program you can Taper down.
Taper, and Taper.
We are all suppose to have reasons we drink. Mine was supposedly a bad childhood. I don't remember it as bad. But then again, a Therapist said abused children often recall happy childhoods. It really wasn't bad. I too tired to argue again. I started drinking after a bad panic attack, that turned into General Anxiety.
Just Taper.
If your drinking hard alcohol, switch to wine, or beer. If your honest with yourself, and your drinking because of a verified psychological problem; treat the alcohol as medication. Panic attract--two, or three drinks, and stop. Stop all social drinking. Only use ethanol when absolutely necessary. Try not to become addicted. Use exercise instead.
I've been appalled at the way we treat drug addiction. I remember when I was a normal person, and had my old brain back, I rememeber when Jerry Garcia went to some new age clinic, with no doctors, to stop his drug use, out in sudo hippie west Marin--Olema.
By day two, he dies of a heart attack over breakfast. His death really bothers me. I know the clinic was well meaning, but no one should go cold turkey.
That's all I have. Just Taper. If the meetings help--go, you have nothing to loose and they are free.
I stopped on my own.
The last definitive thing I told my Psychiatrist is, "There's no way I'm spending my last twenty grand on a clinic."
If I can stop, so can you. Believe me I was a mess.
(Now I got to figure out how to quit a twenty plus year addiction to benzodiazepines? Fun? My hope is I can find a reasonably priced GP who will write my scripts. I don't see the need to put my body through anymore withdrawals, at this point. By the way, you can Taper off bupenorpine too. Don't read all the horror stories online. Just get down to 1 mg for a few weeks, and then nothing. Good luck.)
And as a comedian once said while holding a mic dripping with sweat, "Why do I drink?"
"Because I have too!"
I believe he stopped, or cut way back. Why isn't cutting way back a treatment? They all think we have no self control is the answer. Some of you do have the self control.
Wow--I went on. Just Taper, and don't hang around enabling fr...
My name is sverige and I used to be an "alcoholic." I have attended at least 2,500 AA meetings in various places since the early '80s, and probably many more than that. I was fully indoctrinated in their literature and methods, having read every book published by AA more than once, and some many, many times. I am also very familiar with similar and related programs, such as Al-Anon, Narcotics Anonymous, etc. I have also known people who have been involved in even more fringe movements, such as Synanon. I have talked to thousands of people "in recovery" over the years, and I have personally known dozens who died as a direct result of their addictions.
The article is a pretty good summary of the sad state of alcohol and drug dependency treatment in the U.S. The prescription is always abstinence, and almost universally any suggestion that moderate drinking might be possible for some is met with scorn and anxiety.
My objections to AA have little to do with their mention of God. I am christian, so obviously that is not a problem for me. I will say that AA theology is awful, basically implying that salvation comes from sobriety, but worse is that it actually indoctrinates many with ideas that hinder their ability to recover from addiction. Regardless of whether or not you believe the way I do, I hate to see people needlessly suffering from this illness (or perhaps, this group of related illnesses), yet the conclusion I came to after 25 years of involvement with them is that AA more often than not prolongs suffering.
I am not saying that naltrexone or any other drug is the magic bullet, but I am certain that it is well worth investigating alternatives to AA. If you or anyone you are close to needs help, please take the time to explore all the options. There is so much snake oil in this area that it can be difficult to know which way to turn. It is worth the time and effort it takes to find the right treatment, and if it is successful, it is probably even worth the inflated cost of said treatment.
The prescription is always abstinence, and almost universally any suggestion that moderate drinking might be possible for some is met with scorn and anxiety.
My understanding is abstinence programs are for those that have tried to moderate and cannot.
To quote AA:
Ch. 3 More About Alcoholism... For those who are unable to drink moderately the question is how to stop altogether.
Ch. 3 More About Alcoholism... We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself, step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.
It also seems strange to suggest naltrexone as an alternative to aa.
From living sober:
AA. members and many of their physicians have described situations in which depressed patients have been told by AAs to throw away the
pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from schizophrenics, manic
depressives, epileptics, and others requiring medication that well-meaning AA friends often discourage them from taking prescribed medication.
Unfortunately, by following a layman's advice, the sufferers find that their conditions can return with all their previous intensity. On top of that,
they feel guilty because they are convinced that "AA is against pills."
It becomes clear that just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it's equally wrong to deprive any
alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.
I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?
However, I strongly suggest, as do you, for those suffering to seek out help and consider all options.
>My understanding is abstinence programs are for those that have tried to moderate and cannot.
I hope I did not suggest that abstinence is not the correct answer for some. It just isn't the answer for all, which is what is generally taught in AA. And the quotes from Chapter 3 are not serious, in the sense that if a newcomer to AA says something like, "Maybe I can drink moderately," the answer is pretty much always, "How did you end up here then!?" (Frequently, the answer is, "The judge told me I had to come in order to avoid jail.")
>It also seems strange to suggest naltrexone as an alternative to aa.
Living Sober was written before naltrexone was invented. I have known a number of folks who were prescribed Valium and similar drugs in the '60s and '70s and '80s who became addicted to both Valium and alcohol.
Further, the Living Sober quote suggests medication may be appropriate, but "alcoholism" (or whatever the DSM-5 calls it now) is often the main diagnosis, with any other diagnoses placed as subordinate to that main diagnosis. The implication is, "Stop drinking and the rest will go away," which is frankly bullshit. The Orange Papers (for all its many flaws) has a good section on this.
>I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?
This is not from the literature, but rather from my observation over many years. Many times I have heard it suggested that AA is "basically christian" or "based on christian principles" but the reality is that it is based on what is properly called "Buchmanism" (for Frank Buchman, the founder of the Oxford Group). There is a tinge of christianity to it, but it is based on works (staying sober) rather than on grace.
This is why many moral failings in AA are glossed over with, "Nobody's perfect! Just stay sober and you'll be OK!" That is an appropriate response to dealing with a medical issue -- for example, a heart patient may also be a greedy, corrupt thief. The moral failing does not generally have any bearing on the treatment of the cardiovascular issues. So why are alcoholics taking moral inventories and making amends and confessing their shortcomings to others?
In other words, is it a disease, or is it a moral condition? If it's a moral condition, then let's not call AA's solution "christian," because it is not. If it is a disease, then let's treat it like one rather than using the twelve steps.
> In other words, is it a disease, or is it a moral
> condition? If it's a moral condition, then let's not call
> AA's solution "christian," because it is not. If it is a
> disease, then let's treat it like one rather than using
> the twelve steps
I think that in AA alcoholism itself is considered a disease, with at least two components: an allergy of the body; and an obsession of the mind. The disease of alcoholism is considered to have far-reaching effects which are best dealt with by two things: staying sober and working the 12 steps and thereby having a spiritual experience.
I'd say it's analogous to someone who's had a heart attack. The immediate crisis needs to be addressed at an emergency room. Then there are lifestyle and diet changes that need to happen, too. The heart attack might have been the initial problem that precipitated the crisis, but the lifestyle issues are the real cause.
AA is a big organization, and there are certainly different interpretations, but I think it's fair to say that alcohol is certainly seen as the problem, but the underlying cause of the problem is seen to be the lack of a spiritual lifestyle. Hence the two-pronged approach. Very often Christianity is used because it's what's familiar. But I'd hardly call AA a Christian organization.
It's not clear to me from your comments that you've read the article-- especially "It also seems strange to suggest naltrexone as an alternative to AA". Is it just because it's an 'evil drug' or am I missing something?
Also, I feel you're misunderstanding the "moderation" that the article speaks of. The AA literature you quote is about someone who is actively dependent in a bad way trying to moderate themselves. The "moderate drinking might be possible for some" line is about returning to a life of moderate drinking in the future.
I guess my take on AA has always been that it gives people a reason to turn their lives around, and AA is not necessarily the reason itself that people get better. I have had friends and family recover with abstinence-only treatments for their addictions, and have also had a close family member die because they couldn't give it up.
I'm often reminded of the David Foster Wallace passage from Infinite Jest when I think about people who need to break 100% free from their addictions:
“--and then you're in serious trouble, very serious trouble, and you know it, finally, deadly serious trouble, because this Substance you thought was your one true friend, that you gave up all for, gladly, that for so long gave you relief from the pain of the Losses your love of that relief caused, your mother and lover and god and compadre, has finally removed its smily-face mask to reveal centerless eyes and a ravening maw, and canines down to here, it's the Face In The Floor, the grinning root-white face of your worst nightmares, and the face is your own face in the mirror, now, it's you, the Substance has devoured or replaced and become you, and the puke-, drool- and Substance-crusted T-shirt you've both worn for weeks now gets torn off and you stand there looking and in the root-white chest where your heart (given away to It) should be beating, in its exposed chest's center and centerless eyes is just a lightless hole, more teeth, and a beckoning taloned hand dangling something irresistible, and now you see you've been had, screwed royal, stripped and fucked and tossed to the side like some stuffed toy to lie for all time in the posture you land in. You see now that It's your enemy and your worst personal nightmare and the trouble It's gotten you into is undeniable and you still can't stop. Doing the Substance now is like attending Black Mass but you still can't stop, even though the Substance no longer gets you high. You are, as they say, Finished. You cannot get drunk and you cannot get sober; you cannot get high and you cannot get straight. You are behind bars; you are in a cage and can see only bars in every direction. You are in the kind of a hell of a mess that either ends lives or turns them around.”
The short version is that I became a christian. Since that time, the mental health issues I had previously have dissipated. These included diagnoses by various sorts of mental health doctors that included alcoholism, drug addiction, clinical depression, and later bipolar disorder. Lord knows there were probably other diagnoses that could have been applied as well.
In addition to AA and NA, I have also taken various medications for depression and mania, and have been through all sorts of talk therapy. I have not taken any of those medications for over a decade, I no longer go to meetings or therapy, and, among other things, I have found that I can drink in moderation. I drink very occasionally, maybe once every few months, at social occasions.
I cannot claim that anyone who becomes a christian would have the same experience. I do not know that. And I am aware of weaknesses in those areas that used to cause me so much trouble, but I can also say that they are not debilitating the way they were previously.
When I left AA and NA, I went around to all my old meetings and told my friends there why they would not see me any more. There were some very interesting conversations, to say the least. I wish them no ill will, but as I said above, I would not recommend those groups to someone in trouble. I wouldn't say not to go there, but I would not send them there as a first option.
I don't really have any pat advice to offer anyone struggling as I did, beyond, Don't give up. Yes, it's painful, but don't give up looking for solutions. (And as someone else said here, taper taper taper if you're trying to detox.)
AA is a wonderful tool to get sober - its enough to pull you back from the brink and if you're mindful enough reevaluate your life and why you're self medicating - it may not however be the tool you need to stay sober.
Look at AA as addiction transference - you're transferring your addiction from Alcohol to AA - and for some, thats the best they can do, for others its the start of the journey to moderate consumption.
That seemed like an overly long article to the point of having an unclear evidence to its argument and seeming biased against AA. I'd be more interested to see a summary of research about what is proven to be effective in treating the problems than cherry picked study results and anecdotes.
There are so many issues with this article, I am not quite sure where to start.
I guess at the beginning. The article starts with a title that is leading to say the least. Another thing this author does throughout the article is to insinuate that Alcoholics Anonymous it to blame for the sorry state of how our health care system (U.S) pays for addiction treatment.
After stating how hard it is too verify statistics for positive results,the author damns the guess made 50 years ago when Bill Wilson first wrote the book, and most likely had a far better conversion record as they were then dealing with highly motivated quitters.
It is almost humorous that this author is complaining about the success rate of this method, when a large number of the pool of candidates are forced into treatment by either the law or parental coercion.
Now I would like to say mid- rant that I am biased. I stopped drinking 33 years ago, and while I would not admit to membership in this group in a public forum, I would suggest people who WANT to quit, to give it a try.
I would be one of the first to say that there are a lot of hokey parts to the traditions they follow, and I do not agree with a lot of the premises of the literature----
But that being said........It works!
One interesting opinion about AA comes from Charlie Munger, Warren Buffets business partner. Charlie writes quite a bit about the psychology of business, and he gives his fairly well thought out opinion of why AA works so well.
I wonder whether the AA bashing is just for controversy
to better sell the article, or if perhaps the author is helping to market the new version of naltrexone the is being quite heavily promoted to judges recently.
>* I do not agree with a lot of the premises of the literature---- But that being said........It works! *
From the article:
"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."
According to that, about the best you can say is that "it works when it works", which isn't saying much. I'm glad it worked for you, but the fact that for evey one of you there are 10 who go back to drinking doesn't do much to recommend the program as the legally mandated cure-all it currently is.
A quick search on Lance Dodes, shows he has an axe to grind and some books to sell.
Also, remember AA is suggested for people who want to quit.
IF you take 100 kids who got caught smoking pot in high school, force them to go to AA meetings, there is a good chance they will not stop drinking.
Don't attack the method because people misuse it.
I really think there are a lot of other things that do work, and I think the drug naltrexone can be very useful in helping people quit from what I have read. What pisses me off is when shills who really don't know what they are doing push a gimmick for profit.
One of the things that is giving AA a bad name are all the fly by night treatment centers who say they are using 12 step methods, but actually all they are really doing in collecting insurance and warehousing people for 28 days.
When I hit bottom a buddy of mine said the worst thing that can happen is that you become "one of those AA assholes". There's truth there. You'll never kill a family in your car because you've gone to too many meetings.
That said, I'm an atheist, my buddy is an atheist and here in the northeast the religious part is really watered down, from what I hear, compared to other parts of the country.
I go because hearing others stories and talking to others about the being an alcoholic is really helpful.
I haven't drank in 4 years and AA was a crucial part. But I've never done the steps ( I can't even call it a higher power, that's lipstick on a pig in my book ). It's the talking to others that's helpful. People would say things, especially in the beginning, that articulated things I'd felt but unable to put into words.
In addition to speaking with other alcoholics I use philosophy, Eastern thought and stoicism, and the occasional use of lsd and mushrooms to keep me off the sauce. I never say I'm "sober" because of the latter part, but that was never my goal. I just needed to quit drinking and I couldn't.
My biggest problem with AA is the religious side. Overall the program seems to help people face their issues and take responsibility for their actions, but the toolkit, in my mind, barely gets them above water. But it is better than drowning. I'd love to see the organization revamp to catch up to the 21st century. The big book is like reading an anthropology book from the 19th century. It's sad how some people cling to it.
One feature of AA that I think a number of people fail to remember, though, is that there are meetings everywhere at many different times. For those that haven't lost everything you should certainly seek alternatives. But there's a large population of people that are so messed up they've lost everything and quite literally wouldn't know how to find help in other places.
Addiction sucks and is one of the most heartbreaking things for me to see. But not everyone that uses is an addict, whether it's alcohol, marijuana, or even cocaine.
To anyone wrestling with it: good luck, get help and know there is another side to your life. The rest of it doesn't have to be spent feeling the way you do now.
First, a big congratulations on your four years of being alcohol free. From a random stranger on the internet, I applaud your success, and wish you the best. It always puts a smile on my face to hear these types of things.
I've never gone through any programs but have had family who have. On the religious stuff - my general interpretation has always been that it's less a confession of faith in a higher power, but more a surrender of control, or in some senses a selection of values above yourself that you adhere to. From a bird's eye view, it kind of sounds like you already are doing that, with philosophy/Eastern thought/stoicism.
Thanks for your comment, I'm in AA and I really like the aspect of the program that is living a life based on a practical philosophy of stoicism, i.e. the serenity prayer. I've been at a bottom too, which is an experience of depravity and pain that is often difficult for people to relate to.
I'm a big fan of the serenity prayer. I drop God from the the first line. Either way there's a lot of wisdom in those few lines.
I'm very open about my alcoholism. Primarily it's to help other addicts see past the shame almost all of us experience. Secondarily it is to help non-addicts understand the addicts in their lives.
TL;DR: The science around this is terrible so it's hard to know anything with much certainty, but it looks as though AA isn't much better or worse than other treatments. Whether it's more effective than no treatment at all is an open question.
To be fair, also here in Finland some people swear by the “Minnesota Model” (as it is called here) form of treatment – which I've come to understand is very similar to the AA program in the US – almost religiously so, or maybe indeed, so.
One way or the other, perhaps the saddest form is the most used – a very short clinic stay coupled with benzodiazepines to help safely stop a prolonged bender. Nothing wrong with that per se, but it's not really enough... but it's a free world.
I lost nearly everything in my life: my job, my apartment, my car, and very nearly my life from drugs and alcohol. I used for years with few consequences, but with the help of the dark net markets, got my hands on cheap and power drugs my body and mind could literally not handle. I came to a point in my life where I realized I had lost control over my ability to self-regulate consumption of intoxicating agents, and the consequences were dire.
I underwent a pretty radical change getting sober, moved to a different part of the city into a semi-supervised sober house, and started going to AA meetings. What I found there was a diverse group of people, with even more diverse problems (drugs, alcohol, violence, relationships) that had 1) accepted the problem was of their own making and 2) collectively decided that only through their own actions could they make themselves whole again. My AA group is a little unconventional in that we are extremely accepting of different types of addictions, and operate in an inner city area much different than my suburban upbringing. For me, AA is about living a stoic life, accepting what you can control, and disregarding what you cannot control. Seeing these same problems, across race, class, gender and geography was a pretty transcendental moment for me.
AA is just one part of what I'm doing to stay healthy: the other component, which in a lot of ways I trust more, is cognitive behavioral therapy, and group therapy. I think eventually more 'evidence based' group therapy systems will take over, but you just can't beat AA's model: people helping people via donated time and services.
When a new person walks into 'AA' with just a 'desire to stop drinking' their entire experience comes from the individuals, qualified only through their anecdotal experience in sobriety, that they meet. As a data scientist ready to defend AA, it used to be hard for me to rectify the fact that 1) AA is not effective as a prescribed intervention and 2) I'm in AA, and it works. How can I recommend a treatment when I know doing nothing in some cases is often better? Well, I don't know, and for me, AA is about staying sober, statistics be darned, I have something that works.
Finally, getting sober, for me, was a long, difficult, and extremely uncomfortable experience. If you are reading this, questioning if 'AA' is right for you, I would strongly implore you to attend a few different meetings in your area. Raise your hand, introduce yourself, and see what comes forth. AA will not save you, you will save you.
Has anyone tried Naltrexone? I am about to try some after watching the documentary, "one little pill." by Claudia Christensen. I implore anyone suffering from alcohol addiction to watch the documentary and consider it as a treatment that has helped many yet is not widely discussed as it is unprofitable.
I am more then 6 years sober through AA. Before I have tried a professional help and it didn't work. My personality is allergic to psychotherapeutics b..t, I cannot stand someone telling my about my flaws.
What has worked for me in AA?
1) The possibility to go to a meeting when I was starting feeling bad, lonely, depressed, tense - which previously resulted in getting a drink
2) Hearing the real stories from real people. I cannot stress how much it worked on my, how its had changed my perspective.
I am sure AA won't work for everyone but it works for certain types of people. In my humble opinion it works exactly because it isn't based on hard science but on personal experience. Actually - "this is how it works" is something you hear often at meetings.
Now regarding the financial side. 40k$ for bare bone AA meetings is something very American.
In Poland AA is self-financing, meetings are open and free. If you can afford you can make a voluntary donation to your group cash-box which is used for coffee and tea. Like 2-3$. Local community or a church is providing place for meetings. Everyone is welcome (if he is not under influence). In . city the size of Warsaw there are meeting going every day and at different hours.
So AA is affordable to anyone and at any time while even public healthcare therapy will involve some cost or long wait.
I read the Big Book, and went to a couple of meetings. As a logical but also religious person, what they said made no sense.
First, just "give yourself over to God" means nothing. Sobriety takes work. One falls into a bad pattern, and you need conscious effort to break that pattern. I found the SMART program, which uses Cognitive Behavioral Therapy. That worked for me and made sense for my brain.
Also, my religion (Eastern Orthodox Christianity) teaches that God will throw a life raft, but you gotta grab it, hold on, and swim to shore yourself. Again, the same work ethic, not just "turning yourself over".
I really find AA makes it difficult to people to get sober. I'm sure it does work for some, but I believe it may take longer for them.
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[ 3.8 ms ] story [ 114 ms ] threadDoug Stanhope has some insightful comedy on the subject (nsfw)
>I didn’t mention that some bare-bones facilities charge as much as $40,000 a month and offer no treatment beyond AA sessions led by minimally qualified counselors.
After all we also have AA-style treatments, and while I can't comment on their features, a quick Google-Fu reveals that the cost for month's inpatient rehab is 6500 €. (It's a fully private enterprise, and not a part of the public health care.)
Two: But it worked for my dad.
One: Another scientist told me the earth is doomed.
Two: That's good science. Let's get a drink.
edit: maybe linux is a bit strong, php?
Hmmmm that's not a lot when your talking problem drinking as an addiction. That'd be typical in a frat house.
There's a lot wrong with the article and a lot right. Pick carefully.
There's no reason you can't go to AA and do the Sinclair Method. AA is full of Atheists the god bit is misleading.
I'm not sure why they are putting down AA when AA is not against the Sinclair Method. AA has found their way works for some people. It's also cheap councling. Not everyone can afford well paid doctors.
If your drinking is that bad you need a pill to stop it wouldn't hurt to talk to others about the problem as well. And AA is a meme/cult/religion that allows that except they don't go to war and fight others over oil and resources.
> Hmmmm that's not a lot when your talking problem drinking as an addiction.
Twenty drinks at a time is not a lot? Don't most people draw the line way before that? In the Netherlands drinking more than three drinks a day is considered problematic drinking (for men); I wager that this won't differ that much around the globe.
People with alcoholism can drink a lot more than that.
A UK unit of alcohol is 10 ml of pure alcohol. You'd consider inpatient residential rehab for someone drinking 30 units per day. There are roughly 40 units in a litre of spirits in the UK.
https://pathways.nice.org.uk/pathways/alcohol-use-disorders/...
I find it a strange case for a male person with an addiction problem (which is what we are talking, AA style intervention) thinking 'sometimes as many as' 20 drinks to be a statement of supprise.
Pretty sure that's not a good measuring stick for healthy behaviors.
Me, but that doesn't work? There's this study done by the Rand Group. The Rand Group is this think tank, and they--
The Psychiatist cut me off immediately, to tell me, she knows all about the Rand Corporation. She didn't like to be told anything. I like her, but she does have an anger problem.
She then catches herself. I'm not sure if she ever liked me. She than said, "I have never been to a meeting."
Silence.
I told her I could quit on my own. She than said, "Don't stop on your own. You could die. Even two weeks later, you could get the delirium tremors." (She was being helpful. And if your drinking a lot, don't try to stop one your own. In my case he just gave me a reason to continue.)
Psychiatrist, "What don't you like about the meetings. It's the religion thing?" Me, "No--that's fine. I just don't relate to the other drinkers. I'm not doing the stuff they claim they did when they are on stage, and they seem to love those crazy stories?"
Psychiatrist, "Well why are you drinking a bottle of wine a day?"
Me, "Because I need it. I'm not nearly medicated enough."
Psychiatrist, "Your drinking because your life is terrible."
Me, I'll just agree. There's just no use in arguing, and if the tables were turned, I'm not sure if I would up my patients dose of dubious drugs.(benzodiazepines--long half life.)
Moral of story. If your drinking a lot of hard alcohol, don't even think about stopping without medical oversight. Dying is real. Then again, if your poor, like me, and don't have a fancy insurance program you can Taper down.
Taper, and Taper.
We are all suppose to have reasons we drink. Mine was supposedly a bad childhood. I don't remember it as bad. But then again, a Therapist said abused children often recall happy childhoods. It really wasn't bad. I too tired to argue again. I started drinking after a bad panic attack, that turned into General Anxiety.
Just Taper.
If your drinking hard alcohol, switch to wine, or beer. If your honest with yourself, and your drinking because of a verified psychological problem; treat the alcohol as medication. Panic attract--two, or three drinks, and stop. Stop all social drinking. Only use ethanol when absolutely necessary. Try not to become addicted. Use exercise instead.
I've been appalled at the way we treat drug addiction. I remember when I was a normal person, and had my old brain back, I rememeber when Jerry Garcia went to some new age clinic, with no doctors, to stop his drug use, out in sudo hippie west Marin--Olema.
By day two, he dies of a heart attack over breakfast. His death really bothers me. I know the clinic was well meaning, but no one should go cold turkey.
That's all I have. Just Taper. If the meetings help--go, you have nothing to loose and they are free.
I stopped on my own.
The last definitive thing I told my Psychiatrist is, "There's no way I'm spending my last twenty grand on a clinic."
If I can stop, so can you. Believe me I was a mess.
(Now I got to figure out how to quit a twenty plus year addiction to benzodiazepines? Fun? My hope is I can find a reasonably priced GP who will write my scripts. I don't see the need to put my body through anymore withdrawals, at this point. By the way, you can Taper off bupenorpine too. Don't read all the horror stories online. Just get down to 1 mg for a few weeks, and then nothing. Good luck.)
And as a comedian once said while holding a mic dripping with sweat, "Why do I drink?"
"Because I have too!"
I believe he stopped, or cut way back. Why isn't cutting way back a treatment? They all think we have no self control is the answer. Some of you do have the self control.
Wow--I went on. Just Taper, and don't hang around enabling fr...
The article is a pretty good summary of the sad state of alcohol and drug dependency treatment in the U.S. The prescription is always abstinence, and almost universally any suggestion that moderate drinking might be possible for some is met with scorn and anxiety.
My objections to AA have little to do with their mention of God. I am christian, so obviously that is not a problem for me. I will say that AA theology is awful, basically implying that salvation comes from sobriety, but worse is that it actually indoctrinates many with ideas that hinder their ability to recover from addiction. Regardless of whether or not you believe the way I do, I hate to see people needlessly suffering from this illness (or perhaps, this group of related illnesses), yet the conclusion I came to after 25 years of involvement with them is that AA more often than not prolongs suffering.
I am not saying that naltrexone or any other drug is the magic bullet, but I am certain that it is well worth investigating alternatives to AA. If you or anyone you are close to needs help, please take the time to explore all the options. There is so much snake oil in this area that it can be difficult to know which way to turn. It is worth the time and effort it takes to find the right treatment, and if it is successful, it is probably even worth the inflated cost of said treatment.
My understanding is abstinence programs are for those that have tried to moderate and cannot.
To quote AA:
Ch. 3 More About Alcoholism... For those who are unable to drink moderately the question is how to stop altogether.
Ch. 3 More About Alcoholism... We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself, step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.
It also seems strange to suggest naltrexone as an alternative to aa.
From living sober:
AA. members and many of their physicians have described situations in which depressed patients have been told by AAs to throw away the pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from schizophrenics, manic depressives, epileptics, and others requiring medication that well-meaning AA friends often discourage them from taking prescribed medication. Unfortunately, by following a layman's advice, the sufferers find that their conditions can return with all their previous intensity. On top of that, they feel guilty because they are convinced that "AA is against pills." It becomes clear that just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it's equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.
I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?
However, I strongly suggest, as do you, for those suffering to seek out help and consider all options.
I hope I did not suggest that abstinence is not the correct answer for some. It just isn't the answer for all, which is what is generally taught in AA. And the quotes from Chapter 3 are not serious, in the sense that if a newcomer to AA says something like, "Maybe I can drink moderately," the answer is pretty much always, "How did you end up here then!?" (Frequently, the answer is, "The judge told me I had to come in order to avoid jail.")
>It also seems strange to suggest naltrexone as an alternative to aa.
Living Sober was written before naltrexone was invented. I have known a number of folks who were prescribed Valium and similar drugs in the '60s and '70s and '80s who became addicted to both Valium and alcohol.
Further, the Living Sober quote suggests medication may be appropriate, but "alcoholism" (or whatever the DSM-5 calls it now) is often the main diagnosis, with any other diagnoses placed as subordinate to that main diagnosis. The implication is, "Stop drinking and the rest will go away," which is frankly bullshit. The Orange Papers (for all its many flaws) has a good section on this.
>I'm having a hard time finding where it's suggested in their literature that salvation comes from sobriety?
This is not from the literature, but rather from my observation over many years. Many times I have heard it suggested that AA is "basically christian" or "based on christian principles" but the reality is that it is based on what is properly called "Buchmanism" (for Frank Buchman, the founder of the Oxford Group). There is a tinge of christianity to it, but it is based on works (staying sober) rather than on grace.
This is why many moral failings in AA are glossed over with, "Nobody's perfect! Just stay sober and you'll be OK!" That is an appropriate response to dealing with a medical issue -- for example, a heart patient may also be a greedy, corrupt thief. The moral failing does not generally have any bearing on the treatment of the cardiovascular issues. So why are alcoholics taking moral inventories and making amends and confessing their shortcomings to others?
In other words, is it a disease, or is it a moral condition? If it's a moral condition, then let's not call AA's solution "christian," because it is not. If it is a disease, then let's treat it like one rather than using the twelve steps.
> In other words, is it a disease, or is it a moral
> condition? If it's a moral condition, then let's not call
> AA's solution "christian," because it is not. If it is a
> disease, then let's treat it like one rather than using
> the twelve steps
I think that in AA alcoholism itself is considered a disease, with at least two components: an allergy of the body; and an obsession of the mind. The disease of alcoholism is considered to have far-reaching effects which are best dealt with by two things: staying sober and working the 12 steps and thereby having a spiritual experience.
I'd say it's analogous to someone who's had a heart attack. The immediate crisis needs to be addressed at an emergency room. Then there are lifestyle and diet changes that need to happen, too. The heart attack might have been the initial problem that precipitated the crisis, but the lifestyle issues are the real cause.
AA is a big organization, and there are certainly different interpretations, but I think it's fair to say that alcohol is certainly seen as the problem, but the underlying cause of the problem is seen to be the lack of a spiritual lifestyle. Hence the two-pronged approach. Very often Christianity is used because it's what's familiar. But I'd hardly call AA a Christian organization.
The message is the opposite. It's sobriety comes through salvation.
1 We admitted we were powerless over alcohol - that our lives had become unmanageable.
2 Came to believe that a Power greater than ourselves could restore us to sanity.
3 Made a decision to turn our will and our lives over to the care of God as we understood Him.
Also, I feel you're misunderstanding the "moderation" that the article speaks of. The AA literature you quote is about someone who is actively dependent in a bad way trying to moderate themselves. The "moderate drinking might be possible for some" line is about returning to a life of moderate drinking in the future.
I'm often reminded of the David Foster Wallace passage from Infinite Jest when I think about people who need to break 100% free from their addictions:
“--and then you're in serious trouble, very serious trouble, and you know it, finally, deadly serious trouble, because this Substance you thought was your one true friend, that you gave up all for, gladly, that for so long gave you relief from the pain of the Losses your love of that relief caused, your mother and lover and god and compadre, has finally removed its smily-face mask to reveal centerless eyes and a ravening maw, and canines down to here, it's the Face In The Floor, the grinning root-white face of your worst nightmares, and the face is your own face in the mirror, now, it's you, the Substance has devoured or replaced and become you, and the puke-, drool- and Substance-crusted T-shirt you've both worn for weeks now gets torn off and you stand there looking and in the root-white chest where your heart (given away to It) should be beating, in its exposed chest's center and centerless eyes is just a lightless hole, more teeth, and a beckoning taloned hand dangling something irresistible, and now you see you've been had, screwed royal, stripped and fucked and tossed to the side like some stuffed toy to lie for all time in the posture you land in. You see now that It's your enemy and your worst personal nightmare and the trouble It's gotten you into is undeniable and you still can't stop. Doing the Substance now is like attending Black Mass but you still can't stop, even though the Substance no longer gets you high. You are, as they say, Finished. You cannot get drunk and you cannot get sober; you cannot get high and you cannot get straight. You are behind bars; you are in a cage and can see only bars in every direction. You are in the kind of a hell of a mess that either ends lives or turns them around.”
In addition to AA and NA, I have also taken various medications for depression and mania, and have been through all sorts of talk therapy. I have not taken any of those medications for over a decade, I no longer go to meetings or therapy, and, among other things, I have found that I can drink in moderation. I drink very occasionally, maybe once every few months, at social occasions.
I cannot claim that anyone who becomes a christian would have the same experience. I do not know that. And I am aware of weaknesses in those areas that used to cause me so much trouble, but I can also say that they are not debilitating the way they were previously.
When I left AA and NA, I went around to all my old meetings and told my friends there why they would not see me any more. There were some very interesting conversations, to say the least. I wish them no ill will, but as I said above, I would not recommend those groups to someone in trouble. I wouldn't say not to go there, but I would not send them there as a first option.
I don't really have any pat advice to offer anyone struggling as I did, beyond, Don't give up. Yes, it's painful, but don't give up looking for solutions. (And as someone else said here, taper taper taper if you're trying to detox.)
Look at AA as addiction transference - you're transferring your addiction from Alcohol to AA - and for some, thats the best they can do, for others its the start of the journey to moderate consumption.
After stating how hard it is too verify statistics for positive results,the author damns the guess made 50 years ago when Bill Wilson first wrote the book, and most likely had a far better conversion record as they were then dealing with highly motivated quitters. It is almost humorous that this author is complaining about the success rate of this method, when a large number of the pool of candidates are forced into treatment by either the law or parental coercion. Now I would like to say mid- rant that I am biased. I stopped drinking 33 years ago, and while I would not admit to membership in this group in a public forum, I would suggest people who WANT to quit, to give it a try.
I would be one of the first to say that there are a lot of hokey parts to the traditions they follow, and I do not agree with a lot of the premises of the literature---- But that being said........It works! One interesting opinion about AA comes from Charlie Munger, Warren Buffets business partner. Charlie writes quite a bit about the psychology of business, and he gives his fairly well thought out opinion of why AA works so well. I wonder whether the AA bashing is just for controversy to better sell the article, or if perhaps the author is helping to market the new version of naltrexone the is being quite heavily promoted to judges recently.
From the article:
"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."
According to that, about the best you can say is that "it works when it works", which isn't saying much. I'm glad it worked for you, but the fact that for evey one of you there are 10 who go back to drinking doesn't do much to recommend the program as the legally mandated cure-all it currently is.
That said, I'm an atheist, my buddy is an atheist and here in the northeast the religious part is really watered down, from what I hear, compared to other parts of the country.
I go because hearing others stories and talking to others about the being an alcoholic is really helpful.
I haven't drank in 4 years and AA was a crucial part. But I've never done the steps ( I can't even call it a higher power, that's lipstick on a pig in my book ). It's the talking to others that's helpful. People would say things, especially in the beginning, that articulated things I'd felt but unable to put into words.
In addition to speaking with other alcoholics I use philosophy, Eastern thought and stoicism, and the occasional use of lsd and mushrooms to keep me off the sauce. I never say I'm "sober" because of the latter part, but that was never my goal. I just needed to quit drinking and I couldn't.
My biggest problem with AA is the religious side. Overall the program seems to help people face their issues and take responsibility for their actions, but the toolkit, in my mind, barely gets them above water. But it is better than drowning. I'd love to see the organization revamp to catch up to the 21st century. The big book is like reading an anthropology book from the 19th century. It's sad how some people cling to it.
One feature of AA that I think a number of people fail to remember, though, is that there are meetings everywhere at many different times. For those that haven't lost everything you should certainly seek alternatives. But there's a large population of people that are so messed up they've lost everything and quite literally wouldn't know how to find help in other places.
Addiction sucks and is one of the most heartbreaking things for me to see. But not everyone that uses is an addict, whether it's alcohol, marijuana, or even cocaine.
To anyone wrestling with it: good luck, get help and know there is another side to your life. The rest of it doesn't have to be spent feeling the way you do now.
I've never gone through any programs but have had family who have. On the religious stuff - my general interpretation has always been that it's less a confession of faith in a higher power, but more a surrender of control, or in some senses a selection of values above yourself that you adhere to. From a bird's eye view, it kind of sounds like you already are doing that, with philosophy/Eastern thought/stoicism.
I'm very open about my alcoholism. Primarily it's to help other addicts see past the shame almost all of us experience. Secondarily it is to help non-addicts understand the addicts in their lives.
TL;DR: The science around this is terrible so it's hard to know anything with much certainty, but it looks as though AA isn't much better or worse than other treatments. Whether it's more effective than no treatment at all is an open question.
One way or the other, perhaps the saddest form is the most used – a very short clinic stay coupled with benzodiazepines to help safely stop a prolonged bender. Nothing wrong with that per se, but it's not really enough... but it's a free world.
I underwent a pretty radical change getting sober, moved to a different part of the city into a semi-supervised sober house, and started going to AA meetings. What I found there was a diverse group of people, with even more diverse problems (drugs, alcohol, violence, relationships) that had 1) accepted the problem was of their own making and 2) collectively decided that only through their own actions could they make themselves whole again. My AA group is a little unconventional in that we are extremely accepting of different types of addictions, and operate in an inner city area much different than my suburban upbringing. For me, AA is about living a stoic life, accepting what you can control, and disregarding what you cannot control. Seeing these same problems, across race, class, gender and geography was a pretty transcendental moment for me.
AA is just one part of what I'm doing to stay healthy: the other component, which in a lot of ways I trust more, is cognitive behavioral therapy, and group therapy. I think eventually more 'evidence based' group therapy systems will take over, but you just can't beat AA's model: people helping people via donated time and services.
When a new person walks into 'AA' with just a 'desire to stop drinking' their entire experience comes from the individuals, qualified only through their anecdotal experience in sobriety, that they meet. As a data scientist ready to defend AA, it used to be hard for me to rectify the fact that 1) AA is not effective as a prescribed intervention and 2) I'm in AA, and it works. How can I recommend a treatment when I know doing nothing in some cases is often better? Well, I don't know, and for me, AA is about staying sober, statistics be darned, I have something that works.
Finally, getting sober, for me, was a long, difficult, and extremely uncomfortable experience. If you are reading this, questioning if 'AA' is right for you, I would strongly implore you to attend a few different meetings in your area. Raise your hand, introduce yourself, and see what comes forth. AA will not save you, you will save you.
I am sure AA won't work for everyone but it works for certain types of people. In my humble opinion it works exactly because it isn't based on hard science but on personal experience. Actually - "this is how it works" is something you hear often at meetings.
Now regarding the financial side. 40k$ for bare bone AA meetings is something very American.
In Poland AA is self-financing, meetings are open and free. If you can afford you can make a voluntary donation to your group cash-box which is used for coffee and tea. Like 2-3$. Local community or a church is providing place for meetings. Everyone is welcome (if he is not under influence). In . city the size of Warsaw there are meeting going every day and at different hours. So AA is affordable to anyone and at any time while even public healthcare therapy will involve some cost or long wait.
First, just "give yourself over to God" means nothing. Sobriety takes work. One falls into a bad pattern, and you need conscious effort to break that pattern. I found the SMART program, which uses Cognitive Behavioral Therapy. That worked for me and made sense for my brain.
Also, my religion (Eastern Orthodox Christianity) teaches that God will throw a life raft, but you gotta grab it, hold on, and swim to shore yourself. Again, the same work ethic, not just "turning yourself over".
I really find AA makes it difficult to people to get sober. I'm sure it does work for some, but I believe it may take longer for them.