4 ms·

I want to see data driven novel approaches to addiction management. The 12-step model has dismal success rates [0]. Virtually all of the novel programs and faci

• Scaevolus 8y ago
  Very few studies have proper control groups. https://slatestarcodex.com/2014/10/26/alcoholics-anonymous-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2014/10/26/alcoholics-anonymous-m... > In conclusion, as best I can tell – and it is not very well, because the studies that could really prove anything robustly haven’t been done – most alcoholics get better on their own. All treatments for alcoholism, including Alcoholics Anonymous, psychotherapy, and just a few minutes with a doctor explaining why she thinks you need to quit, increase this already-high chance of recovery a small but nonzero amount. Furthermore, they are equally effective after only a tiny dose: your first couple of meetings, your first therapy session.
  • turingcompeteme 8y ago
    > most alcoholics get better on their own. These statements and studies show how little the average person, even a doctor, understands about alcoholics. Anyone who's attended an AA meeting or worked with alcoholics can easily tell you what's so crazy about these types of studies: AA is full of people who, by definition, cannot quit on their own. Other than some court-ordered cases, every single person in AA has already tried and failed to quit on their own. It's a nonsense comparison. You are comparing a group of people who have never tried quitting before, with those who have already spent years failing to quit on their own. Of course the first group does better! The second group is filled with more serious conditions. If they were able to quit on their own they would have never tried AA.
• walrus01 8y ago
  > Any company working in the addiction space should keep accurate records of their success rate and push to improve that rate Collecting metrics on lack of relapse from alcoholics and drug addicts seems like a tough task, since once a person becomes an addict (as defined by the DSM-V), this is a population that is often either less than truthful about the severity of their addiction problem, measures their consumption falsely, or will self-report as being sober when they actually are not.
  • deleted 8y ago
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• logfromblammo 8y ago
  Let's not throw the baby out with the bathwater. New programs are not competing against the actual success rates of 12-step variants, but their highly propagandized perceived success rates. Judges and prosecutors aren't reading published, peer-reviewed science when deciding what to do with an addict that has committed a crime. They are listening to people who tell them "12-step programs just work, so send addicts to my 12-step program, instead of to prison!" And these people are claiming that, because the shipping and handling of convicted criminals is a big business, and they want to get at some of that money. The programs from the article seem to be targeting non-criminal addicts that simply want to stop using without also having to prove it to their probation/parole officer. By that approach, even if they have a 100% relapse rate, they still might be more effective in terms of cost per month saved by abstinence or reduction in use. If someone has a $X/month drug habit, and pays $Y one time from their own pocket on a program that gets them to kick it completely for N months, before relapsing to $Z/month, they still got to spend part of the money they saved from not burning up their whole paycheck, on something other than drugs or drug treatment, and they might still be able to repeat the program before backsliding all the way. That's a different market from the guy caught stealing televisions to pay for meth, who has no money or earning potential left, but the state might still be willing to pay any price less than what it would cost for full imprisonment, to anyone that can manage to keep that one guy from causing more trouble. While those people are burning up their brains and spare time on para-religious, pseudo-scientific procedures, they might also be holding down a regular job and not stealing stuff. That's a success, in that they are not actually wasting away in prison limbo or out actively tearing down society. That's the standard of success that the 12-step program has to meet. It isn't managing the addiction, but managing the addict. It's not part of the addiction market, but part of the criminal justice market. That's a somewhat cynical and skeptical view of the system, from someone who hasn't been in it. From the outside, the 12-step program more closely resembles a cult than a valid psychiatric therapy. If your addiction hasn't cost you your job, your savings, and your friends, that 12-step program is probably not for you. And the rehab center designed around capturing some of the not-going-to-prison money is not for you. The online seminar that tries to teach you to recognize how much is enough, and to stop somewhere before getting there, might be. It's very likely that it's just another package of woo-woo bullcrap that worked for one person, anecdotally, but it is still a valid tactic to try the cheaper options first, on a cost/perceived-utility basis.