7 ms·

I think articles like this are dangerous to us addicts cause it solidifies the "this is just a phase" mentality that many of us have. They sampled 42,000 people

I think articles like this are dangerous to us addicts cause it solidifies the "this is just a phase" mentality that many of us have. They sampled 42,000 people, but how many others had to die, have their lives ruined, or ever worst, hurt someone they loved or end up in prison because of their addiction? YES I'm sure some of us can quit on our own or can "grow out" of our addiction if we don't end up dead or in jail first. I'm sure there cancer patients out there who are cured and have never had a single treatment, but you can bet that most people with cancer get some sort of treatment and help. Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE. There is help available, so why not use it? AA, NA, HA ,CA, Wellbriety, going to therapy, medical professional, it's all there to help so use it. You doesn't HAVE to take 15 years to "grow out" of alcoholism if you can get the support you need to help you quit sooner. Tonight I'm speaking at a DETOX and I suggest that they go through the 60 day RIT program that it offers so they have a better chance of beating their addiction. Again, please don't wait to get help. You don't have to fight this battle alone.

avar 8y ago
You're 100% right that people shouldn't have an attitude of "this harmful part of my life will fix itself". Although I don't think just observing that you'll likely "grow out" of it makes the article dangerous. People also tend to grow out of violent behavior (how many hyper-violent 20 v.s. 80 year olds are there?). That doesn't mean it's not harmful behavior when you're younger, or that it doesn't need to be addressed at that point. But it's just as dangerous to propose that simply because you have issues in your life that some religiously-motivated program like AA is the way to go. We should provide people with help that's scientifically developed and proved to be effective, and AA and its various sister programs are neither of those. They're just "get the drunks to worship god instead" programs. In recent years they've gained the thin veneer of talking about a "higher power" instead of "god", without becoming any more scientific or empirically-supported as a result. If you have a problem with addiction start by talking to your physician, not a church group.
- pfisch 8y ago
  Are you saying that there are no statistics that back up AA as effective? I am pretty skeptical of a claim like that.
  - simple_phrases 8y ago
    Efficacy rates are low, but so is almost every other intervention available. It works for some people. It's also completely free, which you can't say about medical intervention. Around here, detox and rehab facilities have 6 month long waiting lists and cost tens of thousands of dollars.
    - pfisch 8y ago
      Are you saying rehab facilities also don't work compared to a control group? I am skeptical about that too. I'd be surprised if both rehab and AA don't have a statistically significant effect on addiction treatment.
      - simple_phrases 8y ago
        No. People tend to expect that rehab will cure addiction, and become disillusioned with the reality that addiction is a chronic illness. Relapse rates are high in chronic illnesses, like diabetes and hypertension, the latter having a relapse rate of 50%-75% according to the NIH. Addiction is no different, and its relapse rates are between 40%-60%, even with ongoing treatment. Efficacy rates will reflect this harsh (and often very expensive or deadly) truth.
  - cc-d 8y ago
    The success rate of AA is somewhere around 5-10%. Perfectly accurate stats are hard to acquire due to the nature of the disease of addiction, and the programs themselves intentionally do not track efficacy rate (after all, a program based on religious ideology instead of actual evidence has hilariously become the defacto prescription for drug addiction in the american legal system. Why ruin a good thing?). You would achieve a similar efficacy rate by giving addicts a sugar pill and telling them it was a miracle drug that cures addiction. Also instead of taking the time to write out multiple comments expressing your doubt as to the efficacy of AA, you could've found the information you needed in a single google search.
fitba1969 8y ago
The disease model of addiction ( a la AA) has been thoroughly discredited by science. Indeed believing in the disease model is a primary determinant of relapse. The incredible work of Stanton Peele in the US is the route that "addiction treatment" should move towards.
- xfitm3 8y ago
  Dr Gabor Mate has also done fantastic work on addiction. Stanton Peele seems to share some viewpoints with Dr Mate. "Dr. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery" https://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician) https://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician)
Mirioron 8y ago
>Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE. >if we don't end up in jail first The former statement does not work because of the latter. Any additional person that knows about it is a risk to your freedom.
- P_I_Staker 8y ago
  Can you elaborate on that if you see this? You're saying seeking treatment can increase the likelihood of jail? Not criticizing, I don't doubt it, but I'd be interested to know the ways that can happen. Your therapist / addiction specialist will snitch on you?
  - Mirioron 8y ago
    Yes, that's what I'm saying. I don't mean that a therapist will snitch on you, but there's always a chance. Maybe a cop doesn't like you and sniffs around for this stuff. Furthermore, there are a lot more people involved in therapy than just you and your therapist.
gnode 8y ago
You don't have to go it alone, and some people benefit from help, but I think it's harmful to say people must rely on others, or in any way invalidate people's autonomous ability to escape addiction or overcome any cognitive obstacle.
d--b 8y ago
I think that these articles are there to fight a common view that addicts are hopeless people that in no way can put their life back together unless they go through severe medical and psychological treatment. The problem of wanting to "cure" addiction by using drastic measures like cold turkey or rehab is that it may not be the best course of action. Perhaps it is better for many people to acknowledge that the addiction is in fact "just a phase", and that a proper way of dealing with it would be to accompany the addiction so that the person wouldn't be harmful to himself and others, until the person reaches the point where they "outgrow" it naturally.
- maceurt 8y ago
  I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use. Furthermore, many addicts have predisposed brains to addiction that makes them not able to moderate addictive behaivour. I agree that rehab is not always the best solution, because it does not teach the user to wilingly bot use drugs, just forces them not too.
  - warent 8y ago
    Not sure where you heard that but it's definitely not true for genuine opiate addiction which can actually kill you from the withdrawal. Addiction can be a serious medical condition that requires real medical attention, not just stronger willpower or something. https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512 https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512
  - cc-d 8y ago
    >I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use You can't just group all "hard" (what exactly does this mean anyway? Is diamorphine "hard" but morphine not? Codeine? Tramadol?) drugs under one umbrella. You ESPECIALLY need the appreciate the differences between, for example, benzodiazepine (are these "hard"?) withdrawals and crack withdrawals. An addict withdrawing from crack/coke mainly needs sleep and nourishment, "cold Turkey" is a realistic option. An addict who is physically dependent on benzodiazepines will have a grand mal seizure and die if you attempted to force them to "cold Turkey". Gabaergic withdrawal (alcohol/ benzodiazepines/barbiturates/GHB) is a death sentence, opioid withdrawal (diamorphine/morphine/ methadone) sincerely feels like a death sentence but is very rarely lethal (and then almost always a result of dehydration), stimulant withdrawal (meth/coke) is never lethal. I've oversimplified greatly, but I think you get the point. Also note how alcohol withdrawals are often lethal. Very few people classify alcohol as a "hard" drug comparable in seriousness to heroin, but from a physiological perspective alone, alcohol dependency is far more damaging to the user than heroin dependency. A dependent user could use opioids every day of their life and die at a normal age, completely healthy (the negative health effects from opioids are almost entirely a result of users being forced to turn to a black market). This cannot be said for alcohol. Before advocating for any policy in regards to a serious public health issue, please at minimum read up on the literature regarding physical drug dependency, the differences between the major classes of commonly abused drugs, and which (humane) approaches other countries have tried which have yielded positive results.
pliftkl 8y ago
I think you're broadly labeling "us addicts" here, which is sort of the point of the article. I outgrew my addiction (but I'm not suggesting that anyone who needs help just "wait it out!" - see below). The article is essentially asserting that of the people who clinically qualify as addicts earlier in their lives, about half of those people don't by the time they are in their 30's, and that the pursuit of treatment doesn't necessarily correlate to that outcome. That isn't to say that there are people who absolutely need to treat addiction as a disease, and that viewing the next drink as an existential threat isn't an important part to their recovery. When I was a teenager and in my 20's, my drinking and drug use was out of control, and I did enter treatment including 12 step programs. Those weren't particularly effective at keeping me sober in part because of the mantra that "hey, you have a disease, and you don't have control". That's sort of a self-fulfilling prophecy to a younger brain. What ultimately happened to me was that the life I wanted wasn't compatible with drug and alcohol abuse, and I moved on in my mid-20's. I do occasionally drink now (in my 40's), but there's no fathomable way that I could see myself going back to what I did when I was young, and no clinician would diagnose me as an addict or alcoholic today. So yes, the article is dangerous if you are part of the subset to which it doesn't apply. The question is whether we should be treating all addicts in the same way. One answer might be "use the disease model on all addicts because it may apply". Another might be to try to treat this as a leaning disorder. Right now, we don't know the answer, so I agree with much of your practical advice: if you need help, it's out there, in the form of free communities of 12 step programs, as well as medical treatment programs.
coleifer 8y ago
I think about that often-quoted statistic about Vietnam veterans, most of whom used heroin while deployed, yet only about 5% came back and were full-on junkies. Stuff like 12-step is for that 5%...the folks who have already been to the doctor, the priest, the psychologist, and still can't get clean. Personally, I had to try everything else and completely run out of options before I was willing to try 12-step, which has worked. I also take meetings into detox, it's been very helpful for me and hopefully others. And of course, I don't believe there's any one way to get clean. I have my own experience, though, and that's what I can share.
xfitm3 8y ago
Except that there is a huge social stigma around being an addict. There is a incentive to hide it.
- thrownaway954 8y ago
  while true... same can be said about anything against the normal... it will take time, but society will come around. this is already happening but slowly.
- thrownaway954 8y ago
  oh and if you don't believe me... https://twitter.com/AndrewStellman/status/1077227963177934848 https://twitter.com/AndrewStellman/status/107722796317793484... Never had someone tweeted one my comments before :)

avar 8y ago

You're 100% right that people shouldn't have an attitude of "this harmful part of my life will fix itself". Although I don't think just observing that you'll likely "grow out" of it makes the article dangerous. People also tend to grow out of violent behavior (how many hyper-violent 20 v.s. 80 year olds are there?). That doesn't mean it's not harmful behavior when you're younger, or that it doesn't need to be addressed at that point. But it's just as dangerous to propose that simply because you have issues in your life that some religiously-motivated program like AA is the way to go. We should provide people with help that's scientifically developed and proved to be effective, and AA and its various sister programs are neither of those. They're just "get the drunks to worship god instead" programs. In recent years they've gained the thin veneer of talking about a "higher power" instead of "god", without becoming any more scientific or empirically-supported as a result. If you have a problem with addiction start by talking to your physician, not a church group.

pfisch 8y ago
Are you saying that there are no statistics that back up AA as effective? I am pretty skeptical of a claim like that.
- simple_phrases 8y ago
  Efficacy rates are low, but so is almost every other intervention available. It works for some people. It's also completely free, which you can't say about medical intervention. Around here, detox and rehab facilities have 6 month long waiting lists and cost tens of thousands of dollars.
  - pfisch 8y ago
    Are you saying rehab facilities also don't work compared to a control group? I am skeptical about that too. I'd be surprised if both rehab and AA don't have a statistically significant effect on addiction treatment.
    - simple_phrases 8y ago
      No. People tend to expect that rehab will cure addiction, and become disillusioned with the reality that addiction is a chronic illness. Relapse rates are high in chronic illnesses, like diabetes and hypertension, the latter having a relapse rate of 50%-75% according to the NIH. Addiction is no different, and its relapse rates are between 40%-60%, even with ongoing treatment. Efficacy rates will reflect this harsh (and often very expensive or deadly) truth.
- cc-d 8y ago
  The success rate of AA is somewhere around 5-10%. Perfectly accurate stats are hard to acquire due to the nature of the disease of addiction, and the programs themselves intentionally do not track efficacy rate (after all, a program based on religious ideology instead of actual evidence has hilariously become the defacto prescription for drug addiction in the american legal system. Why ruin a good thing?). You would achieve a similar efficacy rate by giving addicts a sugar pill and telling them it was a miracle drug that cures addiction. Also instead of taking the time to write out multiple comments expressing your doubt as to the efficacy of AA, you could've found the information you needed in a single google search.

fitba1969 8y ago

The disease model of addiction ( a la AA) has been thoroughly discredited by science. Indeed believing in the disease model is a primary determinant of relapse. The incredible work of Stanton Peele in the US is the route that "addiction treatment" should move towards.

xfitm3 8y ago
Dr Gabor Mate has also done fantastic work on addiction. Stanton Peele seems to share some viewpoints with Dr Mate. "Dr. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery" https://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician) https://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician)

Mirioron 8y ago

>Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE. >if we don't end up in jail first The former statement does not work because of the latter. Any additional person that knows about it is a risk to your freedom.

P_I_Staker 8y ago
Can you elaborate on that if you see this? You're saying seeking treatment can increase the likelihood of jail? Not criticizing, I don't doubt it, but I'd be interested to know the ways that can happen. Your therapist / addiction specialist will snitch on you?
- Mirioron 8y ago
  Yes, that's what I'm saying. I don't mean that a therapist will snitch on you, but there's always a chance. Maybe a cop doesn't like you and sniffs around for this stuff. Furthermore, there are a lot more people involved in therapy than just you and your therapist.

gnode 8y ago

You don't have to go it alone, and some people benefit from help, but I think it's harmful to say people must rely on others, or in any way invalidate people's autonomous ability to escape addiction or overcome any cognitive obstacle.

d--b 8y ago

I think that these articles are there to fight a common view that addicts are hopeless people that in no way can put their life back together unless they go through severe medical and psychological treatment. The problem of wanting to "cure" addiction by using drastic measures like cold turkey or rehab is that it may not be the best course of action. Perhaps it is better for many people to acknowledge that the addiction is in fact "just a phase", and that a proper way of dealing with it would be to accompany the addiction so that the person wouldn't be harmful to himself and others, until the person reaches the point where they "outgrow" it naturally.

maceurt 8y ago
I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use. Furthermore, many addicts have predisposed brains to addiction that makes them not able to moderate addictive behaivour. I agree that rehab is not always the best solution, because it does not teach the user to wilingly bot use drugs, just forces them not too.
- warent 8y ago
  Not sure where you heard that but it's definitely not true for genuine opiate addiction which can actually kill you from the withdrawal. Addiction can be a serious medical condition that requires real medical attention, not just stronger willpower or something. https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512 https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512
- cc-d 8y ago
  >I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use You can't just group all "hard" (what exactly does this mean anyway? Is diamorphine "hard" but morphine not? Codeine? Tramadol?) drugs under one umbrella. You ESPECIALLY need the appreciate the differences between, for example, benzodiazepine (are these "hard"?) withdrawals and crack withdrawals. An addict withdrawing from crack/coke mainly needs sleep and nourishment, "cold Turkey" is a realistic option. An addict who is physically dependent on benzodiazepines will have a grand mal seizure and die if you attempted to force them to "cold Turkey". Gabaergic withdrawal (alcohol/ benzodiazepines/barbiturates/GHB) is a death sentence, opioid withdrawal (diamorphine/morphine/ methadone) sincerely feels like a death sentence but is very rarely lethal (and then almost always a result of dehydration), stimulant withdrawal (meth/coke) is never lethal. I've oversimplified greatly, but I think you get the point. Also note how alcohol withdrawals are often lethal. Very few people classify alcohol as a "hard" drug comparable in seriousness to heroin, but from a physiological perspective alone, alcohol dependency is far more damaging to the user than heroin dependency. A dependent user could use opioids every day of their life and die at a normal age, completely healthy (the negative health effects from opioids are almost entirely a result of users being forced to turn to a black market). This cannot be said for alcohol. Before advocating for any policy in regards to a serious public health issue, please at minimum read up on the literature regarding physical drug dependency, the differences between the major classes of commonly abused drugs, and which (humane) approaches other countries have tried which have yielded positive results.

pliftkl 8y ago

I think you're broadly labeling "us addicts" here, which is sort of the point of the article. I outgrew my addiction (but I'm not suggesting that anyone who needs help just "wait it out!" - see below). The article is essentially asserting that of the people who clinically qualify as addicts earlier in their lives, about half of those people don't by the time they are in their 30's, and that the pursuit of treatment doesn't necessarily correlate to that outcome. That isn't to say that there are people who absolutely need to treat addiction as a disease, and that viewing the next drink as an existential threat isn't an important part to their recovery. When I was a teenager and in my 20's, my drinking and drug use was out of control, and I did enter treatment including 12 step programs. Those weren't particularly effective at keeping me sober in part because of the mantra that "hey, you have a disease, and you don't have control". That's sort of a self-fulfilling prophecy to a younger brain. What ultimately happened to me was that the life I wanted wasn't compatible with drug and alcohol abuse, and I moved on in my mid-20's. I do occasionally drink now (in my 40's), but there's no fathomable way that I could see myself going back to what I did when I was young, and no clinician would diagnose me as an addict or alcoholic today. So yes, the article is dangerous if you are part of the subset to which it doesn't apply. The question is whether we should be treating all addicts in the same way. One answer might be "use the disease model on all addicts because it may apply". Another might be to try to treat this as a leaning disorder. Right now, we don't know the answer, so I agree with much of your practical advice: if you need help, it's out there, in the form of free communities of 12 step programs, as well as medical treatment programs.

coleifer 8y ago

I think about that often-quoted statistic about Vietnam veterans, most of whom used heroin while deployed, yet only about 5% came back and were full-on junkies. Stuff like 12-step is for that 5%...the folks who have already been to the doctor, the priest, the psychologist, and still can't get clean. Personally, I had to try everything else and completely run out of options before I was willing to try 12-step, which has worked. I also take meetings into detox, it's been very helpful for me and hopefully others. And of course, I don't believe there's any one way to get clean. I have my own experience, though, and that's what I can share.

xfitm3 8y ago

Except that there is a huge social stigma around being an addict. There is a incentive to hide it.

thrownaway954 8y ago
while true... same can be said about anything against the normal... it will take time, but society will come around. this is already happening but slowly.
thrownaway954 8y ago
oh and if you don't believe me... https://twitter.com/AndrewStellman/status/1077227963177934848 https://twitter.com/AndrewStellman/status/107722796317793484... Never had someone tweeted one my comments before :)