5 ms·

If you're concerned about your drinking habits, you should probably not check out aa.org. There is little solid evidence that AA is a particularly effective tre

by Zak 12y ago

If you're concerned about your drinking habits, you should probably not check out aa.org. There is little solid evidence that AA is a particularly effective treatment for alcoholism. Various types of therapy with real trained and certified therapists have good success rates backed by actual scientific evidence, as do certain prescription drugs. Combining them likely has an even better success rate. Talk to your doctor. http://slatestarcodex.com/2014/10/26/alcoholics-anonymous-much-more-than-you-wanted-to-know/ http://slatestarcodex.com/2014/10/26/alcoholics-anonymous-mu...

richardlitt 12y ago
Thanks. Noted, and updated.
bcook 12y ago
I never could really commit to AA, the organization, but... I met some great people there. I ended up in AA, thinking my life was over, but when I heard what other people had been through (awful awful things), I was very humbled. The people and their shared experiences helped me gain perspective. Although I mostly solved the drinking problem myself, outside of AA, AA still helped me. I compare it to attending Church. I am not a fan of organized religion, nor am I religious, but I have met some great people there.
Devthrowaway80 12y ago
Definitely talk to your doctor. It's not true to claim that there is no solid evidence suggesting that AA is not effective. There is a lot of shitty evidence both supporting and discrediting 12 step programs, and the author of the linked article has found plenty of shitty science to wave his hand at. Look through the dates of the studies referenced - 1967, 1981, 1985, 1996. The most recent paper there is almost 20 years old, with the exception of Project MATCH (2006), which the author appears to have not read very closely. The Project MATCH paper which the author above dismisses as "showing everyone does the same with or without AA" actually shows that "12-step treatment had more than double the number of patients who were continuously abstinent at one year after treatment and about one third more at three years after treatment." That does not strike me as being "the same". The latter interpretation of the results comes from Harvard Medical School professors, the former from some random anonymous dick on the internet. An article on the topic from the aforementioned Harvard Medical School professors (who are addressing a particularly well known "debunker" of AA, who also coincidentally has his own method he is trying to sell) can be read here - http://commonhealth.wbur.org/2014/04/defense-12-step-addiction http://commonhealth.wbur.org/2014/04/defense-12-step-addicti.... It references many recent, randomized, controlled studies that directly contradict the assertion that AA has no effect. My own personal experience is that AA, when stripped down, is very strongly reminiscent of CBT (which I have also been on the receiving end of), mixed in with a strong social support network. I also have seen that AA in practice varies wildly from place to place, so my own experience is likely not the same one that you'd have in the Bible Belt or elsewhere. If you're struggling, by all means check out a meeting AND talk to your doctor. If you hate AA, don't go anymore. I tried and failed repeatedly to get sober on my own and with medical treatment for about 8 years, from 26 to 34. Since I have started going to AA, I have been sober for the longest period of time since I was legal to drink (19). If I had read that smug, halfassed article you posted, I probably wouldn't have gone, and I probably would be either drunk or quite possibly dead, given my intake and behaviour. Addiction is no joke. If you don't know what you're talking about, keep your ignorance to yourself.
- Devthrowaway80 12y ago
  I realize the above post may come off as rather angry. I'm already anticipating a few "cult member identified!" replies. I'd like you to reflect on the fact that you are suggesting people avoid the primary form of treatment suggested by the National Institute of Health, the Substance Abuse and Mental Health Services Administration, the American Psychiatric Association, the Department of Veterans Affairs Health Care System, and many other large organizations. You are recommending against a successful mode of treatment for people who have a problem that is potentially life-threatening, that destroys both their lives and that of their families.
  - Zak 12y ago
    I considered that before I posted, which is why I mentioned other treatment options that appear to have better evidence for their efficacy. It seems to me that's the most ethical thing to do when it comes to a life-threatening condition.
    - Devthrowaway80 12y ago
      Fair enough. The evidence you present is outdated and incorrect.
  - tempestn 12y ago
    For what it's worth I thought the post was fantastic until the last paragraph, which was a valuable anecdote (and obviously a very personally significant one), but very confrontational. Understandably so, but the tone probably makes it less likely that a person on the fence would come around to your point of view.
    - Devthrowaway80 12y ago
      You're right, that last bit was a bit of uncalled-for ranting. I would edit it to remove it, but I think doing so would mess with some of the discussion that has gone on since my post.
  - 12y ago
asperous 12y ago
Your comment might not be precisely true. There is solid evidence that AA may help people with alcohol problems. Some people may not want to go to a doctor, but of course going to a qualified doctor is a good idea. Kelly J. F., Magill M., Stout R. L. How do people recover from alcohol dependence? a systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous. Addict Res Theory 2009; 17: 236–59. J.B. Kingree, Martie Thompson, Participation in alcoholics anonymous and post-treatment abstinence from alcohol and other drugs, Addictive Behaviors, Volume 36, Issue 8, August 2011, Pages 882-885, ISSN 0306-4603, http://dx.doi.org/10.1016/j.addbeh.2011.03.011 http://dx.doi.org/10.1016/j.addbeh.2011.03.011.
- facepalm 12y ago
  I read an article only yesterday which said the success rate of AA is probably "just" 8% or so. AA themselves claim the success rate is "75% for anyone who really tries", which, if you think about it, doesn't mean anything at all. The article was specifically about this issue that AA blames it on the participants if their method fails. Which is pretty absurd, again, if you think about it. It's like claiming I have a cure for cancer that works in 99% of all cases, but only in cases where it works. (Edit: this is the article, it was on HN after all http://www.theatlantic.com/features/archive/2015/03/the-irrationality-of-alcoholics-anonymous/386255/?single_page=true http://www.theatlantic.com/features/archive/2015/03/the-irra... )
macrael 12y ago
I recommend reading Infinite Jest.
- Robin_Message 12y ago
  I tried to like Infinite Jest, but I just couldn't get into it. What am I missing? (My original snarky thought: If you have the willpower to finish reading Infinite Jest, dealing with addiction will be no issue...)
mrmondo 12y ago
While I think your intent and support is admirable I have doubts about the effectiveness and morals of AA.
mellavora 12y ago
Entheogens are far and above the most successful treatment for alcoholism. Also depression.
MaybiusStrip 12y ago
I think you should rephrase that to "you shouldn't solely rely on aa" rather than excluding it entirely. Maybe this just struck a personal chord, because AA helped save me from life-threatening alcoholism, but this seems like a highly irresponsible suggestion (which is why the author of the article you link is very careful not to make it). If you are an alcoholic, you probably should check out AA in addition to checking in to a detox/rehab program where you will have a therapist and a psychiatrist. As a matter of fact, many "real trained and certified therapists" will suggest that you at least check out a few meetings. What's important is to know that if it doesn't work out, it doesn't mean you've failed. But it's really, really hard to stop drinking when you are an alcoholic, and it would be foolish to exclude any safe solution that could potentially help you recover from a fatal condition. When getting sober, there are worst things you could be doing with your time than socializing with other recovering alcoholics for an hour or two, even if you don't like the message. I should add, I am an atheist and it was never an issue in all my time in AA.
- mistercow 12y ago
  > because AA helped save me from life-threatening alcoholism Given that there's pretty good evidence at this point that AA doesn't work on average, either a) AA didn't actually help you (you would have done it on your own anyway) or b) AA did help you, but that is balanced by an equal amount of harm so that the average still comes out as "not effective". In either case the conclusion is unescapable that AA should not be relied on at all. At best, you're going to get nothing out of it and you're wasting psychological resources you can't spare. At worst, you're gambling that you're the kind of person it helps, rather than the kind of person it makes things worse for. I don't want to sound harsh here, but people who have both used AA and recovered from alcoholism seem to have a rationality blindspot around it. From an objective perspective, this is not all that different from a cancer survivor crediting their remission to the "energy crystals" their guru recommended. I'm super glad for you that your cancer cleared up, but I'm going to keep telling people that those crystals are bullshit.
  - pfortuny 12y ago
    You start Speaking on average and then conclude that it did not work FOR HIM. Does not compute, sorry.

by Zak 12y ago

richardlitt 12y ago

Thanks. Noted, and updated.

bcook 12y ago

I never could really commit to AA, the organization, but... I met some great people there. I ended up in AA, thinking my life was over, but when I heard what other people had been through (awful awful things), I was very humbled. The people and their shared experiences helped me gain perspective. Although I mostly solved the drinking problem myself, outside of AA, AA still helped me. I compare it to attending Church. I am not a fan of organized religion, nor am I religious, but I have met some great people there.

Devthrowaway80 12y ago

Definitely talk to your doctor. It's not true to claim that there is no solid evidence suggesting that AA is not effective. There is a lot of shitty evidence both supporting and discrediting 12 step programs, and the author of the linked article has found plenty of shitty science to wave his hand at. Look through the dates of the studies referenced - 1967, 1981, 1985, 1996. The most recent paper there is almost 20 years old, with the exception of Project MATCH (2006), which the author appears to have not read very closely. The Project MATCH paper which the author above dismisses as "showing everyone does the same with or without AA" actually shows that "12-step treatment had more than double the number of patients who were continuously abstinent at one year after treatment and about one third more at three years after treatment." That does not strike me as being "the same". The latter interpretation of the results comes from Harvard Medical School professors, the former from some random anonymous dick on the internet. An article on the topic from the aforementioned Harvard Medical School professors (who are addressing a particularly well known "debunker" of AA, who also coincidentally has his own method he is trying to sell) can be read here - http://commonhealth.wbur.org/2014/04/defense-12-step-addiction http://commonhealth.wbur.org/2014/04/defense-12-step-addicti.... It references many recent, randomized, controlled studies that directly contradict the assertion that AA has no effect. My own personal experience is that AA, when stripped down, is very strongly reminiscent of CBT (which I have also been on the receiving end of), mixed in with a strong social support network. I also have seen that AA in practice varies wildly from place to place, so my own experience is likely not the same one that you'd have in the Bible Belt or elsewhere. If you're struggling, by all means check out a meeting AND talk to your doctor. If you hate AA, don't go anymore. I tried and failed repeatedly to get sober on my own and with medical treatment for about 8 years, from 26 to 34. Since I have started going to AA, I have been sober for the longest period of time since I was legal to drink (19). If I had read that smug, halfassed article you posted, I probably wouldn't have gone, and I probably would be either drunk or quite possibly dead, given my intake and behaviour. Addiction is no joke. If you don't know what you're talking about, keep your ignorance to yourself.

Devthrowaway80 12y ago
I realize the above post may come off as rather angry. I'm already anticipating a few "cult member identified!" replies. I'd like you to reflect on the fact that you are suggesting people avoid the primary form of treatment suggested by the National Institute of Health, the Substance Abuse and Mental Health Services Administration, the American Psychiatric Association, the Department of Veterans Affairs Health Care System, and many other large organizations. You are recommending against a successful mode of treatment for people who have a problem that is potentially life-threatening, that destroys both their lives and that of their families.
- Zak 12y ago
  I considered that before I posted, which is why I mentioned other treatment options that appear to have better evidence for their efficacy. It seems to me that's the most ethical thing to do when it comes to a life-threatening condition.
  - Devthrowaway80 12y ago
    Fair enough. The evidence you present is outdated and incorrect.
- tempestn 12y ago
  For what it's worth I thought the post was fantastic until the last paragraph, which was a valuable anecdote (and obviously a very personally significant one), but very confrontational. Understandably so, but the tone probably makes it less likely that a person on the fence would come around to your point of view.
  - Devthrowaway80 12y ago
    You're right, that last bit was a bit of uncalled-for ranting. I would edit it to remove it, but I think doing so would mess with some of the discussion that has gone on since my post.
- 12y ago

asperous 12y ago

Your comment might not be precisely true. There is solid evidence that AA may help people with alcohol problems. Some people may not want to go to a doctor, but of course going to a qualified doctor is a good idea. Kelly J. F., Magill M., Stout R. L. How do people recover from alcohol dependence? a systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous. Addict Res Theory 2009; 17: 236–59. J.B. Kingree, Martie Thompson, Participation in alcoholics anonymous and post-treatment abstinence from alcohol and other drugs, Addictive Behaviors, Volume 36, Issue 8, August 2011, Pages 882-885, ISSN 0306-4603, http://dx.doi.org/10.1016/j.addbeh.2011.03.011 http://dx.doi.org/10.1016/j.addbeh.2011.03.011.

facepalm 12y ago
I read an article only yesterday which said the success rate of AA is probably "just" 8% or so. AA themselves claim the success rate is "75% for anyone who really tries", which, if you think about it, doesn't mean anything at all. The article was specifically about this issue that AA blames it on the participants if their method fails. Which is pretty absurd, again, if you think about it. It's like claiming I have a cure for cancer that works in 99% of all cases, but only in cases where it works. (Edit: this is the article, it was on HN after all http://www.theatlantic.com/features/archive/2015/03/the-irrationality-of-alcoholics-anonymous/386255/?single_page=true http://www.theatlantic.com/features/archive/2015/03/the-irra... )

macrael 12y ago

I recommend reading Infinite Jest.

Robin_Message 12y ago
I tried to like Infinite Jest, but I just couldn't get into it. What am I missing? (My original snarky thought: If you have the willpower to finish reading Infinite Jest, dealing with addiction will be no issue...)

mrmondo 12y ago

While I think your intent and support is admirable I have doubts about the effectiveness and morals of AA.

mellavora 12y ago

Entheogens are far and above the most successful treatment for alcoholism. Also depression.

MaybiusStrip 12y ago

I think you should rephrase that to "you shouldn't solely rely on aa" rather than excluding it entirely. Maybe this just struck a personal chord, because AA helped save me from life-threatening alcoholism, but this seems like a highly irresponsible suggestion (which is why the author of the article you link is very careful not to make it). If you are an alcoholic, you probably should check out AA in addition to checking in to a detox/rehab program where you will have a therapist and a psychiatrist. As a matter of fact, many "real trained and certified therapists" will suggest that you at least check out a few meetings. What's important is to know that if it doesn't work out, it doesn't mean you've failed. But it's really, really hard to stop drinking when you are an alcoholic, and it would be foolish to exclude any safe solution that could potentially help you recover from a fatal condition. When getting sober, there are worst things you could be doing with your time than socializing with other recovering alcoholics for an hour or two, even if you don't like the message. I should add, I am an atheist and it was never an issue in all my time in AA.

mistercow 12y ago
> because AA helped save me from life-threatening alcoholism Given that there's pretty good evidence at this point that AA doesn't work on average, either a) AA didn't actually help you (you would have done it on your own anyway) or b) AA did help you, but that is balanced by an equal amount of harm so that the average still comes out as "not effective". In either case the conclusion is unescapable that AA should not be relied on at all. At best, you're going to get nothing out of it and you're wasting psychological resources you can't spare. At worst, you're gambling that you're the kind of person it helps, rather than the kind of person it makes things worse for. I don't want to sound harsh here, but people who have both used AA and recovered from alcoholism seem to have a rationality blindspot around it. From an objective perspective, this is not all that different from a cancer survivor crediting their remission to the "energy crystals" their guru recommended. I'm super glad for you that your cancer cleared up, but I'm going to keep telling people that those crystals are bullshit.
- pfortuny 12y ago
  You start Speaking on average and then conclude that it did not work FOR HIM. Does not compute, sorry.