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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 b

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.
- fennecfoxen 12y ago
pseudonom- 12y ago
Looking at the studies linked by the article you've linked, their conclusions for high efficacy mostly seem to be of the form "AA increased the likelihood of abstinence". My understanding is that AA, more than other methods, places an emphasis on total abstinence. It seems that one could support alternative goals (like "reduced incidence of harmful alcohol use") for which AA might not be so well suited. Your thoughts?
- Devthrowaway80 12y ago
  Absolutely, there's room for harm reduction approaches as well. There's an approach called the Sinclair Method that uses counseling and a drug called Naltrexone with the goal of reducing episodes of heavy drinking, and I do know one person who has had success with that. As an aside, I certainly don't mean to suggest that AA is the be-all end-all, just that it's a tool that is often the target of abuse from those who don't necessarily know better. AA indeed does emphasize complete abstinence. Many people, myself included, reach a point where moderation ceases to be a viable path - such a person may moderate successfully for a short period of time, but their alcohol use typically escalates rapidly back to the level that got them into AA or beyond. Some people might be able to go from alcoholic drinking patterns back to safe alcohol use, but the only way I know of to find out if an individual falls into that class is to let them drink and see what happens. The risk/reward ratio there does not favour drinking - if it works out, you can have a few beers with friends (and not feel any of the effects that makes an alcoholic want to drink). If it doesn't work out, it could end in homelessness, cirrhosis, imprisonment and so on. The outcomes in the above risk/reward scenario is not hypothetical - I have met people with a lot of sobriety under their belt who returned to what they thought would be controlled drinking and who failed miserably. A good friend of mine reached 8 years sober and was suspended from his job for 18 months after falling off the wagon. 20 years sober, started drinking and got a divorce and wound up in a rehab facility for the indigent. 15+ (I forget exactly) years sober, lost his license to practice law and spent some time in prison. For myself, one of my returns to "controlled drinking" ended with me consuming 26 ounces of liquor in 90 minutes, picking a horrific argument with my wife, and going out to the bar by myself for at least 15 more standard drinks. As a fun side note, I punched that into a blood-alcohol calculator at one point and my BAC was around the LD50 mark. I have no idea how I was physically capable of walking, let alone ordering more. Alcoholics obsess, in the real sense of the word, over finding a way to return to moderate alcohol use (or heavy alcohol use without negative consequences). I think helping people moderate is a reasonable goal, but I'd think you would need to have an accurate picture of their drinking to determine if it's a safe course of action, and addicts tend to lie about their substance abuse - as far as my doctor was concerned, I only drank moderately a few times a week. She only found out that was not the case when I made an appointment specifically to seek help. I think this post is a bit self-contradictory in a way. I am all for harm reduction where it makes sense, but in my experience, when somebody reaches the point where they are clearly alcoholic, that door has already closed. I think the role of harm reduction for alcohol abuse might really be to stop people from getting to that point.
thedufer 12y ago
> The latter interpretation of the results comes from Harvard Medical School professors, the former from some random anonymous dick on the internet. To be fair, said anonymous dick isn't the only person interpreting the results that way. For example, the only two references on the Wikipedia article about MATCH (that aren't dead links) agree [0] [1]. I'm curious what the actual data looks like that so many seemingly-smart people can draw nearly opposite conclusions, but I'm having trouble finding it. [0] http://www.peele.net/lib/niaaa.html http://www.peele.net/lib/niaaa.html [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185549/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185549/

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.
fennecfoxen 12y ago

pseudonom- 12y ago

Looking at the studies linked by the article you've linked, their conclusions for high efficacy mostly seem to be of the form "AA increased the likelihood of abstinence". My understanding is that AA, more than other methods, places an emphasis on total abstinence. It seems that one could support alternative goals (like "reduced incidence of harmful alcohol use") for which AA might not be so well suited. Your thoughts?

Devthrowaway80 12y ago
Absolutely, there's room for harm reduction approaches as well. There's an approach called the Sinclair Method that uses counseling and a drug called Naltrexone with the goal of reducing episodes of heavy drinking, and I do know one person who has had success with that. As an aside, I certainly don't mean to suggest that AA is the be-all end-all, just that it's a tool that is often the target of abuse from those who don't necessarily know better. AA indeed does emphasize complete abstinence. Many people, myself included, reach a point where moderation ceases to be a viable path - such a person may moderate successfully for a short period of time, but their alcohol use typically escalates rapidly back to the level that got them into AA or beyond. Some people might be able to go from alcoholic drinking patterns back to safe alcohol use, but the only way I know of to find out if an individual falls into that class is to let them drink and see what happens. The risk/reward ratio there does not favour drinking - if it works out, you can have a few beers with friends (and not feel any of the effects that makes an alcoholic want to drink). If it doesn't work out, it could end in homelessness, cirrhosis, imprisonment and so on. The outcomes in the above risk/reward scenario is not hypothetical - I have met people with a lot of sobriety under their belt who returned to what they thought would be controlled drinking and who failed miserably. A good friend of mine reached 8 years sober and was suspended from his job for 18 months after falling off the wagon. 20 years sober, started drinking and got a divorce and wound up in a rehab facility for the indigent. 15+ (I forget exactly) years sober, lost his license to practice law and spent some time in prison. For myself, one of my returns to "controlled drinking" ended with me consuming 26 ounces of liquor in 90 minutes, picking a horrific argument with my wife, and going out to the bar by myself for at least 15 more standard drinks. As a fun side note, I punched that into a blood-alcohol calculator at one point and my BAC was around the LD50 mark. I have no idea how I was physically capable of walking, let alone ordering more. Alcoholics obsess, in the real sense of the word, over finding a way to return to moderate alcohol use (or heavy alcohol use without negative consequences). I think helping people moderate is a reasonable goal, but I'd think you would need to have an accurate picture of their drinking to determine if it's a safe course of action, and addicts tend to lie about their substance abuse - as far as my doctor was concerned, I only drank moderately a few times a week. She only found out that was not the case when I made an appointment specifically to seek help. I think this post is a bit self-contradictory in a way. I am all for harm reduction where it makes sense, but in my experience, when somebody reaches the point where they are clearly alcoholic, that door has already closed. I think the role of harm reduction for alcohol abuse might really be to stop people from getting to that point.

thedufer 12y ago

> The latter interpretation of the results comes from Harvard Medical School professors, the former from some random anonymous dick on the internet. To be fair, said anonymous dick isn't the only person interpreting the results that way. For example, the only two references on the Wikipedia article about MATCH (that aren't dead links) agree [0] [1]. I'm curious what the actual data looks like that so many seemingly-smart people can draw nearly opposite conclusions, but I'm having trouble finding it. [0] http://www.peele.net/lib/niaaa.html http://www.peele.net/lib/niaaa.html [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185549/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185549/