"The Irrationality of Alcoholics Anonymous" -Article- March 18, 2015

[Spiritfree]

It is my opinion that this article hits on a lot of great points regarding alcoholism and treatments. Obviously, AA is not one of them. The good part about the article, in my opinion, is that they never really come out and denounce AA other than the fact that the success rate is only 5% to 8%.

What is your opinion?

This article focuses more on evidence based medical solutions. Finally.

http://www.theatlantic.com/features/archive/2015/03/the-irrationality-of-alcoholics-anonymous/386255/

"The Irrationality of Alcoholics Anonymous"

Excerpt:

AA: Its faith-based 12-step program dominates treatment in the United States. But researchers have debunked central tenets of AA doctrine and found dozens of other treatments more effective.

"....he debate over the efficacy of 12-step programs has been quietly bubbling for decades among addiction specialists. But it has taken on new urgency with the passage of the Affordable Care Act, which requires all insurers and state Medicaid programs to pay for alcohol- and substance-abuse treatment, extending coverage to 32 million Americans who did not previously have it and providing a higher level of coverage for an additional 30 million.

Nowhere in the field of medicine is treatment less grounded in modern science. A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University compared the current state of addiction medicine to general medicine in the early 1900s, when quacks worked alongside graduates of leading medical schools. The American Medical Association estimates that out of nearly 1 million doctors in the United States, only 582 identify themselves as addiction specialists."

[little beagle]

Honesty Spirit in my opinion addiction is viewed so much as a moral issue rather than a medical issue that the vast majority, inclucing many addicts, think faith is the cure rather than medical treatment.
And it really chaps my hide.

[MeJustMe]

AA has become the only method for detox programmes that I know of in Australia. This is a great problem. It feels prehistoric. We are talking about a method to help alcohol-addicted people that began more that 65 years ago.

[neophyte]

AA has become the only method for detox programmes that I know of in Australia. This is a great problem. It feels prehistoric. We are talking about a method to help alcohol-addicted people that began more that 65 years ago.

I too was extremly frustrated with the help i received in Australia. I had to take matters in to my own hands.

Things like AA and their cult like behavior just set back progress on addiction. Alcoholism is not a spiritual problem. Firstly a spirit and spiritualism are wishy washy words that don't mean anything in the context of a medical problem for which alcoholism is. One can argue with conviction based on scientific data that mental health problems lead to alcoholism. But once you are an alcoholic, its not enough to cure your original mental health problems to alleviate cravings for alcohol. Furthermore alcoholism causes its own set of mental health problems. So its gets to be a bit of chicken and egg when looking at why someone drinks and what can be done to cure them. So at best I would only refer to spiritualism as mental health.

[YouKayBee]

Most people don't know any different, it's the treatment they are told is successful and which is accepted by society.

Selincro is a reformulation of Naltrexone for use in The Sinclair Method which can break the addiction link for some people. This has recently become licenced for use in the UK and I was really hopeful that it would take off and help a lot of people.

But from the snippets I have heard Drs are not educated, TSM is misunderstood and Selincro is not being prescribed anywhere nearly as widely as it could, or should be to be of benefit (besides the fact it seems to come along with stronger side effects).

I don't however bash the spiritual side, or the 12-step approach, I simple know it is no longer for me. It did however provide me with the will and tools to help me along the way. For instance even to take 1 pill 1 hour before you drink, every time you drink and put a spoiler on your own party, I believe there has to be some spirit and belief there as there has to be for any method of getting sober.

[Spiritfree]

Honesty Spirit in my opinion addiction is viewed so much as a moral issue rather than a medical issue that the vast majority, inclucing many addicts, think faith is the cure rather than medical treatment.
And it really chaps my hide.

LB -you make the point for exactly why I was so glad to come across this article and here is why:

With 12 step programs, especially with AA, you only have a 5% to 8% chance of staying sober for x amount of time -so they say. Thus, and lets just call it 90% for the sake of it, - 90% of the folks that don't make the sobriety mark in AA are left to their own. How much more demoralizing could this be to an alcoholic or addict that already feels as low as one can feel? At the point that an alcoholic leaves AA and is still drinking: there is no way that a person could feel more lonely than this. To no longer belong to the only recognized organization that rewards you for not drinking -with chips, hugs, and discussions?

LB, I spent 6 years in AA listening, learning, and then feeling like a total life failure. I do credit AA for helping save my life when I first joined. I knew of NO, NO- other solution. I did not even know that there were others "like" me when I first went in. I felt safe, for the first time in forever, after my first time in AA. I was and will always remain grateful for my initial term in AA. I was on firewater death row and they were my only source for help. I will also remember -for ever, the part in the book that says; "and then there are those will not and can not........". I knew I was screwed when from the time that I first heard this.

Here we are, 17 years past my first AA meeting (11 years since my last) and we find that are many other potential solutions for AUD (alcoholism) other than AA. (In fact, AA may be doing more harm than good these days). There are REAL medications that help the addict. There are science based solutions to help the alcoholic these days.

AA will become (sooner rather than later) a casualty of modern medicine and science once the majority realize and understand that there are other 'real' solutions to drink/addiction problems -including medicine and other routes of human support. Until then, we will remain on our own, trying to help ourselves and our fellow.

Bill Wilson knew that there was something 'else' out there to really becoming sober and happy -and that something was not in 'meeting' rooms or books.

[Stevo]

As cult like as AA is and as low as its success rate is,it sadly has been the only thing that was on offer for many years.I am not in any way trying to defend AA but honestly I wouldn't have come as far as I have without it.AA definitely helped for me to break the habit by making going to meetings my priority rather than drinking.Aspects like this speak for themselves I think.
Most people on here have read my position on AA and other 12 step fellowships,which is I feel that it definitely isn't right for me and I am grateful that I read Dr.Amiesens book and found another way to continue in recovery(a way that is not governed by the outdated and cult like cultures of AA).
I do think though having spirituality in ones life can be a good thing,I have lived this way for a very long time and my beliefs(which are that I don't know anything about spiritual things therefore I consider everything to be in a way spiritual)were cultivated via life experience not AA.I think that there are a lot of people out there who live a spiritual type life and are willing to admit that this is what they believe without necessarily having mental health issues.That being said I also believe that just being part of this world is grounds for mental health problems whether they are acute or not.

Bill Wilson knew that there was something 'else' out there to really becoming sober and happy -and that something was not in 'meeting' rooms or books.
I agree with this and also think that Bill would be quite disturbed by common AA cultural beliefs these days.His program was all about helping alcoholics any way that they could be helped and I think that he would have welcomed a medical approach,infact I think he did but what was known today was not known back then.
I know people who are very comfortable with being part of AA as it not only provides hope for them but a social outlet and routine.I don't think that bashing the program(which I can easily do myself,yet try not to)is good for anyone really.
I agree with Spiritfree that it will eventually become a casualty of modern medicine and am not in any way trying to defend AA's cult like behaviours.I am just saying that for some people it is exactly what they are looking for and need.
I found it a little saddening to see spirituality being called a mental health issue and this thread heading in the direction of becoming an AA bashing thread.
Just my thoughts.
Cheers Stevo.

[Roadside]

I don't think neophyte meant spiritualism as a mental health [I]problem,[I], he simply only regarded "spiritualism as mental health". Maybe I am wrong, but I think neophyte was simply trying to separate the two: spiritualism and alcoholism. I have had plenty of lectures, "you are going against God" in whatever choices I have made, and it is my belief religion was instated to control the masses. However, whoever started to dissect the 'spiritual' realm in this post, I really think maybe the intention was referring to main stream rhetoric that has been offered as an 'explanation' for why one is in any particular circumstance.

Hope my thoughts are clear as mud.

Totally agree with Stevo, 'we are all mentally ill to a certain degree just by being a part of this world'.

Remember, 'normal' doesn't really exist. People adapt to their surroundings (work, social, familial) for survival. To do what is 'natural' for one may be outside societies' norm, that feeling is so utterly horrible. Maybe all the 'normal' people are mentally ill because they just go with the flow, with less resistance. Did you ever think of that?

My niece, 13, is going to a counselor because she's quiet, a loner and rude to authority (go figure, she's 13!!). I see this more damaging than anything because the family has threatened her with counseling if she didn't 'straighten up', therefore putting negative connotations on counseling. Her parents piss me off because she's probably DAMN NORMAL, society is NOT. So what if she has to go talk to someone? Don't make it a 'punishment' and expect her to change.

[neophyte]

I didn't mean to turn this in to an AA bashing thread, however when we start lumping in this like spirit and spirtuailsm when we are discussing a medical problem we do ourselves a disservice. Alcoholism AUD, whatever you want to call it. Is a complex problem. These words have no place in medical science.

We started problematic drinking because the effects of alcohol in the brain made us feel good. Alcohol effects receptors in the brian dopamine, gaba, opiods, ndma, seretonin and probably more. This quote sums it up well

Substances such as cocaine and LSD work like pharmacological scalpels, altering the functioning of only one or a handful of brain circuits. Alcohol is more like a pharmacological hand grenade. It affects practically everything around it

from - http://lifehacker.com/5684996/what-a...brain-and-body another great article to read.

I think people need to focus a lot more on what alcohol does in the brain once we are addicted, we can quickly see the short comings of talk only therapy at addressing the issue. AA included.

[Spiritfree]

We started problematic drinking because the effects of alcohol in the brain made us feel good. Alcohol effects receptors in the brian dopamine, gaba, opiods, ndma, seretonin and probably more. This quote sums it up well

from - http://lifehacker.com/5684996/what-a...brain-and-body another great article to read.

I think people need to focus a lot more on what alcohol does in the brain once we are addicted, we can quickly see the short comings of talk only therapy at addressing the issue. AA included.

Hi NEO -this is one of the best articles that I have ever read regarding the actual (real) effects of alcohol. I hope others get a chance to read. Thank you.

[Spiritfree]

As cult like as AA is and as low as its success rate is,it sadly has been the only thing that was on offer for many years.I am not in any way trying to defend AA but honestly I wouldn't have come as far as I have without it.AA definitely helped for me to break the habit by making going to meetings my priority rather than drinking.Aspects like this speak for themselves I think.
Most people on here have read my position on AA and other 12 step fellowships,which is I feel that it definitely isn't right for me and I am grateful that I read Dr.Amiesens book and found another way to continue in recovery(a way that is not governed by the outdated and cult like cultures of AA).
I do think though having spirituality in ones life can be a good thing,I have lived this way for a very long time and my beliefs(which are that I don't know anything about spiritual things therefore I consider everything to be in a way spiritual)were cultivated via life experience not AA.I think that there are a lot of people out there who live a spiritual type life and are willing to admit that this is what they believe without necessarily having mental health issues.That being said I also believe that just being part of this world is grounds for mental health problems whether they are acute or not.

Bill Wilson knew that there was something 'else' out there to really becoming sober and happy -and that something was not in 'meeting' rooms or books.
I agree with this and also think that Bill would be quite disturbed by common AA cultural beliefs these days.His program was all about helping alcoholics any way that they could be helped and I think that he would have welcomed a medical approach,infact I think he did but what was known today was not known back then.
I know people who are very comfortable with being part of AA as it not only provides hope for them but a social outlet and routine.I don't think that bashing the program(which I can easily do myself,yet try not to)is good for anyone really.
I agree with Spiritfree that it will eventually become a casualty of modern medicine and am not in any way trying to defend AA's cult like behaviours.I am just saying that for some people it is exactly what they are looking for and need.
I found it a little saddening to see spirituality being called a mental health issue and this thread heading in the direction of becoming an AA bashing thread.
Just my thoughts.
Cheers Stevo.

Hi Stevo -thank you for posting this post -it is extremely helpful.

I, for one, will never be one to 'bash' AA. As I stated earlier, AA very likely saved me from an alcoholic death -years ago. And AA certainly help me keep myself accountable -to myself, for quite some time. Having drank myself into near seclusion and loneliness, I found a group of friends for the first time in years. As the year/years progressed, I found myself still needing to change the way that I thought and/or felt and alcohol was my only know solution. Medications for alcoholism, for the most part, were not brought up, and when they were, the medications were quickly bashed by many of the members. Eventually, I did feel like one of AA flunkies and had to move on.

In this day and age, I wholeheartedly believe that Bill Wilson would have supported medications for alcoholism and would have made them a part of the AA program. Perhaps another revision to BB is now needed more than ever?

[Spiritfree]

I don't think neophyte meant spiritualism as a mental health [I]problem,[I], he simply only regarded "spiritualism as mental health". Maybe I am wrong, but I think neophyte was simply trying to separate the two: spiritualism and alcoholism. I have had plenty of lectures, "you are going against God" in whatever choices I have made, and it is my belief religion was instated to control the masses. However, whoever started to dissect the 'spiritual' realm in this post, I really think maybe the intention was referring to main stream rhetoric that has been offered as an 'explanation' for why one is in any particular circumstance.

Hope my thoughts are clear as mud.

Totally agree with Stevo, 'we are all mentally ill to a certain degree just by being a part of this world'.

Remember, 'normal' doesn't really exist. People adapt to their surroundings (work, social, familial) for survival. To do what is 'natural' for one may be outside societies' norm, that feeling is so utterly horrible. Maybe all the 'normal' people are mentally ill because they just go with the flow, with less resistance. Did you ever think of that?

My niece, 13, is going to a counselor because she's quiet, a loner and rude to authority (go figure, she's 13!!). I see this more damaging than anything because the family has threatened her with counseling if she didn't 'straighten up', therefore putting negative connotations on counseling. Her parents piss me off because she's probably DAMN NORMAL, society is NOT. So what if she has to go talk to someone? Don't make it a 'punishment' and expect her to change.

Roadside -Thank you for the post. Wow, I really do like these thought provoking thoughts posts.

I personally make no connection between spirituality and religion -although the two my coincide every now and then. Too often, in my opinion, religions have condemned some of the greater parts of life -especially sex/sexuality. It is still difficult for me to understand how certain organized religions can condemn the natural human being's needs and desires -as if some creator made a mistake and now his creation must pay a price. Truly, 90% of mainstay religions are based on control.

It is my opinion that religions (not spiritualism) has killed more people than alcohol, sex, and wars combined -as a result of the need to control. If someone does have a mental brain dysfunction order, religious threats and talk therapy are NOT going to help (and will probably only end up hurting)

Roadside, I have no idea really what is considered 'normal' as far as human beings go. In light of the definitions that I have that describe what constitutes normal, it is my belief that if the human race ever does become normal, then it will it will cease to exist.

[Cassander]

Hello Friends (if I still have any left in this somewhat crazy place)!

No offense intended! The 'Medication' board at mwo is a little bit crazy, isn't it?

In all seriousness, I came to the board this morning, for the first time in a long time, to post the Atlantic Monthly article only to see that my friend Spirit has, of course, beaten me to it. It is a great article (I wish I had written it myself, because it reflects everything I have been thinking and have learned, here and elsewhere over the past five years). I commend it to all my friends!

I, too, won't bash AA here (although I certainly have in the past). There is nothing wrong with mutual support and encouragement, and talking things out and facing up to problems. Whether the problem is mood, job, marital or substance...or what have you.

The point is: craving is a disease and there are now medical tools to treat brain-related diseases like craving that weren't available when Bill did his good work. And AA does everyone a disservice by not welcoming medical treatment. I agree with you, Spirit, a revision to the BB is in order.

And, its too bad the author didn't spend more time on baclofen, and in particular, the progress made by doctors in France to establish baclofen as a mainstream treatment. But, no worry, baclofen's acceptance still lies in the future. But now it is the not so distant future.

Perhaps the most encouraging part of the Atlantic article is the reference to the undoubted impact that the Affordable Care Act will have on addiction treatment. At this time of sky-rocketing health care costs, there is no way insurers, and perhaps more importantly, consumers will accept the high cost and low success rates of traditional, 12-step-based rehab. If there is a cheaper and more effective treatment available, insurers and consumers will demand it. or so I would hope.

In any and all events, cheers and best wishes to the stalwarts on this board. Better times are coming. I just know it.

Best,

Cassander

(http://en.wikipedia.org/wiki/Cassandra)

[Spiritfree]

Hi Cass -great to see you back making a post. Thank you.

As far as the 'Medication board', I truly do hope some more of the regulars start back posting -regardless (except we don't want any more posts offering to sell us sunglasses).

Here are a few of my thoughts regarding your post:

(1) AA -Support and Encouragement: (Great point and a perfect way to say it)
"I, too, won't bash AA here (although I certainly have in the past). There is nothing wrong with mutual support and encouragement, and talking things out and facing up to problems. Whether the problem is mood, job, marital or substance...or what have you."

Once I found Baclofen and discovered it worked better than anything else that had ever tried -for negating cravings and anxiety, I desperately wanted to share the good news with some of my former 12 stepping friends. I stopped trying to share the news with members after my first conversation with a senior member in the program. Older-longer term program members are just not going to accept medications (most are not) as a benefit. Many will quickly tell you that they are sober and did not take any medications. This is sad but is generally true. I wish that those just starting in AA could at least hear words regarding Baclofen and other medications.

(2) Baclofen and the article:
"And, its too bad the author didn't spend more time on baclofen, and in particular, the progress made by doctors in France to establish baclofen as a mainstream treatment. But, no worry, baclofen's acceptance still lies in the future. But now it is the not so distant future."

I too am disappointed that they did not mention Baclofen. I also believe that Baclofen's stage entrance is now only a short time away. Even in my correspondence with Dr. Koob and the National Instituted of Health stated to "keep an eye open" regarding Baclofen and France.

Cass, you also make a good point about the insurance situation. I had not really thought about that side of coin. Perhaps the insurance situation in the USA will help promote medications for AUD -especially Baclofen (or the improved models of Baclofen). The sooner the word can get out there really is a 'real' science based solution to alcohol disorder, the better. We all know that too be people are continuing to suffer and some die as a result of alcohol.

Again, Cass, thank you for your post.

[Roadside]

from - http://lifehacker.com/5684996/what-a...brain-and-body another great article to read.
.

Good article; I can't wait to check out the book.