Proof that Alcoholics Anonymous works

[Ray Smith]

After 70+ years, shouldn't there be some sort of proof that AA works?

George Vaillant, Harvard professor, researcher, and member (at the time) of AA's Board of Trustees, attempted to do so, compiling 40 years of older studies and conducting an eight-year longitudinal study that followed 100 people who had gone through 12step treatment.

He found that all but 5 relapsed, then compared that to three studies that involved no treatment, and 4 other studies that involved treament. All had about a 5% success rate, but Vaillant's group had the highest mortality rate of any of the studies. Vaillant said of his findings, "Not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling."

There have been few randomized longitudinal controlled studies that studied the effectiveness of AA, but those that have been done, found AA lacking:

1) Dr. Jeffrey Brandsma found that A.A. indoctrination greatly increased the rate of binge drinking in alcoholics.
2) Dr. Keith Ditman found that A.A. involvement increased the rate of re-arrests for public drunkenness in a group of street drunks.
3) Dr. Diana Walsh found that A.A. just messed up a lot of alcoholics and made them require more expensive hospitalization later on.
4) In England, a British team of researchers, Drs. Orford and Edwards, et. al., found that just having a doctor speak to alcoholics for a single hour, telling them to quit drinking or they were going to die, was just as effective as a whole year of A.A.-based "treatment".
5) The most damning test of all was done by one of the leaders of A.A., Doctor and Professor George E. Vaillant, who is also just about the biggest A.A. booster in the world. He just loves A.A. and thinks that everybody should get shoved into it. Doctor George E. Vaillant is also a Professor of Psychology at Harvard University, and he is also a member of the Board of Trustees of Alcoholics Anonymous World Services, Inc.. Vaillant clearly demonstrated that A.A. treatment kills patients. For eight years, his A.A.-based treatment program had the highest death rate of any kind of alcoholism treatment that he studied. Vaillant also candidly admitted that the A.A.-based treatment program had a zero-percent success rate. At the end of 8 years, his results with his first 100 patients were: 5 sober, 29 dead, and 66 still drinking. But 5% is also the normal rate of spontaneous remission in alcoholics. That's how many quit drinking each year without any treatment. So 5 minus 5 yields zero, the real A.A. success rate.
http://www.orange-papers.org/orange-letters26.html#RLCS

[JustTrying]

OK Ray! You might remember me as Gabby from some other sites . I haven't posted for a while though.

Here is my take on the whole issue. If it works for you GREAT! If not.... well do something else. I do know several people in this area alone that are in AA and have been sober for years.

I have to work or at least discuss the steps with my therapist. She works at the rehab and I am doing out patient. Discussing them will not hurt me.

My biggest downfall about AA is the ones that are sober seem to live for AA. They have made AA their addiction or NA. They go to every meeting they can and most are single.

I am reading and if you remember me you know that I have tried MM. RR and anything else I could find. Searching for the "magic" cure!

I have decided that the cure is in me. I have to fill my life so that I won't have time to drink or so that I won't drink because I have something to do later. I have to continue the outpatient treatment because I managed to get a DUI last month ( I had already started treatment) I let my impulses take over and drove. If I can get my therapist to sign off on it my license will only be suspended a year.

We are also talking about the underlying causes.... dipping into my childhood and my first experience with all mighty alcohol. Personally I find the NA literature more to my liking. Actually I like NA. I have not been going to any meeting lately however. ( no license!)

Hope some of this makes sense... I am a little manic right now.. But sober.... This is Day 19 sober.

JT

[Ray Smith]

I have decided that the cure is in me. I have to fill my life so that I won't have time to drink or so that I won't drink because I have something to do later. JT

That might work until you run out of things to do. I think the real trick is setting up your life so that drinking no longer has any room in it.

My wife doesn't drink and I don't want to be around her drunk. I facilitate substance abuse groups and even though I advocate harm reduction, if I drank, I'd lose credibility. And not just with clients, but when I'm dealing with government agencies, trying to keep them out of 12step treatment.

[JustTrying]

Same boat here. My husband doesn't drink and I don't drink around him. That is one way I have made it as long as I have. I have been spending time with him. He works out of town but, I have been going with him.

Honestly, I should stay home this week. New puppies..... but I am afraid that if I do I will get some alcohol. I have to go do 24 hrs in the county jail Thursday evening and I would use that or my nerves to convince myself that a few beers won't hurt. And if you are like me I don't "drink" --- I DRUNK! I don't have A drink, I have A DRUNK!

Right now I am fooling myself, saying that I can have a few beers now and then.... I do not understand why I don't want to just not drink anymore. It is like saying goodbye to an old lover that you have remained friendly with for years even though he beat the hell out of you when you were together and you know he would do it again if given the chance...( but that is another story!!!:))


I have read some of the Orange papers... back a while back. And I believe that for some AA can be like a cult. How many "new comers" come in fresh from Rehab etc... and they have that "Glow" about them ( pink Cloud) They have found the "answer".... They speak the talk. you know... " easy does it, One day at a time, But for the grace of G go I...Think , Think, think>" They carry the BB with them like some people in some religious groups carry their bible or literature, They preach and sing the blessings of AA to anyone who will listen.They have been brainwashed into thinking ALL they have to do is to come to meetings and read the BB. The ones that scare me are when they quit their meds... because they are told that THEY were the problem and if they leave alcohol alone they won't need the meds.

Alcohol to me is a symptom. What I am working on is the underlying cause of it. I do believe that my body uses alcohol diffrent... How else can a little woman like me put down 24 + beers in one sitting and get up in the morning ready for more. With therapy I am trying to fix the reasons that I feel the need to drink and black out in the first place. But yes for now, I am trying to keep busy and around my husband as much as I can.

Good morning by the way..... let me drink my coffee and maybe I will make better sense.

JT

[Ray Smith]

Good morning by the way..... let me drink my coffee and maybe I will make better sense.

JT

You made perfect sense.

I doubt that there is any one, single cause of your drinking, and even if you discover it, or several, your preoccupation with alcohol won't just disappear.

I talk about getting help for my depression making it possible for me to remain abstinent, but it was still difficult.

[Ray Smith]

Just ran across this article by Stanton Peele:

Real Recovery Requires Life-Building
Recovery must focus on the life the addict will lead

Addiction is like the tail wagging the dog, or person, with the tail being a habit that dominates the person's whole life. Addiction therapy concentrates on the tail - cutting it off in abstinence therapy, making it smaller in behavioral treatment. But the real task is for the person to build a life - body and soul - that can't be wagged by even a very powerful tail.
Here are the five elements to effective addiction treatment and successful recovery:
(more): http://www.psychologytoday.com/blog/addiction-in-society/200901/real-recovery-requires-life-building

[ASchwartz]

Ray and others,

Read the ariticle I just posted on the site, here, about Phoenix Multi Sport. In fact, they were on television news last nite.

Allan

[John Rutledge]

deleted.....

[Ray Smith]

Ray and others,

Read the ariticle I just posted on the site, here, about Phoenix Multi Sport. In fact, they were on television news last nite.

Allan

I'm sure that 12step facilitation plus excercise is better than plain ol' 12step facilitation, but is that really saying a whole lot?

To me it's like slapping a new coat of paint on a house that's termite infested. Looks pretty enough, but is it doing anything about the basic problems?

The people who do best in recovery, by whatever methods are those that have reasons to recover, professionals who have jobs to return to, people with supportive spouses, kids, people who hadn't "hit bottom" and lost everything. And here, people who prided themselves on fitness returning to that community.

That's why I like Motivational Interviewing, helping folks find their motivation to quit, but without "ego-deflation", "powerlessness", and mixing religion and recovery.

I've seen relapes cause a crisis of faith in people without mental health diagnoses. Faith can be A tool, it shouldn't be THE tool.

[JulianP]

............deleted

[ASchwartz]

JP,

Aha, I caught you. Obviously you posted the same objection in the comment section after the article about Phoenix. Why did you post "anonymously?" Curious.

To judge this successful non profit organization without knowing one thing about it because they hold 12 step programs in high regard is reflects the futility of discussing any of this with you. Why? The answer lies in a variation of an Arabic saying. The actual Arabic saying is, "The enemy of my enemy is not my friend." OK, well, does that mean, therefore, that "the friend of my enemy is my enemy?

If that is the case, then, this is not about whether any program is effective or not. Instead, it becomes a discussion over religion and which one is the "one true faith." Let us say that I am Lutheran and, if I dare to state that I hold Catholics in high regard, I am therefore infected with Catholic evil?

Do not reject this metaphor too quickly because this is the way people thought before the twentieth century and even into the first half of the century. There were American opposed to John F. Kennedy becoming president because he was Catholic. People actually feared that he would help the Pope "pollute the nation." It is akin to the way Shiites and Sunnis hate one another today. I am sorry to say this, but, this is an absurd way to think.

Phoenix Multi Sport does not follow anything even remotely connected to steps, whether twelve, fourteen or ten!! They do not follow any kind, type or form of religious or spiritual thinking. Among the members in recovery, some attend AA, some do not and some did in the past but others no longer do.

You see, I chose this issue because I am in Boulder Colorado at the moment and know these people. They are not simply or only based on sports and, if you would go to their site and read, you would realize that. What they are based on is building a community of people in recovery or who want to prevent getting seduced into drugs and alcohol. What they do is based on group cohesivenss, group elan or energy. I have met these people, including the founders and have talked to them and to the members. They are all in recovery. Some are anti AA and some are pro AA and some never attended and do not care.

Sorry, JP, but, I believe I have caught you in the process of being blindly judgemental and absolutely prejudiced in your thinking.

You need to think this over, very carefully.

Allan N. Schwartz, PhD

[JulianP]

............deleted

[Claire Saenz]

I took a look at this as well--I found it very interesting particularly since, for me, exercise was the most important thing I did in my early days of abstinence. I got involved in endurance sports, particularly long-distance cycling, began teaching exercise classes at a local gym, did several triathlons, etc. It was a wonderful way to regain my physical health and also to re-integrate myself into real life. In fact, the friends I've made through exercise activities were a critical support when I left AA--they did not abandon me or leave me phone messages telling me that I was signing my own death warrant.

From this perspective I find Phoenix Multisport somewhat troubling. Exercise is a good thing, but according to the group's website:

"Opportunities to participate in a sober active community and 12 step are fully integrated into formal treatment, assisting with the transition of sustainable support to a broader recovery network in one’s community..."

What does this mean? It sounds like it's another avenue to keep "recovering" people from mingling with the larger society...and indeed, one of the most dangerous aspects of 12 step from my point of view is its tendency to lock people into the horribly inbred "recovery community."

I'll reserve judgment until I find out more...for now though I'm not positively impressed.

Claire

[Ray Smith]

JP,

Aha, I caught you. Obviously you posted the same objection in the comment section after the article about Phoenix. Why did you post "anonymously?" Curious.

To judge this successful non profit organization without knowing one thing about it because they hold 12 step programs in high regard...

You're being very misleading here. First you say you're playing "Gotcha!", then you're claiming that just because they hold 12step in high regard doesn't mean that they have anything to do with 12step. HUH?



I googled "Phoenix Multi Sport". I poked around on their website:
http://www.phoenixmultisport.org/index.php. Partners with West Pines. West Pines:
"With a focus on wellness, the program even provides outdoor exercise/adventure therapy and a ropes course, indoor weight lifting, fitness/yoga and wall climbing, acupuncture, spirituality and 12 step meetings seven days a week."


Went to the video featured on the Phoenix website:
http://www.newsweek.com/id/40211#?l=1785302026&t=27481154001

Starts right off, "When I tell people I'm a recovering alcoholic..."

AA/12step has its own language and all these people are talking it. So you're saying we assumed it to be 12step and it's not, while in reality, in checking it out, the people involved are 12step members and you're claiming.....what, other than we're wrong?

Always in recovery, never recovering is AA. Not SOS, not SMART, and certainly not the people who are proud of doing it on their own. Oh, you might hear some eay it, but only those exposed to AA first. Have you ever heard someone who quit smoking call themselves a smoker in recovery?

I have refrained from any personal comments until now. So now we've determined that you are some sort of AA apologist, you are not unbiased, and I have difficulty believing that you do not have some sort of direct 12step involvement. You're too enamored, too self-righteous, and too smug.

[Claire Saenz]

I posted my most recent contribution to this forum prior to reading Allan's "gotcha" comments to JP.

Allan, I am horrified. I agree with Ray. At this point there can be no further doubt about where you stand. There is simply no way that your perspective about 12 step is is "open minded" or that you are truly interested in having a respectful discussion about the issues and problems surrounding the program.

Say what you will about JP, Ray, JR, Mike, Speedy, David O., and others who have posted here...none of us have attempted to hide our perspective behind a wall of professional neutrality and objectivity. We know what we have experienced and witnessed and we're telling it like it is. You, on the other hand, have repeatedly claimed to be the voice of reason and rationality while at the same time you accuse those of us who disagree with you of being wrong, crazy, deceitful, etc.

But I've suspected for a long time now that you are a 12 step proponent pretending to be "open minded". There is simply no way that anyone other than a 12 step proponent would refer people to AA and Al-Anon without even mentioning the negatives of those programs. And you have done that very thing at least twice on this website, but when I've called you on it you've pretended not to understand what I'm talking about. And it's YOUR website! With YOUR advice on it!

"Gotcha" indeed.

Claire

[ASchwartz]

Claire,

Sorry you feel that way but JP posted anonymously. Why? If you are going to give an opinion, why hide your identity? In addition, who is not open minded here? To condem a new program without knowing anything about them, their mission, their intents, their work, their efforts, is the worst kind of prejudice. You are good at giving out criticisms but not so good at taking them. You are incorrect. Incorrect about what JP did, and about my open mindedness and about this new program.

We all have a limit and I have reached mine with regard to the steady, blind, and ongoing criticims of AA or anyone who has the "temerity" to say anything positive about them. You have placed your opinions of AA above the feelings and views of anyone who disagrees with you. Immediately, anyone who disagrees with you becomes invalidated, negated and devalued.

"Gotcha indeed."

I will no longer address this issue. In fact, with regard to this, I will leave all of you to your narrow and one sided opinions. No more from me.

Allan:mad:

[JulianP]

............deleted

[John Rutledge]

deleted....

[malign]

Well, I hope no one minds if I jump in here.

So far, I haven't. Since my particular problems have never brought me into direct contact with AA, I haven't felt qualified. I've read it simply because I enjoy a good debate as well as the next person.

Undoubtedly, there's a lot of strong feeling on all sides. I see that as a good thing. It's certainly what's keeping the debate going with so little new information.

However, when someone starts suggesting that anyone would take this site down over y'all's little spat in here ...

Have you guys read any of the rest of what goes on here? I do.

There are a lot of suffering people here, some of them addicts of various sorts. And there are a lot of people here trying to help them, in whatever ways we can. That can be done without mentioning AA, either pro or con, believe it or not. It's called "listening". I suggest everyone who considers contributing further to this thread, on any side, try that first.

[John Rutledge]

deleted....

[malign]

John,

You're right, some of my words were poorly considered. In particular, I recognize you as a valuable contributor in several areas, and I wasn't referring to you in particular.

I care about this site a great deal, and even more for the people who participate in it. Perhaps I should have limited my words to that.

I'm afraid I'm actually not a big enough person to have attempted to calm this debate. ;-) I know when something's bigger than I am. I just feel that the many posts in this small set of threads concerning AA are obscuring the rest of what's going on here. I agree that the tone of it, well yeah, it's starting to get on my nerves, too, that's what it is.

I'm just an unpaid volunteer here. (If, by any chance, you may have confused me with Dr. Dombeck, though my name is also Mark, I'm an entirely different human.) I can disagree with some of the things that have been said by either side in this debate without it making me too concerned. You guys will have to sort this out between you, or not.

I was just trying to turn the attention back towards the productive work that also gets done here. I'm sorry if I ended up detracting from that message.

[Ray Smith]

I will no longer address this issue. In fact, with regard to this, I will leave all of you to your narrow and one sided opinions. No more from me.

Allan:mad:

We won't play by your rules so you're going to take your ball and go home? Real mature.

Allan,

For over a quarter of a century, I have endured mental health professionals who pushed 12step nonsense. Most, like you, deny any bias, but all complaints about the programs as treated as some sort of character defect of the person complaining.

Sure Allan, we're all "narrow and one sided" and you keep talking about our "opinions" as if we just decided to be contrary.

A person examines the FACTS, based on those FACTS and personal experiences he or she draws conclusions. Unless presented with new FACTS, the old conclusions are still valid. Where are your facts, Doctor?

I get accused of repeating myself, but you and Dr. Dombeck don't seem to respond to facts. You both respond on some level to our personal experiences, but mostly just to say that others have different experiences.

And why won't you address the facts? It's because you can't. There are no facts that support your position.

Frankly, I don't care what you personally think about AA/NA, 95% of all new members drop out within the first year. Doesn't that say anything to you, Allan? That only 5% of people like AA enough to stay with them for a year?

Why do you need to sell people on the idea of 12step recovery?

Maybe, just maybe, the five or six of us that you see as picking on you here, gives you the slightest idea of what it felt like for me when every mental health professional told me I was wrong about AA.

[Ray Smith]

Well Allan, since I am unable to respond to your articles I'll ask it here:
____________________________________________
Allan,

Why did you feel it necessary to conceal that the members of the Phoenix program are 12step members?
____________________________________________

To Mike the moderator,

I have a question, do you feel I've been out of line?

[John Rutledge]

deleted....

[Claire Saenz]

deleted by poster

[JulianP]

............deleted

[Ray Smith]

:confused:I have now made, I think, 5 attempts to submit my "Reason and absurdity" post, above, to the "Phoenix" thread in the "Readers' Comments" part of this site, for which it was originally intended. Since "Readers' Comments", in general, seems to be working, I am beginning to wonder whether the problem is really at my end ...

Yours mystified,

I'm unable to respond to any of Schwaerz's articles, haven't tried anyone elses lately.

I wrote to Dr. Schwarz yesterday, didn't get a response, but this morning I was unable to sign in, had to reset my password. Another coincidence?

It remains that the doctors here will not address facts and respond with testimonials, and that's not good enough. Too many people have found 12step lacking and are speaking out againt it. AA has been stalled or losing membership in the US ever since the first courts declared AA to be "religious in nature" and mandated AA to be a violation of the Establishment Clause.
(Note that neither Dombeck or Schwartz have addressed the legality of madated AA or the morality of pushing AA on a vulnerable clientele.)

Other methods that meet the criteria for Evidence-based practices are gaining in the US. I am surprised seeing this kind of thinking coming from mental health professionals in this day and age.

[John Rutledge]

deleted....

[Mark]

All,

Several technical issues have contributed to the recent problems submitting comments. We were indeed transitioning some URLs - that is mostly done now so should no longer present a problem - and we had a software error that required some reinstallation of a module. I think it's all ironed out now but let me know if commenting issues persist.

Regarding the tone of this discussion, I don't like it much. No one is ever satisfied and the discussion goes in angry circles.

I recall a time when I was a high school student and liked a particular band a lot. I would force other people to listen to it at every turn and then demand to know if they liked the music as much as I did. Needless to say, a lot of people ended up just defaulting to not liking the music, not on the merits of the music, but instead on the merits of my not-so-stellar social presentation. I try to have better social skills these days. I wish some of the folks who frequent this multi-threaded conversation would do the same. I don't believe it will happen, though.

That malign felt the need to come in here and ask you guys to play nicely is telling. And sad. What it says to me is that there is a threatening tone to the conversation that is frightening people - and that is bad for the community as a whole which is bigger than this conversation. I can't have that continue long term.

I need there to be more civility; more politeness here. Less petulance; less angry demandingness. And yes - less repetition.

If you folks cannot volunteer it from within, I will ultimately take necessary steps (as minimally as I can do so) to enforce it from without. I know that will make me an unpopular figure, but so be it. I'm not here to be popular; I'm here to try to be useful to a broad group of people who are hurting. In order to function, this community needs to feel safe to all the people who would like to talk here legitimately. This includes people who are pro-aa, and people who don't care about aa one way or another, but are freaked out by the tone here.

Mark

[Ray Smith]

I recall a time when I was a high school student and liked a particular band a lot. I would force other people to listen to it at every turn and then demand to know if they liked the music as much as I did.

Mark

And the difference between insisting that we listen to AA testimonials, like them as much as you and Dr. Schwartz, and your high school analogy is...?

I feel that you and Dr. Schwartz have sidestepped any of the issues that have been brought up concerning AA, the 95% dropout rate, the higher mortality rate, and the various studies that show AA involvement resulting in worse outcomes than other treatment methods or no treatment at all. "It works for some people...", yes, but rarely for those with mental health issues and statistically no better than no treatment. These are not opinions, these are the facts that I base my opinions on.

Yes, I'm repeating myself, but neither of you has commented on these things, instead, offering testimonials of people who claim it has worked for them.

I'm all for having a reasonable discussion, but that involves both sides listening and not attempting childish games of "Gotcha!"

If you're truly interested in helping people who are hurting, don't you think you owe it to them to look at the facts about the program and the testimonials of the people here who talk about the harm they felt 12step programs have caused? A 95% dropout rate, doesn't that say anything to you?

[Mark]

Ray,

Since you are obviously in juvenile oppositional mode, even after I have made a clear request for less antagonism, and a clear statement that I will take action from without if you cannot manage it from within, I am placing you on a temporary ban. My hands are kinda tied; if I don't take some action I will have essentially reinforced you for disrespecting my request.

The ban will be for three days - it's a time-out, essentially. Please respect it, and do not post here, or on the main site until Tuesday.

I gather I am playing a role in some transference drama you are enacting, "the evil aa-loving mental health professional" - some version of the "man" who has put you down. Honestly, things are more complex than that. This is not a conspiracy to suppress your truth. I just please need you to not act like an angry oppositional child.

Mark

[Abbadun]

Hi Mark

I think that what gets people so hyper about dealing with the problems of AA is that there are so many of them. Most often while discussing the problems of AA we tend to focus one or two of the categories. What also exacerbates the communication is the absolute denial of the AA membership. AA will never change.

I work with Community Action Agencies, Community Associations, Grassroots Organizations all of them strive to improve their operations. I have and I am currently working in a Residential Treatment facility and it also strives to improve its operations as its funding sources suggest. Until we come to AA and 12 Step practices. omission is the most popular method of keeping the funding source in the blind. Federal and State Funding sources give seminars on diversity in recovery and how there are many roads to recovery, yet 12 Step meetings are the only support group recommended by the facility and a client who rather avoid 12 Step meetings faces having negative reports sent to their probation officers and court officers.

This is the Ethics that I have seen AA install in Residential treatment facilities. I ave never met a counselor in a Residential Facility who did not identify as a AA member or who did not always promote AA meetings as a primary aid to staying sober. These practices are not the act of using attraction to gain members, but method of intense promotion.

Similar is the practice of the Cooperation with the Professional Community (C.P.C.) committee whose mission is to have AA members talk to judges and doctors. Is this attraction?

In ending the problem of AA is too large to keep arguing piece by piece. Debates need to be more like the form of the Orange Papers which outlines the huge mess that is AA.

Yes AA does keep some people sober, but history has shown us that groups of people with bad ideology can do remarkable things and simultaneously do horrific things.

Abbadun








Ray,

Since you are obviously in juvenile oppositional mode, even after I have made a clear request for less antagonism, and a clear statement that I will take action from without if you cannot manage it from within, I am placing you on a temporary ban. My hands are kinda tied; if I don't take some action I will have essentially reinforced you for disrespecting my request.

The ban will be for three days - it's a time-out, essentially. Please respect it, and do not post here, or on the main site until Tuesday.

I gather I am playing a role in some transference drama you are enacting, "the evil aa-loving mental health professional" - some version of the "man" who has put you down. Honestly, things are more complex than that. This is not a conspiracy to suppress your truth. I just please need you to not act like an angry oppositional child.

Mark

[JustTrying]

I still am with whatever works works... However have you all thought that perhaps AA doesn't really want court ordered people there? I know I don't like them much. And perhaps that accounts for the high drop out rate ? Because, being made to do something to an alcoholic or an addict is a ticket to be defiant and not do it... They come to the meetings because someone court ordered them or their family made them etc... and they are only there to make "whoever" shut up. IMHO AA can be benificial to people who are ready to get sober and need the support. It is nice to listen to someone tell their story and say "hey, sounds like my life". I don't agree with the "lifetime" commitment or always recovering. I did like the comparison to the person that use to smoke.. They are an ex smoker ... not recovering... but like all addictions, chocolatte, smokes, beer, food , it could take just one....

I still attend meetings occasionally but I do not want to make AA/NA my WHOLE life. To me that would still be letting my addictions control me in yet another way. My goal is a well rounded life. And yes there are days I need to talk to another alcoholic/ addict....and days that I don't. I have not worked the 12 steps... although at the CDC I am going to have to, perhaps.... I don't know, I am getting a new therapist Monday perhaps I will speak t her about that.

Ok Peeps!!! Lets play nice ... we can all have our say without being .....

Hugs, JT

[Abbadun]

HI JT

I go to meetings and I like most of the people that I meet there, but that does not change the nature of what AA is and the need to let the public see the real AA with all the conflicts in its message, the reoccurring message that AA is the only way (despite any conflicting statements made elsewhere) in the literature, the AA Culture and its ideas about secular people and many other issues.

Abbadun


[QUOTE=JustTrying;13464].........I still am with whatever works works... However have you all thought that perhaps AA doesn't really want court ordered people there? I know I don't like them much. And perhaps that accounts for the high drop out rate ?.................[QUOTE]

[CarlosP]

Its sad and surprising that nobody is addressing the data and studies that Ray and others present, that at best shows A.A. to be not helpful -- A.A.'s claimed one year retention rate of 5% is about the same as the percentage of alcoholics who recover on their own in a year (spontaneous remission) and that at worst shows a higher mortality rate.

And if this data and studies hold up to close examination, then what about the morality of recommending such a program, especially to those with serious mental health problems, considering their very controlling sponsorship system and group pressure for conformity (despite what Tradition 3 says).

My own therapist doesn't think much of A.A., given the negative feedback he gets from his patients. And how some take from it a message of powerlessness and "don't think too hard -- you're best thinking got you in the mess you are in".

And what about A.A. lying about not being religious (tell me how is Step 11 -- "Sought through prayer and meditation to improve our conscious contact of God as we understand Him, praying only for knowledge of his will for us and the power to carry it out" -- how is this not religious? Only a prayer-answering deity fits "God" in Step 11 -- you can't pray to a Group Of Drunks (G.O.D.) or any other secular entity. And reading the other steps and Tradition 2, this entity called "God" is a favor-dispensing deity that restores us to sanity, removes our shortcomings, manages our lives, cares for us, loves us, listens to our prayers, gives us power, and guides our groups. Pretty clear we're not talking about something secular here.

At the very least, the program is endless proselytization about a prayer-answering favor-dispensing deity, and all the highest state courts and federal appeals courts that have heard these cases agree that A.A. is at least "religious in nature" and that based on the First Amendment Establishment of Religion clause -- people cannot be coerced to attend.

And why does the "Alcohol & Substance Abuse, Addiction" home page at
http://www.mentalhelp.net/poc/center_index.php?id=14&cn=14
list only 12-step groups?

-Carlos

[John Rutledge]

deleted....

[Abbadun]

Hi Carlos

What other organization other than AA could write off the 95% or (a more modest rate of 75%) of people reported to reject AA and its ideology?? No Store, Counselor, Church, Doctor or any other entity could accept that much rejection of their services!

An even larger issue is all the state and federally funded programs which recommend AA to their clients even though AA's success rate is the percentage of that 5% that manage keep consistent time sober.

AB





Its sad and surprising that nobody is addressing the data and studies that Ray and others present, that at best shows A.A. to be not helpful -- A.A.'s claimed one year retention rate of 5% is about the same as the percentage of alcoholics who recover on their own in a year (spontaneous remission) and that at worst shows a higher mortality rate..........
-Carlos

[John Rutledge]

deleted....

[Mark]

And why does the "Alcohol & Substance Abuse, Addiction" home page at
http://www.mentalhelp.net/poc/center...hp?id=14&cn=14 (http://www.mentalhelp.net/poc/center_index.php?id=14&cn=14)
list only 12-step groups?Mostly because it would benefit from a rewrite. We'll get to that as we have resources.

I think we have been addressing the arguments made by Ray and many others here. Of course, that is my opinion only. Is full agreement a necessary precondition of addressing something?

The present course of action has been undertaken by myself because in my judgment things have become aggressive rather than assertive, and that damages the community as a whole. I need this place to be one where someone who is happy in AA can post about that without fear of being run over by dissenting voices. Vice versa, I need this place to be one where someone who is very unhappy with AA can post about that without fear of being run over by dissenting voices. It's perfectly okay to speak one's piece. It is not okay to belittle, attack, etc even if you are in possessing of "superior facts" (as each side so vehemently believes to be the case).

Mark

[John Rutledge]

deleted....

[Abbadun]

Hi Mark

I do not think that there has been any reason for people to take the comments here on a personal level, I have gotten that way while debating with AA members who respond to questions about AA with 100% denial or just totally ignoring the issue.

What I do think that the conversation here needs to accept that with AA or any Organization that the bad practices and ideology of the Organization far out weighs the good ones. This is true with any Business, Bank, Church, Civic Organization or Association. This is especially true of AA if medical facilities and state funded programs are going to recommend AA to the public.

AA has gotten a free ride because it is a free service willing to service a population (the addicted) that Society does not know what to do with. In the Rehab that I work in clients go bouncing from rehab to rehab to behavioral hospitals with the tax payer paying the entire bill. AA is having little if no effect even on the ones who feel positive toward AA, the ones that reject AA are simply pushed further away from sobriety. All of these Rehabs of last resort in my state are staunchly pro AA.

AB





Mostly because it would benefit from a rewrite. We'll get to that as we have resources.

I think we have been addressing the arguments made by Ray and many others here. Of course, that is my opinion only. Is full agreement a necessary precondition of addressing something?

The present course of action has been undertaken by myself because in my judgment things have become aggressive rather than assertive, and that damages the community as a whole. I need this place to be one where someone who is happy in AA can post about that without fear of being run over by dissenting voices. Vice versa, I need this place to be one where someone who is very unhappy with AA can post about that without fear of being run over by dissenting voices. It's perfectly okay to speak one's piece. It is not okay to belittle, attack, etc even if you are in possessing of "superior facts" (as each side so vehemently believes to be the case).

Mark

[Ray Smith]

Ray,

Since you are obviously in juvenile oppositional mode...

Mark


Mark,

So, now you're saying I'm like a defiant child? While you continue to sidestep any of the issues I've brought up? I like how you cast yourself in the adult role. I'd be more than happy to have an adult conversation, but so far, I've been talking at you, you do not respond. And you haven't been talking to me, you've been talking to the boards about me. You accuse me of repeating myself, but I do so because obviously, you're not listening.

I am not a child and do not expect to be treated like one. Juvenile oppositional mode? I've been posting facts that you don't want to examine. You and Dr. Schwartz like AA because you like AA and want to believe it works. I ask you all to examine the things I post and you use your positions to dismiss me. If you really wanted to silence opposition effectively, you'd prove me wrong.

And no, I'm not angry, Mark. Disappointed, not angry.

[John Rutledge]

deleted.....

[Mark]

Ray,

... you continue to sidestep any of the issues I've brought up? There seems to be an assumption being made on your part that it's my job or responsibility to address the issues you bring up to your satisfaction. This is not the case.

If you really wanted to silence opposition effectively, you'd prove me wrong.I don't generally think you are wrong in the direction of your thinking. Just way over-zealous and intolerant.

I believe we have a similar understanding (shared with JR apparently) that empirically validated treatments are preferable to those which are not - but we diverge in terms of how this understanding ought to play out in practical reality. You are far more of a "purist" than myself, apparently, and I believe, far less respectful of other's choices when they disagree with your own. It is that lack of respect - for those who choose to support AA for their own reasons - and for myself when I had just asked you and others to cool things down for the good of the community - which I am labeling as childish behavior (or just hostile behavior if you like that term better) and for which I banned you temporarily.

Mark

[ASchwartz]

JR and Others,

As always, you are a sensible man who takes a sensible stance, even on issues that others may not agree with. For example, while I do not agree with you about AA I know, from past experience, that I can exchange views with you and not feel personally attacked. You have also been enormously helpful in other discussions of alcohol and of various other mental health topics and without confusing or mixing the separate issues. For example, I am aware that you, in a very sensible way, responded to someone who stated that they have blackouts from alcohol and then said they do not have an alcohol problem. You were great in pointing them towards the reality of their situation.

On the other hand, there have been a few individuals who have been nasty and disrespectful to others, both myself as well as other people, when they state anything positive about AA. One example of a personal attack was when an individual sarcastically questioned my PhD, my skills as a therapist and even my honesty, when I made a supportive statement about AA. I find it impossible to not take those types comments personally, even though I realize that none of you know me personally. I guess its my weakness but personal attacks get under my skin when they are provoked for no other reason than stating my opinion and my experience. Then, when I do get angry, and that has happened, I am accused of being nasty while the person who originally attacked me is held up to be an innocent victim of my "meanness."

JR, with you and with 99.9% of the people who visit this web site it is possible to have a meaninful dialogue over many issues. Then, there is that tiny percent who seem unable or unwilling to express themselves without becoming offensive.

My wish is to have that open and respectful dialogue, without the insistence that I change my views nor the insistence that you change your views, in an atmosphere of trust.

Can we do it?

Allan

[Abbadun]

I think that a debates based on what each of our experiences in n AA has been is a waste of time, it is relative to what each person believes,

What I find that is unacceptable about AA is:

1. The printed bias and prejudice toward Secular people and Secular Lifestyles.
2. The many printed statements implying that AA and 12 Steps is the only way.
3. The printed statements that one must have a higher power to become sober.
4. The printed statements that have conflicting messages.
5. The printed statements that are false and never have been corrected.
6. The printed statement labeling other types of Sober people "Dry Drunks"

These are just the issues that I can think of on the fly, I could reference the Orange Papers for a much longer list. I can not think of any Organization with all the issues that AA has that I would recommend to anyone.

If asked I say that I drop in to AA meetings as a necessary evil. I tell people that other meetings are moving into my area and I will use them when they get closer or I get a more dependable car.

Ab

[ASchwartz]

Hi Ab and all,

I agree with your statement:

I think that a debates based on what each of our experiences in n AA has been is a waste of time, it is relative to what each person believes,

So, instead of going ahead and listing what the AA statements that you find unacceptable, why not engage in a more useful discussion of what it is like to be addicted, how difficult it is to recover and maintain recovery and what we each know about other types of programs?

In fact, I have even wondered to myself if this preoccupation with AA and twelve steps is a way for each to hide discussing the more painful issues of each of our lives, our addictions and how we had to fight for recovery? In other words, this fixation on 12 steps is an Internet defense mechanism against more painful issues.

Allan

[Abbadun]

Hi Allan

I will do what you said and talk about addiction, but on another thread than this one.

I think that attacking 12 Steps was a big defense mechanism that kept me from becoming sober. Now after being sober for over 8 years and weening myself of AA being truthful about AA just seems like the right thing to do.

All the addiction self help groups are fighting over the same population and AA has a unfair monopoly. I live not far from Bill W's home which is now a museum and groups like SOS still have a long way to go before even one alternative group breaks into this area.

Everything that I have learned in college about Management, Change Management and Organizations tells me that AA should be able to deal with and correct its limitations if it was a healthy Organization. I think that discussion about the limitations of AA highlight the fact that the Organization will never change and maybe more people will realize they need to move on.

OK

Here are some of other topics we could talk about and what has helped me.

Buddhism, Steven Covey, Don't Sweat the Small Stuff, "Taming the Monkey Mind" by Thubten Choddron, "Sober for Good" by Anne M. Fletcher, proverbs from around the world and quotations.

When I get some free time I am going to read more of Virginia Satir because I only read her change management topics that pertained to business and I never knew that she was really a Family Therapist.

A lot of the stuff above have themes that have been borrowed by each generation for thousands of years. I think that what help me stay in AA was the fact that a Greek Philosopher, Abraham Lincoln and Bill W. all agree that we should take one day at a time.

AB







Hi Ab and all,

I agree with your statement:



So, instead of going ahead and listing what the AA statements that you find unacceptable, why not engage in a more useful discussion of what it is like to be addicted, how difficult it is to recover and maintain recovery and what we each know about other types of programs?

In fact, I have even wondered to myself if this preoccupation with AA and twelve steps is a way for each to hide discussing the more painful issues of each of our lives, our addictions and how we had to fight for recovery? In other words, this fixation on 12 steps is an Internet defense mechanism against more painful issues.

Allan

[Ray Smith]

Ray,

There seems to be an assumption being made on your part that it's my job or responsibility to address the issues you bring up to your satisfaction. This is not the case.

Mark

Seems to me that if you are promoting 12step as an effective form of treatment that you would be able to offer some sort of proof of its efficiency. That it works for "some people" isn't good enough when we are talking about people's lives.

--------------------------------------------------------------------------
(Dr. Dombeck) "You are far more of a "purist" than myself, apparently, and I believe, far less respectful of other's choices.."

--------------------------------------------------------------------------
I have no problem with people who choose to join AA, but I believe in informed choice. I was pushed into AA and today, I see it happening to others. Whether it's the courts, government agencies, employee assistance programs, or even well-meaning professionals or family, 12step treatment is not a good fit for the vast majority of people as evidenced by the 95% dropout rate in the first year. It has the highest mortality rate of any of the alcohol treatment methods and I believe that is mainly due to suicides performed by members with mental illnesses.

It has been pointed out that as many as 90% of all problem drinkers never receive treatment of any kind (Hingson et al. 1980; Roizen et al. 1978; Stall and Biernacki 1986) and that 80% or more (Sobell et al. 1993; Treatment of Drug Abuse and Addiction — Part III, The Harvard Mental Health Letter, October 1995) quit on their own. These numbers dwarf AA's numbers, but they don't appear to be taken seriously in the treatment field. When a person recovers on their own they are invisible to the treatment professionals. Plus the fact that 12step treatment virtually owns the recovery industry suggests that there is little interest in recognizing these numbers or in establishing new treatment methods with greater effectiveness.

But all these numbers have to do with the general public. Studies also suggest that success in recovery has much to do with natural supports and the fear of losing social and economic standing (Waldorf et al. 1991). The clientele I work with have been marginalized already by moderate to severe mental illness and have little encouragement to live without drugs and alcohol. While AA might provide the encouragement, one must look at the downside, especially with a vulnerable population: the anti-medication faction, the predators, the insta-friends who disappear just as quickly when their mental health status becomes known. The rooms are difficult enough to navigate for those without mental health issues, but for those who have profound mental illnesses, it is a minefield.

Most of the clients I've worked with were not substance dependent, but substance abusers or casual users forced into treatment that dismisses their mental illnesses as products of addiction. AA establishes an alcoholic identity in its members that several have pointed out may limit social reintegration, what does it do to those who had no such identity before the rooms? In my experience, those who adopt the alcoholic identity get worse and research seems to agree: Outpatient Treatment of Alcoholism; A Review and Comparative Study, Jeffrey Brandsma, Ph.D., Maxie Maultsby, Jr., M.D., and Richard J. Welsh, M.S.W.; A controlled study on the use of court probation for drunk arrests,American Journal of Psychiatry, 124:160-163, 1967, Ditman et al. ; A randomized trial of treatment options for alcohol-abusing workers, The New England Journal of Medicine, 325:775-782, 1991, Walsh et al.

A good portion of the program is based on ego-deflation, is this proper treatment for those who come to AA with existing self esteem problems?

And when is it justified to place delusional people in a program that tells one they must seek "through prayer and meditation to improve our conscious contact with God"?

Mark, I came across something you wrote elsewhere:

“Part of the reason that it [abuse] is sometimes so difficult for people to recognize when they themselves are being abused is because their self esteem – their personal culture – has been either dominated and invaded by the abuser or was never strong – such that abuse in not recognized as abuse because it is perceived instead as deserved punishment."

Many in AA are primed for "deserved punishment". It is a contradictory program that absolves and instills guilt at the same time and is motivated by fear. The program is never wrong, only the individual, any success belongs to the program while any failure is the failure of the individual. Imagine that you had a penicillin resistant infection, would you doctor keep giving you more penicillin and berate you for "not trying" if you didn't get better? When the conventional treatment for most illnesses was blood letting I imagine those prescribing it met those who did not believe in the practice with the same sort of retorts, that it works for "some people" and demanding that the dissenters provide a new method that performs better. When a treatment fails to perform better than no treatment it does not matter if another treatment is ready, although in this case, there are many.

If AA wants to call addiction a disease. then by all means treat it as a disease, with medication and therapy, not faith healing. When the American Cancer Society evaluates cancer methods, they start by asking three questions:
Has the method been objectively demonstrated in the peer-reviewed scientific literature to be effective?
Has the method shown potential for benefit that clearly exceeds the potential for harm?
Have objective studies been correctly conducted under appropriate peer review to answer these questions?
AA is a placebo, it cannot stand up to scrutiny.

If I was trying to come up with an anti-therapeutic concept, I don't think I could come close to "powerlessness" . As it is explained in the rooms, "I can do nothing about my drinking, God fix me." While many find this concept attractive, I find it difficult to work with those who have embraced it. Another difficult AA concept is Step 2's "Came to believe that a Power greater than ourselves could restore us to sanity." What happens when their "Higher Power" does not remove their mental illness or their desire to drink? It is a very slippery slope when you start mixing God with recovery and worse when you do it with people who have mental health problems; a relapse can cause a crisis of faith more devastating than any relapse.

Dr. Mark Ragins (Village Integrated Service Agency, LA, CA) states that there are 4 stages in mental health recovery: (1) hope, (2) empowerment, (3) self-responsibility and (4) a meaningful role in life. He describes empowerment as "access to information, ability to make choices, assertiveness and self-esteem" . Most of these are in conflict with the program of AA. Some of the thought stopping slogans employed by AA:
"Don't go into your mind alone; it's not a safe neighborhood. "
"Your best thinking got you here."
"You have a thinking problem, not a drinking problem."
"Utilize, don't analyze."

These and the hundreds of other AA slogans do not foster hope, empowerment, self responsibility or provide healthy meaning on which to base one's life.

At the risk of being told that I'm repeating myself, that I'm suffering from oppositional defiant disorder, or being banned, I will say again, AA success rate for the general public is lower than the rate of spontaneous remission and the success rate for those that have coexisting mental illnesses is practically nonexistent. That it works for "some people" is based on what? Some of the 5% of AA members that liked the program so much they stuck it out for a whole year?

Claiming I'm aggressive rather than assertive is a cop out Mark. I'm asking you to examine things you don't want to examine. I offer the facts on which I base my opinions and present them in a logical manner. I do the same with people in real life and have been called a real pain, but not aggressive. Not sure if you're reading into my remarks or stating it for effect. Calling me aggressive is just another way of dismissing me and attempting to sway the other readers by attacking my character rather than the facts. So was the crack about people believing they have "superior facts" when you offer NO facts.

[Ray Smith]

Welcome back, Ray (aka "Matthias),

The only Matthias I know was the saint that replaced Judas in the apostles.

[John Rutledge]

deleted....

[ASchwartz]

Ray Smith, JR and others,

Ray, for some very odd reason you have cast Phoenix Multisport as the same old twelve step stuff painted over to hide the rot. Perhaps it is the way I wrote the article but that is so far from the truth that it defies logic. OK, so you report that you want facts. The facts are that Phoenix is not some painted over rot to hide the same old, same old. The is no requirement that anyone has to have ever been to any program. They just have to want to stop and they do not have to take any oath or make any promises. It is not an "all day program" and many of those recovering are working to support themselves.

Ray, JR and others, there is another program that is not 12 step at all and it is called Smart Recovery. It can be found at http://wwwsmartrecovery.com

Ray, what I find so frustrating in attempting to reason with you is that anything positive that is presented is immediately cast in the most negative light possible. That includes your insistent and persistent statement that we (Mark and I) are attempting to promote AA. It may seem that way to you but it is not what you refer to as "fact." The problem is that it is not enough to be critical alone without offering positive alternatives. You said something vague about "motivational interviewing." If there is something to offer there why not state what it is and where people can go to get it.

At the risk of sounding too pro AA again, if you do a search of outcome studies for addiction treatments, even alcohol alone, on GoogleScholar
you will find many controlled studies that focus on treatment and outcome. The results do not damn AA. They do not praise AA or praise anything. You can read the abstracts if you do not wish to purchase the articles but the controlled studies really give a balanced view. As to percentages of people helped by any programs of any type, the results are mixed at best.

What seems to be factual is that some programs help some people some times. That incudes treatment with medications. That also includes psychotherapy diagnoses.

By the way, Ray, I agree with you that diagnosis and treatment of the emotional disorders is overlooked and is probably a good reason why so few get better regardless of where they go.

How about that, I actually agree with you about something.

Allan

[John Rutledge]

deleted.....

[ASchwartz]

JR,

Thanks for that posting. It is very helpful and you are correct.

Allan

[Ray Smith]

Ray Smith, JR and others,

Ray, for some very odd reason you have cast Phoenix Multisport as the same old twelve step stuff painted over to hide the rot. Perhaps it is the way I wrote the article but that is so far from the truth that it defies logic. OK, so you report that you want facts. The facts are that Phoenix is not some painted over rot to hide the same old, same old.

It wasn't your article, I googled Phoenix Multisport. Read about it on several sites, watched a Newsweek video, the people in the video were all AA/NA members speaking in AA language:
( http://www.newsweek.com/id/40211#?l=1785302026&t=27481154001 ) Phoenix holds 12step in high regard. Affiliated with West Pines, a 12step treatment center. It is not a 12step group, it is an outside activity for 12step members. It is not a recovery method and in my opinion, not germane to recovery discussions.

Yes, I'm familiar with SMART, and also with RR, LifeRing, WFS, but mostly with SOS. I believe that these alternatives to AA have a place (primarily for those who have been exposed to AA and have been lead to believe that a face to face group is necessary for recovery), but I do not believe they are necessary for people to quit drinking. In a way, these groups re-enforce the concept that one needs a group to quit. Stanton Peele examines this in Diseasing of America . The vast majority of people who quit alcohol and drug problems do so on their own, attending a group that tells them they cannot do it alone is counterproductive. Convince someone they can't do something and they most likely will be unable to do it.

I don't believe in any one size fits all program, especially when it comes to dually diagnosed people. I believe most people will benefit from CBT or DBT classes, or by working with a therapist who employs Motivational Interviewing or Motivation Enhancement. ACTT programs around the world use MI, the main problem being that most of the professionals working on ACT teams today were trained with 12step in mind and some have not kept up. The substance abuse counselor I work with is a Hazeldon graduate who would be pushing 12step if she could. I was hired because I understand the objections to 12step recovery, and because I have stayed sober without it.

MI boils down to getting the client to decide what it is THEY want, and then helping them explore what they are willing to do to get there. I was in an ACT program that was starting up in New York and had the opportunity to attend workshops given by Minkoff and Scaicca. (My Human Services professors were jealous.)

As far as studies go, I've been making a serious study of AA the past 7 years. There have only been a few randomized longitudinal controlled studies, Brandsma, Ditman, Walsh, Orford & Edwards, and in each of these, AA was found to be lacking. About the only studies that show AA in a positive light are the studies by Humphries and Moos, who cherry pick the subjects of their studies and confuse correlation and causation. The work of George Vaillant, Harvard professor, researcher, and former member of AA's Board of Trustees is a real eye-opener. He set out to prove that AA worked (bad start for a serious study), instead, he proved that AA did not change the rate of spontaneous remission and raised the mortality rate of those involved in the program as explained in his book The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery

You claim I'm trying to portray AA in a bad light, I say you're spotlighting the few people who stay in AA and maintain their sobriety while ignoring the 95% of new members who drop out in their first year and the objections to AA that caused them to drop out.

[ASchwartz]

Ray,

First:

This debate continues:
For example, you statement about Phoenix Multi Sport:

It is not a 12step group, it is an outside activity for 12step members.

You seem to have a talent for distorting and that results from your logic. For example, you watched some sort of Newsweek video about Phoenix and it evidently included members who came from twelve step programs. So, you grant that Phoenix is not a twelve step program, instead, you state that "it is for twelve step members.

I believe (but someone else may need to check this) that you are using converse reasoning. The fact that the people you saw in the video were twelve steppers does not mean that Phoenix is for twelve steppers.

Why am I stressing this? In and of itself this is a minor point. Phoenix is a small program and makes little difference to what we are discussing. However, I believe it points up your tendency towards faulty reasoning. And, for that reason, I am saying that, in this case, the major facts are less important than the reasoning.

Phoenix is not for twelve step members. Phoenix is for anyone who wants to stop abusing drugs, regardless of whether they were in a program or not. As I have said before, there are members who have been to twelve step programs and there are members who have not.

Second:

I do insist that you are portraying AA in a bad light. But, the reason for my making this assertion about you is that you entire argument (in my view) is negative.

Here is what I mean. Much of your anti AA and anti 12 step argument is more about the nature of addiction and not about any programs of any kind or type. The addictions have built into them this tragedy of relapse, suicide and destruction of life.

How do we help people. You seem to be someone who is deeply involved in the field, has done lots of research and reading, and who leads your own groups. You more than anyone should be moving towards alternatives that might help.

Your anti AA and anti 12 step attitude would not rankle if it was balanced with positives in the direction of what works or what might work. Phoenix Multi Sport, thus far, and with the people involved (admittedly a small sample and it is a very young organization) may be on to something. The real and living people out here who I met are very enthusiastic. What are you enthusiastic about? What do you point to as possibilities for people who are trapped by an addiction?

In my mind, the problem is not AA or 12 steps but Addiction and why people need to be addicted. And, it in my opinion, so many are addicted because they find no meaning in their lives. They feel empty inside, unfulfilled because they see no purpose to their lives.

Allan

[Ray Smith]

In my mind, the problem is not AA or 12 steps but Addiction and why people need to be addicted. And, it in my opinion, so many are addicted because they find no meaning in their lives. They feel empty inside, unfulfilled because they see no purpose to their lives.

Allan

Allan,

You're quick to dismiss Narconon, what is the difference? Their members, like AA members are convinced that they have the inside track to dealing with addictions. Could it be that Narconon (Scientology) is a thinly disguised quasi-religious program that fails to demonstrate any validity to its claims?

For the select few, there is no harm and some even seem to thrive in those groups, so should we look the other way when it comes to all the people it doesn't work for?

[ASchwartz]

Ray,

You're quick to dismiss Narconon, what is the difference? Their members, like AA members are convinced that they have the inside track to dealing with addictions. Could it be that Narconon (Scientology) is a thinly disguised quasi-religious program that fails to demonstrate any validity to its claims?


Once again, you have missed the point and given another example of your negativity. Yes, Narconon is scientology and that is extremely suspicious. But, what do you have to offer in a Positive direction?

Allan

[John Rutledge]

deleted.....

[Ray Smith]

Ray,



Once again, you have missed the point and given another example of your negativity. Yes, Narconon is scientology and that is extremely suspicious. But, what do you have to offer in a Positive direction?

Allan

Because of the huge overlap people in who have coexisting mental health and substance abuse disorders, first thing I'd suggest is a mental health assessment. This assessment can be a guide as to what may be the best treatment method for the person. The program I work for uses Motivational Interviewing with MH clients with or without substance abuse issues.

Brief interventions performed by health care providers, statistically, have the best outcomes, followed by Motivational Enhancement.

If you have a supportive family, Community Reinforcement Approach and CRAFT for the family.

Antabuse or craving reduction drugs in combination with individual therapy. CBT or DBT classes.

If the person is a reader, there are now hundreds of books available on the subject; one of the best known of these is Rational Recovery by Jack Trimpey.

If the person is computer savvy, there is plenty of online support and information:

SOS:
http://www.sossobriety.org/
http://health.groups.yahoo.com/group/sossaveourselves/

SMART:
http://www.smartrecovery.org/
http://smartrecovery.org/SMARTBoard/

LifeRing:
http://www.unhooked.com/index.htm
http://forums.delphiforums.com/lifering/start

WFS:
http://www.womenfor sobriety.org/

RR:
http://www.rational.org/

And with all those options, the majority of people, 80%, quit on their
own. The idea that a person NEEDS a face to face group in order to be able to stop is one of the most successful pieces of misinformation that has come out of AA. People quit drinking or drugging on their own every day and have been doing so for thousands of years. Teaching people they cannot quit on their own keeps people from making a serious effort and makes it more difficult to succeed. Imagine if everyone believed they must join a 12step program in order to quit smoking.

I haven't missed the point, I've been trying to make a different point, and that's why I brought up Narconon. Almost any objection you can raise against Narconon can also be leveled against AA. Don't get me wrong, I'm not suggesting Narconon as a recovery program, but you'll find people in that program who will swear by it and give glowing testimonials who cannot see the downside of that program. I see a major flaw in mixing recovery and religion of any kind; dealing with both a relapse and a crisis of faith is traumatic. When you start telling people they have a 'spiritual disease', you're getting into a very murky area, I think professionals should stick to evidence based practices. Peele's Diseasing of America: How we allowed recovery zealots and the treatment industry to convince us we are out of control does an excellent job of shedding light on this problem.

And if something doesn't work, you try something else. Relapses do not make a person a "poor unfortunate" who cannot get clean. People who fail at 12step treatment are told they aren't trying hard enough and sent back for more of the same until they finally get sick of the cycle and quit, while AA grabs the credit.

Until AA outperforms spontaneous remission, it cannot be considered a valid form of recovery. It is a false path, one that keeps people away from other methods that have better outcomes.

[John Rutledge]

deleted....

[Ray Smith]

I have not made the kind of study into Narconon/Scientology that I have into 12step treatment, but from what I have found it that there exists a layer of deniability between Narconon and Scientology that reminds me of AA and 12step rehabs. "No, no, no, it the other one that takes all your money and we're not really them."

Narconon is the hook, if people do well in it, it gets them curious about Scientology.

Both are quasi-religious treatment methods that deny they are religious, the people involved claim they have the true way and both claim inflated success rates. Members are encouraged to cut out people who are not members, claiming outsiders cannot understand, I believe it is more of an attempt to keep members from being exposed to outside views.

I really don't see any difference in the more extreme cases. Granted, the anti-medication faction of AA is only about 20% as compared to Scientology's 80%+,but people die no matter who is preaching it.

I tried Antabuse once in rehab after two weeks of not drinking. Made me feel slightly nauseous all the time, so I ignored it for years. It may have helped me a later date had I not had a negative first opinion. Several people I talk to tell me that it works for them. That taking it in front of a spouse helped restore a level of trust that would have been difficult or impossible to achieve without it.

[ASchwartz]

Ray,

The difference between AA and Narconon is that Narconon is part of what is truly a cult. Scientology is a very real cult. They are extremely secretive, have been accused of following and threatening members who want to leave it and keep its leaders in the shadows. AA is not quasi religious, even though you think so. Rather, they are attempting to replace lack of meaning with something meaningful. Its fine that you do not approve and I understand but the Christian religions are not cults: they are not secret, they do not hide in the shadows, etc. But, yes, Christianity is religious and AA does believe that religion helps.

You continue to point out the high drop out rate and the failure of AA. But, it is not the failure of AA but the frustrating nature of the addictions.

Antabuse was itself a failure from the start because, if someone wanted to drink, they just did not take it and that way did not feel nauseated. The new medications claim to take the craving for alcohol away. However, even there, the results have been mixed and there, too, if people stop taking the medication, the cravings return. In addition, if the person wants to drink, they stop the medicine. It seems that there is this "wanting to drink" that is separate from "craving."

I happen to agree with you, as do many others, that psychogical problems cannot and should not be separated from the treatment of the addicted person. They need to be treated together and to be seen as part of the same "syndrome."

Allan

[Ray Smith]

Well Allen, I haven't called AA a cult, but it is at least cult-like. Former member of AA's Board of Directors, George Vaillant and AA historian, Dick B. both call AA a cult, but I find it to be a conversation stopper. I do find that AA does fit almost all the 100 signs of being a cult on "The Cult Test" at:
http://www.orange-papers.org/orange-cult_q0.html

Narconon is not as obvious as Scientology, it's more of a way to entice people into the real cult. I would agree that Scientology is an obvious cult, but I don't think the difference between Narconon and AA on the spectrum is vast.

Antabuse? That's all you got out of all I wrote? I believe it's justified to say it works for some people.

"Researchers analyzed data gathered from 1993 to 2002, when 180 chronic alcoholics admitted to a two-year comprehensive integrated treatment program called the Outpatient Longterm Intensive Therapy for Alcoholics (OLITA), in which supervised intake of disulfiram or calcium carbimide is a major component of the program.

"We found an abstinence rate of more than 50 percent among the patients studied," said Ehrenreich. "Long-term use of alcohol deterrents appeared to be well-tolerated. Abstinence rates were better in patients who stayed on alcohol deterrents for more than 20 months as compared to patients who terminated intake at 13 to 20 months." "
http://alcoholism.about.com/od/meds/a/blacer060108.htm

The Handbook of alcoholism treatment approaches: Effective alternatives lists Disulfiram 22nd in effectiveness of the 48 alcohol treatment methods they studied.
http://www.behaviortherapy.com/whatworks.htm

My biggest problem with the promotion of 12step treatment on these boards is that we're not talking about the general public, these boards are for folks with mental illnesses. The rule of thumb in the treatment of coexisting disorders is that half of all people with mental illness have substance abuse issues and half of people with substance abuse issues have a mental illness. So why are all people with substance abuse issues directed to treatment where mental health is largely ignored?

In 12step treatment, mental health is given lip service and little else; the abstinence rate for those with coexisting disorders in traditional 12step treatment is "too small to be accurately measured." [Kathleen Sciacca]

"(12step) Addiction professionals may believe that mental illness is a symptom or manifestation of substance abuse; mental health professionals may believe that substance abuse is a symptom of mental illness. Neither group is therefore likely to provide effective treatment for multiple diagnosed patients in their usual treatment setting." [Kenneth Minkoff]

Interagency Program development was implemented in Michigan in 1985. It proved that continuity of care across systems, with professionals of varied disciplines, is attainable and resulted in improved, less costly services for the dually diagnosed clients. So why, almost twenty five years later, has so little changed?

I think the question of whether AA is religious or not deserves its own thread and it is way too late for that tonight.

[ASchwartz]

Ray, I am impressed with your knowledge and am beginning to enjoy our conversation. Have a good evening.

Allan

[John Rutledge]

deleted.....

[Ray Smith]

Ray, I am impressed with your knowledge and am beginning to enjoy our conversation. Have a good evening.

Allan

Thanks, Allan.

My objections to AA started with the religious nature of the program, but the more I examined the program I found statistically, it doesn't work very well, and for the population I work with, those with moderate to severe mental illness, it rarely works at all. Beyond the statistics, I have ethical problems with those who would send folks with anxiety, depression, or self esteem problems to a group that believes that every substance abuser needs ego deflation or that delusional people need instruction in magical thinking.

Working with people who have mental illnesses, helping them with simple things that allow them to stay out of group homes or institutions is my job and my passion. I primarily work with those who have coexisting substance abuse issues.

After being treated unsuccessfully for depression, I discovered amphetamines not only afforded me the energy to work my two jobs, but relieved my depression. This led to drinking in order to sleep at night.

After a couple of years, I was noticing the side effects and amphetamines were becoming more difficult to obtain, so I quit, but I had developed a sizable addiction to alcohol.

I experienced more problems with depression. No one would treat the depression until I had several months clean from alcohol, I was told that AA was the only way to quit. Thus began my two decade journey into ineffective, inappropriate treatment.

I've experienced some of the worst and come through. I want to use what I learned in those years and in the eight years that I've been sober to help people avoid going through the same things.

[Ray Smith]

I now believe that the most harmful aspect of the program as written is the idea that one is powerless over alcoholism (or their addiction).

I joined AA in order to do something about my addiction. Yes, I was conned into it, but I wasn't forced. If I had been powerless, I wouldn't have done anything, I shouldn't be able to comprehend doing anything about it. None of this "powerless over the first drink" nonsense, that is not how it is written in the literature, that is a rationalization, an afterthought attempting to make sense of the absurd.

Bill Wilson describes alcoholics as having out of control egos. While that may have been the case for Bill Wilson, it simply is not the case for many, if not most. Foisting powerlessness on a person with a negative self image is digging the hole deeper. Alcoholics have been marginalized by society, they do not need to further internalize powerlessness. Empowerment, gaining control of self, realizing potential, tapping internal strengths to make positive changes, rather than relying on outside forces to "fix" them, this should be at the center of any substance abuse treatment, but especially for those who experience coexisting mental illness.