Real Science

[Ray Smith]

Peele on "maturing out"

"I give this common sense example because "addiction experts" (like this reader) are unlikely to be deterred by actual data. According to the National Survey on Drug Use and Health, 21 percent of Americans ages 18-25 are dependent on or abuse substances (the most being alcohol dependent), while 7 percent of those over 26 are. According to Kenneth Sher and his colleagues in Psychological Theories of Drinking and Alcoholism (p. 91): "The large declines in the mid- to late 20s is often termed 'maturing out' and is associated with . . . . marriage, pregnancy (for both women, and to a lesser degree, their spouses)." The failure to mature out is often due to psychopathology factors., 21 percent of Americans ages 18-25 are dependent on or abuse substances (the most being alcohol dependent), while 7 percent of those over 26 are. According to Kenneth Sher and his colleagues in Psychological Theories of Drinking and Alcoholism (p. 91): "The large declines in the mid- to late 20s is often termed 'maturing out' and is associated with . . . . marriage, pregnancy (for both women, and to a lesser degree, their spouses)." The failure to mature out is often due to psychopathology factors.
full article: http://www.psychologytoday.com/blog/addiction-in-society/200907/addiction-experts-want-you-be-michael-jackson



2007 National Survey on Drug Use & Health: Detailed Tables:
http://www.oas.samhsa.gov/NSDUH/2k7NSDUH/tabs/Sect5peTabs1to56.htm#Tab5.2B

[Ray Smith]

Handbook of alcoholism treatment approaches: Effective alternatives, Allyn & Bacon, shows 37 out of 48 methods tested to be superior to Alcoholics Anonymous (and that's not dual diagnosis specific).

1) Brief interventions

2) Motivational enhancement

3) GABA agonist (Acamprosate)

4.5) Community Reinforcement

4.5) Self-change manual

6) Opiate antagonist (Naltrexone)

7) Behavioral self-control training

8) Behavior contracting

9) Social skills training

10) Marital therapy-Behavioral

11) Aversion therapy-Nausea

12) Case managment

13) Cognitive Therapy

14.5) Aversion Therapy, Covert Sensitization

14.5) Aversion Therapy. Apneic

16) Family Therapy

17) Acupuncture

18) Client-centered Counsling

19) Aversion therapy, Electrical

20) Exercise

21) Stress Management

22) Antidipsotropic- Disulfiram

23) Antidepressant-SSRI

24) Problem Solving

25) Lithium

26) Marital therapy- Nonbehavioral

27) Group process pyschotherapy

28) Functional analysis

29) Relapse Prevention

30) Self-monitoring

31) Hypnosis

32) Psychedelic medication

33) Antidipsotropic-calcium carbimide

34) Attention Placebo

35) Serotonin agonist

36) Treatment as usual

37) Twelve-step facilitation

* 38) Alcoholics anonymous

39) Anxiolytic medication

40) Milieu Therapy

41) Antidipsotropic-metronidazole

42) Antidepressant medication (non-SSRI)

43) Videotape sefl-confrontation

44) Relaxation training

45) Confrontational Counseling

46) Psychotherapy

47) Gerneral alcoholism counseling

48) Education (tapes, lectures, or films)

[Ray Smith]

I was just over on RichardDawkins.net and saw that someone used this to explain "miracles" in AA:

ARGUMENT FROM AIRPLANE CRASH, a.k.a. YOU ONLY HEAR FROM THE SURVIVORS (II)
(1) An airplane I was on crashed, killing most passengers.
(2) I survived!
(3) It was a MIRACLE!
(4) Only God could have done that.
(5) Therefore, God exists.
(from http://www.godlessgeeks.com/LINKS/GodProof.htm )

[Ray Smith]

Many Alcoholics Recover on Their Own

But the study’s real shocker came from examining that larger group that never seeks treatment. It turns out that, contrary to common treatment wisdom, untreated, undiagnosed alcoholism doesn’t usually mean a lifetime of suffering the disease’s ravages. In fact, the overwhelming majority of dependent drinkers stop and recover completely on their own. “One of the big surprises was that 72 percent of people develop alcohol dependence at some point in their lives, and have a single episode of alcohol dependence that lasts on average three or four years,” says Dr. Willenbring. “And then they remit and they don’t relapse — ever. Only 28 percent have recurring episodes. People with recurring episodes have, on average, five episodes of decreasing length. So that really flies in the face of what most of us have thought for many years, and certainly what’s taught in treatment programs.”
http://www.bhcjournal.com/News/SpecialFeatures/tabid/252/Default.aspx?PageNumber=2&ArticleId=14149&PageNumber=2

[Ray Smith]

What's the most important factor in overcoming alcoholism?

Dear Stanton:

Does the amount or extent of what there is to lose in one's life (successful
career, loved ones, money, respect, etc.) have an impact on helping an alcoholic
to recover? At the risk of overstating, if an alcoholic realizes how much is at
stake personally and/or professionally, has this been shown to be a positive
incentive for cessation of alcohol abuse?

Thank you in advance for your guidance.

Best regards,
Jason

Dear Jason:

I couldn't put it better myself. To quote George Vaillant, in The Natural
History of Alcoholism, refering particularly to Baekeland et al. (1975):

The most important single prognostic variable associated with remission among
alcoholics who attend alcohol clinics is having something to lose if they
continue to abuse alcohol.... Patients cited changed life circumstances rather
than clinic intervention as most important to their abstinence.... Improved
working and housing conditions made a difference in 40 percent of good outcomes,
intrapsychic change in 32 percent, improved marriage in 32 percent, and a single
3-hour session of advice and education about drinking... in 35 percent.

These results apply in all situations-in other words, more than the type of
therapy, or even whether the person enters therapy, the best chance for recovery
is due to the number and quality of the person's attachments to life. Having
people that care about them, including family, friends, and community
involvements; having activities of every sort that they find meaningful; having
work skills, opportunities, and involvement; and so on predict whether people
will have the motivation and resources to overcome alcoholism. They have both
more to lose and more to counteract the appeal of the addiction.

References

Baekeland, F., Lundwall, L., & Kissin, B. (1975). Methods for the treatment of
chronic alcoholism: A critical appraisal. In R. J. Gibbons, Y. Israel, H.
Kalant, R. E. Popham, W. Schmidt, & R. G. Smart (Eds.), Research advances in
alcohol and drug problems (Vol. 2, pp. 247-327). New York: Wiley.
Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge, MA:Harvard
University Press.

Best,
Stanton
http://www.peele.net/faq/factor.html