Addiction in America

[Kevy Baby]

Originally Posted by Alex

Yes, AA is a fraud.

A program that has proven successful for a large number of people is a fraud? And so far, the evidence that you are providing is a single episode of an entertainment show? (I enjoy Penn and Teller, but their Bull**** program is just swinging the pendulum to the opposite extreme on most topics, providing a HEAVILY slanted view of the given topic). And yes, I am sure you will find obscure testimony that also downplays AA. But the bottom line is that the program works for a vast majority of the people. Even if you believe that its success is strictly due to some placebo effect, does that make it a fraud?

There exists enough evidence (empirical, not anecdotal) to support the success of AA. Yes, there is some support to the contrary (particularly a Harvard study), so it is not a "slam dunk." No, AA is not for everyone and no, AA is not 100% effective. But its TRUE success rate speaks for itself.

Originally Posted by Alex

...my major complaint with it is that it is frequently legally mandated and despite what proponents will say, it is a religious program. If I were ever convicted of a DUI, odds are good that my government would give me the choice of going to jail or participating in a religious institution. That pisses me off, both at the government and at AA

I would say that it is a religious BASED program, not a religious program. I have brought this up with two different friends who have gained success through the program and BOTH have said that there are many non-religious options of the AA program.

But the bottom line is that if convicted of DUI, you have options: AA or jail. Would you prefer the only option to be jail? No one is forcing you to participate in a religious program - you always have another choice. However, I do agree that OTHER proven methods of alcohol recovery should be allowed - a third (fourth, etc.) option. But the bottom line is that no one is FORCED to AA (or at least shouldn't be - there have been a few exceptional cases of which the basis of has been thrown out in higher court appeals all the way to the Supreme Court).

But how about the second part of the statement that you are pissed off at AA that AA is an option to jail? What is the justification for this anger?

Originally Posted by Alex

Like I said, addiction is a condition beyond personal control. Becoming addicted is not.

Then you do not understand the psychological aspect of this disease.

No one starts drinking (or taking drugs, et. al.) to BECOME an addict (OK, yes, there are rare exceptions to this, but they are quite exceptional). The transition is beyond their control. It is a psychological drive fueled by a physical driver. The psychological/physical balance is different for each case, but both aspects are present. If you believe that every person has the capability to prevent becoming an addict, then I flat out say you are wrong and that you need to research the topic more.

[Alex]

NA: That is a religious (spiritual if you wish) idea that I do not accept. And simply changing the word God to "power" does not make it any less religious than it did when Creationists moved on to Intelligent Design, which most here would reject as forcing religion into our science classes.

I do not accept that there is a force outside of myself controlling my life. And the fact that this "force" can be different things for different people just emphasizes the religious/spiritual nature of it. And every time a forced attendance case has made it into the federal appellate system the court has agreed.

The reason I think government agencies (as well as employers and insurance companies) find AA so attractive is not because it is so effective (AA has never officially released any numbers quantifying the success rates of their program and independent studies tend to find minimal improvement if any over controls) but because compared to other treatments it is, by far, much cheaper than the alternatives.

===

Kevy Baby, AA's own internal survey says that the 12-month effective rate for AA is 5% per year of participation. That is the same rate as among people who don't seek any treatment at all. So I hardly see how it could be said to be effective for the "works for a vast majority of the people." Among people who willingly seek treatment for alcoholism the success rate of AA is identical to pretty much every other moderated treatment method.

If 5% will be sober after a year no matter what, were the 5% who do so while attending AA give credit to being one of the lucky ones or to AA when actually that just happened to be where they were standing when it happened?

So, if you have empirical cites that AA works for the vast majority of people I'd be very interested in seeing them (note: I'm assuming "works" means that you're not drinking).

And being sentenced to AA is still a very common occurence. The fact that I consider it to require an unacceptable religious statement to attend (and NA says it is the only required thing you believe) that is unacceptable to me. No, if arrested for a DUI I would go to AA instead of jail for the same reason that if given the choice I would go sit in the mall food court for 30 days instead of going to jail. That is my justification for my anger. If it were entirely a self-chosen thing then I wouldn't really care about it at all in any way than I care about other forms of faith healing (defined as any treatment where failure is blamed on the willingness of the patient to be cured).

Nobody base jumps to find the one parachute that won't open but when it happens they are still responsible for having taken the risk. Yes, every person has the capacity to avoid becoming an addict. If you want to be certain of not becoming an alcoholic, then don't drink (or do whatever else you don't want to be addicted to). Of everything on that list above the only thing you can't abstain from is food.

I don't smoke because I don't want to become addicted to it and I consider it high risk. I'm pretty sure that so long as I keep making that decision I will never wake up to suddenly realize that I can't get through the day without a nicotine hit. That's the same reason I was willing to try LSD (low risk of addiction) but not heroin (high risk). Taking the risk is a choice, the outcome of taking the risk may not be. I do hold you responsible for making the initial choice even if I don't for the ultimate state you're in. I also hold you responsible for your behavior while addicted. Being a heroin addict may be explanation for why you robbed the convenience but it is not an excuse.

I'm willing to run the risk that 6-12 drinks a year will turn me into an alcoholic. If it does, my addiction will not be by choice but my exposure to the risk of becoming addicted will have been. And if I drive while drunk, I am responsible for that decision.

Personally, I don't find holding people responsible for the decisions they made to be a "stigma." It also doesn't mean that I don't want to help people deal with their situations and move themselves to a better place.

I have no problem with the idea that having a supportive social network will aid in finding the inner strength and desire to kick a habit (and still fail most of the time). I just don't buy that the specific 12-steps have anything to do with it which is why AA is generally found equivalent to other guided treatments.

===

Chernabog, of course they put strain on their families and the health care system. But that does not make it a public health issue except insofar as you accept that idea that any decision an individual makes that can conceivably result in a hospital bill gives the state an interest in prohibiting that decision.

And if so, then once again prohibiting alcohol should be everybody's single biggest public health issue. But while alcohol is legal I am of the opinion that heroin and vicodin should be legal.

Criminalize the bad behavior, not the decision. If you can do a half pound of coke a day and still be high functioning then, you're not a criminal and shouldn't be one just be the guy next to you will go out and rob convenience stores.

Prohibition of drugs and alcohol among minors is something I completely support for the very reason that they are not yet old enough to make informed decisions about their behavior. And if you were an alcoholic by 15 I have full sympathy for such people.

I still support, though, broadly available federally (and locally) subsidized dependency treatment for dependencies shown to cause serious immediate threats to the community and others. I just expect the treatments selected to bear up under the strain of proving effectiveness.

=====

I do find it interesting that alcoholism (and other addictions) seem to simultaneously be considered a physiological medical disease, but one best treated by apologizing to ex-girlfriends about bad behavior and talking it through in a group. What other medical disease is treated this way?

Why is smoking not generally treated using the 12-step method?

=====

Anyway, I didn't mean to cause a debate specifically about AA. iSm asked for thoughts on addiction so I shared mine.

I do not intend to minimize the difficulties and personal tragedies of addiction, though I wouldn't agree that my views on the nature of addiction do so.

[€uroMeinke]

Originally Posted by Alex

I do not accept that there is a force outside of myself controlling my life.

And yet you also do not believe in Free Will, so if it's not you in control, nor an outside force - what is it that is in your cosmology?

[Alex]

Chemistry and physics. The key aspect of it that I am balking at is not "outside of myself." Obviously there are things outside of myself that affect me, change me, and direct me.

The part that I balk at is "controlling" in the sense that there is some force out there that is aware of me, of my condition, and can change it.

To my view, there is no non-religious (and I consider "spirituality" to just be religion without a church; government has no more right to force a view of spirituality on me than they do to force a specific religion) way to accept and say these phrases:

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

7. Humbly asked Him to remove our shortcomings.

8. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His Will for us and the power to carry that out.

Now, if you want to argue that the outside force can be something completely disinterested in you, your condition, and your fate, then that is a different thing. But then those 5 steps out of the 12 have essentially zero meaningful content. A disinterested force cannot remove your shortcomings. A disinterested force cannot offer increased understanding of its will. It can not return you to sanity, at least not with an intent. It can not accept responsibility for our care, will, and lives.


===

One other thing, I don't mean to offer up that episode of Bull**** as a cite, but just a fair compendium of my views. And they were my views long before that episode existed. They were my views when I took the anti-mandatory view in a high school debate back in 1991. But in trying to avoid a long itemization of my views I just figured I'd point there. I don't expect (or ask) that anybody accept it as correct simply because it was on TV or because Penn Jillette said it while Teller stood quietly beside him.

[Morrigoon]

Thank god it is legally demanded or some LoTers might not be here today.

[Not Afraid]

I wouldn't call AA a religious program. A spiritual program would be a more fitting description. There is a basic tenet you must accept - that there is a power greater than yourself and that you are not it. But, that's pretty simplified to be considered a religion. However, falsely believing it is a religious program keeps many people away.

[Chernabog]

And you are certainly entitled to your opinion, even if it discounts factual information and the experiences of hundreds of thousands of recovering addicts. (And Penn & Teller are always right, RIGHT?)

You do realize that because of stigmas like the ones you present above, that many people who need help do not reach out and are unable to have the willingness or the means to better their lives? People relay experiences (very, very often) where they drank like fish starting at 11 years old when they tried their first drink. You rolled the dice kid, you got born to your cracked out mommy, tsk tsk shame on you!

Those people that you knew that destroyed their lives with alcohol, heroin and pot, they just killed themselves in their own little bubble world now did they? Dropped off the face of the earth without putting any strain on the healthcare system or their families did they?

Drunk driving is not an addiction issue? No, not every time. But jeez, if you're an addict who can't control your drinking (again, it is not a WILLPOWER issue) then how are you going to get home? If you get one DUI, then perhaps, oops you had one too many glasses of wine with dinner, and hopefully didn't run over someone's kid in the road. If you get more than one DUI, you REALLY gotta look at your drinking. If that one DUI puts you in AA and the thought of having to forcibly go there again turns you off of drinking heavily, then GOOD.

I'm glad that more people would agree with me. Sort of gives hope towards a general understanding and solution rather than a blind fumble into a pile of bull$hit.

[Capt Jack]

drugs - back in my 20's I had a pretty serious meth habit. wasnt exactly called that then but I digress. got pissed off, almost killed someone in a blind rage over drugs and money, got scared, quit...never looked back. after it was behind me, never had the remotest urge to do it again. still don't


tobacco - geebus. cigs....100x harder to stop than meth. not a clue why, but it is. my mom died from smoking. my dad and my wife, smoking and booze. you'd figure I'd know better...and I do.

still...I havent stopped. Im workin' on it. at least its not a pack and a half a day anymore

its freakin hard.
stopping is easy. quitting, not so much

44.3% of young adults ages 18 to 25 use tobacco, the highest rate for any age group.

yeah, that surprised me a lot. kinda makes me sad


caffine - is it bad to say I dont want to and have no intention to ever stop? I know Im incredibly hooked. dont honestly care. not in the remotest

[Not Afraid]

All I can say is that I'm glad you're not an alcoholic or an addict, Alex.

[Alex]

Originally Posted by Not Afraid

All I can say is that I'm glad you're not an alcoholic or an addict, Alex.

Why? The studies indicate that I have about the same chance of kicking it as anybody else? But can you explain to me how those five steps do not require belief of a religious nature? Or at least a belief that almost all of us would laugh out of the room if put forward in a biology class?

But I too am glad I'm not an addict. Addicts tend to do stupid **** and if I have one phobia it is embarrassment. Being addicted to something seems like a surefire recipe for me to be embarrassed a lot (which is why my one drink-to-puking-in-the-bar-on-the-waitress incident was enough to keep me to 6-12 ever since).


I agree with Steve that the treatments ultimately (though way off in the future probably) are likely to be pharmacological (either in drugs that can "cure" the addiction or in creation of drugs that can create the highs without addiction).

Steve, I believe the 20% study was a multi-year study (sobriety without treatment among alcoholics approaches 50% over a ten year span) and also self-selected. That is one irony I find in enforced-AA. That if AA does have a benefit it is mostly likely to manifest among self-selected participants (those who were already motivated enough to find assistance in quitting) which is a benefit largely negated by mandated participation.