So far the comments have been about people's prior experiences with the topic (which is great), or prior opinions about the topic (which is ok). But the more interesting story is being overlooked: this is heavy-duty new research that overturns previous conclusions, including the prior expectations of at least one of the lead authors. It would be good to discuss the specifics of the article and the new study.
Do you think you could elaborate why you believe this is "heavy-duty" new research (or even new research at all, rather than a new meta-analytic synthesis of old research)?
My quick read of the study suggests that they examined several outcomes, got null or low powered results on most of them, and chose to highlight the single result which did show a significantly positive effect on recovery; that result was based on a meta-analytic estimate of the pooled sample of just two studies. In particular, my understanding is that this study found a null on "percentage days abstinent", a null on "longest period of abstinence", a null on "drinks per drinking day", a null on "alcohol-related consequences". For alcohol addiction severity they report the results of one study without doing any original analysis. And for "rates of continuous abstinence" they found a positive effect. In most cases these are graded as "low certainty evidence". The positive effect is claimed to be "high certainty evidence", but the CI / p-value for the positive effect is not adjusted for multiple comparisons -- I don't think that's fatal, but it does speak to the fragility of the outcome.
The other concern I have is that they separate "manualized" treatments (e.g. AA treatments administered according to a protocol) from "non-manualized" (e.g. ad hoc administration of the AA treatment) treatments. This is fine -- we would expect to see that if something about the protocol was useful, the non-manualized treatments would display an attenuated version of the same effect. Instead we get a null on the original positive effect, and a positive effect on one of the original nulls
Finally, the authors seem a little loose with what the comparison groups are. They claim they recruited studies which compared AA to no treatment, but the results are all motivated as being AA versus CBT. What happened to the no treatment studies? Perhaps these are buried in the full text. The rate of spontaneous remission of addiction is believed to be fairly high and most of the past criticism of the efficacy of AA has been motivated by comparison to spontaneous remission.
It strikes me that there is significant distortion of the study findings from the Cochrane write-up to the Stanford press release, and from the Stanford press release to the NYT piece, and that in both cases the distortion is in favour of claiming the study has found affirmative evidence that AA works better, rather than just no evidence to claim it works worse. For instance, one of the thrusts of the NYT piece is that the past Cochrane review was based on a limited number of studies... but the operative finding in this review is based on an even more limited number of studies, even if the pool of studies from which they drew has become larger over the last 15 years.
All of this is from a quick read of the review -- I am off campus right now and don't feel like VPNing or pirating the full text to deep dive the analysis.
> And for "rates of continuous abstinence" they found a positive effect.
It’s been a while since I reviewed the literature for substance abuse disorder, but if I remember correctly it was highly disputed whether complete abstinence was necessary (or even beneficial) for treatment. Has this changed?
The argument was that by focusing on abstinence you are setting a significant part of your patience up for failure with all the psychological harm involved in knowing that they’ve failed, which might result in severe and frequent relapses.
EDIT: To conclude. I find it hard to draw conclusions if success is measured in “days of abstinence”. That means that a patient that has recovered from cognitive behavior therapy (CBT) that uses occasionally and non-detrimentally is not considered a success! Further AA or other 12-step programs do often stress abstinence while CBT does not, this creates a counting bias in favor of 12-step programs.
Thanks! That's a fabulous comment. By "heavy duty new research" I was just referring to this from the article:
In the last decade or so, researchers have published a number of very high-quality randomized trials and quasi-experiments. Of the 27 studies in the new review, 21 have randomized designs. Together, these flip the conclusion.
That sounds impressive. If it turns out not to be so impressive, that's definitely on topic.
This reply will probably be ignored, since it has been two days and ycombinator has a pretty short attention span, but I have skimmed over the full study.
There are about 10 findings, and the only “high” quality finding is that there appears to be a significant increase in abstinence, especially long term abstinence from people who get treatments which get them in the rooms of AA (“TSF” treatments).
We can dive down in to the details about this finding (percent abstinent) on pages 88 and 89 of the report. They actually use six different studies, but only two of them provide information at the one-year follow-up, so only those two get listed in the summary on page 4 of the report.
Considering that they compared a number of things, and only percentage of subjects abstinent showed, with high confidence, a difference between AA/TSF and other treatments, I’m a little worried we may be seeing a multiple comparison fallacy. Then again, this is unlikely: They are seeing P values of 0.02 and 0.03 (1-in-30 to 1-in-50) for the abstinent numbers, but only look at about 10 factors.
Humphreys 2014, another meta-analysis of multiple studies, showed AA effectiveness which can not be attributed to self-selection, but it saw something different: A fairly small but significant increase in the percentage of days abstinent. While they did see in the 2020 Cochrane review, they did not see it with a high level of confidence (see pages 89-90).
Percentage days heavy drinking — I don’t have a copy of Brandsma 1980 handy, but I think that’s what the “Brandsma 1980 shows that AA results in increased binge drinking!!!111!!!!!” claim parroted by the usual anti-AA crowd talks about — might be increased in the short term after starting AA treatment, based on the one study which has 6-month follow-up figures for this; Brandsma 1980 only saw it at the 3-month follow-up and not later. Then again, the Cochrane study of those numbers show a pretty high P value (0.79, just glancing at those figures), which means we still don’t really know if Brandsma 1980 actually saw something. Scott Alexander dismisses it as an example of a multiple comparison fallacy, and the P values for it in Cochrane 2020 means we probably didn’t actually see something, but this may merit additional investigation.
Cochrane 2020, of course, didn’t look at the longitudinal studies showing really high abstinence rates for people who self-select to go to a lot of AA meetings, but even using only randomized studies, we are seeing a significant increase in number of subjects who get and stay sober when they engage in treatment which encourages AA attendance.
Another thing: There are no recent high-quality studies comparing AA to no treatment (“spontaneous remission”, an expression I see used mainly by people with a pretty strong anti-AA bias) because it’s been established for a long time that AA (or any other treatment you can think of) is better than no treatment. Even Brandsma 1980 saw that going to their AA-like meetings was significantly better than getting no treatment at all.
In summary, with some caveats, we are seeing solid scientific evidence that AA really helps alcoholics get sober and stay sober. Ten years ago, someone could still say “AA does not have a higher success rate than no treatment” with a straight face; today, to claim something like that requires ignoring a lot of scientific evidence.
Sorry for going on a rant here, but I dislike the framing implicit in "spontaneous remission".
Addiction does vanish spontaneously with a wave of a wand. These are people of flesh and blood and free will that managed to overcome their addiction. They are making attempts at treating themselves. They might be reading blog posts with advice. They may avoid buying alcohol for fear they'll drink it all. They be taking detours around bars. They may be meditating or even self-administering cbt.
This meta-analysis isn't ground breaking. What has been known for awhile is that AA works very well for some, but not at all for others. This has always been the dilemma with AA in research as well as clinically. It won't affect treatment because no one was ever discouraged from trying it at least in my experience.
Bill Wilson[1], co-founder of Alcoholics Anonymous, believed LSD could help alcoholics achieve a "spiritual experience" that was crucial to them attaining sobriety[2] (incidentally, that a spiritual experience could help alcoholics was an idea he got from Carl Jung[3]). Wilson's own experiences with LSD are discussed in detail here: [4]
In the 50's and 60's there was research in to using LSD to treat alcoholism, with promising results:
"Osmond treated more than 700 chronically alcoholic patients with LSD and ended up with around a 50 percent overall success rate. One of Osmond's most compelling studies took place in the late 1950s with a cohort of subjects from the group Alcoholics Anonymous. This cohort was comprised of individuals that had failed the famous 12-step program, and again Osmond hit his 50 percent success rate, this time with a 12-month follow-up period."[5]
In 2012 a meta-analysis of studies with a total of 536 participants found "evidence for a beneficial effect of LSD on alcohol misuse".[6]
I just finished Michael Pollan's How to Change Your Mind and found this bit of history to be one of the most interesting pieces of an overall super interesting book. So frustrating that a moral panic essentially wound up locking away this research for 50 years.
Ibduilast, which is a drug that has been on the market in Japan and safely used for 30 years, has also been used to treat alcohol and opioid addiction.[1][2]
A year ago, for two weeks, I binged on five grams of some drug. It seems it saturated the NMDA receptors (my own uninformed explanation) so for six months alcohol was same as water to me. Cannabis and benzos were also useless.
Now alcohol does make its effect again, but I just drink some beer occasionaly, no more hard liquors. I haven't had any mj in a year, the best part. Oh, and the drug in question... I tried it again a month ago and found it unpleasant, and keeps building that crappy cross-tolerance.
I won't name the drug because I wouldn't like to encourage anyone to try this kind of "treatment", I'm pretty sure my reaction is not typical at all. But it would be nice if there was research about this.
Jungian psychology (shadow work) and the occult have been absolutely critical for me to work through the internal contradictions that led me to seek out drugs in the first place.
The AA way was described in The Power of Habit as one of the examples of successful habit change. Basically: keep the habit's cue(e.g. feeling depressesed) and the reward(social interaction) but replace the bad habit(drinking) with a better one(meeting with the sponsor).
My alcoholism (if it can be called that - it is a spectrum) is driven in part by the social interaction of fellow drinkers. The predictability of seeing each other at the bar, of hanging out and not worrying about the day.
I've talked to one or two of them about doing tea on Tuesdays, or some other thing that could get us from drinking 3-7 stouts a night.
recovering addict here. some words for those who may be struggling.
i tried a number of things over many years (life coach, therapy, meditation retreats, ayahuasca, ibogaine, etc).
i reached a bottom, and nothing i had tried really worked or stuck. kept relapsing after a few months of sobriety at most.
ultimately it was going to AA that i largely credit to my successful transformation into a happy life of sobriety.
if you're not sure if it's right for you and struggling with addiction, i highly recommend having an open mind, and trying 90 meetings and 90 days. see how you feel after. it's the daily practice that is transformative.
there is something powerful about being focused on a purpose with a group of similarly motivated people.
the people in the rooms of AA understand the challenge you're facing in a way that friends and family often don't.
you quickly realize that the 'higher power' thing is a pretty easy to move beyond, regardless of your religious orientation. a 'higher power' can even be a conceptual device - e.g. the wisdom of the people in your meeting who have achieved a life of sobriety.
it's also not to say that AA in itself is a savior. it's a healthy component to integrate as part of a balanced recovery of body, mind, and spirit.
eating well, exercising often, and finding ways to be helpful are other important pillars to incorporate along your journey.
I had other experiences. The friendships I had in AA were superficial. Once, when I was struggling and needed help and people to talk to, I was completely ignored by the people around me. They didn't want to help the struggling - just to have this toxic positivity that nothing is wrong.
I later moved out of state. I came back to visit family, and went back to a meeting to find out that there were rumors that I had relapsed after I moved and continued using until I was homeless. It was a drama fest. Absolutely ridiculous.
When I moved, the meetings I encountered were extremely hostile to atheists.
sorry that you had these experiences, i can relate to aspects of them as well.
each meeting can be quite different. i had to try 10-20 of them in my city to find a few that were on my wavelength.
i don't attend aa meetings as often as i used to in early sobriety, but i still go if i have a friend that's struggling and want to open this resource to them.
at every meeting, there are things that people say that resonate and things that are cringe-worthy or even inflammatory.
part of the meditation and process is being able to be hear and react to everyone's words with equanimity.
> ... and went back to a meeting to find out that there were rumors that I had relapsed after I moved and continued using until I was homeless. It was a drama fest.
I obviously don’t have your unique and nuanced understanding of the situation, but this seems like a common occurrence with all humans when they lack information.
In my experience when we don’t have information, our group tendencies lean towards filling gaps with the outlandish and dramatic.
Again, I don’t know much about AA but I’d question whether that situational behavior was driven by something unique to AA.
Though, their hostility to atheism is a problem they should have addressed long ago.
> When I moved, the meetings I encountered were extremely hostile to atheists.
In my experience there are two types of atheists who go to AA: those for whom religion “isn’t their thing” and those who are actively hostile to religion.
I think the latter group should find an alternative to AA.
> When I moved, the meetings I encountered were extremely hostile to atheists.
That's unfortunate, and mostly in line with other experiences I've heard from friends, etc. AA seems like just another bullshit Christian recruitment/retention facility, that sometimes accidentally helps people who buy into it recover from addiction. Too bad.
I always fancied the stoic concept of “higher power” basically a combination of the Universe and “reason”. This is what I turn to in any theological discussions.
It’s great you’re willing to overcome the technicalities for a greater good. Too many people are restrained by their own ego. Keep up on your righteous path.
After 15yrs of a-abuse, 4 bottles of alcover (sodium oxibate? i believe available - prescription only - only in one country) cured me. I bought 2 cases of xtra-strong beer 'just in case', have had 2 cans on my desk for months now. 0 interest in drinking.
Sodium Oxybate (ie: incredibly expensive GHB) is on the market elsewhere, but not indicated for alcohol abuse and usually heavily controlled (ie: special doctors and pharmacies only).
The heavy control always surprised me while other powerful sedatives flow freely with little control.
AA's 12 Steps use the word God four times. They also refer to "Him" three times, to a higher "Power," a "spiritual awakening," and prayer.
Nearly every step has a reference to spirituality of some kind and most of them are laced with Christian undertones.
More generally the idea behind the 12 steps is to place yourself in the hands of this higher power and allow it to guide you. Basically it requires a belief in prayer.
AA has worked for many many people--which is wonderful and it is demonstrably a great tool for them! But an atheist, humanist, or more generally someone who doesn't believe in spirituality is going to have to go through significant mental gymnastics to deal with the 12 Steps.
It seems to me that if someone doesn't believe in God or a higher power of any kind, there are probably better first line treatments for alcohol addiction. It isn't necessary for an atheist to change their spiritual or religious beliefs in order to recover. Therapy, medication and secular support groups all exist.
I came here to say the same (but undoubtedly not nearly as well as yourself).
It was the religious stuff that put me off completely. Being in a group of people all there with a common cause I felt was quite powerful. Hearing shared experiences from the community was helpful. I just couldn't pretend I was OK with peddling any form of faith.
You can take God as an euphemism for nature or more general something beyond your control. If he exists he probably wouldn't hold it against you. You don't have to deceive yourself to a degree to believe it. You probably can watch a Batman movie without believing in Batman.
I would be skeptical too and it can certainly have a negative impact on addiction groups. Although I would think these negative factors to be worse for people actually believing it. Some people classify them as a sect, but I wouldn't go that far to be honest.
But if it doesn't work for you, I think there are other groups or those that set the focus elsewhere.
I drove someone close to me to a 12 step program, and stayed with them for a session. It was a remarkably positive group of people helping each other through problems.
> Keith Humphreys, Ph.D., professor of psychiatry and behavioral sciences, and his fellow investigators determined that AA was nearly always found to be more effective than psychotherapy in achieving abstinence.
This does not appear to include other programs like pharmacological extinction or the Sinclair method.
> We included randomized controlled trials (RCTs), quasi‐RCTs and non‐randomized studies that compared AA or TSF (AA/TSF) with other interventions, such as motivational enhancement therapy (MET) or cognitive behavioral therapy (CBT), TSF treatment variants, or no treatment.
Ok, I've edited the title to mention psychotherapy, since that's the alternative that the submitted article (at least) focuses on. Which is still an interesting finding.
Outsider's uninformed opinion: if you attend AA then regardless of any official narrative or agenda this means you're spending important time with people who (a) used to drink, and (b) don't drink any more. Their example plus hearing what they've got to say seems like an excellent approach.
I didn’t do AA but did AlAnon for children of alcoholics recovering from trauma. Despite what people think, the 12 step program is super light on the spirituality stuff and very atheist friendly. As a recovery group AlAnon was super useful for getting some closure on the hell my parents dragged me through and just leaving that stuff behind.
Edit:I guess I should have qualified that I’ve only done support groups in SF that have been great and usually hosted by churches.
> the 12 step program is super light on the spirituality stuff and very atheist friendly
This is highly dependent on where you are. I experienced verbal abuse and was made to feel unwelcome at meetings when people found out I'm an atheist. People have told me, verbatim, "You don't belong here if you're denying God".
Needless to say, I am no longer a part of that little cult. I'm doing fine without it.
You know, I've gone to these meetings with a number of people (my mother, who unfortunately lost her battles with it, and other family members/friends). I'll note that I've done this worldwide, to some degree - Japan, USA (east and west coast). I'm saying this to point out that I'm in there as an observer for these people attempting recovery, so this experience is cultivated from multiple viewpoints/locales/etc.
I have witnessed _exactly_ what you're saying, and I've seen people feel so unwelcome that it hurts them more than helps them. It blows my mind the stranglehold that AA has on this industry, given how demeaning it can be to people who are looking for help.
I've seen more success with people going to SMART recovery meetings, which focus on providing a space to talk and seek help without the judgement level associated with AA.
My understanding is that they don't even need you to acknowledge a God, just that "there is cosmically something bigger than you and you have no power to govern it"
While that is touted as being the case, many groups make use of the Serenity Prayer[1]. Most of the time, it directly invokes the use of "God" or "Father" which can turn off non-believers. Some groups use a variation that omits direct reference to a religious entity, while a few groups are committed to avoiding the prayer altogether.
The experience varies from group to group, and even between different meeting times at the same group. They all have their own interpretations and subcultures.
Same here, been to Al-Anon meetings in London UK, all hosted in church basements and with zero religious nonsense being spouted... just the Serenity Prayer and tbh that one is just plain good advice so I did not mind :)
I have nothing but praise for the 12-step system as I experienced it
If you're one of those for whom AA didn't work I would encourage you to look at the The Sinclair Method. It has changed many lives for the better (including mine).
This is how I quit and it's a profoundly disappointing and discouraging thing that this is not more broadly known. I should have quit 15-20 years before I actually did and had I known about The Sinclair Method the first time I was subjected to AA and did that instead, I'm convinced I would have been able to quit then. However, I wasn't aware of this and continued drinking for another 17 years.
This is a significantly-incorrect, surface-level understanding of the "Sinclair Method". As another poster noted, naltrexone (or similar) prevent one from feeling much of anything from alcohol (though you'd still be physically impaired...). Without any dose (drink) --> response (pleasant-feeling) relationship, users tend to stop drinking significantly (because drinking doesn't really do anything)...
The "Sinclair Method" is, basically, to promise to take naltrexone (or similar) 30 minutes or so before you ever take a drink. That way, if/when you drink, you never feel the "drink" and your mind can return to normal.
No drug will "make you stop drinking" (though disulfiram may make you want to do so); the Sinclair Method attempts to remove your interest in drinking.
Readit News
My quick read of the study suggests that they examined several outcomes, got null or low powered results on most of them, and chose to highlight the single result which did show a significantly positive effect on recovery; that result was based on a meta-analytic estimate of the pooled sample of just two studies. In particular, my understanding is that this study found a null on "percentage days abstinent", a null on "longest period of abstinence", a null on "drinks per drinking day", a null on "alcohol-related consequences". For alcohol addiction severity they report the results of one study without doing any original analysis. And for "rates of continuous abstinence" they found a positive effect. In most cases these are graded as "low certainty evidence". The positive effect is claimed to be "high certainty evidence", but the CI / p-value for the positive effect is not adjusted for multiple comparisons -- I don't think that's fatal, but it does speak to the fragility of the outcome.
The other concern I have is that they separate "manualized" treatments (e.g. AA treatments administered according to a protocol) from "non-manualized" (e.g. ad hoc administration of the AA treatment) treatments. This is fine -- we would expect to see that if something about the protocol was useful, the non-manualized treatments would display an attenuated version of the same effect. Instead we get a null on the original positive effect, and a positive effect on one of the original nulls
Finally, the authors seem a little loose with what the comparison groups are. They claim they recruited studies which compared AA to no treatment, but the results are all motivated as being AA versus CBT. What happened to the no treatment studies? Perhaps these are buried in the full text. The rate of spontaneous remission of addiction is believed to be fairly high and most of the past criticism of the efficacy of AA has been motivated by comparison to spontaneous remission.
It strikes me that there is significant distortion of the study findings from the Cochrane write-up to the Stanford press release, and from the Stanford press release to the NYT piece, and that in both cases the distortion is in favour of claiming the study has found affirmative evidence that AA works better, rather than just no evidence to claim it works worse. For instance, one of the thrusts of the NYT piece is that the past Cochrane review was based on a limited number of studies... but the operative finding in this review is based on an even more limited number of studies, even if the pool of studies from which they drew has become larger over the last 15 years.
All of this is from a quick read of the review -- I am off campus right now and don't feel like VPNing or pirating the full text to deep dive the analysis.
It’s been a while since I reviewed the literature for substance abuse disorder, but if I remember correctly it was highly disputed whether complete abstinence was necessary (or even beneficial) for treatment. Has this changed?
The argument was that by focusing on abstinence you are setting a significant part of your patience up for failure with all the psychological harm involved in knowing that they’ve failed, which might result in severe and frequent relapses.
EDIT: To conclude. I find it hard to draw conclusions if success is measured in “days of abstinence”. That means that a patient that has recovered from cognitive behavior therapy (CBT) that uses occasionally and non-detrimentally is not considered a success! Further AA or other 12-step programs do often stress abstinence while CBT does not, this creates a counting bias in favor of 12-step programs.
In the last decade or so, researchers have published a number of very high-quality randomized trials and quasi-experiments. Of the 27 studies in the new review, 21 have randomized designs. Together, these flip the conclusion.
That sounds impressive. If it turns out not to be so impressive, that's definitely on topic.
There are about 10 findings, and the only “high” quality finding is that there appears to be a significant increase in abstinence, especially long term abstinence from people who get treatments which get them in the rooms of AA (“TSF” treatments).
We can dive down in to the details about this finding (percent abstinent) on pages 88 and 89 of the report. They actually use six different studies, but only two of them provide information at the one-year follow-up, so only those two get listed in the summary on page 4 of the report.
Considering that they compared a number of things, and only percentage of subjects abstinent showed, with high confidence, a difference between AA/TSF and other treatments, I’m a little worried we may be seeing a multiple comparison fallacy. Then again, this is unlikely: They are seeing P values of 0.02 and 0.03 (1-in-30 to 1-in-50) for the abstinent numbers, but only look at about 10 factors.
Humphreys 2014, another meta-analysis of multiple studies, showed AA effectiveness which can not be attributed to self-selection, but it saw something different: A fairly small but significant increase in the percentage of days abstinent. While they did see in the 2020 Cochrane review, they did not see it with a high level of confidence (see pages 89-90).
Percentage days heavy drinking — I don’t have a copy of Brandsma 1980 handy, but I think that’s what the “Brandsma 1980 shows that AA results in increased binge drinking!!!111!!!!!” claim parroted by the usual anti-AA crowd talks about — might be increased in the short term after starting AA treatment, based on the one study which has 6-month follow-up figures for this; Brandsma 1980 only saw it at the 3-month follow-up and not later. Then again, the Cochrane study of those numbers show a pretty high P value (0.79, just glancing at those figures), which means we still don’t really know if Brandsma 1980 actually saw something. Scott Alexander dismisses it as an example of a multiple comparison fallacy, and the P values for it in Cochrane 2020 means we probably didn’t actually see something, but this may merit additional investigation.
Cochrane 2020, of course, didn’t look at the longitudinal studies showing really high abstinence rates for people who self-select to go to a lot of AA meetings, but even using only randomized studies, we are seeing a significant increase in number of subjects who get and stay sober when they engage in treatment which encourages AA attendance.
Another thing: There are no recent high-quality studies comparing AA to no treatment (“spontaneous remission”, an expression I see used mainly by people with a pretty strong anti-AA bias) because it’s been established for a long time that AA (or any other treatment you can think of) is better than no treatment. Even Brandsma 1980 saw that going to their AA-like meetings was significantly better than getting no treatment at all.
In summary, with some caveats, we are seeing solid scientific evidence that AA really helps alcoholics get sober and stay sober. Ten years ago, someone could still say “AA does not have a higher success rate than no treatment” with a straight face; today, to claim something like that requires ignoring a lot of scientific evidence.
Addiction does vanish spontaneously with a wave of a wand. These are people of flesh and blood and free will that managed to overcome their addiction. They are making attempts at treating themselves. They might be reading blog posts with advice. They may avoid buying alcohol for fear they'll drink it all. They be taking detours around bars. They may be meditating or even self-administering cbt.
So calling it spontaneous seems a misnomer.
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
https://news.ycombinator.com/newsfaq.html
https://news.ycombinator.com/item?id=10178989
Bill Wilson[1], co-founder of Alcoholics Anonymous, believed LSD could help alcoholics achieve a "spiritual experience" that was crucial to them attaining sobriety[2] (incidentally, that a spiritual experience could help alcoholics was an idea he got from Carl Jung[3]). Wilson's own experiences with LSD are discussed in detail here: [4]
In the 50's and 60's there was research in to using LSD to treat alcoholism, with promising results:
"Osmond treated more than 700 chronically alcoholic patients with LSD and ended up with around a 50 percent overall success rate. One of Osmond's most compelling studies took place in the late 1950s with a cohort of subjects from the group Alcoholics Anonymous. This cohort was comprised of individuals that had failed the famous 12-step program, and again Osmond hit his 50 percent success rate, this time with a 12-month follow-up period."[5]
In 2012 a meta-analysis of studies with a total of 536 participants found "evidence for a beneficial effect of LSD on alcohol misuse".[6]
[1] - https://en.wikipedia.org/wiki/Bill_W.
[2] - https://www.theguardian.com/science/2012/aug/23/lsd-help-alc...
[3] - http://barefootsworld.org/wilsonletter.html
[4] - https://aaagnostica.org/2015/05/10/bill-wilsons-experience-w...
[5] - [6] - https://www.ncbi.nlm.nih.gov/pubmed/22406913
[1]https://www.nature.com/articles/npp201710?draft\\u003dcollec... [2]https://onlinelibrary.wiley.com/doi/abs/10.1111/adb.12261
[5] - https://newatlas.com/psychedelic-medicine-lsd-psilocybin-alc...
Now alcohol does make its effect again, but I just drink some beer occasionaly, no more hard liquors. I haven't had any mj in a year, the best part. Oh, and the drug in question... I tried it again a month ago and found it unpleasant, and keeps building that crappy cross-tolerance.
I won't name the drug because I wouldn't like to encourage anyone to try this kind of "treatment", I'm pretty sure my reaction is not typical at all. But it would be nice if there was research about this.
I've talked to one or two of them about doing tea on Tuesdays, or some other thing that could get us from drinking 3-7 stouts a night.
That book may be worth a read.
i tried a number of things over many years (life coach, therapy, meditation retreats, ayahuasca, ibogaine, etc).
i reached a bottom, and nothing i had tried really worked or stuck. kept relapsing after a few months of sobriety at most.
ultimately it was going to AA that i largely credit to my successful transformation into a happy life of sobriety.
if you're not sure if it's right for you and struggling with addiction, i highly recommend having an open mind, and trying 90 meetings and 90 days. see how you feel after. it's the daily practice that is transformative.
there is something powerful about being focused on a purpose with a group of similarly motivated people.
the people in the rooms of AA understand the challenge you're facing in a way that friends and family often don't.
you quickly realize that the 'higher power' thing is a pretty easy to move beyond, regardless of your religious orientation. a 'higher power' can even be a conceptual device - e.g. the wisdom of the people in your meeting who have achieved a life of sobriety.
it's also not to say that AA in itself is a savior. it's a healthy component to integrate as part of a balanced recovery of body, mind, and spirit.
eating well, exercising often, and finding ways to be helpful are other important pillars to incorporate along your journey.
good luck, be well.
I later moved out of state. I came back to visit family, and went back to a meeting to find out that there were rumors that I had relapsed after I moved and continued using until I was homeless. It was a drama fest. Absolutely ridiculous.
When I moved, the meetings I encountered were extremely hostile to atheists.
I have had nothing but positive experiences with these groups.
each meeting can be quite different. i had to try 10-20 of them in my city to find a few that were on my wavelength.
i don't attend aa meetings as often as i used to in early sobriety, but i still go if i have a friend that's struggling and want to open this resource to them.
at every meeting, there are things that people say that resonate and things that are cringe-worthy or even inflammatory.
part of the meditation and process is being able to be hear and react to everyone's words with equanimity.
I obviously don’t have your unique and nuanced understanding of the situation, but this seems like a common occurrence with all humans when they lack information.
In my experience when we don’t have information, our group tendencies lean towards filling gaps with the outlandish and dramatic.
Again, I don’t know much about AA but I’d question whether that situational behavior was driven by something unique to AA.
Though, their hostility to atheism is a problem they should have addressed long ago.
In my experience there are two types of atheists who go to AA: those for whom religion “isn’t their thing” and those who are actively hostile to religion.
I think the latter group should find an alternative to AA.
That's unfortunate, and mostly in line with other experiences I've heard from friends, etc. AA seems like just another bullshit Christian recruitment/retention facility, that sometimes accidentally helps people who buy into it recover from addiction. Too bad.
It’s great you’re willing to overcome the technicalities for a greater good. Too many people are restrained by their own ego. Keep up on your righteous path.
Sodium Oxybate (ie: incredibly expensive GHB) is on the market elsewhere, but not indicated for alcohol abuse and usually heavily controlled (ie: special doctors and pharmacies only).
The heavy control always surprised me while other powerful sedatives flow freely with little control.
Nearly every step has a reference to spirituality of some kind and most of them are laced with Christian undertones.
More generally the idea behind the 12 steps is to place yourself in the hands of this higher power and allow it to guide you. Basically it requires a belief in prayer.
AA has worked for many many people--which is wonderful and it is demonstrably a great tool for them! But an atheist, humanist, or more generally someone who doesn't believe in spirituality is going to have to go through significant mental gymnastics to deal with the 12 Steps.
It seems to me that if someone doesn't believe in God or a higher power of any kind, there are probably better first line treatments for alcohol addiction. It isn't necessary for an atheist to change their spiritual or religious beliefs in order to recover. Therapy, medication and secular support groups all exist.
It was the religious stuff that put me off completely. Being in a group of people all there with a common cause I felt was quite powerful. Hearing shared experiences from the community was helpful. I just couldn't pretend I was OK with peddling any form of faith.
I would be skeptical too and it can certainly have a negative impact on addiction groups. Although I would think these negative factors to be worse for people actually believing it. Some people classify them as a sect, but I wouldn't go that far to be honest.
But if it doesn't work for you, I think there are other groups or those that set the focus elsewhere.
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This does not appear to include other programs like pharmacological extinction or the Sinclair method.
> We included randomized controlled trials (RCTs), quasi‐RCTs and non‐randomized studies that compared AA or TSF (AA/TSF) with other interventions, such as motivational enhancement therapy (MET) or cognitive behavioral therapy (CBT), TSF treatment variants, or no treatment.
Edit: we've since changed the URL and therefore also the title (see https://news.ycombinator.com/item?id=22550789)
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The "brand name" of the group is not so relevant.
Edit:I guess I should have qualified that I’ve only done support groups in SF that have been great and usually hosted by churches.
This is highly dependent on where you are. I experienced verbal abuse and was made to feel unwelcome at meetings when people found out I'm an atheist. People have told me, verbatim, "You don't belong here if you're denying God".
Needless to say, I am no longer a part of that little cult. I'm doing fine without it.
I have witnessed _exactly_ what you're saying, and I've seen people feel so unwelcome that it hurts them more than helps them. It blows my mind the stranglehold that AA has on this industry, given how demeaning it can be to people who are looking for help.
I've seen more success with people going to SMART recovery meetings, which focus on providing a space to talk and seek help without the judgement level associated with AA.
Thank you for telling me about Al-Anon - I will look into it myself.
Is that about what you experienced?
https://en.wikipedia.org/wiki/Serenity_Prayer#Use_by_twelve-...
No cosmically, nothing about governance.
Should be loving and tolerant.
At least that’s my experience so far working the steps.
I would obviously let it slide if I needed this kind of thing, but it is clearly cruft.
https://www.reddit.com/r/Alcoholism_Medication/https://cthreefoundation.org/
The "Sinclair Method" is, basically, to promise to take naltrexone (or similar) 30 minutes or so before you ever take a drink. That way, if/when you drink, you never feel the "drink" and your mind can return to normal.
No drug will "make you stop drinking" (though disulfiram may make you want to do so); the Sinclair Method attempts to remove your interest in drinking.
I've since returned to drinking periodically, but, it's nice knowing I can cease at any given moment using this methodology if I choose.