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The Science of 12-Step Programs
Hugh Pickens DOT Com writes "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists. But there is an interesting read at National Geographic where Jarret Liotta writes that new research shows that the success of the 12-step approach may ultimately be explained through medical science and psychology. According to Marvin Seppala, chief medical officer at Hazelden and sober 37 years, attending 12-step meetings does more than give an addict warm, fuzzy feelings. The unconscious neurological pull of addiction undermines healthy survival drives, causing individuals to make disastrous choices, he says. "People will regularly risk their lives—risk everything—to continue use of a substance." Addicts don't want to engage in these behaviors, but they can't control themselves. "The only way to truly treat it is with something more powerful," like the 12 steps, that can change patterns in the brain. Philip Flores, author of Addiction as an Attachment Disorder, says the human need for social interaction is a physiological one, linked to the well-being of the nervous system. When someone becomes addicted, Flores says, mechanisms for healthy attachment are "hijacked," resulting in dependence on addictive substances or behaviors. Some believe that addicts, even before their disease kicks in, struggle with knowing how to form emotional bonds that connect them to other people. Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that.""
had to quit it due to pancreatitis. fuck twelve steps, fuck the AA, fuck the higher power, fuck the addiction treatment industry.
you see what's wrong with for example the AA 12 steps? 8 of the steps are "whee I'm a christian now and can't be judged for raping my cousin" and the rest are pretty much "It's not my fault I am/was an asshole". it's bullshit.
not fucking one of the steps is to ACTUALLY STOP DRINKING! and half of the steps are practically just setting up that it's not their fault if they drink!
here's my two step program.
1) stop drinking.
2) try to fill the time with something to make things feel as fun as when drinking.
step two is hard, because, hey, drinking is highly enjoyable.
(* due to having stopped drinking, I find myself unable to stop posting obnoxious poorly spelled comments to slashdot, but hey, it works. btw if you drink, don't be an asshole. AA is geared for people who are so big assholes they can't even go to the corner shop sober because they know they're such dicks when they drink, which makes for a sorry loop).
world was created 5 seconds before this post as it is.
As a former heavy smoker I can tell you, I did want to smoke. Hell yeah. It felt good. It was relaxing, it was soothing, it was great. Don't give me that "I don't want to smoke but I can't stop" bull. You want to smoke. At least admit it. You may not like the coughing and the shitty taste in your mouth in the morning (no, really...), you may not like how people react to you, but you do like the cigarette (or in my case, cigar), the moment you light that fire you WANT it. Don't gimme any of that crap that you light it with remorse, you don't. You lean back, you put it in your mouth, you light it, you inhale, you enjoy it. Face it, that's the truth. Lie to yourself if you prefer, but that's simply how it is.
Was I an addict? I guess yeah. Did I like to stop? Yeah, I did. But mostly because for some odd reason from one day to the next the craving stopped. I lighted the cigar and it was not enjoyable. I did not like it. I simply didn't. I put it down and that was a few months ago now. The cigar is still lying where I put it, ready to be smoked at any time. I just don't want to.
Pretty much at the same time some important changes came to my life and I think it's pretty much how you described it. The drug was a substitute. Once it's no longer needed, it will cease to provide the enjoyment that it once did. That certainly doesn't work for everyone, but nobody should give me the bull that he doesn't like his drug. If he didn't, he'd simply drop it. Addiction is nothing but a craving that you want to fulfill. A quite heavy craving, I may add, but it's still you that decides whether or not you give in or whether you look for other ways to relax and enjoy.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
Addiction is a habit that has developed a chemical dependancy. Try taking a regular coffee drinker's coffee away from them for a couple of weeks. It is down right scary to watch the withdrawal.
Some have a hard time stopping others enjoy it so much they really don't want to stop. you can break the habit but because of the chemical dependency it is much much harder.
Also Habits are only a choice in the beginning. once they get going you have to choose to stop, to break the habit.
i thought once I was found, but it was only a dream.
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
First of all, there's no (official) 'Christian' angle in 12-step programs. The higher power is nothing more than a technique for letting go of trying to control things yourself.
I refer you to steps 2, 3, 5, 6, 7 and 11 all of which explicitly invoke a diety of some kind. Claims that the twelve steps do not involve religion hard to swallow and frankly a bit disingenuous. It's pretty hard to buy the claim that those steps collectively are somehow independent of christian teachings. Those steps collectively are little different in function from confession in the christian tradition. Furthermore the founders of the twelve step programs themselves come from a christian tradition.
If 12 step programs clearly worked I would have little problem with that fact. If some prayer genuinely helps someone get their life together and stop drinking, who am I to judge? Anything that helps without harming others is fine with me. The problem is that it is not at all clear if they are actually effective. Some evidence points towards them being helpful for some people, much indicates that they provide little benefit and in occasional cases might have actually proved harmful. It's hard to study their effectiveness because the nature of twelve step programs tends to be secretive and there are other problems such as lack of a control group. The evidence supporting AA as an effective treatment is scientifically quite weak. Most evidence seems to show that at best it has a success rate barely better than those who do not take the program. I have a problem with the notion of prescribing religion as a treatment regimen in light of the fact that there is no compelling evidence that it actually has the desired outcome.
You say that you suspect that they work. But there is no data to support that. In fact, most 12 steppers fail, and the success rate for 12 steppers is as low as the success rate for people just deciding to quit without using the 12 step program. Penn and Teller did an episode of their show "Bullshit" that talked about 12 step programs and gave some interesting data on its success. I'll suggest that you may want to see it before telling more people why you think 12 step programs work. They do not. You can usually find copyright infringing episodes of this show on You Tube. This supposed report is just more Bullshit.
I'm an American. I love this country and the freedoms that we used to have.
The article is propaganda, plain and simple. In the first few sentences the author is already using words like “success” and “a miracle” to describe 12-step programs. I was interested in the article at first because the headline seemed to promise coverage of a genuine scientific assessment into the efficacy of the 12-step approach, something that is badly needed here in the USA where the 12-steps are frequently treated as The One True Religion by the established addiction treatment community. But the piece is just fluff, apparently written by a true believer who seems only interested in research aimed at retroactively determining just how 12-step programs accomplish such great things... The greatness is just assumed to already be a settled matter. The fact that AA and especially NA don’t work for the overwhelming majority of addicts is something that is just glossed over.
And that’s really too bad, because AFAIK most studies find only marginally better outcomes when evaluating 12-step program performance, on the order of a couple of percentage points when compared with alternative treatment methods, particularly over the long term where the numbers are barely statistically significant. The sad fact is that something like 99% of the addicts who walk in to a NA meeting for the first time will relapse in a matter of weeks or even days, and often just hours. As for the long term outlook, there are studies showing no measurable difference in sobriety levels after 5 years of NA versus no treatment at all. Even when the 12-step rules are scrupulously adhered to and all meetings are faithfully attended by the recovering addict, it remains a method of dealing with addiction that works only for very, very few people, although admittedly when it does work it can be a godsend. The question that needs to be asked in the USA, a country still obsessed with the patently un-winnable War On Drugs, is this: why is a program with such abysmal success rates still considered the gold standard in addiction therapy by treatment providers? Too bad you won‘t find any such question in the article.
It trades one addiction for others: religion, caffeine, and nicotine. It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
Quite glib; your implied point is "it" is worthless because it just swaps addictions.
I haven't seen a definition of addiction yet, so I'll suggest this:
Someone is addicted if they repeatedly make damage-causing choices, to the point where normal life is unsustainable (e.g. cant hold a job, arrested, or maybe death).
Now instead of a question of "Addiction" it becomes a question of Sustainability: how long can somebody carry on?
Some people carry on for a full lifetime with whatever. No problem, I'd say they're not addicted.
Other people have trouble sustaining after a while.
As for "trading one addiction for another", think of it as damage control.
Different behaviors have different time frames to their consequences.
Some things, like meth or heroin, can lead to severe consequences quickly (think Trainspotting).
Alcohol tends to be longer-term maintainable; often drinkers can sustain for years, possibly even decades. Eventually health issues (like liver damage, possibly fatal), judgement issues (drunk driving, possibly fatal), and other "consequences" (getting fired, divorced, passing out in risky situations) tend to make life unsustainable.
Marijuana is perhaps more sustainable than alcohol and other drugs.
Now, let's talk about some of the other "addictions" that you're concerned about.
Coffee? (Oh noes, they iz addixted to caffeen!!) WTF! Coffee is arguably completely sustainable, it doesn't cause damage to the user or to others.
Cigarettes? *shrug* I don't know about that one but damage-wise, but it is probably safer for somebody to smoke than to routinely make poor decisions because they're blackout drunk.
Sex? (Oh noes, they are sleepn roundz!) This is pretty sustainable; arguably healthier than lots of alcohol / chemical "entertainment" options. Do actually you have a problem with people engaging in sex?
Look... whatever behavior you're thinking about, try thinking of it in terms of sustainability. Maybe some of these things are "just" substitute addictions"... but is that really so bad?