Remember when a glass of wine a day was good for you?
popsci.com
popsci.com
2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was enough equipoise. Post-2014, I would need to see some strong counter-evidence to make me think there is equipoise once again.
3. The environment changes. A trial came out last week showing that ASA may be harmful for older healthy people [2]. This probably reflects that our bloodstream is no longer nicotine-filled, etc., so the heart attack risk is low enough that the bleeding risk may outweigh it. There may be something about alcohol that was helpful in the 1950s that is no longer so today, due to these environmental changes.
1 = (Free full link): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091648/
2 = https://www.nejm.org/doi/full/10.1056/NEJMoa1800722?query=fe...
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If I'm reading correctly, that 2015 MR paper establishes that LDL and triglycerides play a role in heart disease by filtering populations used in prior studies for genetic blood lipid factors. But it doesn't make any claims about alcohol. Is there already a well established link between alcohol and LDL / triglycerides?
My impression is that the relationship between LDL, HDL, and triglycerides and what we eat/drink is not well understood. But I'm not involved in biology or medicine, so maybe you can help me understand this better?
Maybe an interaction with the prevalence of leaded gasoline?
Do you happen to know if rs1229984 is linked to any particular group that could make this result problematic? I noticed that the paper mentions that "There was also some evidence for a difference in years of education, and, while the size of the effect was small, this requires further investigation." That sounds like a decent-sized red flag.
It seems to me that we would not have to know about the link in order for the conclusions to be unfounded. These MR analyses rest on the assumption that the instrument is not linked to any potential confounders. This seems like a bold and unwarranted assumption when we are talking about an instrument linked to behavior, given the complexity of the chain of events (chemical, biological, and psychological) between gene expression and observable human behavior.
That education red flag involves just one possible confounder out of many that were never considered.
Take a look at the population frequencies on the right. While the minor allele is infrequent in Europeans, it is extremely common in East Asians, for example.
That's a very convenient way to socially forbid replication attempts. I don't buy it. The argument basically amounts to a claim that we answered the question definitively in 2014 and anyone questioning that result now is unethical. Today's scientific research, especially in any area pertaining to people, is too unreliable to blindly trust this way.
Declaring this level of risk to be outside the bounds of permissible research is an attitude incompatible with scientific progress. It's elevating short-term harm prevention to an unjustifiable extreme that makes it impossible to determine whether we have an accurate model of the world.
My reading (not just [1], although [1] is a lucid examination) suggests to me that IRBs are net detrimental to research. There's an incentive misalignment that pushes them too far in the "harm" prevention camp and that makes it too difficult to answer scientific questions.
That's too bad. The rest of us try to learn something from Nuremberg.
So I guess what I'd say is that it looks like the one thing you know about IRBs is that Scott from SlateStarCodex once had a run-in with them and generalized wildly from it.
I think neither of will profit from continuing this discussion, though. You can safely sum up my point as "the problems people in psychology, and the social sciences in general, have with IRBs do not necessarily generalize to biomedical research". One of the basic complaints scientists have about IRBs is the "mission creep" from human medical research to the rest of the sciences. The premise of that argument doesn't line up with your argument here on this thread.
Also, SlateStarCodex is bad.
My point is that IRBs have an incentive structure that encourages excessive risk aversion. My citation is an instance of this phenomenon in action. It has nothing to do with the particulars of psychology. You have not attempted to address this incentive alignment argument in any way. Blocking an attempt to replicate an alcohol study due to weak evidence for a very small negative effect is another example, albeit hypothetical, of this same excessive risk aversion. You have not made a similarly substantial argument. Instead, you've just asserted that institutional review is embedded in biomedical research. It is, but I think it shouldn't be.
> Also, SlateStarCodex is bad.
It's amazing that immediately after a paragraph in which you claim to be making a substantive argument, you make a bald and unsupported assertion that an influential and widely-read blog, one that Pinker has called "wonderful", is in fact "bad".
This is not the kind of intellectual conversation that HN was meant to host.
Moreover, nutritional studies of any kind have been infamously bad at giving reliable information. The advice from one decade is almost routinely found in the next to be invalid, or even the opposite of the truth. That's for things like carbohydrates, about which there were few religious injunctions or political polarization. For a topic with as much emotional and political baggage as alcohol, I find it unlikely to be any better. Whatever your decision about alcohol, I think the reliability of the science (pro- or anti-) is just not sufficient to help you make your decision.
I understand that it's difficult to control for various factors when doing large scale studies of health and behavior, but my perception as a layman is that there is some willful ignorance or absence of rigor. I realize this is perhaps too harsh a statement; I'm just trying get my point across.
Of course there is great research being done. The problem is that the cognitive load of evaluating which research is useful has been shifted to the end "consumers" of that research.
How would one really prove causality or does it even matter. When I think of science, I try to think of it like how I think of physics, where we create a model that best describes the evidence but which doesn't have any guarantee of being how things really work.
Take Newtonian gravity. It is a pretty good model that describes a lot of basic interactions. Given a state at a given moment in time, it lets us determine things going forward or backwards (though for more complex physics, backwards stops working because of assumptions and estimates in the model). But at the same time, it is wrong. More complex physics shows there is a model that fits even more experimental data which contradicts what we thought was happening in the Newtonian model. Mass doesn't attract mass. Mass bends space time and impacts objects traveling through it in such a way that it appears mass attracts mass (though even this may end up being wrong and something else entirely is at play).
So, is it really important to describe why a ball falls to the ground when I release it, or is it good enough to have a system that describes the interactions enough that I can apply it to problems? If I solve a problem, say what angle and what speed I need to throw a ball to get over fence, does it really matter if I think the ball falls back to earth because mass attracts mass or because mass bends spacetime? Or is it just important for my equations to be accurate enough that any error is less than what is innate in applying the solution to real life (measuring the exact height of the fence, throwing at an exact angle).
What does applying a similar mind set in something dealing with vastly more complicated systems, such as in medicine, looks like?
What actually causes a ball to drop to the ground when I release it? We don't know. The best model (that I know of) is the bending of space time, but that isn't the real answer and may one day be overturned just as the older idea of mass attracts mass.
I guess the question is, are we sure enough of our model to be able to trust the airplane isn't going to drop to the ground like the ball does, and how do we achieve equivalent certainty in the biological sciences.
I think you answer this question in your own post. The answer depends entirely on your goals.
"All models are wrong, but some are useful".
If all we ever wanted to do was shoot cannon balls over/into walls accurately, then we probably would've never bothered inventing modern physics.
But we did want to do other things, so we built better models. It's worth noting that some of those things we wanted to do were more philosophical than others, e.g., engineering ("put satellites into orbit"), explaining empirical observations that seem important ("explain how electricity really works") and philosophical ("understand the nature of reality") are all answers to the question "what are you goals?" that have inspired progress toward better models in physics.
> What does applying a similar mind set in something dealing with vastly more complicated systems, such as in medicine, looks like?
It takes a certain amount of philosophical sophistication to realize that even the most perfect model is still a model and to then reason through what that entails -- epistemologically -- for less perfect models and for the entire scientific enterprise.
I'm personally a fan of the 'make a better model to have a better model and let someone else figure out the application' model, but that one is harder to get funding for.
This does matter in physics too.
Does cataract surgery reduce mortality in older women? It sure looked like it, until it was recognized that the study suffered from a concept called "immortal time bias" [1]. Now the reverse "seems" to be true. (Unhelpfully, it's easy to make an "explanation" for either case. Surgery lowers mortality? Of course! Better vision keeps you safe. Surgery increases mortality? Of course! Failing vision is associated with other failing organs, and surgery itself poses risks.)
In cardiology, we like to refer to immortal time bias as the "cheetos" effect. An example: Let's look at people who had an event (heart attack) and try to estimate the benefit of a procedure done afterward (literally eating a bag of cheetos within 60 days after the heart attack). You will find that eating a bag of cheetos confers increased survival compared to not eating a bag of cheetos. The reason for this is that in order to have eaten the bag of cheetos, you necessarily lived long enough to eat the cheetos. If you died first, you count toward the non-cheetos group. So stacking things up, it will look like cheetos keeps you alive longer. (The solution to this problem is not to count the time before eating cheetos towards your survival time. If you do this with literal cheetos, which don't have a survival effect, then you will correctly see no difference between groups.)
This is just one of the numerous biases that exist and can be difficult to account for. In my opinion, this stuff is just hard. If you are interested, Judea Pearl is developing tools for causal inference [2].
1 = https://retractionwatch.com/2018/08/28/a-high-profile-paper-...
[1] - https://jamanetwork.com/journals/jamaophthalmology/fullartic...
I perhaps understand the sentiment behind this, but if this is really what you think then probably you don't really 'understand' how difficult it is to do large scale studies of health and behavior. As a thought experiment, pretend you are the researcher studying a glass of wine a night and write the script you would pitch to potential research subjects. You have to try to convince them to be randomized to either completely abstain from alcohol for a period of 10-20 years OR to drink 1 glass of wine a night for that same period. Do you think you could get 10,000-50,000 people to participate and that those people would reliably stick to their randomized groups? How would you monitor compliance? How will you keep track of those people for 30-50 years to see differences in mortality or other outcomes?
Science is never 100% on practically anything. Even in physics there are keystone works that are mutually incompatible indicating errors in one or both. But there is a difference between models that are based on predictiveness, direct experimentation, and falsifiability - and models that are based on correlation. Newtonian mechanics is a good example. The equations that determine a body's position given a set of inputs and time could be shown to be 100% correct in every single scenario. Well at least until Mercury came along with it's 1/100degree per century orbital aberration. And that 1/100th aberration per century of a single body was enough to inform that something was wrong. With correlational studies, actual results don't really matter and entire views become practically impossible to falsify. And when they do provide predictions, rarely is it the case that the failure of that prediction to come true would falsify the study. That's just not science by any stretch of the imagination. It is the difference between astronomy and astrology.
But I don't think that coming to wrong conclusions is necessarily 'far more dangerous'. People who drink 1 drink a night are not likely to have dramatically different outcomes than people who abstain. (perhaps unless it contributes to binge drinking, but science already says that is bad)
Compare science that's goal is to find a truth to science that's goal is to prove an assumed truth, and you'll see the standard of research sharply decline.
There are some systemic issues in play for sure. Publish or perish means researchers need to put out new publishable work, or find a new career. And that in turn also introduces a publication bias. Spend 5 months researching a hypothesis only to find that it's wrong? Well that's pretty much 5 months wasted because journals are not so fond of publishing negative results. Massage the numbers a bit to get that positive result though, and you're good to go. Pretty nasty incentive systems there. And now add into the fact far more people than ever before are pursuing postgraduate education. It's a mess.
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Are those things ever taken into account?
We could a nutritionally determined portion of specific foods every day, sit at home to avoid accidents outside, get out enough for the required sunlight, and exercise the optimal around.
While it's good to know whether a "glass of wine" is good or not, it bad when such research is used to cut off any bad-for-us enjoyment we get.
Besides, it's a bunch of factors which makes the whole "one glass of wine is harmful" a moot point if you can take care of the rest (and why not start with them?).
In the "blue zone" of Icaria for example, one of the places in the globe where people live the most, people regularly drink several glasses of wine per meal and have been doing so for millennia. Yet, there they are regularly at 90+ and 100+. Then again, they're stress free, sleep whenever they feel like (no really, they'll casually open their shops at 2pm or at 3am if they feel like it), and don't eat junk food.
Maybe that's good.
The facts are overwhelming and we shouldn't just keep consuming alcohol because muah cultur. Many alcoholics end up causing traffic accidents and require lots of state support in other ways. Just walk into ED on any Saturday/Friday night. I have done that
Not for me. I truly enjoy a good drink with or without friends. It's possible to drink in moderation and enjoy yourself.
> Media brainwashing has done its job well.
Again, heavy drinking was extremely common well before mass media. I don't think you can pin this particular issue on them.
Alcohol consumption in the past was necessity because of cold climate and manual labor. Alcohol is made from ethanol is made from sugarcane and is extremely calories rich. 100 gm beer contains 43 calories. One can contains 154 calories
It was quite fine in the past as most of the calories were burned due to harsh living conditions.
Fast forward to 21st century. We are hardly exposed to extreme cold. We live in extremely protected environments. From temperature controlled office to car to home. But we haven’t changed our drinking habits to reflect that.
Add to that mass media consumption due to profits. We have an epedicmic which can easily be prevented. 5% of all deaths are due to alcohol.
Just visit ED of any hospital on Saturday night if you want to see the ills for yourself
You are discounting the positive psychological benefits that can be attributed to alcohol. Even if it really is bad to ever drink, ever, it's not like you're going to instantly keel over and die, it's a very subtle effect if it's there at all. People will weigh that risk against the benefits they get from drinking and act accordingly.
One could say that a lot of these "soft limits" are already in place due to humanity's long relationship with alcohol. It's already not seen as a good thing to get black out drunk for instance...
Facts weigh against alcohol consumption and I hope people choose their, societal and environmental health
Sure, banning smoking in restaurants makes sense, as it actively ruins the experience for other people. But this whole vegan teetotaler thing is getting extremely aggravating.
Shaming people for enjoying alcohol responsibly is just as bad as shaming people for choosing to not drink. Both groups of shamers need to cut it the hell out.
You set a weekly limit and the app tells you when you're getting too close. Features Untappd integration, HealthKit calorie syncing, and various charts and stats of your drinking over the past year. Figured I'd build it after reading numerous articles like this and deciding that 100g/week was the optimal risk/reward point for my health.
Seriously, does anybody in publishing actually visit their own sites? I see UX like this and all I can think is, “gee, somebody got _paid_ to make this?”
Edit: I see from another comment that the scrolling was (partly) a result of the link being to an anchor tag. I stand by the rest of my point, though.
"But as the headline-generating study in The Lancet notes, “Until recently, most meta-analyses of alcohol consumption have not controlled for the composition of the reference category,” and that “subsequently, assessments of harm relying on these studies have been biased.”"
...but overall systemic bias wasn't what I was thinking of.
[1] https://www.google.nl/url?sa=t&source=web&rct=j&url=https://...
From TFA:
"An analysis from 2007 by an international group of alcohol epidemiologists and addiction researchers, published in Annals of Epidemiology, notes that “as people progress into late middle and old age, their consumption of alcohol declines in tandem with ill health, frailty, dementia, and/or use of medications.” That decline means that, as people become less well—even if they’re not elderly—they will also tend to stop drinking."
The article points to adverse health related events that cause abstainment. Clear and good the AoE-article works that out.
I however point out that it's pretty clear within the drinking categories you have effects that go in tandem with other illnesses as well (like self-medicating with alcohol for psychological issues).
So the whole argument they propose should at least be carried out to its full, working both ways. You've got illnesses moving people into abstainment and illnesses moving people into moderate or high alcohol usuage. The only way to control this is to use changes in comorbidity over time as a factor.
TBH the scientists in the underlying article write this down as an issue as well.
Not the best way to get your ad revenue up.
The interesting thing is how people react to it. For some reason you are expected to provide a reason for why you don't drink. I don't smoke either but nobody asks me why. I've noticed also that it makes people uncomfortable if you're not drinking. When I do go out now I drink diet soft drinks so that I don't get constantly asked why I don't have a drink.
I foresee a shift in cultural views towards alcohol much like the shift with respect to tobacco of last century. I wonder if the USA and UK will again lead the way with this leaving much of continental Europe behind.
Cutting out alcohol completely is certainly not a bad thing health-wise, but I think it was much more significant that you stopped going out so much.
> My diet is very well-controlled
Pick one
I get constant questions as well unless I'm babying a random non-alcoholic beverage. I've found that the best non-follow up to "why don't you drink?" is "I used to drink a lot but my doctor told me to try and abstain for my health."
A few pints of beer or some wine with dinner should not completely wreck the day after, unless there is some medical condition that is worsening the effect.
Personally, I don't care of people drink or not, that's their choice. What I'm saying is that his intake was probably heavier than he claims, which would certainly account for his marked improvement in health when he cut out alcohol completely.
People disputing this have probably never gone more than a week without alcohol. I'm not prepared to maintain a tolerance to alcohol and it makes me feel bad when I drink occasionally.
All I'm claiming is that a literal poison has a negative effect on me that far outweighs any positive I get from the enjoyment of drinking. Yet people are jumping up in arms saying there must be something wrong with me because they drink regularly and feel fine. I think people could do with some careful introspection and maybe to reconsider what "fine" is.
What you seem to be claiming is that we (who enjoy alcohol in moderation and on occasion) are lying to ourselves about how we feel.
I can tell the difference, trust me. I've been there myself, and I still go there on occasion, in good company at a concert/festival, when I know I can waste a Saturday/Sunday after. A couple of pints will not do it.
It is also quite funny: anesthesiologists always know who lies on the intake forms based on the answer to alcohol consumption question. The more the drink, the longer it takes to put them under.
It is a very observable thing in among the healthy living crowd: August and September are popular abstain from drinking months in these circles. Meeting these people for dinner in October pretty much means they would be visibly buzzed after a glass or two of wine.
What you're describing only happens on an empty stomach, which is a mistake anyone should be able to identify easily.
Same is happening to me.
And the last time I bought alcohol, I bought a pack of 0% alcohol beer by mistake at the supermarket. I would never do that intentionally, as I consider 0% alcohol beer a ridiculous idea and also never tried it. However, I finished the pack, and the first beer was special. It actually tastes like beer, without alcohol, it's mainly sugar with water.
Won't buy another pack ever again, but it was an interesting experience and opened my eyes about the taste of beers
Also, there is more and more a decent selection of <0.5% alcohol beers - I find this the easiest way to not get strange looks when at a drinking occasion.
But then again, maybe the point of drinking together is it provides some kind of bonding effect, being a shared vice. It makes it harder to lie and shows you value others more than your own health (relatively).
“Approximately 36% of East Asians (Chinese, Japanese, and Koreans) show characteristic physiological responses to drinking alcohol that includes facial flushing, nausea, headaches and a fast heart rate.”
Later, I was diagnosed with sleep apnea and after daily treatment now drinking a few beers is completely ok.
I don't understand what the relationship between those two things are. I would have never imagined.
Is it, though? I know plenty of people who will just waste whole days away in front of the TV doing nothing because they don't feel like doing anything else. People are constantly telling me they're "tired". I used to be like that too. But now I work on my career or on my hobbies day in, day out. Barring seasonal illnesses I never have down days.
I cut out drinking altogether for about a year right after college. Since then, I drink maybe 6 times a year. If I drink anything more than two drinks I feel pretty horrible and can feel it the next day.
The places I've been to in the Bay Area has never served anything like <0.5% beer. I'd much rather drink something like ginger beer or kombucha anyway, which is what I do given the occasion.
In my case, even a small amount of alcohol consumption will make me feel heavy in my abdomen the morning after.
People in my family have historically been alcohol drinkers. So idk why, but it helps since I dislike drinking anyways.
Reminds me of this: https://www.youtube.com/watch?v=r-X2zPMB5dk
I never drank aside from a few sips in past attempts to placate people bothering me about drinking. I used to be more annoyed by people who seem to really want to know why, but I've found that simply being firm about not drinking is usually enough to get people to drop the subject. I don't usually give a reason, as that seems to be an invitation for others to harass you. I also will refuse to even sip an alcoholic beverage for the same reason.
Some people seem to take the fact that you don't drink as personally offensive, as if you are judging others for drinking. But I really don't care that much about how much you drink any more than I care about how much ketchup you put on your fries. That is, I don't care much at all unless you're using obviously too much. The view that non-drinkers are judgmental seems to be caused by a combination of psychological projection and the drinker having mixed feelings about alcohol.
If I had to give a reason, it would be something like this: I never was convinced of any benefit from drinking, but I can see many risks. The main benefit to me is that many drinkers will socially exclude non-drinkers, but I think a better solution is to avoid people who don't like non-drinkers.
The reasons I've heard from people about why they drink or want to encourage me to drink vary a lot. One that comes to mind is "I want you to be happy", which don't find convincing because I am perfectly happy and don't think drinking would improve my happiness. The people who insist that I just haven't tried the right drink are getting tiring. If you didn't like ketchup and I said that you haven't tried the right ketchup and then insisted that you try small amounts of a half dozen ketchups, that would be considered fairly weird. But it happens to non-drinkers.
In France we were raised on water (school, home - surely tzp wzter in large quantities) then wine and beer (not that much soft drinks compared to US).
When you go to the restaurant, it is meal to order tap water (no matter the restaurant) and often you will find some people drinking water, some other wine. Yesterday (upscale restaurant) it was 50/50 at my table
In z bar people commonly take a juice when other take alcohol.
Nobody ever saw that as weird in my circle of friends (an average and quite random one)
I grew up in a family that didn't drink - and this was always weird/uncomfortable to explain to friends.
I do drink now; but I've noticed over the years that it is becoming much more socially acceptable to not drink ..and people don't think it so strange; "I just don't like it", "religious beliefs", "trying to get healthier". So, yeah, people still ask "why?", but often out of genuine curiosity IMHO.
This is a good thing - frankly, I like to have a drink with friends, but its more about being with the friends - and if they're drinking soda I'm just as happy they're with us.
On the beer side - I see a lot less (here in Portland OR) but read more about the trend. ...I might not be looking hard enough though.
Last night I watched a video by Mel Robbins on friendship¹ in which she made the very cogent argument that when you mention you don't want to drink you remind others in your social circles of their own struggle to quit drinking, hence the negative feedback. Her solution is to accept that those people are part of an old chapter of your life, and although you don't dislike them in anyway, it's important to recognize that you will slowly develop new friendships with those that match the lifestyle you now choose to live.
__________
Between not drinking alcohol at all and drinking so much that you feel bad the following day there is a middle ground of drinking moderately. If a low amount still makes you feel bad, drinking alcohol of a better quality can help (there is a huge difference in this regard between really cheap wines and more expensive ones).
In fact the topic article describes research suggesting that there is no “good” amount.
For me if you have ill effects it is no longer moderate drinking. Note that I am talking about short-term effects such as having an hangover, not the long-term issues that are the topic of the "good" amount in the article.
For sure according to my definition for some people such a level may be zero, and in that case they should refrain from drinking, but the person I replied too talked about "a few pints of beer" at a time, not exactly a minimal amount.
That's probably one of the absolute worst ideas one could have as a substitution.
Now there has been a shift in regards to driving while intoxicated, but that happened about 20 years ago, and while it has continued, it shows no signs of leading to a movement to make alcohol illegal. On the other hand, marijuana legalization is gathering steam lately.
Do you have a source for this claim, which both does a good job of defining a measurement schema for alcoholism and also shows convincingly that it is on the incline?
Do you also have a source for the claim that this particular increase is the reason (or even a contributing factor) to the apparent decline in correlation between moderate wine consumption and positive health outcomes?
> if you think you have a problem, you already have a problem
Now this just seems like toxic thinking to me. Plenty of thoughtful, responsible people continually ask themselves whether they are experiencing various problems in life, and sometimes the answer really is "no."
> Go to AA, NA, a therapist, a doctor, rehab, a detox, doesn't matter
Really? It doesn't matter?
Your links at the end of your comment are only to AA and NA. Can you explain what aspects of these programs are preferable to you?
I hope that my comment isn't minimizing the issues of drug abuse (including alcoholism) in our culture - I totally respect that these are serious issues with many grave outcomes. I just want to be sure that we're discussing them in a way that is... well, sober.
Anyway, even if you don't have answers to the above questions, your perspective is welcome IMO.
So yes thinking about whether something is a problem worth addressing is totally healthy behavior for anyone with a modicum of self-awareness.
> Now this just seems like toxic thinking to me. Plenty of thoughtful, responsible people continually ask themselves whether they are experiencing various problems in life, and sometimes the answer really is "no."
To you it may seem like "toxic thinking", but to anyone with a problem who had the insight to ask themselves such a question, it can be a life changing moment.
If someone is at a point in their alcohol consumption career where they step back and have to ask, "Do I have a problem?", that insight usually stems from encountering a problem most people don't face.
The nature of alcoholism is to tell yourself everything is fine and normal, that there is no problem even though your life is falling apart.
To wish to portray as truly pivotal insight that an alcoholic would be lucky to have as "toxic thinking" is, IMO, minimizing the issues of drug abuse in our culture.
> Really? It doesn't matter?
When you're at the point where a substance controls your life, there's no saying when you might overdose or drink too much and plow your car into innocent people.
Finding someone who can direct you to help now is paramount.
> Your links at the end of your comment are only to AA and NA. Can you explain what aspects of these programs are preferable to you?
There are no months-long waitlists for AA or NA like there are for rehabs, detox clinics, therapists, psychiatrists and addiction specialists.
There is no pretense of requiring an in-network insurance provider that will cover the tens, if not hundreds, of thousands of dollars worth of treatment you might require.
As much as I disagree with some aspects of those programs, their existence is infinitely better than the alternative. Which, for most people with that problem, is the destruction of what is left of their life.
[1] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Plus "just do anything" can lead you to the abusive profit seeking sketchy "rehab" industry, and that's probably going to leave you worse off. I think the worst offenders have been shut down recently though thanks to exposés.
Most people are able to reduce alcohol consumption to less harmful levels on their own. That's not saying you shouldn't seek help if you need it, just you may not need it. Everyone is different. If you wish to reduce your alcohol consumption don't assume you are "powerless" just because AA says you are.
https://www.theatlantic.com/magazine/archive/2015/04/the-irr...
>The 12 steps are so deeply ingrained in the United States that many people, including doctors and therapists, believe attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol is the only way to get better. Hospitals, outpatient clinics, and rehab centers use the 12 steps as the basis for treatment. But although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation. Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work. For J.G., it took years of trying to “work the program,” pulling himself back onto the wagon only to fall off again, before he finally realized that Alcoholics Anonymous was not his only, or even his best, hope for recovery. But in a sense, he was lucky: many others never make that discovery at all.
>Whereas AA teaches that alcoholism is a progressive disease that follows an inevitable trajectory, data from a federally funded survey called the National Epidemiological Survey on Alcohol and Related Conditions show that nearly one-fifth of those who have had alcohol dependence go on to drink at low-risk levels with no symptoms of abuse. And a recent survey of nearly 140,000 adults by the Centers for Disease Control and Prevention found that nine out of 10 heavy drinkers are not dependent on alcohol and, with the help of a medical professional’s brief intervention, can change unhealthy habits.
>AA truisms have so infiltrated our culture that many people believe heavy drinkers cannot recover before they “hit bottom.” Researchers I’ve talked with say that’s akin to offering antidepressants only to those who have attempted suicide, or prescribing insulin only after a patient has lapsed into a diabetic coma. “You might as well tell a guy who weighs 250 pounds and has untreated hypertension and cholesterol of 300, ‘Don’t exercise, keep eating fast food, and we’ll give you a triple bypass when you have a heart attack,’ ” Mark Willenbring, a psychiatrist in St. Paul and a former director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, told me. He threw up his hands. “Absurd.”
>But many in AA and the rehab industry insist the 12 steps are the only answer and frown on using the prescription drugs that have been shown to help people reduce their drinking.
>People with alcohol problems also suffer from higher-than-normal rates of mental-health issues, and research has shown that treating depression and anxiety with medication can reduce drinking. But AA is not equipped to address these issues—it is a support group whose leaders lack professional training—and some meetings are more accepting than others of the idea that members may need therapy and/or medication in addition to the group’s help
Lazy survey door to door salespeople posing as scientists dominate this field unfortunately.
This is not science. This is guesswork. And this causes serious problems to people who trust this crap.
Throw away your shitty biased studies and start doing actual science.
It took Newton a lot of time to observe and repeat and prove the physics of gravity. And that stood the test of time for several decades at least.
This shitty research area needs to stop. People post media coverage as somehow being the final validators of their crappy research.
But this isnt a choice between hard science and shitty survey based science.
I am saying this is a choice between hard science and NOTHING. Do nothing. Don't do lazy work. That's my point.