Comment by avar | Hacker News Reader

Comment by avar | Hacker News Reader

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You're 100% right that people shouldn't have an attitude of "this harmful part of my life will fix itself". Although I don't think just observing that you'll likely "grow out" of it makes the article dangerous. People also tend to grow out of violent behavior (how many hyper-violent 20 v.s. 80 year olds are there?). That doesn't mean it's not harmful behavior when you're younger, or that it doesn't need to be addressed at that point.

But it's just as dangerous to propose that simply because you have issues in your life that some religiously-motivated program like AA is the way to go.

We should provide people with help that's scientifically developed and proved to be effective, and AA and its various sister programs are neither of those. They're just "get the drunks to worship god instead" programs. In recent years they've gained the thin veneer of talking about a "higher power" instead of "god", without becoming any more scientific or empirically-supported as a result.

If you have a problem with addiction start by talking to your physician, not a church group.

Your perception of AA is based on ignorance. AA is not a "get the drunks to worship god instead" program... It is suggested that you find a higher power, but not required. Remember..."Our book is meant to be suggested only, we realise we know only a little."

I go to Agnostic meetings that don't involve any prayer or spiritual aspect, just a group of drunks gathered together helping each other to stay sober. So if the whole religious or spiritual aspect of the program leaves a bad taste in your mouth, try finding a secular meeting in your area: https://secularaa.org/tsml_meeting/

What am I supposedly ignorant about? That AA is a religious sobriety program? The next sentence of the "Our book..." quote you've cited is "God will disclose more to you and to us". So perhaps it's not not doing the work you think it is.

In any case, the motivation for my comment was to point out that many of these "xA" programs are inspired by the 12-step "AA" program. That program is not scientific, or even amenable to change as new evidence about the efficacy of sobriety comes in.

Rather, it's dogma. Whatever white-washing of AA's mention of "God" over the years as "higher power" doesn't change the fact that it's not science-based.

Does that mean it's completely useless? No, but as others have pointed out studies of its effectiveness are rather damning[1]. It just bears pointing out when treatments for addiction are discussed that AA is a dogma-based therapy, because many people suffering from addiction think AA is just what you're supposed to do.

1. https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_An...

"That AA is a religious sobriety program" - exactly that. It is a suggested spiritual sobriety program with an emphasis on "suggestive". It's not a religious program what-so-ever. They use the word God to incubus whatever "higher power" a member chooses (or chooses not to) believe in. I'll give you that God was an EXTREMELY POOR choice for the word, but it's what everyone could relate to at the time. In any case, don't let the fact that God is mentioned in the book confuse you, it's already confused most.

This is disingenuous. The entire history of AA up to and including now (literally read any 12 step guide, 8+ steps mention God) is pushing a protestant christian philosophy that man is irreparably fallen and flawed and the only salvation is through a higher power, and that you must give up your self and any semblance of control to that abstraction.

It works for some, but anyone who says its not a christian organization is absolutely lying - its like taking the caramel coloring out of cola - its still cola, it still tastes like cola, you just took away the color that reminds people that its cola.

There are secular AA programs. I attend a couple in my area, have found them to be extremely helpful as a support group, and would not label them as a "church group".

Physicians aren't a cure-all, because there's no guarantee they've been trained in addiction medicine. After a few doctor visits and them hearing the word "anxiety", you might just leave with a new prescription to Xanax or some other benzo, which could be a virtual death-sentence for someone with a dual-diagnosis.

I’m agnostic and probably about as liberal as they come. My brother is atheist and getting and staying sober through AA. The “god” can be anything you want it to be, as it is for him.

That is not to say that AA is for everyone, but this advice to just “talk to a physician” as if that is the only fix is absurd. Look at how many people are hooked on opioids after “talking to their physician.”

True, but predatory church groups abound. Motivations for helping people with addictions ranges from compassion, to dispassioned dominance and exploitation, with most being somewhere in between (money). This is not to say that they are all bad, but peverse incentives seem more common than most industries, even when the intentions are noble.

Exploitive and dominance-motivated people exist in the medical sphere, as well.

I never understood the "god can be anything you want" line. Five of the steps involve accepting "god" as an authority over your life, including "His will for us" and the power to "remove all these defects of character". It reminds me of Henry Ford's infamous "any customer can have a car painted any color that he wants so long as it is black"; i.e. you can have any god you want, as long as it's at least a metaphor for a personal god that deserves authority over your decisions and well-being. Your brother might have no problem with that sense of authority, but plenty of atheists do (e.g. believe that if Yahweh existed, He would be a tyrant undeserving of worship).

You can reduce those to the authority of the laws of physics, if you want. Try defying the authority of gravity, for example. Then, have faith that the laws of physics will work in such a way that your brain will be altered and addiction no longer so strong.

How does physics "remove all these defects of character"?

It's accepted physics that all defects of character will be removed at the heat death of the universe :)

Removed, or frozen in perpetuity?

The only way to alter one's character are through physics, presumably.

Almost everyone I know who is successfully clean and happy in 12-step had long ago exhausted all the options: doctor, priest/preacher, psychologist, moving to a new town, "going to the gym", etc. Nobody would ever (myself included) do 12-step because we actually think it would work. And yet it has worked for me when nothing else did.

Are you saying that there are no statistics that back up AA as effective?

I am pretty skeptical of a claim like that.

Efficacy rates are low, but so is almost every other intervention available.

It works for some people. It's also completely free, which you can't say about medical intervention. Around here, detox and rehab facilities have 6 month long waiting lists and cost tens of thousands of dollars.

Are you saying rehab facilities also don't work compared to a control group?

I am skeptical about that too. I'd be surprised if both rehab and AA don't have a statistically significant effect on addiction treatment.

No.

People tend to expect that rehab will cure addiction, and become disillusioned with the reality that addiction is a chronic illness. Relapse rates are high in chronic illnesses, like diabetes and hypertension, the latter having a relapse rate of 50%-75% according to the NIH. Addiction is no different, and its relapse rates are between 40%-60%, even with ongoing treatment. Efficacy rates will reflect this harsh (and often very expensive or deadly) truth.

The success rate of AA is somewhere around 5-10%. Perfectly accurate stats are hard to acquire due to the nature of the disease of addiction, and the programs themselves intentionally do not track efficacy rate (after all, a program based on religious ideology instead of actual evidence has hilariously become the defacto prescription for drug addiction in the american legal system. Why ruin a good thing?). You would achieve a similar efficacy rate by giving addicts a sugar pill and telling them it was a miracle drug that cures addiction.

Also instead of taking the time to write out multiple comments expressing your doubt as to the efficacy of AA, you could've found the information you needed in a single google search.

So what's the solution?

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