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Comment by SargeZT | Hacker News Reader

For anyone who wants a more evidence-based approach to addiction than 12-step programs, SMART recovery might do the trick for you. It helped me greatly with my alcohol addiction, and it doesn't treat addiction as a forever thing. I've been sober for 6 years or so now, and I haven't needed to attend a meeting since I beat the addiction.

Meetings are free, there are online sessions all the time, and it's just a great community overall.

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What is your experience about the following paragraph?

> you can go from being addicted to alcohol, to having a social drink once a week.

That goes against pretty much everything I've ever been told by addicts to alcohol and drugs. Once you've been "in the tunnel", there just isn't "a social drink" - even a drop will get you off the wagon for good.

It's not my experience. I do believe it's riskier than simply abstaining long-term. You are, in fact, reminding yourself of something you found so compelling once that it derailed your life. But personally, I have been addicted to amphetamine and alcohol/benzodiazepines badly enough in the past, that I could not discontinue them suddenly due to the severity of the withdrawal. Yet in recent years I have felt able to get drunk at a party for example, without serious cravings in the weeks that follow. And I'm back on amphetamines for ADHD which I take to schedule. I won't lie though; the thought of taking two pills instead of one does occur to me not infrequently. The temptation is probably always there once you know what it's like. But my experience is that no, it doesn't automatically derail necessarily.

That’s not 100% true. Exhaustion is real. Can you watch the same Marvel super hero movie for the n-th time, even though you loved the first few? You can’t, you just get tired. Burn out is real even amongst addicts.

You literally get tired of this shit. Before I became an addict, another legitimate addict told me why he stopped - he just got tired. I’m talking years of daily drinking, and all the consequences that come with it (every bridge burnt, every path destroyed, credentialed as a true fuck-up). Exhausted.

That’s the thing about abuse. If you took one hit of cocaine, and you die, that’s the end of your abuse. Addicts can take hit after hit after hit, and still live. That’s scarier than death, and extremely tiring.

I am tired of it, pure exhaustion is a way out. The implication of that is that you yourself are such a piece of shit that you didn’t quit until you yourself got tired.

It’s shameful.

Check out the Sinclair method.

I'm going to second the Sinclair method, which involves taking naltrexone or nalmefene. I started with the Sinclair method at the same time I started participating in SMART recovery online meetings. I only drink alcohol about once a week now and only in moderate quantities.

Here are some links for anyone interested:

https://www.amazon.com/Cure-Alcoholism-Medically-Eliminate-A...

https://www.youtube.com/watch?v=6EghiY_s2ts

For alcohol that may be true, but the ultimate goal of SMART is sobriety. There is another (smaller) branch of REBT drug-based therapy called 'Rational Recovery' that uses naltrexone (an opiate blocker) before drinking to reduce the pleasurable feeling associated with drinking.

I tried it, but it didn't work for me. It certainly makes drinking less pleasurable, but I was using it as a coping mechanism for my anxiety.

I think for some people, that approach might work. Also, if a person solves their underlying psychological problem which led to the need of alcohol for a coping mechanism, I think it might work as well.

I'm probably saddled with anxiety for life, but I've learned healthy coping mechanisms. Besides the taste of a cold beer after mowing the lawn, I don't miss it in the slightest.

What evidence is it based on? When you say evidence-based, do you mean the initial development of the program, or its ongoing claim to efficacy in light of the results?

There is evidence supporting AA as a treatment for alcoholism.

https://pubmed.ncbi.nlm.nih.gov/29606223/

https://pubmed.ncbi.nlm.nih.gov/32159228/

It's great there are alternatives, and I'm sure different treatments will work best for different people, but it is for that reason you shouldn't imply other programs are not an evidence-based treatment (at least of similar quality).

Interesting, I'll take a look at that. Congrats!

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