A Different Path to Fighting Addiction
nytimes.com
nytimes.com
First and foremost obviously one has to clear themselves of physical addiction, which in most cases should be done with professional medical guidance. Afterwards comes the psychological compulsion to use. For me the best thing was to think rationally about the decision to use, and whether it was going to give me the benefit I sought. In most cases, having a drink doesn't help with the situations in which I wanted it, except for very short-term (hour or two); clearly not a long term solution to problems like anxiety, social awkwardness, depression. I think rational positive thinking like this can be made habitual with practice. Having group support from something like A.A can be beneficial in the early days of this process.
The issue with abstinence based programs is that they don't treat the underlying cause of the problem. Their focus is purely on a singular behavior which the problem led to. People in them are terrified of a single drink because it represents failure, but they don't identify what that single drink really means to them psychologically and how to address that problem in a rational way.
I know people who have benefited from AA, but their attitudes generally seem to be "don't throw the baby out with the bathwater." They take out the positives and ignore the negatives.
There are alternatives to A.A. however, for example SMART: http://www.smartrecovery.org/
Furthermore, it is highly encouraged to seek outside help (psychiatrists, therapists, etc.) if needed.
Whether what you say is official canon or not doesn't seem to matter to the reality of how it's managed at the group level. There seems to be for example a very wide variation in how people interpret the "12 steps," particularly amongst atheists or agnostics.
I am glad that medical assistance is encouraged at the very least.
There are people who hit rock bottom from drinking and realize they need help. For them the thought of getting back to that rock bottom point can be terrifying. Abstinence only isn't forced upon them, but rather it can be viewed as the only option.
This article also doesn't do anything to address drug addiction. I don't think moderating heroin intake is going to be a viable option for people with a heroin problem.
There is certainly a large group of people in the world who can benefit from the treatment described here, but I think the article oversteps a great deal by saying this is a more effective addiction treatment than AA.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032...
Please dont speculate on recovery unless you have first hand experience. I know many people who have improved their lives from AA and other meetings of the same type.
There are many people with addiction problems who do not trust doctors or religion and a place of like minded people is the only option for them (AA).
I've never been in AA but I am close to someone who has. The primary benefit I see AA provide them is a group of like-minded people who will do fulfilling non-drug-related activities with them.
Addiction is as much social as it is physiological. It's very difficult to quit an addiction if you continue to hang out with the same people in the same environment in which you developed your addiction. Replacing that social environment with a new one composed of people who are sworn to avoid those substances and which is filled with fulfilling activities unrelated to your addiction is a superb way to keep from slipping back into old habits.
I didn't downvote but I have a knee-jerk reaction to want to downvote people using anecdotal evidence to support medical treatments.
Isn't this exactly the kind of thinking that makes people believe that homeopathy works?
For example, saying "I put cumin oil in a vaporizer and now I don't get colds as often" is different than saying "I joined an AA program and now I have been sober for 10 years".
* observation is simpler (are you in AA? are you still drinking?)
* so measurement is simpler (how much blortzroot do you add to your lotion to clear up that rash? can you show your rash is 65% better than last week?)
* AA attempts to provide a permanent solution, not a remedy for symptoms, so it's more clear when AA fails.
* Also the things homeopathy "cures" tend to be in a completely different class and severity than chronic substance abuse
Also I'm not speculating and I do have personal experience since you ask, I didn't say you need a psychiatrist and a prescription but from years of talking to addicts and going through recovery myself I've found that setting goals and staying positive and within limits and simple things like looking at changes in a certain way is very effective compared to what seems like a New Years Resolution that you'll likely fail and beat yourself for failing to keep up. Such therapy mentioned in the article can motivate people more than AA-style regimes can and that's more important in the long run.
That's a shame because research is difficult and also ignored if politicians find it doesn't suit their view.
Substitution therapy (eg, methadone instead of heroin) has strong supporters and detractors and it's hard to get good quality research to see whether substitution is better than abstinence.
Indeed, Russell Brand (comedian, actor, addict) has been talking about the benefits of abstinence based treatment and asking why it's not more available in England, which suggests to me that most people don't get abstinence based treatment. (Although he's talking about drugs and not alcohol).
It is weird that cognitive behavioural models are really old now and are only just starting to get a lot of use.
How about maintenance? There's ample evidence from the UK, Switzerland, and elsewhere showing that diacetylmorphine maintenance (treating heroin addiction with heroin) is incredibly effective[0][1].
The effectiveness of treating existing users is the primary concern, but a nice bonus is that it also seems to have served as a deterrent for new heroin users due to its social image as a medical problem, rather than a criminalized behavior[2].
(Remember that, when administered in a controlled setting and in predetermined quantities (and purity), heroin use carries few of the dangers commonly associated with its use on the street, and is fairly similar to the related drugs that you already receive in the hospital[3])
[0] https://en.wikipedia.org/wiki/Heroin_maintenance
[1] http://www.nejm.org/doi/full/10.1056/NEJMoa0810635
[2] https://en.wikipedia.org/wiki/Heroin_maintenance#cite_note-9
[3] Such as morphine (the similarity of the names "morphine" and "diacetylmorphine" is not a coincidence!)
That's obviously better for users, but it's better for wider society too. People who are addicted to drugs will take drugs, so forcing them to do so hidden away in places without safe needle disposal means members of the public or cleaning staff risk needle stick injury.
It doesn't ever mention quantities.
In England "binge drinking" can be a surprisingly small amount. Risky drinking can be as little as 2 glasses of wine a day. (One large glass of wine (200 ml) at 13 % would be about 2.5 units - two of those is 5 units. That over 5 days is 25 units).
We use a "unit of alcohol" as a public health measure. One unit is 125 ml of drink at 8% ABV (Alcohol by Volume).
There's a handy chart at wikipedia here: https://en.wikipedia.org/wiki/File:Units_of_alcohol_chart.sv...
Advice about sensible drinking says "no more than 3 to 4 units per day (men) 2 to 3 units per day (women), with some days drink free, and don't save up units to drink at once".
But problem drinking is much much larger quantities of alcohol. NICE guidelines say that 15 units per day get assisted withdrawal and 30 units per day (that's 750 ml of 40% vodka every day) is the threshold for medically supervised intervention.
The current English guidelines do not strongly recommend total abstinence, especially for people at the milder end of alcoholism. There are a variety of psycho-social interventions that are recommended.
Extending both axises would be useful.
It's a bit fitting: a bastardization of the spelling which underscores the bastardization of nutrition going on with the product.
That's why we call peanut butter 'pindakaas', for example, which means 'peanut cheese'; producers were not allowed to use 'butter' in the name if the product did not contain actual butter.
It's amazingly underused and it's great to see modernizing approaches to the "command line" to the brain.
Most addicts dont start out abusing substances heavily from day one, if we had more programs that focused on the early addiction phase then we may be able help many people who are teetering on the edge.
The text of the first amendment of the United States of America reads: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."
AA (in my understanding) doesn't force any religion. The 12 steps (link http://www.aa.org/assets/en_US/smf-121_en.pdf) talk about "a power greater than ourselves". There's no reason that couldn't be the judge assigning the sentence, in this case.
When you force people into a program that references some idea of God you are doing exactly that..
Doing a quick Google search, it appears that at least one court has found mandated AA unconstitutional: http://www.sfgate.com/bayarea/article/Appeals-court-says-req...
"Do this or go to jail" is pretty much the definition of something which is -- legally speaking -- compulsory, not voluntary.
Its voluntary in the trivial sense that a conscious choice is involved, but not voluntary in the legal sense (or the substantive sense of a free choice made without threat of force.)
Which is why its not an independent First Amendment issue, but a Fourteenth Amendment issue, however, as it is well-settled law that the scope of the rights considered fundamental to the concept of ordered liberty and thereby incorporated against the States under the Due Process Clause of the Fourteenth Amendment includes the entirety of the protections of the Free Exercise and Establishment Clauses of the First Amendment, the usual legal analysis of religious freedom issues, whether state or federal, is under the First Amendment logic applied the same way whether the government involved is state or federal.
> nor is it making a law.
It is either (a) enforcing a law that Congress or a state legislature made (which law, if it violates First Amendment religious freedoms, violates the Due Process Clause of the Fourteenth Amendment when a State does it or the applicable clause of the First when the federal government does it) or (b) depriving someone of Constitutional liberty without a basis in law in the first place (which also violates the Due Process Clause of the 14th Amendment when a State does it, and the Due Process Clause of the 5th Amendment if it were a federal court.)
Your understanding is incorrect on two levels; first, AA are religious even if in a somewhat generically deistic way, and not secular in and of themselves, second, the actual AA groups in a particular area to which defendants are permitted to choose are often even more specifically religious than AA-on-its-own, to the point of being affiliated with specific established religious institutions other than AA itself.
So, while it has been a common practice, the tide is turning fairly rapidly against it in the legal system.