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PostPosted: Thu Dec 01, 2011 10:53 am 
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I found a recent study review from 2009, which tried to come up with some real answers. Basically they combined the data of a number of other studies on the subject. This is the closest to an answer they could find:

Quote:
Main results

Eight trials involving 3417 people were included.

AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive.

Other studies reported similar retention rates regardless of treatment group.

Three studies compared Alcoholics Anonymous and other 12-step programmes for alcohol dependence against other treatments and found few differences in the amount of drinks and percentage of drinking days.

Severity of addiction and drinking consequence did not seem to be differentially influenced by TSF versus comparison treatment interventions, and no conclusive differences in treatment drop out rates were reported.

Included studies did not allow a conclusive assessment of the effect of TSF in promoting complete abstinence.


http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/pdf/standard

It's strange that the 12-steps have become such a dominant recovery force, yet there's so much vague and conflicting results. As this review has shown, it doesn't seem to matter what type of support someone chooses. Whether it's relapse prevention classes, NA, motivational interviewing, counselling. All that matters is that they we seek out some kind of help or support.

This forum seems to be mine at the moment.

There was another really interesting one that looked into what kind of personalities do best in 12-step groups. But I couldn't find the whole article.


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PostPosted: Thu Dec 01, 2011 1:57 pm 
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This is so very interesting. Somehow 12-step has become the "gold standard" of treatment. I'll bet if you ask most people in the world, they would tell you that 12-step works well, that it is the undisputed way to treat addiction, that it is the undisputed way to go - just about like having an ear or throat infection and taking an antibiotic to treat it. I'll bet most people see them both the same way, while the fact is, they are not.

I have been involved in emergency medical services for coming up on 25 years now. We have had something similar that was and often still is thrown out called Critical Incident Stress Debriefing or CISD. It was "invented" about 25 years ago and even sprung up CISD teams throughout the United States, training programs, etc. The drill goes something like this, EMT/Paramedic/Firefighter/Police Officer experiences a horrific incident - like violent death of a child, death of a co-worker, etc. Everyone on the call then comes to a Critical Incident Stress Debriefing, led by one of the CISD teams, talks about the call, blah, blah, blah. This then somehow magically makes them feel better and keeps them from have problems down the road and having to leave the profession. The only "problem"???? IT HAS NEVER BEEN PROVEN TO WORK. In fact, some have shown evidence that it is actually harmful. That's right, some studies have shown that people who took part in CISD actually did worse than those who did not. It became very controversial a dozen or more years ago in the industry, yet, if you know anyone who is a paramedic, firefighter, police officer, first responder, ask them about CISD and see what they have to say. I'll bet you they say it's great, it works well, yadah, yadah, yadah --- just like 12-step. Ask a dozen [non-addict] friends what they think the percentage is of people staying sober with 12-step and I'll bet it's much higher than it really is.

Worst of all, we really don't know. Meanwhile the courts, the "experts", the treatment centers, the halfway houses, on and on - even some Sub providers - all require involvement with 12-step programs. But does it really work? From everything I can find or have read it seems like it works 10% of the time - pretty much like everything else non-12-step does... other than Sub where I see success rates as high as 50% depending on the study.

So my question then is, yeah, I'm finally getting to it..., How long will it take the USA and the world to actually decide that 12-step doesn't work nearly as well as it was thought? Which will come first, we get proof that 12-step doesn't work as advertised or global warming is a farce? I'm betting on the latter.


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PostPosted: Thu Dec 01, 2011 2:19 pm 
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I think that 12-step has such a stranglehold on addiction treatment for the simple reason that for a really long time, 12 step groups were the only game in town.

Treating addiction as a medical illness is a relatively new concept and standards and best practices for treating addiction are still evolving. But there is so much interesting research going on in the field of addiction treatment, so there is hope that better treatment will become available as researchers continue to develop their understanding of how addiction happens, what the underlying processes are in the brain, how genetics plays into it, etc.

And as treatments become better, I hope that the stigma against addicts will decrease. Remember when psychiatric medications were relatively rare? When I first sought treatment for depression, the medications sucked, didn't work that well and had hideous side effects. I had to be hospitalized to be stabilized and find the right medication; yet still people would tell me to just snap out of it. Now every other person and their mother is on an SSRI and no one thinks twice about it.

It's not just pharmaceutical treaments that are evolving either. Talk-therapy based treatments like DBT are being studied for addiction treatment and are showing positive results in well-designed, peer reviewed clinical studies. I have a friend who is a researcher on a project that is studying the effects of supportive housing for chronically homeless addicts and alcoholics and they are getting positive results. I think that a sea change is happening in the way addiction is viewed - that it is a public health problem, not a moral failing, so there is some motivation there to look for new ways to address the issue.

Unfortunately, the economy is so screwed right now and like always mental health and addiction treatment is right at the top of the list of things to be cut from state and federal budgets. But hey, we're just another marginalized population, so who cares? Sorry, just a little bitter. Anyway, that brings me to another reason why the 12-step groups persist as the go-to treatment for addiction: They Are Free. Many addicts seeking treatment are poor, have no health insurance or their health insurance doesn't cover addiction treament. Therapy is expensive and even if you have access to a low-cost or free mental health center the waiting list for an appointment can be really long. Lots of addicts also have co-occuring disorders which just puts another hurdle in place when trying to navigate the system and seek treatment. But NA and AA are free and really accessible to just about anyone.

So that's my two cents on the subject.

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PostPosted: Fri Dec 02, 2011 2:03 am 
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Diary of a Quitter wrote:
Anyway, that brings me to another reason why the 12-step groups persist as the go-to treatment for addiction: They Are Free. Many addicts seeking treatment are poor, have no health insurance or their health insurance doesn't cover addiction treament. Therapy is expensive and even if you have access to a low-cost or free mental health center the waiting list for an appointment can be really long. Lots of addicts also have co-occuring disorders which just puts another hurdle in place when trying to navigate the system and seek treatment. But NA and AA are free and really accessible to just about anyone.

So that's my two cents on the subject.


That's one of the things that kept me coming back. Not so much the idea that it was free. Moreso the fact it's based on a real idealistic concept of one addict helping another, of being a non-profit fellowship. It's really fantastic. When coming out of addiction, where everyone wants to rip each other off... it was a real breath of fresh air. And I believed in it for some time.

What's been good to see, and it gives me some real hope. Is that same non-profit idealism is being transposed to other peer-support programs. New Life, SMART ... Have been inspired by 12-step groups to be run off donations as well. Maybe one day, an addict seeking recovery will have options to choose from many different programs, no one greater than another. I'm hoping. :D


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PostPosted: Fri Dec 02, 2011 3:35 pm 
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my best friend kim was going to aa/na for a strait 10 years " he stop'd going,16 years ago finding if he continued to go he would slip and die? but he is now sober for 26 good YEARS!!!!! :lol: he felt all the negative story's and blindness he got from
the group's would deff- make him slip. kim and i believe that some programs are not as colt like as others. AA/NA is not a colt"
but it is colt like. but who has the say or money to change it?


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PostPosted: Fri Dec 02, 2011 11:35 pm 
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That's so true Johnboy. At 10 years clean, do you still want to be regularly hearing people talk about using drugs, and bitch about their lives for 90 minutes?

At 10 years clean I wanna be going to BBQ's with good friends, talking about tax evasion, planning holidays and buying shiny stuff. Not drinking cheap coffee from a plastic cup next to some dude with his chin on his knees.


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PostPosted: Sat Dec 03, 2011 11:32 pm 
tearj3rker wrote:
I found a recent study review from 2009, which tried to come up with some real answers. Basically they combined the data of a number of other studies on the subject. This is the closest to an answer they could find:

Quote:
Main results

Eight trials involving 3417 people were included.

AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive.

Other studies reported similar retention rates regardless of treatment group.

Three studies compared Alcoholics Anonymous and other 12-step programmes for alcohol dependence against other treatments and found few differences in the amount of drinks and percentage of drinking days.

Severity of addiction and drinking consequence did not seem to be differentially influenced by TSF versus comparison treatment interventions, and no conclusive differences in treatment drop out rates were reported.

Included studies did not allow a conclusive assessment of the effect of TSF in promoting complete abstinence.


http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005032.pub2/pdf/standard

It's strange that the 12-steps have become such a dominant recovery force, yet there's so much vague and conflicting results. As this review has shown, it doesn't seem to matter what type of support someone chooses. Whether it's relapse prevention classes, NA, motivational interviewing, counselling. All that matters is that they we seek out some kind of help or support.

This forum seems to be mine at the moment.

There was another really interesting one that looked into what kind of personalities do best in 12-step groups. But I couldn't find the whole article.


The link just brings you to a page that requires you to log in. You cannot see the article.

I'd love to read it though..maybe I will try the DOI # thru my university library.


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PostPosted: Sat Dec 03, 2011 11:36 pm 
tearj3rker wrote:
That's so true Johnboy. At 10 years clean, do you still want to be regularly hearing people talk about using drugs, and bitch about their lives for 90 minutes?

At 10 years clean I wanna be going to BBQ's with good friends, talking about tax evasion, planning holidays and buying shiny stuff. Not drinking cheap coffee from a plastic cup next to some dude with his chin on his knees.


I always found everything after the first 10 minutes to be off-putting.

I am a not very religious Jew, and AA especially always reminded me of church. When they said the Lord's Prayer, it made me so uncomfortable. I knew Aleinu, Kaddish, Shema...but no "Lord's Prayer." So I remained silent while people glared.

NA is nearly as religious and equally as laughable. If it really worked, the recovery rate from alcoholism would not be the same as it was 100 years ago.


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PostPosted: Sun Dec 04, 2011 9:33 am 
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Ironic wrote:
I always found everything after the first 10 minutes to be off-putting.

I am a not very religious Jew, and AA especially always reminded me of church. When they said the Lord's Prayer, it made me so uncomfortable. I knew Aleinu, Kaddish, Shema...but no "Lord's Prayer." So I remained silent while people glared.

NA is nearly as religious and equally as laughable. If it really worked, the recovery rate from alcoholism would not be the same as it was 100 years ago.


AGREED!

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 Post subject: Hey Ironic ......
PostPosted: Sun Dec 04, 2011 10:17 am 
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AA is about learning to Humble yourself.... If you cant really humble yourself you cannot be taught anything... The only way to humble yourself is to realize that the world does not revolve around you, Humility is teachablity.. Programs help you learn about yourself, and its Free !!!!! at the end of your AA meetings , close your eyes and talk to whoever YOU think is in control of everything going on, just as long as you believe its NOT you.... also : KISS = keep it simple stupid.. Good Luck.....


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PostPosted: Sun Dec 04, 2011 10:29 am 
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But those are YOUR beliefs, Painter. And not everyone believes the same way you do. That's the problem many of us have with NA/AA. They expect ALL of us attending to fit into the same small box and then actually change our fundamental beliefs to fit into that tiny little box. Can't you see that to fit into your little group we're required to change and become like you? Talk about one size fits all! That never works because we are NOT all the same.

The bottom line is it's a religious program and the courts are finally starting to realize this. That's why First Amendment challenges to people being forced to go to 12-step programs are winning, because people cannot be forced to attend religious programs. And 2+ federal appeals courts have already deemed 12-step programs to be religious organizations.

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-I'm only responsible for what I say, not for what you understand.


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 Post subject: Re: Hey Ironic ......
PostPosted: Sun Dec 04, 2011 4:58 pm 
Painter wrote:
AA is about learning to Humble yourself.... If you cant really humble yourself you cannot be taught anything... The only way to humble yourself is to realize that the world does not revolve around you, Humility is teachablity.. Programs help you learn about yourself, and its Free !!!!! at the end of your AA meetings , close your eyes and talk to whoever YOU think is in control of everything going on, just as long as you believe its NOT you.... also : KISS = keep it simple stupid.. Good Luck.....


AA is about learning to rely on quack medicine and cult religion instead of learning to look in the mirror and fix yourself.

Sorry, but "keep it simple, stupid" and "your best thinking got you here" are just silly slogans. Do you know anything about Bill Wilson? Do you know that he wrote a portion of the Big Book while under the influence of Belladonna, and that at first he tried to push belladonna treatment for alcoholism in addition to the silly steps he stole from the Oxford Group? I know too much about AA history to be duped by their silly program.

And how about this? [web]http://www.na.org/?ID=bulletins-bull23[/web]

That is NA's bulletin #23. It states that people on bupe or methadone are not clean as according to the group conscience of NA.

So if you believe in xA, you should follow their rules and stop sharing and pick up a white chip every day that you take a sub. I want to make clear that this is NOT my opinion, this is the rules of xA.


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PostPosted: Sun Dec 04, 2011 6:29 pm 
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I was not trying to jamb my beliefs down anyones throat... Boy Hatmaker, your way over emotional about this !!!! citing court rulings ?? NA and AA are not for everyone , even I'll admit that !!!!!!


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PostPosted: Sun Dec 04, 2011 7:00 pm 
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I'm gunna take the middle road on this one.

NA does have some really good qualities, and some huge flaws, just like any form of recovery.

The main problem I have with the 12-step groups today, is that it's the only recovery method that refuses to acknowledge other ways to get clean. The general consensus in NA is that other recovery programs just don't work. And that the 12-steps are the only way true way to get clean. People who use other methods are just "dry druggies".

My counsellor, my smart group, and even this forum ... encourage people to look wherever they need to for answers. In NA I was even told to stop meeting my old "non-addict" friends, because they were still drinking socially. I nearly lost some good friends from my time in those rooms

Towards the end of my years in NA, I started sharing from the floor exactly how I saw it. I'd say "At 13 months clean, I was working the steps, doing service, doing regular meetings, praying, talking to my sponsor. I was doing everything I was told! And I still relapsed."

Things like that don't go down too well. There's this belief that if a person does everything they're told in the program, they're somehow immune from relapse. That their higher power will create a little force field around them.

I shared that at maybe a few meetings before I bailed. And some people hated it, and cross-talked me. An equal number spoke up, and said they had the same experience.

I was talking to an ex AA guy who was doing a thesis examining cult behaviour. He told me that 12 step groups tick all the boxes for being a cult, except for one. They don't seem to have a fearless & charismatic leader.

That being said, my years is NA were not all bad. I had some fantastic times, especially up north. But my quality of life has improved a lot since going on Suboxone, and leaving those rooms. I'm no longer surrounded by drug talk and drugs every day, and it's done wonders for my recovery.

Quote:
The American Family Foundation defined cults as:
"A group or movement exhibiting great or excessive devotion or dedication to some person, idea, or thing, and employing unethical manipulative or coercive techniques of persuasion and control (e.g. isolation from former friends and family, debilitation, use of special methods to heighten suggestibility and subservience, powerful group pressures, information management, suspension of individuality or critical judgment, promotion of total dependency on the group and fear of leaving it), designed to advance the goals of the group’s leaders, to the actual or possible detriment of members, their families or the community.


I'll run through it:

- Excessive dedication to [higher power] *tick
- Isolation from former friends *tick (in my experience)
- Isolation from family [I saw so many people told to leave their spouses / partners in those rooms] *tick
- Use of special methods [holding hands, chanting, candles, repetition] *tick
- Information management [you can't read or refer to non-NA material in the rooms] *tick
- Suspension of individuality ["you're just an addict"] *tick
- Suspension of critical judgement ["You can be too smart for this program / you gotta get stupid to get the steps"] *tick
- Promotion of total dependence ["People who leave these rooms die!"] *tick
- Fear of leaving rooms [same as above] *tick

- Designed to advance group leaders goals, to the detriment of members & their families [NO tick]

Even if it is a cult, it still helps a lot of people. Let call it a "benign cult" :D


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PostPosted: Sun Dec 04, 2011 9:14 pm 
Bill Wilson is the charismatic leader. And then you get those crazy guys, like Clancy I. who start their own groups (like Pacific Group) and become leaders in their own right.

Cults can definitely venerate a dead leader.


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PostPosted: Sun Dec 04, 2011 9:58 pm 
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I dunno. Bill W certainly has a presence. But there's hardly big banners of him adorning the walls, like there is of L. Ron at Scientology conventions.

Most people in AA/NA I've known, at least in Australia, think Bill. W was a great man, not some mystical prophet. I agree that there are some hardliners who get carried away and think the steps were "channeled from God". But at least down here, they're in the minority. And they're usually quite sick.

People who are a bit more balanced, and who've studied Bill W & Dr. Bob's story, believe Bill may have suffered bipolar disorder. It accounted for a lot of his behaviours - his alcoholism, his manic stock trading, megalomania, his wild business ideas, his years of dark depression. He also experimented with clinical LSD in later life. A lot of it makes sense to me. People who are hypomanic, as Bill W was often, can be very charismatic & creative. Bipolar disorder has been called the "prophet's disease", as religious delusions and mania often go hand in hand. Most of these people end up in a psychiatric unit, clearly very ill. Some however manage to surf a level where it doesn't get that extreme.


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PostPosted: Sun Dec 04, 2011 11:43 pm 
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ya' aa is to humble your self. this is how leader ship started in the first place. i would not humble or trust a brain washed person again. i have seen aa/ na for many years. i hate to say this but' 30 years later, i go to meatings and see a few of the old timers ,saying the same thing, siting in the same position . a lot older. and that is fine'.


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PostPosted: Mon Dec 05, 2011 4:16 am 
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Painter wrote:
Boy Hatmaker, your way over emotional about this !!!!


Why is it that when a woman responds with a firm and assertive answer that we are deemed "emotional". I'll bet if a man had written the exact same words that it wouldn't have been described as "emotional".

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PostPosted: Mon Dec 05, 2011 4:46 am 
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Ironic wrote:
I am a not very religious Jew, and AA especially always reminded me of church. When they said the Lord's Prayer, it made me so uncomfortable. I knew Aleinu, Kaddish, Shema...but no "Lord's Prayer." So I remained silent while people glared.


WTF? People say the Lord's prayer in AA over there? I thought 12-step programs were in their very nature meant to be secular.

Here's something from the NA Oz website:

Quote:
Narcotics Anonymous is not a religious organisation and does not mandate any particular belief system. It does teach basic spiritual principles such as honesty, open-mindedness, faith, willingness, and humility that may be applied in everyday life.


There were heaps of Jews in Melbourne / Sydney NA. The most "religious" word I heard used in NA was "God", but it was referred to more as a spiritual concept than anything religious. There are no references to Christianity, or any particular religion in the official NA literature.

It sounds to me like AA/NA in certain parts of the world have been hijacked by religious beliefs.

My experience of NA was always quite secular. There were Christians, Muslims, Jews, athiests, agnostics. All spread across the city. And I quite liked that idea. People who shared on religious themes were always frowned upon, no matter the faith. There was a belief that everyone's conception of their higher power is personal, and it was a bit taboo to even discuss our higher powers.

What I found really funny, was how many times I heard "I know someone who's higher power is a ROCK! So you can make it anything!" Everywhere I moved up the east coast, I kept hearing about this infamous guy who preyed to a rock. Then, in rehab, I saw a video of this guy in LA saying "I know a guy who's higher power is a ROCK!" WTF? Is this guy hiding from me or something? He sure gets around! He must be a really cool guy if everyone knows him. Maybe I should make my higher power a rock. Or maybe people are just full of it. :lol:


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PostPosted: Mon Dec 05, 2011 5:02 am 
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It is far from secular over here in the states. And it's not unusual for them to recite the lord's prayer at meetings. It's why I never stayed or kept going. They can write what they want in their literature, but their actual practices at their meetings is what is real to me.

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