[kolla]

Same here, I'm probably considered an alcoholic because of the ammount of liquour I drink per week/month but I can work out every single day and stay in great shape but come friday and saturday I do empty quite a few units. Stopping the weekend urge is hard.

[phs318u]

Speaking as an addict in recovery, this definition is the most practically useful. It’s step 1 of every 12-step program.

If you really want to stop doing something, and are trying your hardest to not do that thing, and yet despite that desire you feel an overwhelming compulsion to do that thing, even though you rationally know the consequences for you or others will be bad - that’s addiction.

Or as I once put it to my daughter when she was a teen, “If you are making a choice that feels like an exercise of your own free will, and yet every single time without exception, you make the same choice - is it really free will?”

(I was trying to get her to reflect on her own weed usage. Almost a decade later she acknowledges her addiction).

[sneak]

> Speaking as an addict in recovery, this definition is the most practically useful. It’s step 1 of every 12-step program.

Note also that 12 step programs are pseudoscience/ineffective and are, when measured, no more or less successful at helping people beat addiction than not using a 12 step program, so take that endorsement with a grain of salt.

[hn_version_0023]

They seem to help a lot of people. It helped my father, and if I’d continued my ways, it might have had the opportunity to help me.

You may see pseudoscience, but I see broken people without a safety net finding empathy and a healthier group to spend their time with.

I don’t know if you’ve experienced addiction yourself, but your comment comes across as woefully dismissive of something that helps lots of people.

[sneak]

That's the thing: many things are both a) popular and b) seem to help.

These are not useful tools for scientifically measuring effectiveness, however. This is why we have clinical trials and things like double-blind studies.

There is an overarchingly popular human pastime that underlies these 12 step programs' philosophies that a majority of human beings on Earth believe will result in improving your life, but that doesn't make it true.

[kar5pt]

That's not true. Newer research shows AA is the most effective way to quit drinking https://med.stanford.edu/news/all-news/2020/03/alcoholics-an...

[phs318u]

There are a few recent studies that clearly indicate we have barely scratched the surface in understanding both the neurological nature of addiction as well as the mechanisms by which programs like 12-steps work.

https://pubmed.ncbi.nlm.nih.gov/26306329/

"We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms... It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms"

[phs318u]

I can only speak of my experience. I first found the fellowship 24 years ago. In that time I’ve seen hundreds of people come and go. Only 10 people I know who were around in 1998 are still in the program. Of those, 9 have been in successful recovery for many years (10 years for me after walking away for several years and relapsing). The tenth has a history of relapsing every few years. I’d call that a remarkable success rate. I have no idea what has become of all the hundreds that walked away from treatment. But I know for some it’s ended in death in full-blown addiction.

Your comment reflects a deep misunderstanding of the 12-step program, and one that many addicts also fail to grasp. That is that the belief that addiction is curable. It isn’t. It’s a lifelong condition which therefore requires lifelong treatment. Much like diabetes. Diabetes treatments can be incredibly successful - but only for as long as you continue to strictly adhere to the care regimen. The elements of that care regime are not optional, and are required no matter how healthy or fit you may feel at any given moment. That’s because you’ll always be a diabetic. Failure to accept that fundamental aspect of the disease can be fatal.

In measuring the success rate of diabetic treatment do you include the measurement of those that have stopped treatment?

The 12-steps are not teleological. There is no cure. Only remission, and in remission a clear mind and the possibility of a healthy and serene life.

I get why 12-steps can rub people the wrong way. The “god” aspect. I won’t go into all that here because it would literally be an hours long discussion. Suffice to say that the program can work for atheists too. I know because I was one (I consider myself agnostic these days).

[sneak]

> That is that the belief that addiction is curable. It isn’t. It’s a lifelong condition which therefore requires lifelong treatment.

This concept is at odds with modern psychiatric medicine and scientific inquiry, and is likely objectively false, yet persists as a core tenet of 12 step programs, seemingly beyond debate.

[phs318u]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506170/

"In individuals who are vulnerable to addiction, repetitive exposure to the agent induces long-lasting neuroadaptative changes that further promote drug-seeking behaviors and ultimately lead to persistent and uncontrolled patterns of use that constitute addiction. These neuroadaptive changes are the bases for tolerance, craving, and withdrawal and lead to a motivational shift.3 Motivation to drug-seeking behavior is initially driven by impulsivity and positive reward. In contrast, compulsivity and negative affect dominate the terminal stages of the pathology. Addictions are in a sense “end-stage” diagnoses because at the time diagnosis is made potentially irreversible neuroadaptative change have occurred—changes that were preventable at an early point of the trajectory of the illness."

Two key things are pointed out here: 1. not everyone is vulnerable to addiction, and 2. "addiction" as understood behaviourally, is an "end-stage" diagnosis of possible irreversible neuroadaptative changes".

[phs318u]

Forgot to add this in my other response (where I addressed effectiveness).

With respect to your characterisation of 12-steps as pseudoscience, I can only state that it’s a program designed to change your thinking and by so doing, trigger neurological changes or divert previously default responses. In that sense it’s in the same category as the many and varied approaches used in the field of psychology (eg CBT, DBT etc). Is psychology a pseudoscience in your view?

[sneak]

The effectiveness of a treatment can be measured, and results observed.

CBT is effective. 12 step programs are not.

[phs318u]

For someone who has made a lot of absolute claims, you have not provided any references to back up your claims. Here's a recent study that directly refutes your claim.

https://med.stanford.edu/news/all-news/2020/03/alcoholics-an...

[at-fates-hands]

Anecdotal evidence so take this as you will.

I have alcoholism in my family. When my Dad finally went into a 30 day in-patient treatment, I was still a sophomore in college. I was very much like you. An athlete (played D3 soccer), so I was working out, and in great shape, but wouldn't touch alcohol during the week - when I first got to college, my drinking was all done on the weekends. Then when I was of legal drinking age (US 21 years) then it started to creep into Thursday, then eventually I was drinking Wed-Sat, drying out Sunday and then cramming all my homework and studying into three days just to get ready for the weekend again.

One of the things they do is a screening. You fill out a long survey - How do you drink, when you drink? When do you drink? How often are you drinking, etc. I fill it out based on my current activity.

Counselor sits me down, and starts telling me that I'm not an alcoholic YET, but I'm clearly heading that way. I do abuse alcohol on a regular basis and these are the behaviors they look for and she basically told me if I continue doing what I doing? I will be there in a few years. I was 22 or 23 at the time. I kind of shrugged it off. Dad continued in and out of rehab while I continued doing what I was doing.

Then the wheels fell off for my Dad. Like really bad. Disappeared for a week, Mom couldn't find him, started getting worried. Found him in a shady hotel on the edge of town. He was trying to drink himself to death. We got there, got him into the psych ward and they forcibly detoxified him. He was basically under medical house arrest until he sobered up and vowed this was indeed the end.

I finally had a front row seat to see what my future was. My mom pulled me aside that Christmas in the midst of our entire extended family at my parents house celebrating. She grabs my arm and pulls me into a room, looks me dead in the eyes and says, "If you want to put someone you love through what your father just put our family through these last two years? Then keep drinking, keep partying and doing whatever you're doing." and then just walked away from me.

That was pretty much it. I decided a few weeks later to put a cap on it, I had a good run, but gambling with my future like that? No thanks. Been sober 14 years. Sure I have a beer here and there, but its only one (I'm a total lightweight now, so its no fun) and then that's it. And I never judge the people I'm around if they want to drink.

I would tell you what the nurse told me. It sounds like you do abuse alcohol, and you're heading down that road. Is your future predetermined? I don't think so, but it took a litany of close calls and the one major episode with my Dad to make me realize what was happening and change course before it was too late.

[ozim]

I don't judge people that don't drink.

But people that drink I don't believe that it is only alcohol that is their demise.

There was probably whole range of feelings your father had that led him to that.

Cannot blame anyone but your father would be the only person that could explain it. Because people are so different and even if you think you know your father, there is bunch of emotions that are outside of anyone that can comprehend.

Well it is true also for EMO kids as we are ale separate entities struggling with life.