[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...