I suppose I'm in the "despise AA" camp. After decades of alcohol abuse, I quit drinking using Naltrexone following the "Sinclair Method". In my opinion it's a far more rational and reasonable treatment program as compared to AA's 12 step.
I would encourage anyone who wants to stop drinking and doesn't feel well served by AA to try to find a doc willing to prescribe Naltrexone and give it a try.
Unlike AA, the Sinclair method not only works but it has a well understood mechanism of how it works and emphasis self-control rather than learned helplessness. It's psychology 101 really.
What you say interests me. I am not an alcoholic but have lived in close proximity to one all my life. One of my observations is that a strong desire for self-reliance and control can prevent the person from accepting that they have a problem. In other words everything has to happen on their terms or not at all and it is partly this unwillingness to accept the common nature of their problem that makes any change impossible.
Regardless of the merits of AA specifically, it seems to me that if such a person can acquire the humility to accept help that would be the key to breaking the underlying emotional impasse. This could be characterized as "learned helplessness" or as a recognition that not everything is within our power and that external help is OK.
I guess what I'm saying is that for some alcoholics the desire for an impossible level of self-control is the source of the problem and, ironically, leads to this uncontrolled behaviour.
It's really frustrating to read healthy people criticize a method of treatment for sick people that was created by other sick people out of desperation.
Sure, and while we're at it, we should also not criticize faith healers who do parlor tricks with soggy sponges to cure people of cancer. After all those patients are desperate and spontaneous remission is a thing. So what, some of them might have had a better chance with a chemo or surgery but Land of the Free, right?
Look, as far as I'm concerned, as long as you're not hurting anyone (and that's asking a lot because addiction hurts more people than just the addict) you can seek out any nonsense therapy you want. Wave a chicken, swallow some sugar pills and pray the gay away.
But the second your ghost healing clinic becomes the industry standard and courts send people their under threat of punishment it's no longer fun and games. Those people could be helped if they received proper treatment but instead they get to waste their time (and worsen their health) by sitting through a so-called treatment that actually makes them less likely to succeed in overcoming their addiction.
But the premise of the AA falls flat if you don't accept the notion of a higher power (and many chapters of the AA are fine with substituting arbitrary objects for God for that purpose so they're acknowledging the higher power doesn't actually have to do anything).
Yes, the first step in beating any addiction is to recognise that you have an addiction and to decide that you want to get rid of it. But that's true for any other psychology problem: if someone's clinically depressed but refuses to cooperate with their therapist, they're not going to get better.
The thing is that with normal secular therapy you learn to control yourself. You learn to reflect on your thoughts and why you might have them. If you're depressed, you don't really want to kill yourself, you just think you do because you can't imagine things will ever be any different. If you're addicted, you think you need the drug because it's the only way to feel better but of course it isn't.
That said, the bigger problem is that addictions are rarely isolated problems. There's usually something that started it and something that sustains it. Frequently addiction starts out as a coping strategy (I'd say for many adults nicotine and caffeine are obvious coping strategies although they become inefficient on a chemical level fairly quickly).
I'm not seeing addicts should avoid therapy and simply will themselves out of their addiction. This works for some people but obviously not universally (again, consider how giving up nicotine is so challenging it has become a widely known trope in Western media). But those people who can't do it on their own should instead seek actual help, not the AA.
For all we know, the small group of people who actually managed to overcome their addiction while attending AA would have been able to do it on their own, whereas those who failed would have benefited from actual fact-based therapy.
You wouldn't suggest a treatment as the go-to default solution if its viability was never tested and there are easier and more reliable treatments that have a scientific basis and have been proven to work.
The great thing about the Sinclair Method is that it works both if you do it yourself or with supervision. You don't have to will yourself to stay sober, you just have to will yourself to take the pills and your body does the rest. Sure, that in itself is a feat of willpower but that's why actual therapy is a thing that exists.
In the UK Nalmefene is approved for this kind of alcohol treatment also. It's less toxic to the liver than naltrexone so GPs can prescribe it (without specialist intervention and liver checks).
Disclaimer: am shareholder in manufacturer. Feel there is a massive lack of emphasis on novel pharmaceutical interventions in drug and alcohol rehabilitation.
> In the UK Nalmefene is approved for this kind of alcohol treatment also. It's less toxic to the liver than naltrexone so GPs can prescribe it (without specialist intervention and liver checks).
Hadn't heard of nalmefene, thanks for the reference. Naltrexone is also useful in much lower doses than the standard 50mg tablets, as "low-dose naltrexone" (1-5mg).
IIUIC the Sinclair Method is very much a CBT hack. The drug disrupts the positive effects of alcohol. By making the experience of consuming alcohol unpleasant instead of rewarding, it becomes easier to overcome the psychological addiction.
Interesting - I've been thinking of trying it out but was going to use a clinic like contral.com in Finland. Maybe I'll just see if I can find a local doc who will write me a script
There's a book that outlines the treatment program. If I recall, I just found a PDF online. Basically it calls for a dose before drinking and before long it's no problem to just not drink any more.
I will say that drinking while taking Naltrexone was an odd experience because I felt none of the europhoria that typically comes with drinking.
I have never felt any kind of euphoria with alcohol; experimenting, I've reached large enough amounts to severely affect my balance, coordination and concentration, but was otherwise hardly affected at all (as confirmed by a teetotaler friend who was with me in some of those times).
Some people, when I tell them that, respond with "well, what did you expect? that's drinking" and some with "that can't be, perhaps your vodka was watered down". Your comment reminded me of that.
Having experienced both versions (euphoric and non euphoric), do you have any insight about the difference, how much of it is physiological vs. psychological?
I would encourage anyone who wants to stop drinking and doesn't feel well served by AA to try to find a doc willing to prescribe Naltrexone and give it a try.