None of that is anti science. There’s no “distrust in studies”, unless you’re referring to the distrust in the “some studies” you cryptically referenced in your post. Not that you bothered even to cherry pick, but cherry-picked studies can show results that the preponderance of evidence does not support. Nor do I claim that quantity beats quality. Scientific communities are as capable of systemic bias just like any other. However, the preponderance of evidence does cut against your unsourced assertion that peer groups don’t aid in recovery. Lastly ancedotes: they aren’t anti-science, nor are they useless. They are statistically unsuitable for the purposes of drawing conclusions about large populations or general trends, and therefore shouldn’t be used as the basis for broad scientific claims, which is why I did no such thing. They are stories that humans share with one another in casual conversation, and I thought it was one worth sharing here.
And not that you deserve this, making your wild claims with no evidence, but as Exhibit A for the scientificness of my paragraph I’d like to enter into the record the first result when searching for AA meta analyses on pubmed. Relevant sections are presented below.
Main results: We included 27 studies containing 10,565 participants (21 RCTs/quasi-RCTs, 5 non-randomized, and 1 purely economic study). The average age of participants within studies ranged from 34.2 to 51.0 years. AA/TSF was compared with psychological clinical interventions, such as MET and CBT, and other 12-step program variants. … AA/TSF (manualized) compared to treatments with a different theoretical orientation (e.g. CBT) (randomized/quasi-randomized evidence) RCTs comparing manualized AA/TSF to other clinical interventions (e.g. CBT), showed AA/TSF improves rates of continuous abstinence at 12 months (risk ratio (RR) 1.21, 95% confidence interval (CI)
Thank you, this is very valuable data and discussion.
They didn’t control for AA-only versus AA+Real-Treatment, studies which do almost never show improvement.
The problem with religion is it is ever-pervasive and its followers will do anything to justify it.
There is also a long-running problem with the followup interviews where calling and asking the patient is accepted as evidence, studies which look at longterm recidivism show a darker trend and even then you’re not grasping the full picture.
Of course, effective addiction recovery is very near to my heart, and I care about getting it right. I’d be curious to see which studies you’re pulling from that define AA in opposition to “Real Treatment”. Most treatments for alcohol addiction are rather hit-or-miss, and all the literature I’m familiar with generally find that combination therapies are more effective than any one therapy alone. Peer recovery groups are “a” therapy, AA is one of them, and they help some people, not all.
AA groups are as religious as their members; some of them are chill about it, many of them are insufferable about it, particularly in the southern US, and I suspect this is a big reason why people wash out of the program. Some of those washouts find their ways to more accepting groups or programs, some do not. I think the widespread attitude of “the program works if you work it” is a pretty grisly and self-satisfied example of survivorship bias, in AA and a lot of similar programs, propagated by people who found something that works for them and insisting that it’s the one true program that should work for everyone. This happens in religious and non-religious groups and it gives people the idea that if they can’t find help in that one group, that they must be broken beyond repair. I struggled with that for a long time before I found my people.
That’s a bit of a diversion, I don’t want to get into the gritty details of the many things I think are wrong with addiction recovery culture. Suffice to say that peer support groups can help, we haven’t really worked out all the problems with doing it well, and addiction is a hard problem. I think it’s worth taking the imperfect tools we have and trying to improve them, rather than throwing them out entirely because they are imperfect.
None of that is anti science. There’s no “distrust in studies”, unless you’re referring to the distrust in the “some studies” you cryptically referenced in your post. Not that you bothered even to cherry pick, but cherry-picked studies can show results that the preponderance of evidence does not support. Nor do I claim that quantity beats quality. Scientific communities are as capable of systemic bias just like any other. However, the preponderance of evidence does cut against your unsourced assertion that peer groups don’t aid in recovery. Lastly ancedotes: they aren’t anti-science, nor are they useless. They are statistically unsuitable for the purposes of drawing conclusions about large populations or general trends, and therefore shouldn’t be used as the basis for broad scientific claims, which is why I did no such thing. They are stories that humans share with one another in casual conversation, and I thought it was one worth sharing here.
And not that you deserve this, making your wild claims with no evidence, but as Exhibit A for the scientificness of my paragraph I’d like to enter into the record the first result when searching for AA meta analyses on pubmed. Relevant sections are presented below.
Thank you, this is very valuable data and discussion.
They didn’t control for AA-only versus AA+Real-Treatment, studies which do almost never show improvement.
The problem with religion is it is ever-pervasive and its followers will do anything to justify it.
There is also a long-running problem with the followup interviews where calling and asking the patient is accepted as evidence, studies which look at longterm recidivism show a darker trend and even then you’re not grasping the full picture.
Of course, effective addiction recovery is very near to my heart, and I care about getting it right. I’d be curious to see which studies you’re pulling from that define AA in opposition to “Real Treatment”. Most treatments for alcohol addiction are rather hit-or-miss, and all the literature I’m familiar with generally find that combination therapies are more effective than any one therapy alone. Peer recovery groups are “a” therapy, AA is one of them, and they help some people, not all.
AA groups are as religious as their members; some of them are chill about it, many of them are insufferable about it, particularly in the southern US, and I suspect this is a big reason why people wash out of the program. Some of those washouts find their ways to more accepting groups or programs, some do not. I think the widespread attitude of “the program works if you work it” is a pretty grisly and self-satisfied example of survivorship bias, in AA and a lot of similar programs, propagated by people who found something that works for them and insisting that it’s the one true program that should work for everyone. This happens in religious and non-religious groups and it gives people the idea that if they can’t find help in that one group, that they must be broken beyond repair. I struggled with that for a long time before I found my people.
That’s a bit of a diversion, I don’t want to get into the gritty details of the many things I think are wrong with addiction recovery culture. Suffice to say that peer support groups can help, we haven’t really worked out all the problems with doing it well, and addiction is a hard problem. I think it’s worth taking the imperfect tools we have and trying to improve them, rather than throwing them out entirely because they are imperfect.