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from the Stopping-is-easy...-I've-done-it-many-times! dept.
A new study published by the scientific journal Addiction has found no reliable evidence for using nalmefene, naltrexone, acamprosate, baclofen or topiramate to control drinking in patients with alcohol dependence or alcohol use disorder. At best, some treatments showed low to medium efficacy in reducing drinking, but those findings were from studies with a high risk of bias. None demonstrated any benefit on health outcomes.
The study pooled the results from 32 double-blind randomised controlled trials representing 6,036 patients, published between 1994 and 2015. The studies compared the effects of oral nalmefene (n=9), naltrexone (n=14), acamprosate (n=1), baclofen (n=4) and topimarate (n=4) against placebo.
Many of the studies provided unreliable results due to risk of bias (potential exaggeration of the effects of the drug). Twenty-six studies (81%) showed an unclear or high risk of incomplete outcome data due to the large number of withdrawals. Seventeen studies (53%) showed an unclear or a high risk of selective outcome reporting, as they did not include a protocol registration number, which would allow another researcher to check whether all outcomes were reported.
Clément Palpacuer, et. al. Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders: a systematic review with direct and network meta-analyses on nalmefene, naltrexone, acamprosate, baclofen and topiramate. Addiction, 2017; DOI: 10.1111/add.13974
Back to the drawing board.
(Score: 2, Touché) by looorg on Friday September 22 2017, @10:53AM (22 children)
Have they tried Jesus? From what I know about AA and it's 12 step program it seems if you just admit you are a sinner and powerless he will eventually show up and magically help cure you of your alcoholism and possibly all other things that ails you.
(Score: 4, Interesting) by tfried on Friday September 22 2017, @11:36AM
I suppose the "finding Jesus"-method might even work, provided you are the type for that. A very powerful way to break up addictions (or habits in general) is to find a strong novel reason, why you will no longer do, what you have been doing for so long. Simply, "I always wanted to stop" is never going to work, because that has been around for a long time, and you have already acted against it many times before.
Some candidates besides religious conversion, would be death or birth in your vicinity, a shocking (and sudden!) medical diagnosis, or a novel medicine (even if it's just a placebo). For getting rid of milder addictions, I have found, personally, that just leaving your familiar surroundings and routine will do a lot to help you break them. Going on holiday is an excellent occasion for such efforts.
(Score: 3, Insightful) by Anonymous Coward on Friday September 22 2017, @12:57PM (7 children)
Alcoholism is a progressive, potentially fatal disease.
I've lost count of the number of people I've seen relapse and return to a life of torture (daily hangovers, puking out their guts each morning, etc.), or continue on to the very end and die from the disease (e.g. cirrhosis of the liver) .
I'm pressed for time, but it is FAR from asking to have the obsession removed and *poof* you are all better.
If you are not addicted, count your good fortune and be grateful you do not understand. If you would like to have a better idea of what alcoholism is about, I'd suggest going to aa.org [aa.org] and reading the chapter "More About Alcoholism" in the "Big Book" -- "Alcoholics Anonymous".
And, those 12 steps may be simple (not complicated), but the amount of work involved in actually *doing* them is another matter all together. They are listed in the chapter "How it Works" in the same book.
I was fortunate to be diagnosed early, before the onset of the worst symptoms, and even then it was all I could do to get and stay sober.
To get an idea of what addiction feels like: skip your breakfast, skip your lunch, too. Getting hungry? At dinner time, open a big bag of potato chips, pour them into a large bowl... and then eat only 4 of them. That will give you a tiny hint of what the craving is like.
Disclaimer: Thanks to AA and working the 12 Steps in my life, I've been sober for 24 years.
I'm late for work, so will have to end with that. Suffice it to say there is much more to recovery than meets the eye.
(Score: 0, Disagree) by Anonymous Coward on Friday September 22 2017, @04:35PM (6 children)
Alcoholism is not a disease. AA is not a scientific source and its efficacy as an organization is indistinguishable or inferior to other interventions.
I'm glad you find personal value in AA, but they are not worth promoting as a general purpose "treatment".
(Score: 2) by DeathMonkey on Friday September 22 2017, @06:02PM (5 children)
Alcoholism is not a disease. AA is not a scientific source and its efficacy as an organization is indistinguishable or inferior to other interventions.
And?
Some things work for some people and other things work for other people.
You're begrudging someone's recovery, why, exactly?
(Score: 0) by Anonymous Coward on Friday September 22 2017, @06:19PM (2 children)
Because it's not clear that the recovery was actually due to AA. I care about what is actually true.
(Score: 2) by DeathMonkey on Friday September 22 2017, @06:30PM
It's hard to measure but does appear to have some benefit. [nih.gov]
(Score: 2) by Anonymous Coward on Saturday September 23 2017, @02:47AM
(Topmost AC in this thread replying here.)
I used to be able to stop. Easily. Forty days and nights of Lent; not a problem. Even did that several years in a row!! The years passed. When I next tried to quit, I was stunned. I could not quit -- and stay stopped. Sure, I could last a day or two, but always found myself going back. I tried all kinds of things. Exercise, keeping busy, new hobbies, working extra hours, taking extra breaks. Nothing worked.
Then I had an intervention. I went to my first AA meeting. Found others who went through the wringer, found a way out that worked for them, and were willing to help me get sober, too. Went to lots of meeting, got a sponsor, found a concept of a "higher power" that worked for me, worked the steps, and have been sober ever since that first meeting... over 24 years ago. And the thought of a drink is the furthest thing from my mind! I don't even miss it. But, if I were to pick up a drink today, I have no doubt I'd be a mess all over again. I've seen it happen too many times to count. And too many funerals, too.
tl;dr at first I could quit on my own. Then I could not. I went to AA. Did some work and I got stopped, and have stayed stopped.
(Score: 0) by Anonymous Coward on Friday September 22 2017, @07:14PM (1 child)
It seems that my information is out of date. The previous Cochrane Review showed no difference, but their upcoming one seems like it is going to show some positive effect.
I oppose pseudoscientific explanations of reality, especially in a medical context. I also oppose ineffective interventions that are mainly supported by anecdotes and subject to selection bias, survivor bias, and all the other biases that come with them.
I'm not "begrudging" the OP (the next line of my comment that you failed to quote).
https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous#Cochrane_Review [wikipedia.org]
(Score: 0) by Anonymous Coward on Saturday September 23 2017, @01:12AM
You may be underselling the social aspects of AA meetings.
We mentioned before how rats with cool rat toys and rat friends tend to ignore the water bottle spiked with drugs.
Portugal Cut Drug Addiction Rates in Half by Rejecting Criminalization [soylentnews.org]
...then there's The Placebo Effect where thinking something is effective can make it effective.
...and let's not forget that there's lots of drug consumption at AA meetings (coffee and cigarettes).
So, substitution.
-- OriginalOwner_ [soylentnews.org]
(Score: 1, Interesting) by Anonymous Coward on Friday September 22 2017, @02:37PM (3 children)
Jesus would give them LSD.
The studies evaluated nalmefene, naltrexone, acamprosate, baclofen, and topimarate, but somehow forgot to try LSD. Fuck 'em and the DEA too!
(Score: 4, Interesting) by DeathMonkey on Friday September 22 2017, @06:33PM
Jesus would give them LSD.
This isn't offtopic...
LSD May Help Treat Alcoholism [time.com]
(Score: 3, Informative) by curunir_wolf on Friday September 22 2017, @07:59PM
They also left out MDMA (Ecstasy). Maybe the study doesn't have any results yet, but they have started the trials. [theguardian.com]
In Studies to help with PTSD it has been shown to work surprisingly well! [mdmaptsd.org]
I am a crackpot
(Score: 0) by Anonymous Coward on Saturday September 23 2017, @01:29AM
-- OriginalOwner_ [soylentnews.org]
(Score: 0) by Anonymous Coward on Friday September 22 2017, @03:22PM
This should have been modded as "4: Funny"
(Score: 2) by DannyB on Friday September 22 2017, @04:22PM (2 children)
Maybe you think Jesus won't magically show up.
I would say: don't knock it 'till you've tried it.
It seems to work for some people.
To transfer files: right-click on file, pick Copy. Unplug mouse, plug mouse into other computer. Right-click, paste.
(Score: 2) by Gaaark on Friday September 22 2017, @05:15PM (1 child)
and then there is the people who say "Jesus saved me from drugs!" and the next thing you know, their life is a complete waste and they are back on drugs again.
Jesus saves? No: you gotta do that yourself. If you rely on God/Jesus/Jebuz/Trinity/Neo/Nemo/Pinocchio whomever, you are f*cked.
"God helps those who help themselves" is the closest.
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 2) by DeathMonkey on Friday September 22 2017, @06:16PM
I think the common denominator there is addiction, not Jesus.
(Score: 0) by Anonymous Coward on Friday September 22 2017, @04:30PM (1 child)
Jesus is no help at all.
The mother fucker turns water into the best quality wine. Hell, even his "blood" is wine.
(Score: 2) by DeathMonkey on Friday September 22 2017, @06:43PM
Yeah, I'd say 100% is a pretty high BAC!
Sounds like he needs to acknowledge the existence of a higher power and get some help.
(Score: 3, Insightful) by linkdude64 on Friday September 22 2017, @08:07PM (1 child)
More like it "preys on" (utilizes) the "religious" mind-bug that human brains seem to have for a purpose other than encompassing morality or idolatry. That being the functional application of separating from alcohol.
For the people who quite literally destroy their lives and burn bridges with their friends and family (all for a drink? How logical is that, really?) I think the millions of success stories are quite an impressive demonstration of self-training not found elsewhere in Western society, where impulse is King - for better or worse.
When a "successful" person with a stable life and a healthy mind and body accomplishes something positive, nobody thinks twice about it, or maybe they are even encouraging.
When an "unsuccessful" person who has had an abusive and unstable life, with a sickened body, and a self-defeating mind accomplishes something positive, it seems they are mocked and ridiculed if they found that success through AA. I really am curious what the root cause is, myself being the offspring of a drug addict and alcoholic, who benefitted greatly in life due to my parent becoming a gradually more successful member of AA. You won't convince me that my life wasn't improved, but I'm curious how yours was negatively impacted.
(Score: 0) by Anonymous Coward on Saturday September 23 2017, @01:43AM
Amen. (Too much on the mark??)
What galls me is the judges who say that e.g. an atheist drunk driver has to go to AA.
A real separation of church and state violation there.
...and nobody yet has mentioned the pill that makes you feel like shit when you drink booze after taking it.
A judge could require convicted folks to show up every morning at a clinic and have a staff member watch you take the pill.
(A powder would probably be better.)
-- OriginalOwner_ [soylentnews.org]
(Score: 2) by urza9814 on Friday September 22 2017, @08:37PM
Yeah, I've seen AA work, but I'm pretty sure the actual "steps" have nothing to do with it -- and I've seen some studies that back that up -- it works for some people, doesn't work for others, isn't much more effective than other methods. And frankly, I'm not sure how much of the improvement I've seen had anything to do with AA, other than perhaps providing some semi-mandatory socialization that gets you used to leaving the house.
The critical piece IMO is just finding something else to do -- and sticking to it. You can't just replace drinking with sitting around the house watching TV, because then you'll be sitting there thinking about drinking every night. An AA meeting once a month or even once a week is good, but it's not nearly enough. And that's part of why the religion stuff can perhaps help -- IF it makes you add in mass or whatever once or twice a week too. Volunteer a couple places, that gives you a couple more days a week. Start going to the gym every day. Keep piling more crap into your schedule until you just don't have time to drink.
So if the AA steps look like something you would be willing to do, great, do that. If not, find something else. What you're doing matters less than the fact that you're doing something. But merely taking a pill just won't occupy enough time...it might help reduce the cravings, but it's not solving the primary problem.