More From Jim - Statistics and Recovery

[joe]

I WANTED TO BRING THIS OVER AS IT ISN'T INCLUDED IN THE STUFF THAT MCGOWDOG HAS PREVIOUSLY TRANSFERRED FROM OUR BLOG. I THINK IT DESERVES TO STAND ALONE.





Saturday, February 12, 2011
From Jim I
Like most statistics that these organizations put
together, they fail to separate the alcoholics
from the hard drinkers. The test base they always use has both, the difference is; that a hard drinker can
stop or moderate if they really try and the alcoholic can't. What good are statistics for a treatment
process when there are people in it who can do it anyway by themselves when they decide to. When the
treatment field gets with that fact, real alcoholism statistics will finally mean something to me, don't
trust what you read made by people who do not understand the nature of alcoholism, many
professionals don't.
With a lot of treatment or awareness programs, what they try to do is get you to decide to stop or
moderate, they show you what you can do to stay clean and sober. These can be as affective and are
good things, but what happens is there is harm reduction or sobriety for the heavy or potential drinker
but no real help for those who are already alcoholic or real drug addicts. They need a personality
change at depth, a spiritual awakening with a shift in perspective so large they operate with a
completely different perspective and perception, that can only come after a conversion experience
following extensive use of spiritual practices.
I end up working with those who have been in 12 treatment centers or whatever and have been
desperately trying to separate from drugs or alcohol for years, they absolutely cannot summon up the
needed fortitude to not pick up. After the 12 step work, if they remain focused on spiritual disciplines
and carry the message of the 12 steps to others who have their problem, they find the power comes into
them and become safe and protected from the first drink or drug, but this takes constant willingness and
persistence, something only the desperate have, 90% of people in treatment would not bother to do this
work, they would feel it an overreaction to a problem they can handle because maybe they can. Read
the doctors opinion, and chapter 2 and 3 in the Big Book really carefully. This is still the best
understanding I have ever read about the nature of powerlessness and addiction.
Most positive statistics with professional addiction studies are with the category of the Hard Drinker
not the Alcoholic, treatment processes alone fail almost always with the real alcoholic or addict, that is
where the 12 steps can be one of the only solutions.
This probably does not answer your question, but I don't intensively delve into the study of something I
see as irrelevant to my own work, why rearrange deck chairs on the Titanic? I need to stay focused on
what works for me and not get sidetracked by things that are interesting intellectually but of little value
to my work in the trenches. I don't mean this to sound negative, treatment processes are needed, we
need every rehab we have, its just they have nothing to gain by the separation of the real from the hard
drinker, what would it profit them to say they cant do anything permanent for a percentage of their
clients? So I understand what they do and why, I just get frustrated when I see a whole industry with
statistics that do not apply in a way I would find meaningful and truly accurate. They do help people
realize that drinking and drugging is a negative behavior, so they should stop. This is important for
those who can. The good treatment centers emphasize the need for a 12 step way of life for a real
recovery and the bad ones don't.
Chris S. February 11, 2011 6:34 PM

Attachments:

[joe]

An addition problem I see here is how different organizations/alcoholism commentators et.al. define alcoholism. What we in AA call alcoholism is not what you'd necessarily find in DSM IV or on Dr Peele's website for example. We consider alcoholism to be a malady of body, mind, and soul. Drop any one of those three parts of the malady/disease and we have a whole new issue to discuss. I think that this definition problem, combined with the one Chris S. identifies - lumping the Hard Drinker with the real alcoholic as we define him, really muddies the waters when we talk about alcoholism and recovery.

If you consider alcoholism to be only a mental issue, as indeed some other addictions (Gambling and Overeating come to mind here) are, then the obvious solution to recovery and maybe even a cure is often sought through some form of behavior modification therapy. From the pure psychiatric perspective perhaps psychoanalysis or, depending on the school of psychiatric theory one belongs to, some other form of treatment. This "alcoholism is a mental issue" approach seems to dominate most non-alcoholic psychologists involved in addiction treatment.

The extensive and, in my mind, absolutely useless Intensive Outpatient (IOP) approach to treating alcoholism is one of the most significant by-products of this "mental issue" approach. Throw a real alcoholic into a group therapy crowd with a bunch of drug addicts, moderated by a psychologist who doesn't have a clue about what alcoholism or drug addiction really are, and you have a recipe for disaster. And unfortunately what I see today is the unquestioned embrace of newer, more rational, "scientific" approaches to treating alcoholism. Progressive, chronic, fatal? These things are dismissed with the wave of the "intellectual" hand.

It seems to be almost a reversion back to the days when alcoholism was considered a moral failure and all it took was more will power to stop drinking. Now we see that all it takes is a little analysis of "where you're coming from", perhaps a little psyche-searching to find out why you really drink and zap!, you're cured. Go in peace and drink in moderation. Too bad a real alcoholic can never drink in moderation.

Bill Wilson recognized that AA doesn't have a monopoly on sobriety and recognized the success of other treatment programs. We alcoholics down at the street level also accept the fact that AA isn't going to work for everyone but still believe that it's the best game in town. Yet we don't throw recovery statistics around to say we're more successful than any other program as such statistical data is immeasurable. What's success in recovery? Do you measure it in years of sobriety? If so, what's the benchmark? 5 years? 10 years? What's the control group? Are you going to publish irrelevant data (Thaddeus Jude comes to mind) to attract more clients? If someone relapses after the benchmark, how would that affect the recovery rate? Throw Hard Drinkers into the mix and you're measuring apples and oranges.

It's sad that the problem of alcoholism (and drug) treatment has developed into an industry with the agenda of making a profit rather than treating sick people. Given the fact that the relapse rate for drug and alcohol addiction hovers around 70 to 90%, and the long term recovery rate for alcoholism is probably pretty low, you wouldn't make money by acknowledging that your program wasn't very successful. So the industry does what any successful business would do - change the rules. Redefine the problem and thus make the solution simpler to solve. Even good treatment centers, as Chris S. mentions, that use a 12 step approach and emphasize a 12 step way of life still have their eye on the bottom line - profit.