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View Diary: Good news: ACA covers addiction treatment - Bad news: addiction treatment may not work (149 comments)

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  •  AA is not a first line treatment (0+ / 0-)

    there are people who get sober in AA but those who go through a rehab may be referred to and generally are referred to  AA or some other weekly support group that goes on forever, with fellow addicts, as part of a relapse prevention program.  Among other parts. They're individual in that not everyone has the same support from home. And some are in more risk of dying and may need more protection.  It's the same disease but not everyone comes at the same stage and it isn't manifested exactly the same for each person.  

    Some treatments were found to be harmful.  One of them won. Hands down. Not all programs use the evidence based treatments, but in time insurance will only pay for those treatments.

    •  Your proposition is that treatment programs work (1+ / 0-)
      Recommended by:
      Lonely Texan

      in that they have a high success rate, even 100%!

      Prove it.

      Show me a study which defines a pool of alcohol abusers, even by secondary characteristics such as you lay out above (home support, etc...) which proves any one program has a success rate over 60%

      Hell prove it works sometimes, 30%

      Prove it works as well as doing nothing, 5%

      Until then stop using the words "evidence based", those words don't mean what you think they mean.

      •  no it isn't (0+ / 0-)

        I said that the evidence based rehabs are defined as having highest rates of success, as measured by independent researchers, like universities, or by insurance companies, I didn't say the rate of success, they vary from program to program, and the measurements aren't standard.  

        When they do a study it's between this type and that type, but they don't always measure the same thing.  it's always stated like, 'as measured by six months of sobriety post treatment,' or by 'improvement in liver functioning,' or whatever they may chose as a desirable outcome.  

        Evidence meaning they did better than the other ones they were compared with. I said individual psychotherapy is now contra-indicated based on those studies.  Actually, all of them. That's what's wild, whatever the measure, cognitive behavioral works best and insight oriented is worst.  

        I said all evidence based rehabs recommend life-long support groups, and as AA is free and everywhere and is great, AA is never ruled out.

        •  This is an asinine definition of success (0+ / 0-)

          that is customized to make your field feel justified in sucking down the money of taxpayers and suckers.

          Again, are these programs provably better than doing nothing?  

          - "Statistically, "evidence based" rehabs are one way to help" - Can this statement be supported?

          Are these programs provably better than other kinds of programs - individual therapy, joining Scientology whatever?

          -  "- "Statistically, "evidence based" rehabs are the best choice among all other options to get help" - Can this statement be supported? (you seem to be saying this but not backing it up)

          Finally, what actual success rate do these programs have that justify public/taxpayer support as opposed to seeking/designing alternatives.

          -  "- "Statistically, "evidence based" rehabs help at least _% of people beat addiction - Can this statement be completed and supported?

          Your above comment is more obfuscation - there is no evidence behind your evidence based programs that you have been able to produce anywhere in this thread that these programs satisfy any of the above criteria from low to high.

          The Intoxicated Driving Resource Centers of NJ which feed into the IDP issue annual reports per county:

          IDP Reports

          You can review by state or county  You will see a lot of "activity" based reporting none of which to my mind is credible given my experience.  However you'll note a paltry amount of actual "results" or "evidence" based reporting.

          The IDP exists to address alcohol and drug abusers, to prevent DUI recidivism - the program's actual purpose as designed by lawmakers and supported by taxpayers.  You can't even find the word recidivism in any of these reports.  There is no indication how many people referred or not referred to treatment based on evaluation committed second DUIs.  I.e. one of the most critical facts to support this program.

          It's not there because I bet it's not favorable given how this program is run and the general lack of ethics of the addictions counseling community in NJ (and I suspect elsewhere).  I bet they miss alcoholics all the time who go on to cause bodily injury, death or property damage to themselves or others.  I bet they have little to no evidence that those who went through the program have any better or worse results in terms of recidivism than those who haven't.  I remember in my own class a girl who blew a BAC (.39) that could kill an elephant did not get referred to the program though I with a .095 did

          All they can tell you is how many people went through the program, which indicates that beyond all reason 45-60% of DUI's are clinical substance abusers.  That figure is absolutely absurd.  At most I'd say 25% would seem to be a legit number and even that's a stretch.

          •  here's one for you (0+ / 0-)

            http://www.learnoutloud.com/...

            It's part of Charlie Rose's brain series, but there are others, those that compare identical twins reared separately, and those that showed only biological family history but nothing from the effect of parenting.  

            the outcome studies don't always use the same outcome measures, they compare one treatment with another treatment or treatments to see which works best.

            There are addiction journals, it's a real field of study. Right now ten medical schools offer addiction as a speciality.  Most of the research now is biological, there have been many studies over many years that contribute to the 'best practices' that you seem not to have encountered and sincerely believe don't exist.  

            In many states it's possible to earn an AA degree in addiction studies, which should tell you there must be some, or what would be studied?  The textbooks are updated, but they all lead to the same place, which is clearly amazing, that one treatment would be so much more effective than any other, whatever the chosen outcome, and however much individual junkies might want to know better.  

            It is very common for junkies to 'defend' their 'lover,' heroin, cocaine, opiates, designer crap, whatever.  And how special these junkies are, so special as to take them into the grave.  But, even in hard-nut cases, programs refer to those defensive know-it-alls as the dinosaurs, with actual sobriety comes new experience and leads to new knowledge.  It can't be faked, the body heals, inflammation is reduced, memories improve, people feel less cranky when they're not regularly ingesting or injecting some poison, go figure.  

            And it's sad so many just assume the field hasn't changed over the last ten years, with the hard data finally in and the programs adjusting if they want to be approved for insurance payments.   And on a place like this, to be making a case for death seems sad.  

            I feel sorry for you, but you seem to have a mission, and if someone is stupid enough to believe you and avoid treatment and then happens to die or even take someone with them, can't be helped.

            Good luck.  

            •  You are the one arguing with me (1+ / 0-)
              Recommended by:
              bsmechanic

              Not Charlie Rose's panel.  I have laid out various scenarios of statistics that could demonstrate success and efficacy of the methods you defend.  You have not in many, many responses cited one statistic in support of your position.

               

              the outcome studies don't always use the same outcome measures, they compare one treatment with another treatment or treatments to see which works best.
              The outcome is presumably that one who suffers from addiction, no longer suffers from addiction or is at least able to manage/resist their addiction for some substantial period of time directly due to that treatment to such an extent it is superior to other treatments or placebo time and time again.  Outcome studies that don't use consistent measurements are not actually measuring outcomes.  They are anecdotal fairytales about giant legendary shifting goalposts.
              There are addiction journals, it's a real field of study. Right now ten medical schools offer addiction as a speciality.  Most of the research now is biological, there have been many studies over many years that contribute to the 'best practices' that you seem not to have encountered and sincerely believe don't exist.  

              In many states it's possible to earn an AA degree in addiction studies, which should tell you there must be some, or what would be studied?  The textbooks are updated, but they all lead to the same place, which is clearly amazing, that one treatment would be so much more effective than any other, whatever the chosen outcome, and

              Ten medical schools out of slightly less than 200 nationwide is less than 6%.  Not a strong support for your point  Again you obfuscate the science behind the factors influencing addiction, with the efficacy of the programs you are defending.  There is some emerging hard science behind the former, but no credible science behind the latter.

              Again, you make unsupported statements about treatment being effective.  I have asked you to provide direct statistical figures to that effect.  You have none to support that statement.

              and however much individual junkies might want to know better.  

              It is very common for junkies to 'defend' their 'lover,' heroin, cocaine, opiates, designer crap, whatever.  And how special these junkies are, so special as to take them into the grave.  But, even in hard-nut cases, programs refer to those defensive know-it-alls as the dinosaurs, with actual sobriety comes new experience and leads to new knowledge.  It can't be faked, the body heals, inflammation is reduced, memories improve, people feel less cranky when they're not regularly ingesting or injecting some poison, go figure.  

              I wonder if in your mind this line of commentary is subtle.  It's not, you are again accusing anyone who questions the total lack of factual and evidential support you have brought to the table as junkies, myself obviously included.  You have made this implication over and over again.

              You are representing this field on this forum.  You accuse anyone questioning it's validity of being a junkie or an alcoholic.  If that's not a statement on your quality as a professional and as a person and that of your industry, I don't know what else is.  One thing that always shines through with addictions counselors is their total resentment for the standards of science, their clients and the public understanding.  It's sad, pathetic and weak and nothing else in your rhetoric really shines a light on the state of your profession than these continued immature insinuations.

              A junkie or an addict is a real person with a real problem.  The fact that you imply and outright accuse anyone who disagrees with your religion must be one is again, just really revealing about who you are as a person and a professional.  What evidence do you have right now, clinical addictions professional, that I am a junkie or an addict as you have repeatedly insinuated?

              And it's sad so many just assume the field hasn't changed over the last ten years, with the hard data finally in and the programs adjusting if they want to be approved for insurance payments.   And on a place like this, to be making a case for death seems sad.  

              I feel sorry for you, but you seem to have a mission, and if someone is stupid enough to believe you and avoid treatment and then happens to die or even take someone with them, can't be helped.

              My mission here was to support the original poster and discuss the fraud of the addictions counseling industry.  I appreciate your help in this matter.

              You have produced no evidence that seeking counseling through so called professionals such as yourself actually results in any tangible or demonstrable benefit to people who do suffer from addiction.  There is no hard data that you have pointed to given multiple opportunities and framings, even with my helping you to do so.  

              Not only can you not prove with any rigorous scientific measurement that your profession has any actual demonstrated track record of helping people than the alternatives, you can't even prove it's better than doing nothing.

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