BlueChair

Lexi, the behavioral therapies I mentioned are listed on NIDA as being evidence based. These are what make up treatment along with other approved treatments per them, not me. ( I didnt mean it was a criminal law ).

I follow the guidelines of the professionals. Thats it. I often recommend Smart Recovery so Im not against self help groups.

I have no idea what type of treatment IHO wife is in. Hes never said. I did suggest he look and see if it follows recommended guidelines. This was my suggestion because its what I would do. You can suggest he do whatever you think is best. and he can do whatever he wants.

LexieCat

I understand all of what you are saying. I'm simply pointing out that the constant use of the term "evidence-based" carries the implication that other treatments are not effective.

We aren't a bunch of scientists here. I am a retired prosecutor and still train them. When courts decide cases involving expert testimony, there is always a concern that juries will attach inordinate significance to the "expert's" opinion simply because they ARE "experts" (the only ones who are permitted to testify based on opinion rather than personal knowledge). There is concern that juries will abandon their common sense about whether the expert's opinion makes sense.

So debates over what is, or is not, evidence-based isn't really that relevant here. My CONCERN is that use of that term, when talking about what may or may not be most effective for an alcoholic, may steer people away from some very effective treatments.

Make no mistake, AA is much more than a "support group." It IS a treatment method--the 12 Steps are intended to TREAT alcoholism. It may not for every alcoholic, but that doesn't make it any less a treatment program. Many alcoholics DO use it (the Fellowship) as a support group--which is fine, but sometimes people who use it that way claim that it "doesn't work." What "works" (or doesn't "work") is the alcoholic's working of the Steps in AA, not just going to meetings and hanging out with a sober crowd. Those things can be very helpful, but they are not the AA PROGRAM.

totallytrying

Especially when the term is being used repeatedly with newcomers who are looking for reasons why the alcoholic in their life isn't really an alcoholic and doesn't need AA, or any treatment at all.

BlueChair

Have you ever considered the possibility NOT sharing the fact that there are treatment recommendations suggested by professionals MIGHT cause someone NOT to seek proper treatment?

It goes BOTH ways Lexi. People on this forum cant be protected from the facts and have their rights to make educated choices taken away. NOT knowing there are options can kill people,

Not to mention this is a thread from someone who is ASKING for information on treatment.

And, This is a General Family Forum where we all share.

This is getting ridiculous.

Have a nice day.

LexieCat

I agree--I have never for a second suggested that AA is the only effective treatment program. Or even the MOST effective treatment program for every alcoholic.

I have never suggested that people not investigate rehabs and other recovery programs. I can only give my personal experience with AA.

It sounds as if you have personal (well, through your husband) experience with one or two programs. That's great. Love to hear your personal knowledge and experience with these programs that you know.

redatlanta

Insurance companies can now deny paying for treatment if the programs are not evidence based. This has come about because people were not getting better and it was a revolving door.

Ha Ha Ha this gave me quite a chuckle this morning. I don't think I have ever heard anyone apply conscience thinking to an insurance company before now. This came about because Insurance looks for every possible loophole to NOT pay for any treatment they can avoid they are for profit not non-profit. Facilities having to implement EVIDENCE-BASED treatment comes at a very high cost. Some can't do it. End of business. Some choose not to do it that before ACA were part of the insurance market. Yay for insurance Your statements are very misleading implicating that someone shopping for a Rehab can be comforted that there is legislation which will "protect" their loved one from receiving sub-par treatment. Not so much.

NIDA's determination of evidence based vs. support group is a non-issue. The information as stated is directed at treatment facility and requirement of which free groups like AA et al aren't a member. Its impossible to determine efficacy due to anonymity and lack of reporting of results due to that anonymity.

What to do when searching for a rehab? Read, research, review. Don't cut out those that are non-evidence based - look at them all.

jaynie04

My mother has been sober over 35 years and all she has ever done is AA.

I have been sober two years, and I used an addiction counselor, attended inpatient, work with a psychiatrist (I detoxed off benzos and Ambien too) to manage a chronic pain issue without mood altering substances.

I am very familiar with AA, I didn't find it to be a good fit for me. Obviously AA changed my mother's life. I think exploring the different options available is wise. I think sobriety is much more attainable when we find a method that is congruent with who we are. I doubt that my path would be as comfortable for my mother.

I think knowledge is key and I don't think any method has to be mutually exclusive. I think the reason sobriety stuck for me is that I didn't have to go through the process of understanding that moderation isn't attainable, and I understood the concept of the progressive nature of alcohol. I can attribute this directly to growing up with a mother who was in AA. So while I don't attend, I do believe that concepts from that program weighed heavily in my recovery.

I don't think addiction treatment will ever be simple. There are many variables that we each bring to the table. Introverts/extroverts, age, gender, religious beliefs, medical history and other physical complications, how much someone has lost or stands to lose, even what age you are when issues manifest, etc. I am a very different type of person than my mother, so it makes sense that the road I chose would be different.

I think a porous approach is healthy but I think early on in sobriety most of us benefit from some directives and constraints. And because the nature of addiction often bristles at constraints it can be challenging to understand what is a tolerable amount of discomfort to change and what truly is going against someone's grain.

I think finding some sort of external structure early on is important, be it from a group, a therapist, a facility. Accountability is key and even joining a class here at SR seems to provide motivation for many.

Sites like SR have opened up huge opportunities for people who are in recovery. The fact that people can engage in talk about different aspects of recovery, cross pollinate, and even work out personal issues within a chosen method is actually groundbreaking. To the best of my knowledge, 20 years ago such a discussion would be fairly impossible.

I think that the intersection of different concepts will cast a much wider net. The average Joe is much more educated about addiction simply because of access to information. I also think that the illusion of the wino on the park bench will continue to be squashed. That myth was perpetuated because people couldn't find info or talk about what they thought was a very isolated issues.

My husband was on the golf course yesterday. One guy was sober for 10 years with a son heading to rehab, another guy mentioned that his wife was in AA and asked for the name of my therapist, my husband (with my blessing) offered that I am continuing to get better. I doubt that conversation would have happened 20 years ago. I think it is important that we continue to be open and forthright about the idea that addiction is a fact and affects a substantial amount of the population, as well as their loved ones.

My psychiatrist used to work at Silver Hill and my therapist came from Hazelden. Yet early on in recovery I kept AA mantras running through my head "easy does it" and "first things first". I would argue that we should pull from as many sources as we can to find success.

Refiner

I think the main takeaway for the OP is that (A) there are many different approaches to recovery and it's best to get her into one that is the right fit for her, and (B) NO rehab/recovery program will work for her unless it is SHE HERSELF who wants to get truly sober.

Best of luck in your family session today!

iGirl66

Motivated patient. That is the bottom line. Though the degree of their issues, mental health, emotional health, support structure and finances vary, without inner motivation, NOTHING works and I think this is what the OP needs to grasp more than anything.

As far as "evidence based" is concerned. I think that Blue is referring to the fact that AA/NA and other step programs evolved from them are spiritual in nature having sprung from a religious group rather than scientific having roots in the ever evolving medical/research field. In fact, more than a few court cases in the U.S. found that the step groups were religious in nature, specifically Christian despite the "God of your understanding" and claiming to be merely spiritual language used and as such, it violated an individual's constitutional rights to be mandate to step meetings by courts. Griffiths vs Coughlin, Kerr vs Farrey, Evans vs Tennesssee Board of Paroles to name a few. But whatever works for an individual works.

I stayed on Xanax and vodka for a year. Chucked it down the sink one day and never looked back. Went through withdrawal by myself losing my mind because I didn't know what was happening to me. No steps, no doctors. No meetings. Done and done. I felt bad and didn't want to feel bad anymore. So I stopped.

Old eating disorder kicks back in after being dumped and cut off by addict bf (who now says he was just "spiritually unhealthy") who found a pretty little sickie in his rehab. The ED is taking an actual program to navigate because I can't just stop eating like a drunk can stop drinking booze. But the motivation is there and I've lost 20 lbs so far. 40 to go.

My problem with AA/NA is that no other methods or theories are allowed. It seems limiting and controlling. It's one of the reasons that I left the Al a non group that I went to. So much admin stuff, so much time debating and voting on what constituted cross talk and all of it driven by two of the most controlling alpha women I've ever seen who would shut down anyone not towing the line as they saw it and no one making progress beyond detaching. I saw new comers siting with tears in their eyes looking for help while they hashed out on what books to buy with the basket money. Not for me.

I can go to a SMART meeting and talk about how something from Deepak Chopra helped me or about something that came to me at Mass. I can quote from any book if that's what helped me work on something in the SMART book. I can work on my ED and interdependency skills at the same time. Just as we have been telling the OP that his fiancé will mix with others who have different issues, I've learned so much from the addicts of other DOC's in my meetings. We are all together because the underlying root of addiction is the same. It starts in the head with the thought processes. It so strange and enlightening to sit and hear the perspective of the AH who has been kicked out and living in the hotel. The gambler and the porn addict too. Same stories, same fears and regrets just different maladaptive coping mechanism.

Also, people in NA told my daughter that if she continued on her bi-polar meds, she wasn't sober. I pulled that kid out of a psych ward with slit wrists because she wasn't stabilized. That to me is tantamount to giving medical advice and can kill someone. Indeed I've mentioned that one of the sickest people that I know is huge in AA here. He is severely mentally ill, preys on newbie girls and is violent. He will not go back on his meds because he doesn't want to lose his status. It's not drinking! It's his meds to keep him off of the roof with a rifle. Why is that a bad thing?

But like I said, whatever works. Sobriety, stability and living a productive life is the aim for all of us.

NoelleR

Since I was getting tired in the ole apple vs apple debate going on here, I went to the NIDA website to research 'evidence-based' treatment.....

Evidence based..............:
Evidence-Based Approaches to Drug Addiction Treatment | National Institute on Drug Abuse (NIDA)

Behavioral therapies.............:
Behavioral Therapies | National Institute on Drug Abuse (NIDA)

12-step facilitation therapy..............:
12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates) | National Institute on Drug Abuse (NIDA)

For those not willing or too tired to slog through all dat, here's what the 12-step facilitation approach is..............:

Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, thereby promoting abstinence. Three key ideas predominate: (1) acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative; (2) surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program; and (3) active involvement in 12-step meetings and related activities. While the efficacy of 12-step programs (and 12-step facilitation) in treating alcohol dependence has been established, the research on its usefulness for other forms of substance abuse is more preliminary, but the treatment appears promising for helping drug abusers sustain recovery.

It would appear that NIDA considers 12-step approach to be evidence based. Now everyone can have his/her own personal debate with himself or herself.

(o:
NoelleR

LexieCat

iG,

AA doesn't "allow" or "disallow" ANYTHING. Any AA member is absolutely free to engage in whatever recovery-related activities s/he wants to. Nobody is disciplined for not "toeing the line" because there IS no line. There are 12 Steps.

Discussion of other methods of recovery is discouraged in meetings because people going to AA deserve to hear the AA program. But outside of meetings, anything goes. A sponsor might not want to work with someone pursuing a different program, but it's because sponsorship is based on transmitting the AA program as the sponsor understands it.

AA is very clear that it does not have all the answers. It only purports to teach a specific program of recovery that was effective for the first one hundred or so members in the 1930s, and has proven itself to be effective for many, many alcoholics all these years later.

So I don't consider it limiting in any way. I have found a lot of stuff useful for my own recovery in readings on CBT and Buddhist recovery theory. I don't talk about them in my meetings, but I talk to other members outside of my meetings and nobody has ever told me I should stay away from anything but AA.

I do think that in VERY early recovery, it's less confusing for new people to stick with the 12 Steps, just because they are simple and easy to apply. But again, no rules.

SadInTX

ihatealcohol: IMO and in my situation dealing with my AH, the A has a "sense of entitlement". They use their past as an excuse to drink. They will then start using anything as an excuse to drink. My AH also grew up in an abusive household...and alcohol is just a symptom. They do not know how to cope with life. Your A is right where she needs to be...getting help with her issues...not just the alcohol and drugs. If you move her to another place it might give her a message that she is okay and that he is " better" than those people...no, she is not better than them...she is one of those people! She is an alcoholic! Sorry you are dealing with this....it sounds like you are truly standing by her side throughout all of this...she must be an amazing person...I hope she knows how blessed she truly is....

Needabreak

I know there are a lot of double winners on this board, as well as people who have chosen to stay with their partners, whether they are in recovery or not.

But, to sort out my own thoughts on this thread -- for me, rehab and recovery rates just aren't questions that I dwell on anymore. I never had interest in drugs, never even drank more than an occasional glass of wine socially.

And after going through hell with my ex partner, I made the decision a couple years ago that I simply did not want to deal with other people's addictions or substance abuse in my life -- period.

I was with my ex for many years before his addiction became apparent. If anyone is interested, they can go back and read the history in my older posts. When I decided to split up with him, I faced a lot of anger from others. I had to let many other people go as well; his family members, mutual friends, etc. I chose to remove addiction as a focus in my life.

I'm noticing that there is a lot of focus here on other people's addictions, to the point where I'm realizing that my ESH, my perspective isn't very helpful.

But for me it's simple. I will make sure that others' actions don't derail my own life, my own happiness. I guess once I hit 50 a couple years ago, I saw that my own time left to live is limited, and that I had wasted an awful lot of it on other people's drama.

hopeful4

I am going to pray for both of you because you are both deep in denial. If my child were on that bus, I would show up at court and have such a fit that the judge would look like a complete a$$ if he did not give her some jail time. She is showing no remorse for putting many children's lives at steak. Judges are elected. I would lead a media nightmare if she got off with rehab alone.

All of us wanted our qualifiers to get it the first time. Ultimately, if she wants to recover, she will. If not, she won't. It's that simple. Beware of many rehabs. They are a huge money maker and will offer up some very promising results that may be skewed a bit.

I hope things work out for both of you. I hope she does get some jail time to teach her that there are consequences for actions. I hope she works rehab and gets well, and that you use this time to educate yourself.

NoelleR

Your fiancé is right where she's supposed to be ........... prostitutes, thieves. and drunken children's school bus driver.............criminals all.

Of course you want her to get it the first time; don't we all. However, whether you pay $0.00 or 10k or 30k or 70k-100k, there's no guarantee. I don't have any studies to link for you, so no 'real' evidence, but I do have some anecdotal evidence (and it's 'real' for me)....................:

I've had a friend now for going on 50 years. We're both recovered A's. She went to Betty Ford [yes when Liz was there; even had her picture on the cover of the National Enquirer with Liz. They became close friends (she'd even hang up on me when Liz called.....lolol)]. I, on the other hand, when I got into recovery (2 years later), didn't go to any treatment center; I went to AA, and did a LOT of reading.

My friend now has 31 years clean & sober (yup, a one-time treatment) and I have 29 years clean & sober (also a one-timer). Do you think her sobriety/recovery is better than mine because she paid to go to a treatment center....? I think my 29 years is a pretty good outcome for a $0.00 output.

Just some things to think about.

(o:
NoelleR

LexieCat

I dunno, Noelle, being on the cover of the National Enquirer doesn't strike me as moving up in the world. Thankfully your friend stayed sober in spite of the dysfunctional people she hung out with.

NoelleR

I don't know as I'd go so far as to call Liz Taylor dysfunctional.......but actually the picture was a shot by a paparazzo (very long lens) of a group therapy session on the grounds of the center.

(o:
NoelleR

LexieCat

I was just being a smartass. I think Liz had lots of issues (don't we all), and it was more of a riff on the rehab riffraff. And I think anyone who would take (or publish) a photo like that deserves to be slapped with a big, fancy invasion of privacy suit.

iGirl66

Lexie,

I've never once ever heard anyone claim that step groups were treatment, only a fellowship. It seems to me that once you bring in the idea of acknowledging and surrendering to a HP, you have gone from science to faith and that's why the courts ruled that it violates separation of church and state when courts mandate participation in step meetings. I'm Catholic, I got nothing against faith, but sending a person to John Hopkins for treatment and sending them to Lourdes for a miracle are not the same thing. My faith centers me, it gives me a new perspective, but I wouldn't call it "treatment " on the same plane as psychology and nuero-science just because we meet everyday and share and confess and people have been turning from all sorts of bad behaviors for the last 2,000 years because of it. But just like the church, AA has some questionable structures, ideas and it's fair share of abuses that people are loathe to address because the organization and its protection from scrutiny becomes more powerful than the people it's supposed to help. The people and problems I've seen are real. There is no one with authority to stop it and there is no way a new comer is going to know that this is not how it's supposed to be.

NoelleR

12-step groups may not be treatment, but the 12-steps are an evidence-based form of treatment used in some treatment centers.

(o:
NoelleR