Kinds of treatment

Discussion in 'Substance Abuse' started by toughlovin, Sep 17, 2012.

  1. toughlovin

    toughlovin Guest

    OK so I would really love to have a discussion about the pros and cons of different kinds of treatment. I was struck by Suz statement that she felt she had to be careful not to say anything negative about AA on this board. I was interested in that part of the discussion... and then of course on that thread things really deteriorated and the thread had to be closed. I totally understand that and don't want to have a discussion where one option is totally bashed etc.... but I am interested in the topic.

    I know many people where AA has been really beneficial and the more I go to alanon I can see the value in the 12 steps... but clearly a whole whole lot depends on the meeting you find and the particular people you find at the meetings. So far I don't think AA has helped my son much but then again he seems to run from every program that gets close to helping him.

    It is clear to me that really no treatment will work for him unless he is willing to stay and do the hard work. However I have looked at a lot of treatments and there is not much substance abuse treatment that i have found that is not based on the 12 steps

    So I am interested in others thoughts and experiences on this and a bit frustrated that we could not have this discussion calmly and rationally on the other thread. Can we do it now? I am hoping so.

  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I think anything that works for the person is good. I know a lot of people who quit drinking due to AA and don't believe ANYTHING should be bashed on this board. Maybe it works better if you have a higher power...I don't know. My daughter quit 100% on her own. She had no help at all. She just quit.

    I'm not sure how useful it is to "go there" again. Different countries probably have different methods and there are a lot of countries represented here, but most of us are from the US. I think cultural differences are huge when it comes to treatment.

    in my opinion whatever works for you works. Most people here are still struggling with young addicts who nothing has worked for yet...let's not open wounds and pour salt in them. JMO.
  3. SuZir

    SuZir Well-Known Member

    My meaning is not to bash AA. I'm happy for everyone who founds sobriety through their program. And I understand that availability and affordability are huge pluses. I'm just not sold to their program and first I will tell you why. I have to say, I don't have that much personal experience with AA/twelve steps. Some al-anon meetings mostly. I have a very close friend who was coerced to attending AA for two years and it really didn't work for her but made her worse. She got sober later on her own. (By the way, just quitting on their own is the most common way to get clean in all the studies I have seen.) And her experiences are a big part why I didn't want my difficult child close to twelve steps. They share some character traits that I think are rather ill-fitting with AA. That of course doesn't mean that AA wouldn't work well for someone else. I just have very much doubts with my passive-aggressive, petulant, rebellious teen son, who doesn't have much faith to higher powers and who is science orientated.

    My other big problem with AA is that same personality structure (I'm bit more mature than my son though.) I want scientific evidence. AA approach can be very dogmatic and I don't totally agree with their views with addiction. And I don't like it, when AA considers itself an authority in matters about who is 'a true addict' (and who is apparently imposter) and how someone who doesn't recover in the way AA sees only possibility 'never being a true addict.' Same goes with with AA defining sobriety in their own way and calling others just 'dry' if they are not believing AA, working twelve steps or if they are for example using medications. I also have a problem with how twelve steps are stuck to the idea of sober date and trying to force it to everyone. Approach there a short relapse for example every two years somehow minimizes or makes even naught all the success of the rest of the time, and forcing it to others, also feels quite hostile. I also don't think it would be beneficial for example for my son to try to sell him a model there he should spend regular, significant time going over his gambling, talking about it etc. the rest of his life. To my common sense that in fact would keep gambling fresh in his mind as a possible solution to his problems and make urges worse, not less. I also anticipated my son would have slips and relapses and I feel twelve steps tend to make too big of the deal out of them. They are likely to happen with most of addicts and I find approach, there the idea is get quickly over them, learn from them and go back to normal more beneficial.

    I didn't write any of above to bash AA and certainly not it's members. But I wanted to tell my reasons why I rather have my son in other programs. The programs my son has used are not any worldwide models, but part of local health care. First he was in intensive program (weekend camps, phone and online meetings, working the workbook etc.) for gamblers under local University Hospital. After that his continued treatment is under his local hospital's addictive medicine department (his treating MD is psychiatrist specialised in youth addiction medicine and he has regularly met a counsellor whose is also specialised to addicted youths.) Both programs are based on scientific studies about addiction and likely to change according to new information. We were given a lot of material shared also by SMART Recovery, if that is something some of you are familiar with. The principals are similar, but my difficult child's treatment is under everyday, local public health care.

    What I do like a lot in this type of treatment is lack of 'hysterics' and scaring. It much more matter of fact than many other. Very similar to treatment of other health problems. It's not like they would deny the dangers (with gambling the suicide rate is really scary), but they are not flaunted any more than possibility of death is flaunted to breast cancer patients by their doctors. It is also not all or nothing attitude, but the goal is to minimize the hazards. In my son's case only way to do so is to not gamble. But no one is going into hysterics for example him playing cards without stakes with friends to kill time. He is also encourage to take actions and use 'crutches' to help him to get over urges and avoid relapsing. It's not considered a failure to use medical or technological help to make it impossible to relapse, but a smart move to control your addiction. Addiction is also seen as something one can have control of. It's maladaptive behaviour and one can get over it and learn better ways to deal. Addiction also don't have to be a central point of your life rest of your life.
  4. Signorina

    Signorina Guest

    Not to beat a dead horse, but the "science vs deity based programs" piqued my interest.

    I struggle with Nat' l Healthcare models. And while I agree 110% that we need some sort of something to cover everyone, I also like the freedoms that comes with good insurance (a blessing I don't take for granted and pay dearly for) and the ability to choose ones own care,(so long as you can pay for it) but that's all I will say about that.

    Anyhow, my firm belief is that anything that works is great. Different things work for different people. What works for a person in one part of their life may not work as they grow & mature (or simply age) and transitioning to another type of treatment can help. I am a belt and suspenders type of girl and i would exhaust every resource and treatment possibility if need be.

    I feel fortunate that where I live, one doesn't need to make a choice between science and MN style/AA programs. It's not a fork in the road. And the popularity of 12 step programs usually mean there is a style of meeting for every need & comfort level. Hospital led meetings directed by medical staff to crunchy meetings, LGBT meetings, teen meetings, vegan meetings, etc.

    The posts piqued my interest. I read about the pill based treatment. That medication is the 146th most rx'd drug in the US (with- a bullet) so it's certainly a widely accepted and widely used method. And not just on the coasts. From what I read- especially an interview with the Harvard doctor who was its biggest proponent originally and directed a major study- there is controversy over the idea of simply substituting an illicit illegal drug for a legal rx maintenance (and still addictive) medication. In what I read- and I am no means an expert- the most success has come from using the detox, "rx medication" and tapering off while introducing reliance upon a 12 step (or therapy based) program. So ideally the best of both worlds. Ethically, I am not sure I am comfortable w the idea of just substituting a lifelong CVS or Walgreens bag for a ziplock! (there is a lot if abuse & misuse & hi street value for the rx.) But if that was the only thing that worked for my kid or me- sure. I won't write anymore about the pill because I fear the return if yesterday's poster who frankly has made this board a sharp, hard, pointy corner of the web for me. But I will be happy to share the links by pm once I get to work.

    As far as 12 step programs, they work for a great many people. I have no doubt in my mind. Again, everyone's needs are different and they don't work for everyone. What works today may not work tomorrow. And all that. But I have 3 very close friends who have long term (28 years, 24 years, 12 years) chemical sobriety thanks to AA. My sister in law attended her first GA meeting 16 years ago and now leads GA meetings. I've had a first row seat to the incredibly positive changes that 12 step recovery has brought to all of their lives and I don't doubt and could never dismiss the validity and success of this form of treatment. I think the ppl at AA would be the first to tell you that it works in conjunction with other forms of treatment and while it can be the primary or only form, it can also be a supplemental/reinforcement resource.

    Whatever works for just 1 person is wonderful in my opinion. There is no moral or intellectual or medical superiority in any form of successful treatment.
  5. toughlovin

    toughlovin Guest

    Thanks for your reply Suz.... I think with AA so much depends on the actual meeting and the people at the meeting. That is both the strength and weakness of AA in my opinion. A lot of what you describe as wrong with AA is really how people in AA interpret things... I don't think the 12 steps say that stuff anywhere. What I have found if i look at the 12 steps itself is it is really about admitting you have a serious problem with addiction, being accountable for the things you have done, making amends for the things you have done wrong, and accepting and loving yourself in the process. However it can be totally misconstrued by the people in AA or at a particular meeting. I also think there are many mental health issues that AA does not address. However one thing that it does do which is important is provide support for people who are addicts by other addicts and I think that can be key to recovery. I know the alanon meeting i go to has been hugely helpful to me and a big part is because there is support there, and people who have been dealing with the issues of children and addiction for a long time... and the old timers keep the rest of us on track and reminding us to keep thinking about taking care of ourselves.

    I don't really care how my son finds sobriety, whether it is through AA or something else, I just want him to find it and somehow become a productive member of society.... with him I don't see him doing that totally on his own but who knows maybe he will suprise me.

  6. SuZir

    SuZir Well-Known Member

    Yes, you are lucky. Around here AA/Minnesota treatment often pretty much strongly discourages people using health care system for their addiction issues. They like to ridicule it and are very vocal about how wrong it is and how only AA/Minnesota model works. Of course many sneak to have health care treatment and just don't tell it in AA. What I have seen in local addiction forums they may be in fact be a majority. When new people are asking about it on those forums they are usually told that trick is not to admit in AA meeting that you are for example using Antabuse or even worse SSRI and seeing counsellor. Then again our health care does encourage people to go to twelve step meetings, if they feel it would be helpful for them. So you can use both also here, if you just remember not to tell about it in AA.

    I don't know if AA tends to so against medications elsewhere. Here it may be partly because they feel need to differentiate from public health care, there for example many of the addicts are dual diagnosed and mental health issues are treated even if person is not sober (that to my understanding is a big philosophical difference.) We also have much less availability of twelve steps programs. For example my difficult child's small city (little less than 100 000 habitants) has three or four AA groups, one weekly NA group and one monthly GA group. So of course finding a group you are comfortable with is much more difficult. And being comfortable with a group is always very important thing when it comes to any kind of support groups. If you have to grit your teeth through every meeting you are not going to benefit, whatever the method is. If for example difficult child's town would had had a group for addicted teens, I could had seen benefit for him in participating.
  7. Nancy

    Nancy Well-Known Member Staff Member

    Amen Sig! I couldn't have said it better.

    I agree that I'll take whatever program works for difficult child. Honestly AA worked the longest and gave her a real chance at making the kinds of changes in her life that are needed to maintain sobriety and live in a world where alcohol is everywhere you turn and you can't go to a social function without it staring you in the face. But I don't have to put down one program to build up another. It's not an all or nothing thing. I too struggle with substituting one pill for another, althought they haven't yet found one for alcohol. difficult child had been on medication since the age of seven to try and control whatever is going on in her that causes her to seek comfort in drugs/alcohol. None of them worked so I'm not keen on trying that again. But if they found a pill that cured her I would jump for it.

    But the other thing is that there is no certainty with any program. At any time the addict can relapse and from what I just read in our city newspaper today there is up to a 70% relapse rate with any program. Some even put it higher. So I guess if my difficult child was successful in a certain program all I could say is that she was successful so far because any relapse would put that program into just another one that didn't work. I believe it is up to the addict to want to get help and find a program that suits them, and then work it. It won't work if you don't work it.

    As far as support groups, I have gone to many many al anon groups and while I did not find one that fit me I did find two support groups that are awesome and it all has to do with the members. They both follow the same principles of al anon but with less structure and much more sharing. The FA group laughs more than any support group I ever thought possible. I have found people there who understand and care about each other.

    I will say that difficult child has often said that she felt the best and most herself when she was in AA. She loved being accepted and around so many caring people. It was her demons she couldn't keep at bay.

    Sig don't worry, we really are the soft place to land that everyone has worked so hard here to create and that is not going to change, I promise.

  8. SuZir

    SuZir Well-Known Member

    This I kind of disagree. I don't think relapse means that program isn't working. I would say, that you only see if something is working or not by taking a longer time frame and looking if maladaptive behaviour is getting more or less frequent. If the decrease of for example drinking is significant, I think it works. I mean, if for example someone goes to AA after drinking being out of control and (almost) daily for example two years. First they are sober one month. Their first relapse is six month. They come back and this time they are sober three months before relapsing. Then they drink again four months. Come back, are again sober three months relapse, but are back after a month. Then they make it to a year, relapse and drink again another year. Come back and make it a year again, but this time relapse is only two weeks. They are back and are sober two whole years and relapse for a weekend. And so on. I see that as a success story and meaning that AA is working for that person.
  9. Nancy

    Nancy Well-Known Member Staff Member

    Suz that isn't how it usually works with alcoholics or drug addicts. When they relapse they don't usually have a few beers for a couple weeks and stop or get back on the wagon, it is usually a full blown relapse that often sends the addict into a tailspin. I have heard this over and over from so many addicts and is why I am convinced that a drug/alcohol addict can't drink or take drugs socially and stop when they have had enough. The chemical dependancy part makes that impossible. It would be wonderful if that were the case. My difficult child thinks she can drink responsibly but has lost four jobs in the past year and has stolen from her employer and has almost been evicted for non payment of rent and is now involved with sugar daddies to provide her money.

    I never though life was over if she relapsed. Even in rehab they told us to expect that and the addict has to tools to use to get back on track. But if one relapses over and over again, there is no sobriety, just some spaces in between when they don't use/drink.

    Last edited: Sep 17, 2012
  10. InsaneCdn

    InsaneCdn Well-Known Member

    Like so many other areas... SA treatment and what works/doesn't work seems to be, to a large extent, dependent on several factors:
    1) personality
    2) history
    3) co-morbid conditions

    Unless you can find a method that covers all three of those for a particular person, it probably isn't going to work.

    I can't handle group-work. Period. I know others who are the same. That really kills options like AA.

    My GFGbro, due to the way he was brought up, couldn't deal with the "higher-power" driven AA approach. He ended up with a therapist who was also an addictions counsellor... and that worked for him.

    And I have friends who still haven't found answers, because the therapies that seem to work for their addiction, work against their other issues.

    If a particular therapy doesn't work... it's important (but not always possible) to figure out WHY it doesn't work. If you can figure that out, then it is more obvious if the therapy needs more time, or if something different is needed.
  11. Kathy813

    Kathy813 Well-Known Member Staff Member

    I don't think our forum has ever been a my way or the highway forum. We have had these discussions before. My difficult child does not like the deity-based AA meetings since she is an atheist. We found something called Smart Recovery meetings that she went to for a while but they are hard to find. They are non 12-step based groups with a lot of cross-talk and sharing which we both liked.

    My difficult child's DBT counselor doesn't like AA/NA meetings because she thinks they are very judgemental. Many around here do not believe that an addict should take any medications which doesn't work for someone like my difficult child who needs medications for her mood disorder.

    That said, I think that AA/NA has helped many people find the road to recovery. As other posters have said, I don't think there is a one-size fits all kind of answer. The only reason those threads were closed was that OP started out being very judgemental and had an attitude that he had the only correct answer. I think we are always open to a civilized discussion of options.

  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Only one thing matters: The will of the person to quit. Nothing will help until the person is ready. Then, frankly, I believe most quit on their own, just like my daughter did. How did she quit? She DESPERATELY WANTED to quit and was motivated. A bell went off in her head when she happened to see an addict with track marks on her arms and she thought, "That's my future." She then quit without AA, without rehab, without a therapist, with nothing more than her fear of her future and the desire for a normal life. So I do agree with Suzir that probably the most common way to quit is for people to just have an enlightened moment and decide, "I'm going to do this." My daughter took meth and coke a lot, so I'm sure it wasn't easy for her to just quit. She tells us it was very hard, but she doesn't go into detail.

    All the rehabs, military camps, interventions, AA meetings, NA meetings, boot camps, survival camps etc. will do nothing until the person has recovery in his/her heart. Not that they are bad to try, but it is the mindset of the person whether he or she will quit and stay sober. So all programs and no programs work, depending on what the person himself/herself wants to do. A recovery is self-directed. Nobody can force it over the long term.

    JMO and experience.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    This is in response to Nancy's post.I
    I agree with you. An alcoholic can never learn to drink responsibly. The definition of an alcoholic is not that they drink every day, but that they CAN NOT drink without getting totally drunk. They have no ability to moderate. That means that once you have a problem with alcohol, you always will and have to abstain.

    I don't know the definition in other countries, but I believe THIS definition. If one can control his/her drinking one does not have a drinking problem in my mind.

    Suzir, since you will not tell us where you live, I am thinking your country has a different opinion of addiction. I would not agree with it. That does not mean it is wrong, it means I just don't agree. I am guessing that a country when drinking is extremely culturally the norm (even moreso than in the US) would be motivated to soften what they believe an addict is, but, then again, have no idea where you live or if this is true or totally Just speaking my mind as I am never shy about doing :)
  14. InsaneCdn

    InsaneCdn Well-Known Member

    I don't quite agree.
    If the person CAN control the drinking, then they do not have an addiction.

    That doesn't mean they don't have a problem. There will be some other reason why they drink to excess - and that can still be a major problem. But it isn't solved with the same approach as an addiction.
  15. Tiredof33

    Tiredof33 Active Member

    in my opinion the members in AA and Al anon are the deciding factor of how good the program is, the same for in house treatment. 20+ years ago I went to an Al anon meeting in Florida and the group was not friendly at all. When I tried one online all they talked about was a concert and Magic Mike lol, but that has not turned me against Al anon - I know many people from different support groups that have positive feedback.

    AA did not work for my son because he told me he felt out of place being much younger than the others and could not relate to them. Maybe an excuse just not to go, maybe not. I do know many that credit AA for their being 'clean and sober'. The ones I know personally have given a lot of the credit to having a sponsor they could call and talk to when they felt weak.

    I have friends that do not believe in a 'higher power' and both of them say that AA helped them to stay sober, they both had made decisions before going to AA to stop drinking. They do not object to the prayers and discusions of religion, but they have been honest in their beliefs, and they are still going to the meetings.

    My difficult child was 'in house' for 6 weeks during his teens and I did not feel it helped him at all, just as soon as he was out here we go again. The same with the Teen Wilderness program. The same with court ordered rehab TWICE! He also had private counseling.

    So, in my opinion, as others have stated, there is no one fits all approach. All of the programs can be excellent depending on the way they are managed and the willingness of the person to participate. If they are not ready you can not make them.

    I have never felt that this forum advocates any type of program over another. BUT, I read many posts that the person clearly is at a point of high stress and they are asking for help. Most of the time, if not all of the time, they are told to seek some form of counseling for themselves. This forum reiterates we understand, we are not judgemental, you need to take care of yourself, we will be here to laugh and cry with you.

    To the best of my knowledge none of us are abuse professionals, we are here to offer support. That is what I was looking for when I found this forum and that is why I stay.
  16. Nancy

    Nancy Well-Known Member Staff Member

    It seems like it's a bit like splitting hairs, addiction/problem. When does the problem become serious enough to be an addiction and if the person can control their drinking why is it a problem? I don't have the answers, just talking out loud.

    MWM I agree with everything you said, it's my belief also. difficult child cannot moderate herself when she starts to drink. She told people that when she was 15 so that shows you she already knew she was addicted. I'm wondering what role her BM played in al this because she knows her bm is an alcoholic who is still actively drinking and I can't help but wonder if she was trying to prove she was just like her. And I don't care how difficult child gets sober, program, no program, AA, whatever, just that she finally realizes she has a problem and wants to fix it. I think that those who quit on their own have the best success rate. I'm not sure it's most common but I think it has the best chance of sticking.

    But getting back to TL's original question, I still haven't heard anything concrete about any other program that works. It's almoast like the nuts and bolts of the program is a secret. My difficult child has been through years of talking therapy, including cognitive behavioral and DBT. If none of that helped I have a hard time believing how any other type of talking therapy will work any better for her.

  17. InsaneCdn

    InsaneCdn Well-Known Member


    I have close connection who had a drinking problem as a teenager - and was NOT addicted. The real problems were... the group of friends he hung out with, an extreme need for acceptance, and a difficult background (long story). We almost lost him more than once to alcohol poisoning, and once a close call on freezing to death. That IS a problem. He had to get help (therapist) dealing with his self-esteem and his history, so that HE understood what was driving the behavior (late teens by this time). It helped put HIM in the drivers seat, gave him the strength to be different from the group (sports jocks), and removed the "problem" aspect of his drinking. But... it wasn't addiction - at least, not a "substance abuse" addiction. AA and other programs would not have worked.
  18. Kathy813

    Kathy813 Well-Known Member Staff Member

    I agree, Nancy. The bottom line is if acohol or drugs are negatively impacting your life, then there is a problem whether you want to call the person an addict or not. My difficult child seems to be able to go through long periods of not drinking but then goes on binges. Is that an addict? I don't know but there is definitely a trigger versus a compulsion. She claims that means she is self-medicating rather than an addict. Either way, she has a problem with alcohol that negatively impacts her life.
  19. Calamity Jane

    Calamity Jane Well-Known Member

    What has worked so far for my difficult child is one-on-one weekly psychiatrist sessions. difficult child outright rejected NA because he's not a "group" person either, like Insane's brother. However, the sessions with the psychiatrist BEFORE difficult child was ready to quit were a waste of time and money. While he was in the psychiatrist's office once, I was holding his phone, and his friends were texting him to hurry up out of the dr.'s office because they wanted to meet him to get high! I literally almost vomited in the waiting room.
    Only after difficult child wasn't permitted home for the Christmas holiday last year, and after he bombed out in school and he saw what a mess he was making of his own life, and how he was slouching toward irrelevance, did he suggest seeing psychiatrist again, and has been clean so far. (Now he's away at school out of state, and psychiatrist is here. That's the problem, but we're working on video chats if necessary.)
    I have to say that it's a hard road for anyone who has an issue with (fill in the blank here.) My easy child has a weight issue and eats "her emotions." We even went to a gastric bypass info session at the hospital, but she doesn't qualify - not heavy enough lol! but even people who have had surgery can undermine it and not lose much weight even with medical intervention. Everything is truly a lifelong struggle of self control over short term reward.
  20. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Sounds like addiction to me if he almost died of alcohol poisoning. I'm not going to split hairs either. Sometimes therapy can help people with drinking problems/addictions (does it really matter what it's called?). I consider them one and the same, but am fine if some people disagree. And I'm all for anything that works for a particular person. There is no formula I think is bad if it works. But I do think it's mostly up to the user.