Tuesday, October 4, 2011

Nuthins gonna change

This is the third of what looks to be a three part series on atheism in recovery.  The other two parts can be found here, and here

The biggest problem with methods of recovery from addiction is that they are too often unsuccessful.

The most common interaction people have with drug addicts is when the addict has done something to turn them into victims. Whether this is because the addict has actually perpetrated a crime to obtain money for drugs, or more commonly simply because the cumulative psychological effect of the drugs has rendered them emotionally numb in a world full of feeling humans, the addiction is often an excuse rather than a focus for treatment. Often the victims will not even know addiction is a driver in their victimization unless the individual has been caught outright or if the victimizing behavior is the result of a relapse. Usually when one knows that they are the victim of a relapsing addict's behavior it is not the first relapse the addict has had.

A reduction in the magnitude of addicts' impact on society is a poor indicator of a particular treatment approach's success rate. Certainly it is the most important measure as far as a faceless culture’s attention is concerned. If addicts quit behaving so inconveniently then –as far as society was concerned- they would cease to have a problem. This is a criminality approach to viewing drug addiction; it does not address the numbers of people who suffer from in the downward spiral of drug dependency.

Treatment effectiveness can be measured using metrics like one-year and five-year outcomes post treatment. Most treatment options involve a traceable client-patient relationship involving beds and money. Data has been generated from several treatment options. The data varies enough to support the fully salaried efforts of numerous experts, but much of it falls into the 50% effectiveness range. This means that 50% of the individuals completing a treatment remain drug-free (although many data sets focus only on particular chemicals) for a year or five.

The problem with these data is that the selections of their sample sets are highly discriminatory. It is likely that people who would be likely relapsers would not make it into a program, or would not graduate. How much of the data is actually stating that “people who are identified as unlikely relapsers have only a 50% likelihood of relapsing”.

It is interesting to note that two of the major drug-addiction-focused 12-step groups (AA and NA) conduct semi regular “membership surveys”. These suggest that it is a little more than twice as likely to have a person respond that they are in their first year of recovery than that they have been drug-free for one, two, three, four, or five years. This suggests that the success rates are similar for 12-step and medical treatment options. However, there is much overlap in the sample sets; most patients from medical treatment facilities attend a 12-step group after graduation, and many 12-step group members went through a medical treatment facility.

Since addiction is a treatable disease there should also be a background remission rate. Some place this level at 5%. So 5% of people recover from active addiction without identifying a particular treatment. Many of these untreated and cured folks report the ability to use social quantities of drugs like alcohol after their spontaneous cure.

Those addicts whose disease prevent them from ever rigorously seeking help are poorly captured by any data set. Some data has suggested that certain groups (like cocaine-addicted prostitutes in Los Angeles) may on average seek help over a dozen times a year with very low-rates of success (<5% per attempt). Attempts to statistically capture these populations have resulted in hyperbolic assumptions that adjust overall success rates down to levels similar to published spontaneous cure rates. In other words vigorous hand waving while appealing to the degradation of an emotionally-vulnerable community allows all treatment options to be rendered statistically worthless.

To some this appears like an exploitable week point common to available treatment options. Disingenuous comparison between a concrete treatment option and the hand-waving adjusted general data should show that any specific treatment option is ten times as effective as all of the options in the general pool. Since addiction treatment is profitable these comparisons do not go unchampioned.

Since most options in the adjusted general pool take advantage of 12-step programs the 5% impotency statistic has been cited as the effectiveness rate of 12-step programs. Though capitalistic competition is seen in this use of the 5%-12-step statistic, the most common use I’ve seen of this is by religious groups attempting to secure converts.

The “god” of the 12-steps is too secular. Several 12-step groups have splintered from AA in order to establish more rigorously religious groups. It is worth noting that attempts are being made to establish non-religious recovery groups that translate the 12-steps into more rational principles of recovery. I should really write more about them than I do. However, the classic theistic approach to psychological issues is quite different than that practiced in any 12-step group.

In a 12-step group one does not find people chanting or “laying-on” of hands. There is little fasting or burning incense. Some meetings have candles, but none have Ouija boards. In short the amazing magic is missing. There are however, damaged minds willing to accept fantastical explanations for mundane occurrences. And that is prime convert material for most theistic religions.

Recently there was a very minor protest at a major meeting of a 12-step organization. Several young men in bright yellow shirts denouncing AA handed out fliers, and engaged anyone who would listen. They were pushing the 5%-12-step statistic as proof that only their divine solution would cure addiction. These guys even went so far as to pronounce that since the succsess rate of 12-step groups was equal to the spontaneous cure rate that everyone in 12-step groups would burn in a lake of molten sulfur. I hate it when that happens!

12-step groups have been around long enough to be a stable and recognizable pool of potential converts. Usually the fishing for converts is not attempted via the dissolve the 12-step group for god dynamite fishing technique the guys in yellow shirts would like to attempt. Instead the convert is wooed from within the 12-step group. It is not unheard of to have organized cadres of missionaries attempting to surreptitiously harvest converts, but most attempts are made by the divinely inspired individual.

You can imagine the damaging effects an internal holly war could have on any organization, In order to minimize certain things that could harm 12-step groups they have each also adopted principles of group conduct they call the “12 traditions”. Number 6 reads:
“6. An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.”

It is widely understood that any specific religion is an “outside enterprise”. To the devout individual their actions may not be connected to a specific religion, and are therefore exempt.

While the yellow-shirted protestors randomly wandered around outside the main meeting of the conference was going on inside. 20,000 former-addicts gathered to hear the motivational words of two carefully-chosen individuals. Here is a carefully-chosen sample of what they heard:

You want a laugh? I'm watchin' TV last night; the PBS special. Now they must think I'm stupid, or you're stupid, but I'm gonna share it: It was the discovery of -humans- of mankind. They had a little Lucy thing y'know. This little skull. This, this monkey they found then all of a sudden we all tied to it. I'm just bein' sarcastic. And they're sayin that's us; right? They've got a new one, a baby one, called Salam. I'm getting somewhere, trust me. This is a new one. So I'm listening to them. They say that NOW from Lucy to Salam that the monkey came out the tree. Jumped out of the tree. Learned how to stand upright. They also went on to say that the arms of the Salam and the Lucy were monkey's so they could swing in the trees to stay away from predators. If the predators is on the ground why the hell would I want to learn how to walk? THAT DON'T MAKE NO SENSE! Y'know I was sittin' up there like: Are you for real? Y'know like who you tellin' this to? Are you kidding me? The whole thing about [a specific 12-step group] is that what we tell you is what it is in the book! Nothing is gonna change. Lucy ain’t gonna manifest from swingin' no tree!

Apparently either the big stage proves too strong a temptation for some undereducated proselytizers seeking to make a big haul of converts, or the 12-step fellowship’s vetting process for main speakers is beginning to select for a strongly theistic message.

I’m not sure this is a trend more than it is evidence of what has been a long-standing threat. There are no secular institutions that are not potentially under attack from those who would crush them into more theistic dust. Those institutions that are seen as consisting of the most intellectually week are probably the most attractive targets.

Just look at what’s happened to the GOP!

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