Thursday, September 22, 2011

Our Government At Work

I ran across this statement in a Time Magazine article recently:

Research shows that the majority of people who receive a diagnosis of addiction or alcoholism actually recover without treatment or participation in self-help groups. In a 2005 study involving 4,442 people with alcoholism who were not in treatment, researchers found that one year after their initial interview, a full 75% had improved to the point where they were no longer considered to be actively alcoholic.

And being the inquisitive type of guy that I am, I read the study, brought to us by our friends, the PhD's at NIAA. Here it is, in a nutshell:

Recovery from DSM-IV alcohol dependence: United States, 2001-2002.

Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA. ddawson@mail.nih.gov
To investigate the prevalence and correlates of recovery from Diagnostic and Statistical Manual version IV (DSM-IV) alcohol dependence by examining the past-year status of individuals who met the criteria for prior-to-past-year (PPY) dependence.
Cross-sectional, retrospective survey of a nationally representative sample of US adults 18 years of age and over (first wave of a planned longitudinal survey).
This analysis is based on data from the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which data were collected in personal interviews conducted with one randomly selected adult in each sample household. A subset of the NESARC sample (total n = 43 093), consisting of 4422 US adults 18 years of age and over classified with PPY DSM-IV alcohol dependence, were evaluated with respect to their past-year recovery status: past-year dependence, partial remission, full remission, asymptomatic risk drinking, abstinent recovery (AR) and non-abstinent recovery (NR). Correlates of past-year status were examined in bivariate analyses and using multivariate logistic regression models.
Of people classified with PPY alcohol dependence, 25.0% were still classified as dependent in the past year; 27.3% were classified as being in partial remission; 11.8% were asymptomatic risk drinkers who demonstrated a pattern of drinking that put them at risk of relapse; 17.7% were low-risk drinkers; and 18.2% were abstainers. Only 25.5% of people with PPY dependence ever received treatment. Being married was associated positively with the odds of both AR and NR, and ethanol intake was negatively associated with both. Severity of dependence increased the odds of AR but decreased the odds of NR. The odds of AR (but not NR) increased with age and female gender but were decreased by the presence of a personality disorder. Treatment history modified the effects of college attendance/graduation, age at onset and interval since onset on the odds of recovery.
There is a substantial level of recovery from alcohol dependence. Information on factors associated with recovery may be useful in targeting appropriate treatment modalities.

I'll cut through the bullshit here just give a summary. Somehow, these researchers came up with a pool of over 4,000 people who were diagnosed as alcohol dependent using DSM-IV criteria. Where they got these folks is a mystery. Treatment Center patients, therapy patients, wet house occupants? Who knows.
But I'll leave that question open as they ain't tellin'.

I have two big problems with the study. First is the use of DSM-IV criteria to determine alcohol dependence. Using this as a guide, I could develop a tolerance for alcohol over the years, have a desire to cut back on my drinking, and drink in spite of the fact that I give up important social activities as a result of my drinking and according to DSM-IV I'm an alcoholic!

Then to see if I've recovered from this alcoholism over a 12 month period, the folks at NIAA talked to a "randomly selected adult in each household". Wow! Now there's great source of information. Ask my co-dependent spouse or my alcoholic father how I'm doing.

But damn if they don't come up with the conclusion that 75% of the 4200 alcoholics in the study got well, or at least weren't classified as alcohol dependent after a year regardless of the treatment received during that period. In fact, only 25% received any treatment at all. All based on the word of a "randomly selected adult in each household.

I'm all for studies on the effectiveness of various treatments for alcoholism. But this is ridiculous.


Sunday, September 4, 2011

What does spiritual mean to you?

Spiritual to me simply means beyond the 5 senses.

I think folks who drank like me were spiritual seekers from the start.

The haters are astounded and offended when A.A. claims that the summoning of help from God is a must.

There are wonderful scientists, doctors, therapists, chemists, etc. out there. But even they are not immune to the need to appeal to the Divine... imo.

David R. Hawkins says this about depression in Power vs Force on page 278;

"Subtle grades of depression kill more people than all of the other diseases of mankind combined. There is no anti-depressant that will cure the depression that's spiritually based, for the malaise doesn't originate from brain dysfunction, but from an accurate response to the desecration of life. The body is the reflection of the spirit in its physical expression, and It's problems are the dramatization of the struggles of the spirit that gives life. A belief that we ascribe to "out there" has its effect in here." Everyone dies by his own hand- that's a hard clinical fact, not a moral view."

Hawkins loves A.A. So it stands to reason that he's got his haters.

I haven't gotten to the "how to understand radical atheism" section yet.

I may need to write that one myself.

Now to be fair to the garden variety atheist, Hawkins says this,

"Religions that fall below 500 may preach love, but they won't be able to practice it. And no religious system that encourages war can claim spiritual authority without the blatant hypocrisy that's made atheists of many honest men."

Ouch. That's a tough one to swallow.



Rob B's therapy vid for MA;

Now, my brain chemistry vid for MA;

Any questions?