A Different Path to Fighting Addiction - NYTimes.com - 0 views
www.nytimes.com/...ath-to-fighting-addiction.html
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The psychologists also support the use of anti-craving medications like naltrexone, which block the brain’s ability to release endorphins and the high of using the substance.
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A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, which are often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of A.A. and other “TSF” — for 12-step facilitation — programs.
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Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group, reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.
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lifelong abstinence and adherence to the 12 steps mapped out in the Big Book, published four years after the organization was founded in 1935.
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Instead of addict or alcoholic, she prefers the terms favored by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or the DSM-V, which says that patients suffer from “alcohol use disorder” or “substance abuse disorder,” terms that convey a spectrum of severity.
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“Substance use takes on a lot of different shapes and sizes,” Dr. Kosanke said. “There are real downsides to labeling a child with a lifetime identity, when that truly may or may not turn out to be the case.”
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“We don’t have a judgment on how you address your substance use problem. Maybe A.A. is helpful to you and you find everything you need there. If it’s not, we genuinely believe there are many strategies for helping to resolve them.”
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Stanton Peele, a Brooklyn psychologist who has studied substance use for decades and is a longtime critic of the A.A. model.
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That approach runs through the book she wrote with Dr. Foote and Dr. Kosanke, “Beyond Addiction: How Science and Kindness Can Help People Change.”