Wednesday, April 23, 2014

Perhaps the Most Useful Studies are Your Own

There are so many internet posts, as well as a number of books, taking polarized and sometimes rabid positions about questions like (a) whether sobriety is necessary for alcoholic/addicted individuals and (b) whether AA [the most widely recognized kind of help] is the greatest vs the most awful resource available for those who do seek sobriety (meaning ongoing abstinence and improved life).  Much like MSNBC vs Fox, it can be very difficult to tolerate both, and each position draws those who are inclined in any case to embrace the perspectives offered. 

Attempts at scientific investigation, while always laudable, so often also seem to fall in line with the expectations or views or those either performing or reviewing studies.  For example, the large scale study known as Project Match (an 8-year effort that began in 1989) is recurrently put forth as proving both that the AA approach is a bit better than others or that AA offers nothing.  (My own reading at the time was that no particular approach was impressively better than any other, and that attempts to predict which approach would work best for a specific person failed.)

Those of us such as myself who work all the time with people trying to overcome alcohol and drug problems develop our own points of view based on experience, but of course our conclusions are also skewed by factors including (a) our own preexisting views and (b) the particular patient population that we see.  (For example, community epidemiologic studies indicate that many people stop drinking on their own; these people rarely show up at my office, and I would never have known.)

But if you have been concerned about your own drinking or drugging, you probably have already been doing your own experiments.  You may have tried changing beverages, using only on weekends, setting a daily limit on amount consumed, seeing a therapist (either with or without specific addictions expertise), attending 12-step meetings, attending SMART meetings, using online recovery resources, acupuncture, various kinds of medications, etc.  Since you are the only one with your unique brain composition, there is something to be said for running your own “studies” on yourself.  Since you’re probably doing so anyhow, why not get a little scientific?  Write down your objectives, and how you will measure success vs failure of your approach; record the things that you have done, how often, when, etc., and keep track of the results.  Trying to remember without keeping records may not be the best method, since memory is so prone to distortion.  At some point, you may decide to pursue this process with the help of a professional with experience in addictions.  Ultimately, what will matter to you is not the opinion of various alcohol/drug pundits (even those who aren’t so angry) but what works for you.