US Overdoses: Wide Regional Variations

Addiction Recovery Bulletin

Is anywhere safe from Fentanyl? –

July 20, 2020 – Meanwhile, the South, as defined by the US Census standard, is faring better than the Midwest. Out of the 12 Midwestern states, all of them saw increases in overdose deaths except Michigan and Missouri, which each had rates of decrease below 10 percent.

The Midwest suffered the nation’s starkest rate increases. South Dakota experienced a 54.4 percent rate increase in overdose deaths, the most severe in the US, while North Dakota’s rate increase came in second place at 31 percent. Efforts there to stem harms that can result from drug use still largely consist of law enforcement interdiction, exclusionary, traditional rehab services, and tone-deaf ad campaigns, like the widely mocked “Meth. We’re On It” billboards.

In comparison, four out of 16 Southern states saw decreases in their overdose death rate from 2018 to 2019: Georgia, Maryland, Arkansas and Oklahoma. In the latter two, the rate decreases were in the double digits, with Arkansas seeing a significant 16.6 percent decrease. Only Vermont saw a greater drop in its overdose death rate, at 18.1 percent.

A 2019 story from Stateline, the state policy newswire from Pew Charitable Trusts, explains how policymakers and law enforcement in the Southern states have been slower to adapt to harm reduction than their counterparts in the Northeast, but are still making progress in recent years.

more@FilterMag

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An Agnostic and Mainstream AA

By Brendan O’K

“All people must necessarily rally to the call of their own particular convictions and we of AA are no exception,” said Bill Wilson. One of my strong convictions is agnosticism, the belief that nobody knows or can know of the existence or nature of God. So I lack the religious faith that so many people told me was essential to thrive in AA. But after 15 years I’m still involved in our movement: I go to two or three meetings a week (five in the Zoom/Covid period) and am a volunteer for the AA telephone helpline in London.

Although I’ve lived in London for many years, I grew up mostly in Liverpool in the northwest of England, a city unusual for its high number of Catholics – many, like me, of Irish descent. I was an altar boy, a choirboy at the Catholic cathedral and around the age of 17 was being considered by my Jesuit educators as a potential priest. I had what I thought was a deep faith and I sincerely thought (agonised) about being a priest. But my faith turned out to be brittle and just an adolescent passion – maybe I read too many books (Dostoyevsky’s The Brothers Karamazov was a big influence) – and by the time I was 18, 19 I had lost any interest in religion.

I mention this part of my background to show that my attitude to religion isn’t one of “contempt prior to investigation” as the Big Book says of some people – in fact, I know well the religious impulses and feelings, having once experienced them. Incidentally I think people who lapse from their faith often throw themselves into political activism of various kinds to replace what they sense they’ve lost, but that’s not for me.

At university in Manchester, I started drinking regularly. At first it was normal, social drinking, based on parties, girls, friends, the usual things for young men. In my 30s I became more melancholy after various heartbreaks with women and started drinking heavily, often alone. By the time I was 44 I was drinking mechanically, like a robot, and it was now an empty experience. That included my last day of heavy drinking, which was, on the surface, spectacular.

I was staying with friends in New York and on July 4th, 2005, Independence Day, I went to watch baseball in the Bronx for over four hours (of steady drinking), then headed to Battery Park in Manhattan to see James Brown perform, followed by two parties in Brooklyn where I consumed four bottles of red wine, topped off by sleeping with a married woman. The following day, hungover and remorseful, I bought some books including a novel called Dry, by Augusten Burroughs, about a man who is forced to go to AA, hates it, then gradually likes it as he experiences the benefits of sobriety. I read this on the plane back to London a few days later and it planted a seed.

A few weeks on, with all the elation of drinking gone, I turned to AA in desperation. On the one hand, I had misgivings about the religious nature of most people in the programme (this is the nature of AA even in a huge, otherwise largely secular city like London.) This was in stark contrast to my non-AA life, where almost everyone I knew had grown up secular or was a lapsed Jew, Muslim, Anglican or Catholic like me. But on the other hand, after a single meeting I completely lost the desire to drink, and I decided to keep coming back. I will always be grateful to AA for changing my life for the better.

I took on commitments and got a sponsor. I was enthusiastic. But I was always aware of most people’s casual assumption that there is a god, and found it hard to adopt a belief in a higher power helping me towards sobriety. Like many in this position, I settled upon AA itself as my higher power – I mean the members who had empathy with me and who were helping me. After five or six years of this, having done the 12 Steps and become a sponsor for people (who were mostly agnostics and atheists), I realised I was mostly enduring the religiosity of our movement and wasn’t always getting what I needed to thrive. I was too often sitting silently at the back of the room, trying to tolerate what was – to me and a minority of other AA members – sometimes nonsense. I felt present but not involved, like the lapsed Catholic I am who goes to mass once a year with his dad at Christmas but who doesn’t take communion.

I think being in AA should include having a strategy for sharing my own ‘strength, hope and experience’ in meetings, even when the topic being discussed is God. It isn’t productive to angrily challenge what is being said by others in the meeting, and yet there is more to our sobriety and more to Alcoholics Anonymous than merely learning how to blend in. Some of you may know the despair that can accompany having to choose between pretending to fit in and being ostracised by the people around you.

So, with a friend, I revived the mini-tradition in London of meetings for agnostics, atheists and ‘freethinkers’ by setting up meetings for such people in north and east London. They are still flourishing and new ones which are nothing to do with me have also now formed in different parts of the city. In 2018 the General Service Conference of AA in North America voted to adopt the British conference-approved pamphlet, “The God Word: Agnostics & Atheists in AA.” It was translated into French and Spanish from the original English. I’m proud to say this pamphlet, which is now eligible for AA meetings all over the world, was largely the work of the small group I helped to set  up in Islington, north London on Thursday nights. We lobbied AA for a few years about it and eventually won.

In our meeting formats and in our general tone we try to be accepting, encouraging and supportive of anyone looking for a solution to their alcoholism irrespective of what they believe or don’t believe. There is no shortage of newcomers coming to our meetings.

But I also attend ‘mainstream’ meetings, where most people seem to believe in a god. Some are dogmatic about this (a minority – there are also, of course, dogmatic atheists who won’t engage in a dialogue with those who don’t share their views), but most people are friendly to me and accept that I’m secular. Occasionally I’m told point-blank by a religious fundamentalist that if I don’t find God as my higher power I’ll eventually get drunk. I just graciously decline their offer to help me. I’m strong and secure in my agnosticism and will not be marginalised. They have their opinion, I have mine, there’s no need for me to respond angrily. I sometimes point out that the AA headquarters in England (in York) completely accepts the legitimacy of the secular meetings we have set up. I’m strong and secure in my agnosticism. Nobody is going to marginalise me. We’re all in this together, all recovering alcoholics who face similar daily challenges of living a sober way of life.

Frankly, for 15 years I’ve seen AA sometimes – often – being ineffective even for those who strongly believe in a traditional god. This is probably due to the large amount of mystification that usually comes with AA’s message. The difficult parts of our process of sobriety, such as the unruly will, the unmanageable life, the dilemma of our powerlessness and our residual character defects are just ‘turned over’ to a supposedly loving god (a god who it seems chooses to make some alcoholics sober and leave others to carry on drinking ruinously.)

I thoroughly accepted Step 1, I surrendered. This broke the vicious cycle that happened when my own ideas about correcting a bad situation only made things worse. But ultimately, even believers need a more precise understanding of the solution than “Let go and let God.”

AA, I suggest, can sometimes benefit from greater clarity regarding down-to-earth strategies. For many, belief in God is a catalyst in a process that makes sobriety possible, but the process itself is all about tapping into “human power.”

Viewing AA’s solution as “God doing for us what we could not do for ourselves” is to accept magical thinking. I can’t accept it (not in an arrogant way, I hope. ) More relevant to me is the empathy one gets at AA meetings, the actions taken under the 12 Steps, the social co-operation. This is all the work of “human power,’ ordinary people. It has nothing to do with a supernatural entity. All the resources necessary for sobriety are already in the possession of men and women.

If for you God is the answer to helping you get sober, that’s fine by me, and in fact none of my business anyway. But for me and for so many others the most important and salient assets AA has are in-depth identification, a sense of community, pragmatic wisdom about addiction, and sometimes just having something to do something that doesn’t involve using alcohol or drugs.

I’m not really interested in religion, I’m not even that interested in ‘spirituality’ – I don’t really know what that word means, I never have, even when I was a teenage Catholic. I just want to keep up this sober life which most of the time gives me peace of mind. I’m in AA for the same reason as you are, whether or not you have religion.

I hope a time will come when non-believers aren’t a sub-group that is grudgingly tolerated but instead are regarded as people who show AA is more concerned about being properly effective than about preserving AA orthodoxy.

The best way to make people realise that us non-believers aren’t working against AA or practising Satanic animal sacrifices at night is to share a positive message of recovery that everyone can relate to; to share one’s experience, strength and hope in a manner that invites an empathetic understanding of how atheists and agnostics experience AA; to form friendships where you can, focusing on similarities and responding to differences graciously; to always assume that there is someone in the meeting who needs to hear that they are not the only one who feels the way they do; to do service at meeting level and perhaps beyond; reach out to newcomers of the same gender, simply reassuring them they’re not alone; embody an attractive version of recovery, remembering the phrase ‘attraction, not promotion.’ Use humour, if you’re good at that. This puts people at ease, especially self-deprecating humour.

Finally, let’s suppose the word ‘spirituality’ is meaningful. I discovered that my addiction wasn’t a by-product of alcohol abuse, it was ‘a false filling-up of spiritual emptiness.’ It was ‘a set of protective repetitions designed to eliminate difficult feelings and choices.’ (I’m quoting a writer friend of mine who wrote a very good book about heroin and alcohol addition.) My friend continues: “If it is a disease of More, then at last I am Enough. I’ve stopped taking life so personally. I’m not so plagued by shame and self-hate.’ What he really wanted in his years of drugging and drinking, he now realises – and I realise too – was connection and love. I’ve had those two things in AA, with both non-believers and religionists. I hope you get some too.


Brendan O’K is 59 and has been sober since July 23rd, 2005. As an agnostic, he found the Steps difficult to accept at times but did them with a sponsor all the same. Having adopted a more open-minded stance to things he disagreed with, he now felt able to get involved in establishing meetings for other agnostics, atheists and freethinkers in London, having seen many newcomers give up because of the programme’s religiosity. Once these meetings were up and running and providing support for fellow sceptics, he found he had got his resentments against AA off his chest and took part in both mainstream and secular meetings. Brendan wants to put back something of what was freely given to him by AA.


 

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EU Leaders Announce Huge Coronavirus Recovery Package to Help Rebuild Europe’s Economy

European Union (EU) leaders have finally reached an agreement after almost five days of fraught discussions on a huge post coronavirus recovery package. The package involves 750bn euros which will be given as grants and loans over a period of seven years to the 27-member bloc to counter the impact of coronavirus pandemic. it’s the joint biggest borrowing ever agreed by the European Union.

What is the European Union budget? To finance policies at the European level the European Union has a budget. It is mainly is an investment budget and represents around 2% of all public spending in the EU. It implements priorities agreed upon by all the EU members which in line with the principle of proportionality and subsidiarity adds more effectiveness to EU nations then actions taken at the local, regional, or national level. The commission, the parliament and the council all have a say on how the budget will be allocated and what will be the size of the budget.

The European Commission will borrow the money and give half (390 billion euros) of it as grants to the nations hardest hit by the pandemic including Italy and Spain and the rest (360 billion euros) will be given as loans. A new European budget was also agreed by the leaders of nearly 1.1 trillion euros from 2021 through 2027 which will create a combined spending power of 1.8 trillion euros.

The EU leaders said in a joint declaration that this ambitious and comprehensive package combines the classical budget with a special recovery package designed to overcome the effects of the pandemic and is in the best interest of the European Union. The focus of the coronavirus recovery package is to provide funding on three pillars including investing to help protect from any similar crisis in the future, helping businesses to rebound from the effects of the pandemic, and rolling out new measures to reform economies over the long haul. The decision was made after days of deadlock and talks that can be described as one of the most bitterly divided in years.

Also Read: Covid-19 Vaccine: Oxford’s Vaccine Early Trials Shows Promise

The EU is facing a big recession due to the pandemic and the hardest-hit countries need some economic and financial relief. The European Commission predicted a 7.4% slump IN 2020 in the EU economy but now it has risen to 8.3% which is considerably worse. Before today there were some disagreements regarding the conditions attached to the package, the overall size of the fund, and the mix of grants and loans.

The original plan of the commission included the coronavirus recovery package to be 500 billion euros which were to be distributed as grants and the remaining 250 billion as loans but the size of grants was contested by the so-called frugal countries, which include Netherlands, Sweden, Austria, and Denmark, as they were worried that funding the spending of other governments will burden them with debts.

The frugal nations were given the promise of rebates on their contributions to the EU budget which eventually won them over. French President Emmanuel Macron at one point banged his fists on the table as he believed that the frugal four were putting the European project in danger.

President of the European Council Charles Michel said at a press conference on Tuesday that this is a good and a strong deal and most importantly the right deal for Europe right now. He also said that it is the first time all European Union nations were jointly working to support each other against the crisis.

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The Labyrinth Facilitator

The Labyrinth represents a life’s journey. When I walked a labyrinth for the first time, I realized that I wasn’t lost, I had made no mistakes, for a labyrinth has no dead ends, just one path. That path is the unique road each person needs to travel in order to live in the present moment.

By Megan Woodward Moyer

It is July 2020 and I’m celebrating an anniversary – 13 years of sobriety. I’m so fulfilled today and so proud of this achievement that I often have to ask how this perfectionistic Atheist managed such a transformation?  How did I go from feeling so angry, afraid and hopeless to being filled with such purpose?

When I agreed to enter treatment as the result of my husband’s relentless insistence, I felt a brief moment of true relief and peace because I knew I had become an alcoholic and was begrudgingly making the decision to get help. This moment was immediately followed by a tremendous amount of fear and shame. Fear of having to admit to being less than perfect, shamed by the fact that everyone would know that I had failed in every possible way and, of course, fear of the unknown. To make it easier, I told myself that I was just doing this to get my husband off my back and that I’d have a 28-day break from him – which I really needed. I had no intention of admitting to my alcoholism or to staying sober for the rest of my life.

However, when I was confronted with an assignment that asked me to consider the concept of a Higher Power, all I could say was, “Oh, God!” I was contemptuous about all things spiritual and religious, but I was also still quite the perfectionist and doing my homework assignments well and submitting them on time was my MO.

An interesting thing happened while I was working on the assignment. I was outside and found a bird’s nest on the ground. Then I found several hazelnuts in the area, which became the eggs and then I started thinking about how I could clearly see a Higher Power at work in nature but that I was excluding myself from this realm.

WHY?

And why was I thinking about this instead of slamming the door shut on this concept? I was allowing myself to stray from my rigid thinking because, for the first time that I could remember, I felt safe and understood. I felt that I could explore this and, without realizing it, discovered the first inklings of spirituality. Did I have a Higher Power just waiting around for me to wake up and say “Grace?”

Eventually, I realized that I was equating religion with spirituality and that, in fact, they are very different. I was also beginning to realize that the comfort I was feeling was an awakening of my true spiritual nature – a spirituality that naturally exists within all of us, only needing connection to be ignited.

At that moment, I understood how I could believe in something greater than myself – through connection with others, my small spiritual flame could grow, and I would be able to be part of something much bigger and better – I would be part of the interdependent web of all existence. I no longer had to fake the assignment – I had actually completed steps 2 and 3 with honesty and integrity. I did not have to believe in someone else’s God or make one up for myself. The recognition of my spiritual nature was enough.

The realization that my life was not wasted occurred during my second month in treatment while on a Labyrinth walk. We attended a workshop titled, The History and Meaning of the Labyrinth. I assumed, as many people do, that labyrinths and mazes are synonymous and before the workshop began, I was engaging in morbid reflection, equating my entire life to the metaphor of being stuck and lost in a maze. The Workshop Facilitator began by explaining the difference between a labyrinth and a maze. She said that mazes have many entrances, exits, paths and dead ends. Labyrinths, although resembling mazes upon cursory observation, have only one path. In spite of the winding nature of the labyrinth, you cannot get lost if you follow the path. When I heard this my interest was piqued.

When our lecture was finished, we were invited to walk a large labyrinth painted on canvas in an adjacent room. I cleared my mind and set an intention of just being open-minded. As I began my walk, I found myself, reflecting on my life and letting go. Each turn in the labyrinth seemed to represent different times in my life. When I reached the center, I was calm and able to receive an intuitive message that my life had not been wasted and that I was not at a dead end. The paths I had taken were the ones I needed to travel in order to be at the center of that very labyrinth, right then and there. I felt the freedom of a release of psychic burdens that I had been carrying for a very long time. I meditated, mindfully, in the center of the labyrinth and when I felt ready to leave, I experienced a mounting sense of energy, forgiveness and joy. In the space of three hours, my whole perspective had changed from one of despair to hope. I had experienced something transformative.

Buoyed with my newly discovered spirituality and filled with hope, I was able to admit to my alcoholism and to leave the safety of the treatment center willing to do the hard work that I knew would come. I wanted to strive for the ultimate goal – emotional sobriety. That meant taking a look back and identifying the changes I would need to make. I needed to accept responsibility for my behavior and quit blaming others. I needed to be humble and teachable. I needed to change my thinking, work with others and learn to love myself.

With these goals in mind, I began to tackle huge issues with chronic and clinical depression, shame and codependency as well as developing a supportive community that would allow me to be an Atheist and not try to force anything upon me. It wasn’t long before I realized just how consumed I was by the “would’ves, should’ves and could’ves.”  They were like a very large dysfunctional family taking up space in my head and each of them had “or elses” attached. I know now how they found what they thought would be a permanent home in my head but I’m happy to say that they received eviction notices a while ago and when they try to convince me to let them move back in, I’m strong enough to respect myself and my boundaries and say “no.”

During these last thirteen years, I’ve moved through many highs and lows and have experienced the beautiful process of deep change. I now find myself in a loving and supportive relationship, I earned an MA in Psychology as well as certification as a Labyrinth Facilitator and as a Life Coach. All of these profound transitions have not only given me much joy but have also provided me with a purposeful life allowing me to work with others in deep and meaningful ways as well as knowing that physical and emotional sobriety are possible when in spiritual connection.


Megan Woodward Moyer has been sober since July 16, 2007. With this as inspiration, she became a Trained Labyrinth Facilitator, a Certified Life Coach Practitioner and earned an MA in Psychology.  More importantly, she’s experienced life and the process of deep change. 

Her passion is working with women who are also navigating the process of change and major life transitions.  She resides in Santa Barbara, California, and loves spending time with her family, especially her grandchildren, her partner and her 12-step community. 

You can learn more about Megan by visiting her wonderful website: MeganWMoyer.


 

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Researchers Opinion Regarding Pornography as A Public Health Crisis

According to the existing evidence, pornography has been described as a public health crisis. But there is a conflict in the researcher’s opinion regarding this issue.

Boston University School of Public Health (BUSPH) researchers suggest that though pornography may have an undesirable effect on some of the people, considering it a public health emergency can lead to harm. They have reasoned against this claim in an editorial to be published in the February issue of the “American Journal of Public Health“.

Along with their argument against pornography as a public health emergency, they have also provided an explanation about why making such a claim can harm the public’s health.

Dr Emily F. Rothman is a Professor at Boston University School of Public Health in its Community Health Sciences Department. Dr Kimberly M. Nelson had knowledge about both psychology and public health and is an Assistant Professor at the same department of BUSPH.

In the editorial, they have written that presenting pornography as a public health concern or something that can harm public health is a political act. Additionally, this claim doesn’t manifest the best existing evidence and is based on an ideology that negates several fundamental principles of public health promotion.

Pornography has been acknowledged as a public health emergency in almost seventeen states of the U.S. via non-obligatory resolutions. But according to the authors, the public health crisis definition criterion isn’t fulfilled by pornography.

With the passage of time, there has been a slow and gradual increase in the use of pornography instead of a sudden climax.

Also Read: Gender Disparity Related to Poor Sexual Health in the UK

Further investigation has shown that pornography hasn’t any devastating effect on the local health systems. And one can’t expect direct and sudden population displacement, property destruction, disease, or death as a result of pornography.

The available evidence has shown that the use of pornography may lead to adverse effects on the health of some individuals. But Rothman and Nelson explained that many of these adverse health impacts were absent in a considerable number of people.

Instead, in some individuals, safer sexual behaviours like solo masturbation were observed as positive effects of pornography. Authors write that rather than ending pornography entirely, it is better to persuade the public to avoid extreme pornography and to limit its frequent use.

Taking these steps can facilitate in reducing the harms caused by pornography. In the same February issue of the journal, Dr Nelson and Dr Rothman have provided an outline regarding their pornography literacy program via the help of their colleagues.

This program may be proved as helpful for adolescents living in Boston. Rothman and Nelson have also answered the question “how describing pornography as a public health emergency may lead to deterioration of health?”

They have written that claiming pornography as public health crisis may cause shifts in funding sources or result in an unwarranted policy that may lead to a reduction in public health workforce to deal with real emergencies or crises.

They added that making such a claim for any sexual behaviour is adversative to public health and may limit sexual freedom.

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Twitter Hack: Several High-Profile Accounts were Targeted in Arguably the Biggest Security Incident in Twitter’s History

A major security breach occurred on twitter on Wednesday which saw several high-profile Twitter accounts hacked. Cyber Security analysts have given a warning that the personal data belonging to the accounts targeted in the twitter hack may be compromised. The hackers used these accounts to spread a scam involving cryptocurrency. Official Twitter accounts of health organizations such as NHS, CDC, and WHO are also at the risk of being hacked.

Twitter support team believes that it was a social engineering attack by the hackers who targeted twitter staff with access to the internal tools and systems of twitter and got successful. More than 300 people were fooled by this twitter hack and sent more than 100,000 dollars to the hackers before the tweets were taken down and all the verified accounts were locked.

The accounts that were hacked included that of the former US president Barack Obama, Kim Kardashian West, Jeff Bezos, Kanye West, Warren Buffet and Mike Bloomberg, all of them were saying the same thing that they are feeling generous due to coronavirus and will pay back double in Bitcoins what the people will send to them.

These scams stating “double your Bitcoin” have been seen on Twitter for years but simultaneous hacking of actual accounts of several high-profile people on a large scale is unprecedented. So many people were scammed at the same time which implies that there is a problem with the Twitter platform itself.

Also Read: Putting Exercise Bikes at Offices and Encouraging Employees to Use them Will Improve Heart Health, says the Scientists

The motive of this twitter hack seemed clear that the hackers thought of making what money they can and what little time they had because it was obvious that these fake tweets won’t stay there for long. It’s important to remember however that cyber-criminals are known to fill their bitcoin wallets using their own funds to make the people believe that the scam was successful.

Many angry users and law enforcement will have some questions for Twitter management as to how could this happen. A hack of this nature is not only concerning due to any financial scams but also the majority of world leaders including US President Donald Trump use twitter and make some important announcements on the social media platform. A potential hack that may take control of these accounts could have huge consequences.

Twitter CEO Jack Dorsey said it was a tough day for all the people connected with twitter’s management. He assured the people that he and his team will share complete details when they know more about what exactly happened. Dorsey’s own twitter account was hacked last year but the mechanism due to which that hack occurred was fixed, so that mechanism has no reason to be blamed in this case.

Security experts believe that it is fortunate that the hackers were only interested in earning some bitcoins or else they could have caused mass chaos across the globe. Twitter’s share price suffered due to this hack as it went down by more than 4 percent in late trading. It has started recovering since.

While some states have been known to be involved in the hacking of social media platforms, there are suggestions that this twitter hack was the work of amateurs. This attack has revealed the flaws in twitter’s internal system which could be exploited by terrorist organizations in the future to cause chaos or even start a war.

The post Twitter Hack: Several High-Profile Accounts were Targeted in Arguably the Biggest Security Incident in Twitter’s History appeared first on Spark Health MD.

Alcoholics Anonymous vs. Other Approaches: The Evidence Is Now In

An updated review shows it performs better than some other common treatments and is less expensive.

By Austin Frakt and Aaron E. Carroll
Published on March 11, 2020 in The New York Times

For a long time, medical researchers were unsure whether Alcoholics Anonymous worked better than other approaches to treating people with alcohol use disorder. In 2006, a review of the evidence concluded we didn’t have enough evidence to judge.

That has changed.

An updated systematic review published by the Cochrane Collaboration found that AA leads to increased rates and lengths of abstinence compared with other common treatments. On other measures, like drinks per day, it performs as well as approaches provided by individual therapists or doctors who don’t rely on AA’s peer connections.

What changed? In short, the latest review incorporates more and better evidence. The research is based on an analysis of 27 studies involving 10,565 participants.

The 2006 Cochrane Collaboration review was based on just eight studies, and ended with a call for more research to assess the program’s efficacy. In the intervening years, researchers answered the call. The newer review also applied standards that weeded out some weaker studies that drove earlier findings.

In the last decade or so, researchers have published a number of very high-quality randomized trials and quasi-experiments. Of the 27 studies in the new review, 21 have randomized designs. Together, these flip the conclusion.

“These results demonstrate AA’s effectiveness in helping people not only initiate but sustain abstinence and remission over the long term,” said the review’s lead author, John F. Kelly, a professor of psychiatry at Harvard Medical School and director of the Recovery Research Institute at Massachusetts General Hospital. “The fact that AA is free and so widely available is also good news.”

“It’s the closest thing in public health we have to a free lunch.”

Studies generally show that other treatments might result in about 15 percent to 25 percent of people who remain abstinent. With AA, it’s somewhere between 22 percent and 37 percent (specific findings vary by study). Although AA may be better for many people, other approaches can work, too. And, as with any treatment, it doesn’t work perfectly all the time.

Rigorous study of programs like Alcoholics Anonymous is challenging because people self-select into them. Those who do so may be more motivated to abstain from drinking than those who don’t.

Unless a study is carefully designed, its results can be driven by who participates, not by what the program does. Even randomized trials can succumb to bias from self-selection if people assigned to AA don’t attend, and if people assigned to the control group do. (It may go without saying, but we’ll say it: It would be unethical to prevent people in a control group from attending Alcoholics Anonymous if they wanted to.)

Despite these challenges, some high-quality randomized trials of Alcoholics Anonymous have been conducted in recent years. One, published in the journal Addiction, found that those who were randomly assigned to a 12-step-based directive AA approach, and were supported in their participation, attended more meetings and exhibited a greater degree of abstinence, compared with those in the other treatment groups. Likewise, other randomized studies found that greater Alcoholics Anonymous participation is associated with greater alcohol abstinence.

Alcoholics Anonymous is often paired with other kinds of treatment that encourage engagement with it. “For people already in treatment, if they add AA to it, their outcomes are superior than those who just get treatment without AA,” said Keith Humphreys, a Stanford University professor and co-author of the new Cochrane review.

Alcoholics Anonymous not only produced higher rates of abstinence and remission, but it also did so at a lower cost, the Cochrane review found. AA meetings are free to attend. Other treatments, especially those that use the health care system, are more expensive.

One study found that compared with Alcoholics Anonymous participants, those who received cognitive behavioral treatments had about twice as many outpatient visits — as well as more inpatient care — that cost just over $7,000 per year more in 2018 dollars. (Cognitive behavioral treatments help people analyze, understand and modify their drinking behavior and its context.)

Another study found that for each additional AA meeting attended, health care costs fell by almost 5 percent, mostly a result of fewer days spent in the hospital and fewer psychiatric visits.

AA meetings are ubiquitous and frequent, with no appointment needed – you just show up. The bonds formed from the shared challenge of addiction – building trust and confidence in a group setting – may be a key ingredient to help people stay on the road to recovery.

Worldwide, alcohol misuse and dependence are responsible for 3.3 million deaths per year, 10 times the number of fatalities from all illicit drugs combined.

In the United States, alcohol is a larger killer than other drugs; accounts for the majority of all addiction treatment cases; and is responsible for at least $250 billion per year in lost productivity and costs related to crime, incarceration and health care. Moreover, American deaths related to alcohol more than doubled between 1999 and 2017.

Reducing the human and financial burdens of alcohol is an often overlooked public health priority, and the new evidence suggests that on balance one of the oldest solutions — Alcoholics Anonymous has been around almost 85 years — is still the better one.


Austin Frakt is director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and a senior research scientist with the Harvard T.H. Chan School of Public Health.

Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine and the Regenstrief Institute who blogs on health research and policy at The Incidental Economist and makes videos at Healthcare Triage. He is the author of “The Bad Food Bible: How and Why to Eat Sinfully.”


 

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Agnostics and the AA Program

By Witek D. 

We agnostics and atheistic members of AA are sometimes criticized for changing the content of the 12 Steps. It’s partly true, but we MUST do it! We have to do this in order to stay in AA and to implement its program honestly.

We modify the content of only those Steps that are “impassable to us”. Let’s take, for example, Step 7: “Humbly asked Him to remove our shortcomings.” “Him,” written with a capital letter, means an extraterrestrial being, a God, who intervenes in people’s lives, removes defects, heals alcoholism and other diseases, according to his unfathomable will.

Well, agnostics, atheists, freethinkers, skeptics, liberal humanists, however we may call ourselves, do not believe in such a God.

This step, in its original form, is impossible for us to make. We can pretend that we practice it as written, cheat ourselves and others, or omit it. Both ways are incompatible with honesty, which we clearly should regard as an essential element of a sober life. What is wrong with the content of Step 7 in this secular version: “With humility and openness of mind we are looking for a way to eliminate our shortcomings”? Doesn’t it sound sensible? It contains the humanistic belief that we people are personally responsible for our lives, and we can and must face our flaws.

We take personal responsibility but that has nothing to do with isolation. We want to benefit from the help and support of other people, AA groups and the entire fellowship. We don’t believe that SOMEONE will do it for us, but someone, in the sense of other people, can help us. We avoid magical thinking that “God is doing for us what we could not do for ourselves” if only we pray long enough. We know that all AA is saturated with such theistic thinking, but we accept the right of all people to believe – or not believe – as they wish. At the same time, we are asking the traditional majority in AA to accept our disbelief in such solutions.

An acceptance that will allow us to feel fully like members of AA.

We want to be part of AA as its secular, liberal, minority stream. We think that together we could help more still suffering alcoholics. Acceptance, however, means more than just saying “you have the right to exist.” It is also an opportunity to organize secular AA meetings, to publish literature written by agnostics, and to make the necessary modifications to the 12 Steps enabling us to implement this program realistically.

So far, we agnostics in Poland have only one online meeting and no official literature, but we want to believe that alterations are possible. When? Time will show.

Recently I heard from one of the members: perhaps, instead of changing Steps, you could change your views? It would be safer. Really? This is my answer: It is probably easier to die when you believe that something will be there later, so that many of us, confronted with the end of our existence, would choose to convert to a religion. It’s very human and understandable.

On the other hand, it seems more honest and brave to be able to say: I am responsible for my life, for my good and bad deeds. I don’t blame anyone for anything. I don’t believe that “someone” will heal me from alcoholism, but also don’t accuse that “someone” of all the terrible evil that has happened in the world and still happens.

But what about life after death? I think that very few reasonable people believe in a heaven in which we will meet our loved ones and live forever. In happiness and joy, singing songs praising the Creator. Maybe I’m wrong? I don’t believe in it anyway.

Stephen Hawking

The two greatest scientists of the last 100 years, Albert Einstein and Steven Hawking, wrote that from the first nanosecond of the Big Bang almost all further history of the universe is known and follows precisely the rules of physics. There is no sign of any interference from God. The question is, who caused this first explosion and who planned it all? Here is a place for a higher power incomprehensible to our human mind which provided an impulse to start, but that’s it: no subsequent interference in the fate of the world and people’s lives. No particular intervention in our deeds and no requirement for prayers or specific behaviors. Agnostics, like Einstein, Hawking or me, can believe in such kind of power.

Summarizing, I consider myself an agnostic, and I think I would like to stay in this position. Another bonus of being an unbeliever is the real pleasure that comes from reading articles shared by other unbelievers and posted by AA Agnostica.


Witek D., 61 years old, has been sober since December 27, 1994. He has been living in a small town in the middle of Poland, where he attends his home group, “Compass”. For several months he also has had another home group: ”AA in AA”,  “Agnostics and Atheists in AA” (an online meeting).

Active in AA service at all levels, in the years 2009-2013 he was a member of the Polish Board of Trustees. Witek openly talks about his agnostic views and just like Albert Einstein, he considers “The idea of a personal God is a childlike one… which I cannot take seriously”. He is concerned with the fate of agnostics and atheists in AA, tries to translate into Polish some articles from AA Agnostica and sends them to fellows potentially working on their recovery and includes them on the Polish website: AAwAA (In English: Agnostics and Atheists in AA). He attended the International Conference of Secular AA in Toronto in 2018.


 

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New Study Explains What Causes Infertility in Women

Infertility in women affects a large number of relationships around the world and one of the primary factors that influence the ability of a person to procreate is age. Infertility is the inability to get pregnant and instead of a deficiency, it is considered as a disease all over the world. Approximately, one of every eight U.S couples is attempting to get pregnant or keep up a pregnancy.

In the course of the most recent six years, a group of Estonian geneticists drove by Associate Professor Agne Velthut-Meikas and Ph.D. student Ilmatar Rooda from the TalTech Department of Chemistry and Biotechnology have analyzed genes previously related basically with female hormone synthesis and ovarian follicle improvement. The findings propose that these genes may play a more complex role in oocyte development than previously accepted

Bidirectional communication i.e. signaling must happen between the cells in the ovary for the generation of a new life and oocyte maturation. A small filled sac called follicle where an oocyte resides ruptures at ovulation and release the oocyte into the oviduct.

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For oocyte maturation and its release from the follicle, the follicle, and the oocyte cells i.e. granulosa cells encompassing it must exchange signals with one another over a specific timeframe. Some hormones are also produced by these granulosa cells that are important for effective adherence of the embryo to the uterus wall and the survival of early pregnancy. 

Some common causes of infertility in women are endometriosis, implantation failure, problems with the menstrual cycle, structural problems of the reproductive system, failure of an egg to mature properly, infections, and failure to ovulate.

Study in detail here.

Velthut-Meikas, an associate Professor says that in addition to other things, the production and working of two proteins in ovarian granulosa cells are required. These significant proteins are aromatase and the follicle-stimulating hormone receptor (FSHR). FSHR gets the signal of a follicle-stimulation hormone from the pituitary organ, prompting the growth of ovarian follicle and proliferation of granulosa cells.

The present study demonstrates that these genes are produced besides the small RNA molecules (microRNAs) and the hitherto known proteins which after binding to their target genes, determine if these genes assume their expected role in a cell. The microRNA targets are responsible for crucial infertility in women.

In this way, the previously mentioned proteins, already undescribed short microRNA atoms are from aromatase and FSHR genes. The microRNA targets got from the FSHR gene assume basic roles in activating the oocyte maturation and ovarian follicle development. The microRNA targets derived from the aromatase gene are associated with initiating changes in the ovarian tissue required for the process of ovulation.

Both microRNAs probably regulate the functioning of different tissues including mammary glands, the endometrium, adipose tissue, etc and the synthesis of steroid hormones in the ovary.

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Agne Velthut-Meikas says that these study findings are helpful because they provide completely new information on how ovaries function. This information is extremely valuable for diagnosing the reasons for infertility in women and finding new treatment options for them. 

Another highly topical issue is the fertility of cancer patients and everyone around the globe is trying to preserve its ripeness. This includes a process where some portion of the patient’s gonad tissue is frozen before chemotherapy that demolishes the follicles. So, women can conceive their biological children after treatment. The way toward continuing oocyte development from frozen tissue should be studied more.

 

The post New Study Explains What Causes Infertility in Women appeared first on Spark Health MD.

Applying Buddhism in Addiction Recovery

The Buddhist philosophy, as exemplified by (its) eight points, could be literally adopted by AA as a substitute for or in addition to the Twelve Steps. Generosity, universal love and welfare of others rather than considerations of self are basic to Buddhism.

Akron Pamphlet, “Spiritual Milestones in Alcoholics Anonymous”, edited by Dr. Bob, 1940

By Dale Vernor
Originally posted on I Am Sober

Craving. It’s the one word that can sum up the debilitating condition known as addiction. Regardless of the myriad of reasons people may put up to explain their unhealthy obsession, the root cause always lies in an inordinate need – an excessive desire for something they think can make them happy or fill up an empty void in their lives.

In the case of substance abuse, the focal point of a person’s addiction is usually drugs, alcohol, and the like.

Addiction is destructive. It does not fulfill lives, it ruins them instead.

Buddhism in Addiction Recovery

While typical treatment of drug and alcohol addiction is often largely secular in nature, there are also those which are largely anchored on faith. These faith-based drug rehabilitation programs can either cater to a specific religious group, or they can be non-denominational in nature (a good example would be 12-Step Programs). Notwithstanding slight variations, these programs all espouse a similar concept: that people can cure their addiction with the assistance of a higher power.

This brings us now to Buddhism. Call it a religion, a philosophy, a way of life, or whatever, but it cannot be denied that its teachings translate very well insofar as knowing the origin of, and treating addiction.

Also known as the Middle Way, Buddhism teaches the virtue of moderation – that a truly happy life is one that is lived midway between excessive indulgence and extreme asceticism.

For people who want to curb their addiction for good, you’re not required to be a Buddhist to practice and benefit from its teachings. Just knowing and following the main principles – especially the Four Noble Truths and the Eightfold Path – can definitely help you in your road towards an addiction-free life.

The Four Noble Truths of Suffering (and its Cure)

The central tenet of Buddhism, the Four Noble Truths, can be basically summed up thus:

  1. Suffering exists;
  2. The cause of suffering is selfish and ignorant desire;
  3. There is a way to end that suffering; and
  4. Following the Noble Eightfold Path can bring an end to the suffering.

According to the Buddha, a person who does not overcome his worldly desires is doomed to repeat his unhappy existence through an endless cycle of death and rebirth – a condition known as samsara.

However, once that person reaches enlightenment – that is, he truly knows the cause of his suffering and sweeps away all material attachments – he ends his cycle and attains nirvana, which is the state of enlightenment and true happiness.

For people suffering from an addiction, the simple truth that can be gleaned from the Buddha’s teaching is this: Unless they put an end to their desire for alcohol or drugs, they will continue their own cycle of suffering towards destruction.

The Noble Eightfold Path: A Cure to Suffering

Sharing his secret to enlightenment with his followers, the Buddha emphasized eight steps a person should follow and practice if he wishes to attain nirvana. Known as the Noble Eightfold Path, this collective set of teachings can help those who want to free themselves from the endless cycle of suffering, death, and rebirth.

The 8 steps can be basically summarized as:

  • Right understanding
  • Right thought
  • Right speech
  • Right conduct or
  • Right livelihood
  • Right effort
  • Right mindfulness
  • Right focus

Steps One and Two build up wisdom.

Steps Three, Four, and Five improve mental conduct, virtue, and morality.

Steps Six, Seven, and Eight help develop mental discipline.

Put together, these steps help create a mentally strong, upright, and disciplined individual.

Relevance of the Eight Steps to Addiction Treatment

For a person suffering from an addiction, the steps can serve as helpful tools in his treatment and rehabilitation.

Through Steps 1 and 2, the person can begin to fully understand the cause of his addiction and commit to healing himself.

Through Steps 3, 4, and 5, the person can make the needed adjustments to his lifestyle and activities.

Through Steps 6, 7, and 8, person is able to know the dangers of relapsing and conscientiously chooses not to stray from the right path anymore.

Takeaway

Again, you are not required to be a Buddhist to apply the Eightfold Path to your treatment. So long as it (and the other teachings of Buddhism) can help you, then by all means practice them constantly.

According to Buddhist lore, the Buddha often emphasized that the end of suffering begins when one admits his imperfections and takes the necessary steps to rectify them.

Hence, admitting you have a problem is a bold first step towards recovery. While the journey may be long and harsh, so long as you keep going and never give up, then you’re already halfway towards your goal. Once you totally free your body and mind from addiction forever, then you will definitely have attained your nirvana.


Dale Vernor is a writer and researcher in the fields of mental health and substance abuse. After a battle with addiction Dale was able to find sobriety and become the first in his family to earn a Bachelor’s degree. Dale enjoys writing about mental health and addiction so that more people can understand these highly stigmatized issues. When not working you can find Dale at your local basketball court.


We have posted a number of articles about Buddhism and recovery on AA Agnostica. Here are previous ones:

Buddhist Precept: Intoxicants Cloud the Mind (April 7, 2019)

Recovery – What’s Buddhism Got to Do With it? (March 27, 2019)

Buddhist Recovery Summit (August 6, 2017)

A Buddhist Path to Recovery (March 24, 2016)

The Buddha and Bill W. (March 11, 2015)

AA as “stealth Buddhism” (December 14, 2014)

Buddhism and the 12 Steps (July 16, 2014)

A Buddhist’s Views on AA (August 4, 2013)


 

The post Applying Buddhism in Addiction Recovery first appeared on AA Agnostica.