The Orange Papers

[MisterMan]

has this been mentioned in this forum yet? I thought they were a good argument and quite valid. Feedback?

http://www.orange-papers.org/

[garro]

I am not an AA member myself and do not subscribe to their theory of addiction. I do believe that they have done a lot to help many get sober and stay that way. I have met people for who the program has worked. AA has done far more for the drunk than the author of this vile ebook which offers nothing positive. The writer obviously has a grudge and sees an easy target.

I have found the arguments in the book to be very weak. Where have his statistics come from? AA doesn't keep a list of attendees. Other arguments seem to be all over the place. AA and the Nazis?

Edited January 2, 2008 by garro

[Pundi64]

has this been mentioned in this forum yet? I thought they were a good argument and quite valid. Feedback?

http://www.orange-papers.org/

AA has worked for me, and countless millions all over the world, this guy and his remarks are _ ull _ hit!

[kopite]

AA allthough i dont get it, has literally saved my mums life. she would be dead by now without. 100%

met lots of her AA friends back home, and she made some when she was going to AA in pattaya on her holidays.

top bunch of lads and lasses. cant believe some of you went out of your way like you did. thanks

[sgunn65]

As someone who has been involved in Drugs as a user for 15 years and as a counsellor and manager for a further 15 years I have seen the good and bad of AA.

There will be thousands of real stories about how AA saved them and there is no denying it. However just because something is popular doesn't mean its good. AA is popular because there is nothing else and therefore it will always help people and that is good.

It would be interesting to see how it would fare against more modern treatment modalities if they had the widespread coverage that AA has.

Read the Orange book, it also shows what is good about AA and there are good things.

My biggest problem is that it creates victims. Cancer is an illness alcoholism is a learned behaviour. If you believe you are sick you are likely to act sick and if you believe you are well you will behave as though you are well.

However you call it Alcoholism is not a disease or a dis-ease and once you stop drinking you become an ex drinker not an alcoholic who hasn't had a drink. Smokers become ex smokers and nicotine is the most addictive chemical known to man.

However my argument will remain just an argument whilst so little money is invested in community support (especially in the US) and people only have AA.

I always say that as a support system if you use it the right way you can get something from AA just don't replace drugs or drink for the rooms!

[Chris Lawrence]

Sgunn, put a drink in an ex-drinker who is or was an alcoholic and they do for the most part turn back to where they left off? I just beg to differ thru experience but on the same path.

But then this then messes with the concept of CBT, which I do believe helps people. The only problem with a lot of these type of programs are if not state run are expensive for your normal garden variety alcoholic or addicts. Usually some rich kids parents foot the bill or wealthy socialite are found in the upmarket rehabs.

I worked in NGO's and state run organisations when people had no where else to go. Humbling for them and me. The one thing I know is that this disease does not discriminate. It don't care who it takes.

I also worked in a CBT NGO organisation. It was free to enter this establishment except for a portion of your dole money.

Its easy to knock an organisation that won't be drawn into public controversy as that is part of the program. It just gets on with the role it has in recovery.

[sgunn65]

Sgunn, put a drink in an ex-drinker who is or was an alcoholic and they do for the most part turn back to where they left off? I just beg to differ thru experience but on the same path.

But then this then messes with the concept of CBT, which I do believe helps people. The only problem with a lot of these type of programs are if not state run are expensive for your normal garden variety alcoholic or addicts. Usually some rich kids parents foot the bill or wealthy socialite are found in the upmarket rehabs.

I worked in NGO's and state run organisations when people had no where else to go. Humbling for them and me. The one thing I know is that this disease does not discriminate. It don't care who it takes.

I also worked in a CBT NGO organisation. It was free to enter this establishment except for a portion of your dole money.

Its easy to knock an organisation that won't be drawn into public controversy as that is part of the program. It just gets on with the role it has in recovery.

Knocking an organisation is absolutely NOT what I am doing! I think that is clear from my post.

My disagreement is with the theoretical basis, the medical model. It is not a disease!! As you say, put a drink inside a former alcoholic and they may go back to previous learned behaviour but that is the point. You dont put a drink into them they do it themselves. It is a choice. If I go out and have a cigarette then I am likely to go back to smoking. But I am not a smoker I am an ex smoker and no-one seems to argue that point.

And for the record apart from my last job I have worked for charities all my career. In England there are CBT places that are Government funded, in fact CBT is the fastest growing modality in the UK for solution focused work.

Whatever works works and thats good. SOmeone with a broken ankle could use crutches all their life but would it not be better to put plaster on, do some physio and get themn walking again without crutches??

Mine is just a point of view and that view is that we are responsible for getting into a mess and we are responsible for getting out of the mess. Please re-read my e mail and you will see I am not knocking AA.

[Neeranam]

However you call it Alcoholism is not a disease or a dis-ease and once you stop drinking you become an ex drinker not an alcoholic who hasn't had a drink

You obviously were not an alcoholic or understand the nature of the disease.

[sgunn65]

However you call it Alcoholism is not a disease or a dis-ease and once you stop drinking you become an ex drinker not an alcoholic who hasn't had a drink

You obviously were not an alcoholic or understand the nature of the disease.

A brilliant and consise analysis from an expert! Thank you for the depth of your argument and thought that must of gone into it.

Did you actually bother to read my first post which very clearly sets out my background? Its this kind of 5 year olds argument that does no good service to the Medical model followers. If you want to make petulant remarks do it elsewhere, I was under the impression that this was a grown ups forum and that people OF ALL PERSUASIONS could put forward their opinions without silly tit for tat remarks like this.

SInce you could not be bothered to read I will say it again. I have 30 years experience from both sides of the fence and this is my opinion based on that. ANd you are right I can't understand the nature of the disease since I do not believe it to be a disease but a learned behaviour. Telling me I am wrong and suggesting I am ignorant without any back up will not change my mind.

[garro]

<br />

However you call it Alcoholism is not a disease or a dis-ease and once you stop drinking you become an ex drinker not an alcoholic who hasn't had a drink

<br /><br />You obviously were not an alcoholic or understand the nature of the disease.<br />

<br /><br />A brilliant and consise analysis from an expert! Thank you for the depth of your argument and thought that must of gone into it.<br /><br />Did you actually bother to read my first post which very clearly sets out my background? Its this kind of 5 year olds argument that does no good service to the Medical model followers. If you want to make petulant remarks do it elsewhere, I was under the impression that this was a grown ups forum and that people OF ALL PERSUASIONS could put forward their opinions without silly tit for tat remarks like this.<br /><br />SInce you could not be bothered to read I will say it again. I have 30 years experience from both sides of the fence and this is my opinion based on that. ANd you are right I can't understand the nature of the disease since I do not believe it to be a disease but a learned behaviour. Telling me I am wrong and suggesting I am ignorant without any back up will not change my mind.<br />

<br /><br /><br />

I think that it is also worth remarking that it's in your financial interest for it to be a 'learned behavior' considering the fact that you were selling an expensive course of treatment on another thread. Please don't get me wrong, I'm not saying that you should not get paid for your thirty years of experience - of course you should. My point is that you 'have a dog in this race' so to speak. Your support of the critics of AA should be considered in this light.

I spent a lot of time going from treatment to treatment center in the UK and Ireland and grew skeptical of those making a living out of addicts. The great thing about AA is that it is free and while I don't subscribe to the AA philosophy myself, nor to the disease model, I do know that it works. You have admitted as much yourself. I dislike it when people like the author of the 'orange papers' go out of there way to rubbish another man's philosophy.

[Neeranam]

I think that it is also worth remarking that it's in your financial interest for it to be a 'learned behavior' considering the fact that you were selling an expensive course of treatment on another thread.

Lol, that explains a lot. I suspected as much.

[Chris Lawrence]

Good post Garro.

Sgunn, my last sentence in post above was more refrence to the orange paper, not you. Sorry I didn't make that clear.

I have looked at some very expensive procedure's with different rehabs. The best/worst was the miracle drug being used in Isereal some years ago. $7500 and $9500 for the treatment paid and administered by parents. The upshot of it was they could still use any other drug but a opium based drug. The support was parents first line of defence then the medico once a week? He showed me the books. Collected about $1.7 m in 9-10 mths. I new one of the councilors at the service; they were at wits end and starting to also consider AA/NA as after care.

All the treatments that are available can be good one's it just depends were the addict/alcoholic is on the pendalum. Its the maitenance that goes with running a service.

My friend has been running the same service for over 20 years. I remeber him asking me what is it you need to show the client. I said love; to which he added to be also loved back. What he was refering to was empathy compassion understanding and a good strong hand. You also need to be a strong role model for the client. Its also the work u put in when u are not at work. This is how to be a success in treating people with the disease of alcohol.

Treatment in many cases is only as good as the after care that is offered. If you are going to make money from treatment it is best to collect it from the people that can afford it. Unfortunatly I never looked after any A listers. I met a lot of ex-wealthy people who had all their wealth and family taken. But they had no money left.

[sgunn65]

I think that it is also worth remarking that it's in your financial interest for it to be a 'learned behavior' considering the fact that you were selling an expensive course of treatment on another thread.

Lol, that explains a lot. I suspected as much.

You suspected as much Sherlock??? What gave me away? Was it my mask and swag bag?? Another pithy one liner!!! Instead of building up your post count why not build your credibility and put something behind your dismissiveness. I am not hiding behind, "I say it so it is true" statements.

I have no problem in working in substance misuse. That is how I make my living. The way I work is well documented and backed up with good science and research. You believe it is a disease. OK prove it. Show me the evidence of the cancerous growth or viral invasion that would prove that addiction is the disease.

If believing you are helpless keeps you safe then I have no problem with that. I may not think it is the best way but that is different. But you didn't have a biopsy and get told you had a disease' you repeated the same behaviour for many years until it was the only way. That is learnt behaviour. ANd just as your cancerous growth was not cut out you have had to learn new behaviour. How you keep going is up to you and Anonymous is free (which, incidently, I think is brilliant) so great. Just bear in mind that not everyone agrees with you and if you want to enter into the debate then have the good grace to do it in an adult fashion. The world is a big place and there is room for everyone even those you disagree with. As the man said, "I will die fighting fascism but I will also die for your right to be a fascist".

[jumnien]

I think that it is also worth remarking that it's in your financial interest for it to be a 'learned behavior' considering the fact that you were selling an expensive course of treatment on another thread.

Lol, that explains a lot. I suspected as much.

You suspected as much Sherlock??? What gave me away? Was it my mask and swag bag?? Another pithy one liner!!! Instead of building up your post count why not build your credibility and put something behind your dismissiveness. I am not hiding behind, "I say it so it is true" statements.

I have no problem in working in substance misuse. That is how I make my living. The way I work is well documented and backed up with good science and research. You believe it is a disease. OK prove it. Show me the evidence of the cancerous growth or viral invasion that would prove that addiction is the disease.

If believing you are helpless keeps you safe then I have no problem with that. I may not think it is the best way but that is different. But you didn't have a biopsy and get told you had a disease' you repeated the same behaviour for many years until it was the only way. That is learnt behaviour. ANd just as your cancerous growth was not cut out you have had to learn new behaviour. How you keep going is up to you and Anonymous is free (which, incidently, I think is brilliant) so great. Just bear in mind that not everyone agrees with you and if you want to enter into the debate then have the good grace to do it in an adult fashion. The world is a big place and there is room for everyone even those you disagree with. As the man said, "I will die fighting fascism but I will also die for your right to be a fascist".

Mr. Gunn,

Sounds like you are easily frustrated and angered. We hope your stay in Thailand will provide much time for relaxation. You might try an intensive vipassana retreat. They usually run about 1,500 baht for a ten-day course. You will be astounded at the results and your stilled mind will make it much easier to heal the substance misusers who arrive with 8,000 pounds for your 28-day program. We will save a 20 baht seat for you and all here in the rooms!

[Chris Lawrence]

WHO DSM 4, didn't they say it was a disease. The reason for this is that people could start getting treatment for this as a health issue?

'The DSM-IV criteria for abuse included hazardous use was legal problems, failure to fulfill major

role obligations (formerly a DSM-III-R dependence criterion) and continued use despite

social or interpersonal problems.' Doesn't they also see it as major depression?

I haven't read up on the above, but u did ask. There are just some things I know really work.

[Neeranam]

Q. Is Alcoholism a Disease?

From National Institute on Alcohol Abuse and Alcoholism

About.com Health's Disease and Condition content is reviewed by Steven Gans, MD

A. Yes. Alcoholism is a chronic, often progressive disease with symptoms that include a strong need to drink despite negative consequences, such as serious job or health problems. Like many other diseases, it has a generally predictable course, has recognized symptoms, and is influenced by both genetic and environmental factors that are being increasingly well defined. (See also Alcohol Alert No. 30: Diagnostic Criteria for Alcohol Abuse and Dependence.)

[Neeranam]

Managing Alcoholism as a Disease

By Thomas R. Hobbs, Ph.D., M.D.

Thomas R. Hobbs, Ph.D., M.D., is medical director of the Physicians’ Health Programs (PHP). The PHP, a program of The Educational and Scientific Trust of the Pennsylvania Medical Society, is a confidential advocacy service for physicians suffering from impairing conditions.

Published February 1998

The debate on whether alcoholism is a disease or a personal conduct problem has continued for over 200 years. In the United States, Benjamin Rush, MD, has been credited with first identifying alcoholism as a "disease" in 1784. He asserted that alcohol was the causal agent, loss of control over drinking behavior being the characteristic symptom, and total abstinence the only effective cure. His belief in this concept was so strong that he spearheaded a public education campaign in the United States to reduce public drunkenness.

The 1800s gave rise to the temperance movement in the United States. Alcohol was perceived as evil, the root cause of America’s problems. Accepting the disease concept of alcoholism, people believed that liquor could enslave a person against his or her will. Temperance proponents propagated the view that drinking was so dangerous that people should not even sample liquor or else they would likely embark on the path toward alcoholism. This ideology maintained that alcohol is inevitably dangerous and inexorably addictive for everyone. Today, we know that strong genetic influences exist, but not everyone becomes addicted to alcohol.

The temperance movement picked up steam in the late 1800s and evolved into a movement advocating the prohibition of alcohol nationally. Banning alcohol would preserve the family and eliminate sloth and moral dissolution in the United States, according to supporters. Backed by strong political forces, legislation was passed and prohibition went into effect in 1920. Paradoxically, the era of prohibition also marked the death of Victorian standards. According to A. Sinclair in his book, Prohibition: The Era of Excess, a code of liberated personal behavior grew and with it the idea that drinking should accompany a full life. Drunkenness represented personal freedom. Due to public outcry, prohibition was repealed in 1933.

Soon after prohibition ended, Alcoholics Anonymous (AA) was born. Formed in 1935 by stockbroker Bill Wilson and a physician, Robert Smith, AA supported the proposition that an alcoholic is unable to control his or her drinking and recovery is possible only with total abstinence and peer support. The chief innovation in the AA philosophy was that it proposed a biological explanation for alcoholism. Alcoholics constituted a special group who are unable to control their drinking from birth. Initially, AA described this as "an allergy to alcohol."

Although AA was instrumental in again emphasizing the "disease concept" of alcoholism, the defining work was done by Elvin Jellinek, M.D., of the Yale Center of Alcohol Studies. In his book, The Disease Concept of Alcoholism, published in 1960, Jellinek described alcoholics as individuals with tolerance, withdrawal symptoms, and either "loss of control" or "inability to abstain" from alcohol. He asserted that these individuals could not drink in moderation, and, with continued drinking, the disease was progressive and life-threatening. Jellinek also recognized that some features of the disease (e.g., inability to abstain and loss of control) were shaped by cultural factors.

During the past 35 years, numerous studies by behavioral and social scientists have supported Jellinek’s contentions about alcoholism as a disease. The American Medical Association endorsed the concept in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease. In addition, the findings of investigators in the late 1970s led to explicit criteria for an "alcohol dependence syndrome" which are now listed in the DSM IIR, DSM IV, and the ICD manual. In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism: "Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic."

Despite the numerous studies validating the disease model of alcoholism, controversy still exists. In his 1989 book, Diseasing of America, social psychologist Stanton Peele, Ph.D., argues that AA and for-profit alcohol treatment centers promote the "myth" of alcoholism as a lifelong disease. He contends that the disease concept "excuses alcoholics for their past, present, and future irresponsibility" and points out that most people can overcome addiction on their own. He concludes that the only effective response to alcoholism and other addictions is "to recreate living communities that nurture the human capacity to lead constructive lives."

Surprisingly, Dr. Peele’s view that alcoholism is a personal conduct problem, rather than a disease, seems to be more prevalent among medical practitioners than among the public. A recent Gallop poll found that almost 90 percent of Americans believe that alcoholism is a disease. In contrast, physicians’ views of alcoholism were reviewed at an August 1997 conference held by the International Doctors of Alcoholics Anonymous (IDAA). A survey of physicians reported at that conference found that 80 percent of responding doctors perceived alcoholism as simply bad behavior.

Dr. Raoul Walsh in an article published in the November 1995 issue of Lancet supports the contention that physicians have negative views about alcoholics. He cites empirical data showing physicians continue to have stereotypical attitudes about alcoholics and that non-psychiatrists tend to view alcohol problems as principally the concern of psychiatrists. He also contends that many doctors have negative attitudes towards patients with alcohol problems because the bulk of their clinical exposure is with late-stage alcohol dependence.

Based on my experiences working in the addiction field for the past 10 years, I believe many, if not most, health professionals still view alcohol addiction as a willpower or conduct problem and are resistant to look at it as a disease. Part of the problem is that medical schools provide little time to study alcoholism or addiction and post-graduate training usually deals only with the end result of addiction or alcohol/drug-related diseases. Several studies conducted in the late 1980s give evidence that medical students and practitioners have inadequate knowledge about alcohol and alcohol problems. Also, recent studies published in the Journal of Studies on Alcoholism indicate that physicians perform poorly in the detection, prevention and treatment of alcohol abuse.

The single most important step to overcoming these obstacles is education. Education must begin at the undergraduate level and continue throughout the training of most if not all specialties. This is especially true for those in primary care where most problems of alcoholism will first be seen. In recent years, promotion of alcohol education programs in medical schools and at the post graduate level has improved. In Pennsylvania, for example, several medical schools now offer at least one curriculum block on substance abuse. Medical specialty organizations, such as the American Society of Addiction Medicine, are focusing on increasing addiction training programs for residents, practicing physicians and students.

Also, an increasing number of hospitals have an addiction medicine specialist on staff who is available for student and resident teaching, as well as being available for in-house consultations.

The American Medical Association estimates that 25-40 percent of patients occupying general hospital beds are there for treatment of ailments that result from alcoholism. In the United States, the economic costs of alcohol abuse exceed $115 billion a year. Physicians in general practice, hospitals and specialty medicine have considerable potential to reduce the large burden of illness associated with alcohol abuse. For example, several randomized, controlled trials conducted in recent years demonstrate that brief interventions by physicians can significantly reduce the proportion of patients drinking at hazardous levels. But first, we as physicians must adjust our attitudes.

Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated. In the past 10 years, the medical profession’s and the public’s acceptance of smoking as an addictive disease has resulted in reducing nicotine use in the United States. I feel that similar strides can be made with alcohol abuse. We must begin, as we did with nicotine, by educating and convincing our own colleagues that alcoholism is a disease. We must also emphasize that physicians have played a significant role in reducing the mortality and morbidity from nicotine use through patient education. Through strong physician intervention, I believe that we can achieve similar results with alcohol abuse.

[ProThaiExpat]

One thing AA teaches its members is not to intellectualize their "condition". If a alcoholic finds solace and lack of self blame by characterizing his "condition" as a disease rather than his own bad behavior for which he is responsible, all the better. It is what makes his recovery more "doable" that counts, not what some "professional" believes.

As most alcoholics who are recovering or recovered will tell you, its not a name game, it is a life threatening condition and all the crutches in the world are only good, if they work. Many alcoholics in AA have a great deal of difficulty with the concept of God or a higher power and many adopt that groups spiritual concept for purposes of recovery and then abandon it when they have decades of sobriety under their belts. Yes I know of Agnostics AA.

It matters not a bit what the majority of AMA members think about Alcoholism as a disease, it only matters what believing they have a disease does for the recovering alcoholic.

[Prakanong]

Very interesting debate and I am glad I read this thread.

If I was to be honest I would have probably come down on a behavioral isse rather than a diseas but now will have to delve further to see where it goes for me.

Prior to the thread and without thinking I would have been the view that people can just stop if they want to ie smoking, drinking , taking drugs or whatever - I would have said I agree there might be some physical dependence to get over but the big thing was the psychological or mental.

I will also do a straw pole among the Dr's I work with and have lunch with to see where they stand just out of interest- its certainly never come up in conversation and is not an area they are researching.

Is there not a similar debate with M.E.?

I used observe all the people I knew with ME could afford to have it. My best pals sister said she had it and her sister who is a Consultant Dr as well as a Phd considered it a real physical disease but many Dr's I work with do not.

[sgunn65]

An interesting reply Neeranum. However this is not scientific proof that Alcoholism is a disease merely a viewpoint that it should be treated like a disease and an opinion that it is a disease. Just like my opinion that it is not. It also says that the majority of health professionals do bot agree that it is a disease.

Having spent several years working for the National Health Service in the UK I do agree with that.

One of the problems with this two theory basis is that the client (especially those who go on the merry go round of treatment, relapse, prison, treatment etc. If you go to one prison you may get a 12 step regime, in another a CBT. This can create confusion especially as the Government of the UK put little resources into aftercare, thus the popularity of AA and NA being free and available.

However the two treatment modalities have more in common than their differences. Where the differences are is the basis, you say helpless I say not but what we do is work towards the client making positive changes that will help them to help themselves. WHerever you come from that is the point.

I have been accused of being easily frustrated and quick to anger! Because i don't agree with a particular viewpoint and say so. How far from the truth. When all you have done is work with drug addicts for the past 15 years you develop an ability to remain calm and as for believing in something because it is making me money well you obviously don't know how much you earn working in the public sector in the UK. Believe me no-one does it for the money!!

In some ways it would be so much easier if there were only one theory of addiction but until then we each will go our way and do the best we can with what we have. When I treat clients I tell them about AA as a support system. I would never tell someone they are in denial if they don't agree with me. I hope I can just put my case and let them decide, so thank you Sunrise for the offer of a 20 baht chair but I will not be taking you up on that as I don't have a drug problem and haven't for many years.

[ronswelters2]

Relax, gentlemen! Doesn't it seem odd that at this stage of western thinking people should argue about whether chronic excess of alcohol use is a disease? There is no non-dogmatic answer to this question because it is not a valid question, there is no way to either prove or refute such claims about the veracity of human beliefs. But anyone should be free to call it what they want if it doesn't do any harm. Pragmatically AA seems to offer a lot ot many people. We can also call a spouse's compulsive nagging, excess gambling, destructive belief in some kind of personal god, etc diseases if we like and there probably are or could be AA-like groups for these problems too.

It would be interesting to hear of any experiences in regard to the effect of hardcore Buddhist practices on problematical drinking. Buddhism seems to this writer to offer some rather fine-grained approaches to human conduct which differ completely from the western medical model. Has this been addressed on any of the forums?

Ron Swelters

[garro]

Relax, gentlemen! Doesn't it seem odd that at this stage of western thinking people should argue about whether chronic excess of alcohol use is a disease? There is no non-dogmatic answer to this question because it is not a valid question, there is no way to either prove or refute such claims about the veracity of human beliefs. But anyone should be free to call it what they want if it doesn't do any harm. Pragmatically AA seems to offer a lot ot many people. We can also call a spouse's compulsive nagging, excess gambling, destructive belief in some kind of personal god, etc diseases if we like and there probably are or could be AA-like groups for these problems too.

It would be interesting to hear of any experiences in regard to the effect of hardcore Buddhist practices on problematical drinking. Buddhism seems to this writer to offer some rather fine-grained approaches to human conduct which differ completely from the western medical model. Has this been addressed on any of the forums?

Ron Swelters

Well Ron, the philosophy of Wat Thamkrabok in regards to addiction is one example of Buddhist thought in this area. It is the belief that addiction is a tool which people use in order to cope with the frustrations in their lives. This frustration is usually as a result of not finding a correct path in life which provides meaning and purpose. When the path is found it allows people to easily walk away completely from their addictions. In order to find this path the addict needs time in sobriety.

The addicts at Wat Thamkrabok make a satja vow not to use/drink again or for a set amount of time. If broken this vow can not be taken again. It is only possible to enter treatment at the temple once. It is believed that while the satja vow is kept good things will come into the addicts life and the oppostite is also true.

This is the program which I subscribe to and believe in fully. It works for me. I also respect the program of AA and any program which works for the alcoholic. I have less respect for those programmes which criticise other ones. I am also suspicious of those treatments which are big money earners.

[Prakanong]

Just like in many area's of healthcare some treatments work for some and not for others.

There will be treatments worthy of inclusion on quackwatch too.

Are there any long term clinical studies with long term follow up regarding the various treatments?

[Chris Lawrence]

Ron the two boys that got the AA program started I am told by reliable source, the disease concept is more about the person feeling ill at ease with them selves. Dis-ease not disease. The idea that the WHO organisation recognised it as a disease was so medical funding would be allowed. This money also extends to treatment.

Garro, this is where the principle of Wat Thamkrabok of only one go I believe falls short. The people I have come across have had many goes at trying to clean up their act. Sometimes it may take more than one go to multiple goes. You have to always have the door open.

But then again, it takes all types of treatment.

[robint]

IMHO alcohol abuse is NOT a disease. Any form of drug abuse is not a disease, its an addiction A disease is characterized by an agent (beit viral microbial or degenerative) which attacks the body.

I believe there are many overlapping similarities in drug abuse whther its alcohol, nicotine, or substance abuse

There are many different types of abuser, some genetically predestined, some acquire the habit.

Abusers can be socially overindulgent, binge, solitary, terminal. This has all been characterised extensively and examples of the varieties of abuse exist throughout the known world in most cultures

Some people can spontaneously cure themselves (snap out of it so to speak) and you dont hear to much about this types cos he doesnt make the statistics.

Some people need and ask for help to get out of their rut (good for AA)

Some people are terminal recidivists and you cant help someone who doesnt want to be helped

[robitusson]

However you call it Alcoholism is not a disease or a dis-ease and once you stop drinking you become an ex drinker not an alcoholic who hasn't had a drink

You obviously were not an alcoholic or understand the nature of the disease.

Classic AA labelling. Someone questions the doctrine, then deny the person is an alcoholic.

An interesting reply Neeranum. However this is not scientific proof that Alcoholism is a disease merely a viewpoint that it should be treated like a disease and an opinion that it is a disease. Just like my opinion that it is not. It also says that the majority of health professionals do bot agree that it is a disease.

Yup. The truth is the disease model is highly contested. Also the model that AA use is not what has been posted here from the National Institute on Alcohol Abuse and Alcoholism. AA has not changed its model for over 70 years since the hallowed Big Book was written. It deliberately avoids updating it with any new scientific and medical information to "avoid controversy". It's hopelessly outdated at best, pseudo-scientific/religious mumbo-jumbo at worst.

[jumnien]

Bill Wilson, co-founder of AA, wrote that he prefered to refer to alcoholism as an illness.

[robitusson]

Oh right. You mean Bill Wilson, expert in physical- addiction, addiction-psychology and alcoholics? Or Evangelical Oxford group member with a background in law?

[jumnien]

Actually, I meant Bill Wilson, well known for taking LSD trips with his wife Lois long before Timothy Leary ever got hold of the stuff!

[percy2]

The addicts at Wat Thamkrabok make a satja vow not to use/drink again or for a set amount of time. If broken this vow can not be taken again. It is only possible to enter treatment at the temple once. It is believed that while the satja vow is kept good things will come into the addicts life and the oppostite is also true.

How long do you have to study Buddhism to appreciate how serious this satja is?

Cheers