A new study concludes that getting treatment for alcoholism will not increase your chances of survival. Here’s why it’s important – we’re told all the time that there’s an epidemic of addiction, and that some astronomical figure of people who “need treatment” aren’t getting it. Most estimates range around 90%, such as this one, from a report by SAMHSA:
Millions of people suffer from substance use disorders each year, and an estimated 89.6 percent of them go untreated. Substance use disorders are complex conditions that are progressive in nature and negatively impact all facets of society: individuals, families, communities, businesses and the public at large.
The systemic burden of untreated substance use disorders is costly. Untreated substance use disorders result in human suffering for the individual consuming alcohol or drugs as well as their family members and friends.
[NOTE: In this data, SAMHSA considers 12-step meetings a form of “treatment” – SS]
But what exactly are they missing out on? Several studies show that most people get over their substance use problems without ever getting any treatment. And then there are those studies that show that untreated individuals do just as well, if not better, than if they’d received treatment. I have an in-depth analysis of one such study on the site if you wanna give it a look-see: Substance Dependence Recovery Rates With and Without Treatment. The crux of it is, your odds of getting over your substance use problem are not raised by getting so-called treatment for it. The data shows that over time, people essentially grow out of their old habits.
Yet this data is often challenged with claims that the untreated alcoholics are simply dying, and this creates an illusion in the data that people are growing out of addiction. The problem is, these claims are usually just baseless assertions – but it’s obvious why they’re lodged so often: the recovery culture is committed to the idea that if you’re not in the safe embrace of the recovery subculture, then you’re headed for “jails, institutions, or death.” For those who are able to tolerate sticking with it, this fear based credo is what keeps them huddled in church basements rather than getting sloshed at the bar – and the only way to keep the fear alive is to repeat the mantra, and convince yourself at all costs that an early death is promised outside of the recovery world.
I hate to burst people’s bubbles, but you simply won’t instantly die when you stop “getting support to cope with your disease.” In fact, your chances of death will probably remain the same, whether you receive treatment or not. Stanton Peele tackled this issue in a recent article, The Deluded Mantras of Addiction.
the NIDA’s National Survey on Drug Use and Health shows that peak abuse of and dependence on drugs and alcohol occurs from ages 18 to 25, and declines by a third after age 25, and by half after age 30.
…. Meanwhile, how many times have I heard harm reduction people account for the decisive fall-off of substance abuse with age: “Why, they all die!” (One in 10,000 people in this age group dies per annum due to drug overdoses, which occur mainly for older abusers.)
Stanton was referring to data from SAMHSA’s National Survey on Drug Use and Health, an annual survey whose results show the same basic trend again and again and again – people grow out of their substance use habits over time, even when they don’t get treatment. I have a lengthier piece on that part of the data here: Addiction Is For Kids. The fact that those results are nearly identical year after year makes SAMHSA’s alarmist statements about people going untreated all the more absurd. When they’ll get over the problem on their own, and treatment doesn’t get a better success rate than no treatment, then it’s a far stretch to say that the 90% of people who don’t get treatment ‘need’ it. The fact is, they don’t need treatment, and they probably won’t benefit from it.
But let’s get back to the topic of the day: mortality rates. When I saw Stanton deliver the above information to a group in the psychology department at NYU a few weeks ago, he was being the rock star of addiction that he is, and throwing around wild numbers – stating that to account for the drop in rates of addiction for 18-25 year olds and the next age group up, the mortality rate would need to be something like 7000 times higher! I didn’t check all that math, but I think his basic point is correct, the numbers just don’t add up for us to dismiss the NESARC and NSDUH data as an illusion created by the rampant deaths of untreated addicts. To back up his point, I now present a new study from Germany which says point blank that treatment does not in fact lower mortality rates. They started by randomly sampling more than 4 thousand people, identifying the “alcoholics” and waiting 14 years to see what happened with them. The results:
Annualized death rates were 4.6-fold higher for women and 1.9-fold higher for men compared to the age- and sex-specific general population. Having participated in inpatient specialized alcohol dependence treatment was not related with longer survival than not having taken part in the treatment. Utilization of inpatient detoxification treatment predicted the hazard rate ratio of mortality (unadjusted: 4.2, 90% confidence interval 1.8 to 9.8). The severity of alcohol dependence was associated with the use of detoxification treatment. Alcohol-related problems and poor self-rated health predicted mortality.
4.6 times higher doesn’t quite reach the 7000 times higher number Stanton cited, that’s for sure. But notice the difference between men and women – that’s the part that’s making headlines. News stories on this report had headlines such as:
- Alcoholism twice as deadly for women as for men
- For Women, Alcohol Dependence Twice As Deadly
- Alcohol does more harm to women than men: study
Hold the fort though! I know it’s not as sexy, but the real story is that treatment doesn’t decrease the mortality rate. You’re just as likely to die from alcohol related issues whether or not you receive treatment for it. This is one more important finding that shows the complete and utter ineffectiveness and impotency of addiction treatment. To me, that’s a big story, and it flat out blows away the most common brain dead talking point used to dismiss the NESARC and NSDUH data about untreated addicts. If the most basic quality of life issue – being alive – isn’t raised by getting treatment for addiction, then what’s the point of treatment?
Added Nov 16th:
Further, to make sure I connect all the dots for my slower readers, let’s put the SAMHSA, NESARC, and current data on mortality rate’s together. NESARC shows that most people don’t get treatment and they do get well, SAMHSA shows the same, but with more detailed information that shows a trend of growing out of addiction. The german study shows that the mortality rate is what it is – whether you receive treatment or not. Thus, by striking down the objection to the data which says “it looks like people are doing just as well in the untreated group because they’re dying and not being counted” it then validates the interpretation of the SAMHSA and NESARC data which show that treatment is not effective. For good measure, we also includes Stanton’s point about mortality rates in general – even if it’s 4.6 times higher than the mortality rate of 18-25 year olds in the general population (about 1 in 10,000), that would only be 4.6 in 10,000, (or less than 1 out of every 2000 facing an early death due to alcohol) and could never account for the rate of alcoholism falling off by a third between this age group and the next. Or in other words – they’re not all dying; not even a majority are dying; the majority of people with addiction problems are changing their habits, and they are doing it without treatment (including AA).
That’s why Dr. Junig promotes suboxone for opiate addicts. He says treatment does not work, and some people are incapable of staying off substances. He has a website and forum, you can google it if you are interested. He used to be director of a rehab center, and before that was an anesthesiologist who was addicted to the IV drugs they give to patients in the OR.
When I went to meetings, it seems most of the people coming in were middle aged or older. Some don’t grow out of it. Not sure why.
So what should people do? This is now hitting home, with someone I know, who lies in bed all day drinking. A kid. Should he just eventually grow out of it, or should he go to treatment? I think the kid wants help, but they don’t know what to do.
I would avoid treatment at all costs. You will need to take some time and motivate this person. He must decide he wants to make a change and it has to be on his terms. I would show him this website. Get him to understand that most recover on their own without treatment. He should also understand the learning paradigm. Excessive use is really just a very very very ingrained habit. One drinks to get a reward (get high) and if one drinks too much, too often one has withdrawal. The most reliable relief from withdrawal is more alcohol and the cycle starts all over again. I think the worst part of alcohol withdrawal is severe anxiety. I felt like I was going to go mad if I didn’t get a drink right away. Alcohol withdrawal is more mental and much less physical than opiate withdrawal. One should then seek other rewarding activities to substitute for the drinking reward. Whatever they like to do. They should put themselves in situations where they know they won’t drink. There is a lot of good information at the HAMS network: http://hamsnetwork.org/ and hamsnetwork.org/taper.
The little footnote that says SAMHSA considers 12 step meetings a form of treatment is problematic. The basic text of AA published in 1939 says very little about meetings, it emphasises one alcoholic working the steps with another to find a new way of life. Meetings are suggested as a way of finding new people to work with. Of course many mistake the meeting for the message. Check out BBAworks for a different approach.