re: John Oliver - Last Week Tonight - "Rehab"

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Problem is, the success rates of even the most "effective" rehabs, is still pretty awful.

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Probably because most of them don't know what they're doing

Hopefully advances in research will improve results with these programs

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The ONLY people I know who succeeded were cold turkey people.

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Chantix legit works

If people still like the taste of a cigarette after about 4 days worth of Chantix in their system, then those people are straight up masochists

What is your basis of knowledge of the rehab industry and methods if you don't mind me asking?

Where specifically in Europe would you recommend? Do you know of any peer reviewed literature coming out of Europe with evidence of superior outcomes that I'd be able to review?

I think it can be dangerous to toss out blanket statements such as "the problem with US based treatment is its centering around the 12 steps". There are charlatans galore that are abusing the patient and system purely on the "non 12 step" method. They have limited evidence to support their methods I might add.

This thread really went off topic due to the polarizing effect of Oliver, but the industry is ripe with opportunists. It remains a pathology that is difficult to treat successfully long term, and the need for care outpaces providers.

There are wonderful opportunities for strides to be made in this field and I expect large ones to occur over the next decade.

In the meantime, if you want to know what has the best evidence for success it would be a 30-90 day residential based treatment with monitoring followed by an outpatient vs sober living vs intense 12 step meeting based program, all combined with an ongoing random urine/hair/nail bed testing for a period of at least 5 years. Personally, some form of random testing for the life of the patient would be best as the condition is chronic, progressive and ultimately fatal if untreated. People with diabetes check their glucose and people with addiction should check their urine etc.

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What is your basis of knowledge of the rehab industry and methods if you don't mind me asking?

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I don't have any professional basis if that's what you're asking.

I had some personal involvement several years ago, and took the chance to dig into numbers on my own. As I said, it's been several years, but what I found then was available online and not difficult to get to.

The couple of items I remember are:

1. a clinic in the Scandinavian countries that doesn't use anything like the 35-day model used here, and apparently has a pretty good success rate.

2. a drug that's used in some cases over there that's effective in reducing drinking to socially acceptable levels, but isn't prescribed here, apparently because it doesn't fit with the universal "don't ever drink again" solution of AA. Notice I write that it's used in some cases; nothing is treated as a universal solution there as AA/12-step is here.

This NYT piece talks about some of what I found

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30-90 day residential based treatment with monitoring followed by an outpatient vs sober living vs intense 12 step meeting based program

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the reason these sorts of programs are successful is that people are removed from their lives and the lucky ones create a new life (or their old one has left them).

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People with diabetes check their glucose and people with addiction should check their urine etc.

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wha wha what?

I have extensive knowledge about this subject, and know where all the weak points are and what advancements need to take place to make major progress in the field.

I think that given the current "crisis/epidemic" that the general population will begin to understand the issue on a more personal level. If you take any disease type process the general public only understands bits and pieces of the issue. Some people with a little knowledge think they have a better understanding than they do. Misinformation abounds. For instance, just yesterday I saw in a thread someone discussing cancer treatments and the idea that acidic environments kill cancer. They went on to say the body pH is 7.25 and you need to raise the pH to make it more acidic etc.

Their explanation had pretty laid out details and seemed extremely well thought out and based in fact. To most people it would be simple to agree with such an idea. Too bad the body maintains pH between 7.35-7.45 and raising the acidity in the body means lowering the pH etc.

The addiction issue still remains one of not only public education, but even medical education. Physicians in training are still woefully deficient of the pathology, its recognition, and best course of treatment.

SFP-yes the main reason those methods are successful is the fact that the patient's life needs to drastically change in almost every aspect. The alteration of neurotransmitter densities, production and neural pathways cannot occur unless the brain is allowed a long enough time period to alter itself.

Edit-when I say addicts check their urine I mean it in the context of urine drug screens as a form of accountability. This accountability is only really effective if there is a consequence the patient has agreed they desire to avoid.

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the reason these sorts of programs are successful is that people are removed from their lives and the lucky ones create a new life (or their old one has left them).

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I decided to quit drinking recently since I'm working out of town

A lot easier when I don't have my normal social circle

My decision is based more on weight management but it definitely makes it easier being transplanted somewhere else

pretty sure it affects/increases depression iirc

2 somewhat off topic but legit questions

1. do you utilize a chiropractor on a regular basis?

2. do you believe you can fight cancer by adopting pro-alkaline behaviors?

I went to a fairly good facility. Daily meeting with primary counselor, weekly meetings with a psychiatrist. Primary process group each morning which was a good thing. The rest was just fluff.

And I didn't care for how they infantilized the clients. We were all grown arse men. We shouldn't be treated like children, don't care if we're addicts or not.