Letters, We Get Mail, CXC

Date: Mon, August 16, 2010 10:28 pm     (answered 13 September 2010)
From: "Ryan M."
Subject: a.a. world confrence

hi my name is Ryan M. i am sober because of a.a. since 1998, i have no beef with what you do in fact i put myself in positions to keep a.a. honest .its a fine line a.a. walks . because just like anything, human beings are involved.

i need to know the relationship and why the world conference is selected. who runs it . it cannot be a.a.. i know city's bid on stuff like that. i just thought i would ask you first.

thanks for doing what you do. i feel you do two things you reinforce results of a.a. in spite of all that you find . it still works . and you keep it real. so many a.a.s live in a la la land like it fell out of the sky, am everyone floats around. you point out and check peoples realty.

thank you orange

Hello Ryan,

Thanks for the thanks. Of course, in spite of everything, A.A. still doesn't work. You work. Congratulations on your sobriety.

I don't know about the bureaucratic machinery for selecting the site of the A.A. world conference. I imagine that the New York A.A. headquarters has a lot to do with it. Perhaps some of the readers who have more experience with the organizational side of A.A. have some ideas?

Have a good day now.

== Orange

*             [email protected]        *
*         AA and Recovery Cult Debunking      *
*          http://www.Orange-Papers.org/      *
**     The Devil and Jesus were walking together one day, when Jesus
**     found a glowing jewel laying on the ground. He picked it up
**     and held it in his hand, admiring it.
**     "What is that?" the Devil asked.
**     "This is Truth," Jesus answered. "Isn't it beautiful?"
**     The Devil reached for it, and said with a smile, "Here, let
**     me organize it for you."

May 19, 2009, Tuesday: Day 19, continued:

Canada Goose goslings, ready for lunch The Family of Nine
There is no doubt in these little guys' minds that it is lunchtime. And yes, I brought them some oatmeal.

[More gosling photos below, here.]

Date: Thu, August 12, 2010 12:26 am     (answered 15 September 2010)
From: "Jock M."
Subject: refute these!

Jock M.

ST KILDA VIC Australia

[Files renamed to replace spaces with underscores.]

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Timko et al 2006 Intensive Referral.pdf
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Okay Jock,

Thank you for the documents. This is more grist for the mill.

  1. Starting at the top of the list, with:


    A report from the Role of Self-Help Groups in Drug Treatment Research Project

    John W Toumbourou1
    Margaret Hamilton2

    1 Centre for Adolescent Health, Department of Paediatrics, University of Melbourne and Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne
    2 Turning Point Alcohol and Drug Centre, Melbourne and Faculty of Medicine, University of Melbourne

    The first thing I see is that one of the two principle authors actually works for a 12-Step treatment center. Margaret Hamilton apparently wears two hats, and divides her time between the Turning Point Alcohol and Drug Centre, Melbourne and Faculty of Medicine, University of Melbourne. Do you really expect her to report that she is selling cult religion and quack medicine?

    The report begins by explaining how they recruited their test subjects:

    From June 1994 through to May 1995, 91 people who had recently joined NA self-help groups were recruited into the study and interviewed.

    Right there, the study is biased. They did not start off with a random sample of drug addicts or alcoholics to see what effect 12-Step "self-help" groups have on addicts; they recruited people who had already decided to quit ruining their lives with drugs, and who had gone and joined Narcotics Anonymous because somebody told them that it was a good thing. Thus this is not and cannot be a demonstration of whether 12-Step "self-help" groups make addicts quit drugs or improve their lives. It is a study of people who have already decided to quit drugs and improve their lives, before involvement with the 12-Step cult.

    The authors also had no control group. That is, they did not recruit a similar group of addicts who quit drugs all on their own, and who did not go to 12-Step meetings, so that they could compare the two groups to see what effect 12-Step groups really have on people. How are they supposed to know whether any observed improvement is due to the influence of a 12-Step group when they have nothing to compare it to? All that they can do is guess that maybe a 12-Step group caused something, rather than that quitting drugs caused something, which makes the whole report worthless.

    Then the authors used the passive voice to assert that 12-Step self-help groups actually work, without providing any evidence to that effect:

    Although self-help groups have long been acknowledged as a useful adjunct to formal drug treatment services, there has been little research into drug user self-help groups or their relationship to drug treatment services.

    Have long been acknowledged by whom? What unnamed bozo said that, and what does he know? What valid randomized longitudinal controlled studies established that the 12-Step religion really makes people quit drugs and improves their lives? There is no such evidence that I know of, and no such studies.

    Thus, the authors used two standard propaganda tricks there:

    Then the authors wrote:

    Study aims

    The present study focused on the experience of new NA members with the aim of investigating changes associated with the initial period of participation in self-help groups. Group entry and early initiation experiences were considered important to study, as they influence later decisions to continue or discontinue group involvement and, thus, impact group capacity for development and growth.

    Again, without a control group, they have no way of knowing whether any observed improvement in people is due to joining Narcotics Anonymous, or due to quitting drugs.

    I suggest that the improvement is due to quitting drugs. When you quit your addictions, the improvement in your health, both physical health, and mental health, is immense and dramatic. And your financial difficulties, and legal difficulties, are greatly reduced. And your overall quality of life, and how good you feel, is improved so much that it is hard to describe.

    Thus this "study" is worthless, and does not measure what they wish to measure. But the erroneous assumptions are neatly packaged in an impressive-sounding load of academic words. Now you can see why "B.S." means "Bullshit", and "Ph.D." means "Piled High and Deep".

    Then the authors explained how they collected their information: they just questioned 91 newcomers to N.A., and then they were able to find and re-interview 62 of them a year later. (They couldn't find or get the others. Guess what happened to them...)


    From June 1994 through to May 1995, 91 people who had recently joined NA self-help groups were recruited into the study and interviewed. Respondents were then briefly recontacted at three monthly intervals and 62 (68%) of the original participants completed a second interview, an average of 12.8 months after their first interview. The process of tracking and reinterviewing was completed in July 1996.

    The present report used two methods to analyse the early impact of self-help group attendance. A first set of analyses examined findings from the 'baseline' interview relevant to initial participation in self-help groups, the patterns of early attendance in these groups, characteristics of newer members, and factors associated with more stable (at least weekly) group attendance. A second series of analyses used data from the subsequent 12 month follow-up to explore the characteristics of members who had maintained stable weekly attendance through to follow-up.

    So they questioned some people who were easy to find, while not questioning the ones who disappeared. Now we know that some of the people who were impossible to find were the ones who didn't want to be found, because they had gone back to drugging. But then there were also the people who quit both drugs and cult religion, and just went their own way, and wanted no more involvement with the recovery cult. So the authors questioned some people who seemed to have improved their lives by quitting their addictions and abstaining from taking drugs and alcohol for a year, and then the authors assumed that the improvements in the ex-addicts lives were due to involvement with the 12-Step religion, rather than due to not taking drugs.

    That is a bunch of bull. That makes the whole rest of the report, and their analysis and conclusions, worthless. Joining a cult religion just not improve people's lives in wonderful and dramatic ways. But quitting drugs and alcohol does.

    In their "findings", the authors try to assume two cause-and-effect relationships where none exists:

    Key findings

    ... Retrospective accounts suggested that those having spent longer periods in stable group attendance prior to the first interview demonstrated lower rates of treatment, alcohol and drug use, illicit income and sickness benefits in the three months prior to interview. Evidence confirmed a strong link between involvement in self-help and use of formal treatment services (other than methadone); 86 per cent had used a treatment service prior to their first entry to a self-help group.

    So the people who kept themselves clean and sober, and who also attended some N.A. meetings, took fewer drugs than the people who relapsed and quit going to N.A. meetings. What else is new? That does not show that going to N.A. meetings causes people to abstain from taking drugs. It shows that taking drugs causes addicts to abstain from going to N.A. meetings.

    And then of course the authors just had to slip in a little endorsement of treatment centers (since the authoress works for one), and hint that T.C.'s have good effects on the clients. (Can you say, "Conflict of interest"?) The authors did not establish whether going to the treatment center improves the clients, or whether deciding to quit addictions before going to treatment is the magic that does it. The evidence is that the latter one is true. (See Herbert Fingarette, Heavy Drinking.)

    Here, the authors again engage in deceptive double-talk:

    There is now a growing body of research evidence to support participation in self-help groups as a means of alleviating drug-related harm. Most of this evidence has been based on research examining Alcoholics Anonymous (AA). Available evidence is indirect, coming both from an important review of research evidence (Emrick, 1987) and epidemiological investigations (Mann et al., 1991; Smart & Mann, 1990; Smart, Mann & Anglin, 1989). It should be noted that questions concerning the relevance of this research to other forms of self-help treatment have yet to be explored.

    When they say, "Available evidence is indirect", what "indirect" actually means is: "We don't really have any good relevant evidence to support what we are claiming." None of the cited "research" was a valid randomized longitudinal controlled study to test whether 12-Step meetings really reduce drug and alcohol consumption. So their "research" wasn't research. The Emrick study was notoriously bad. All that he did was write a paper where he cited a bunch of other 12-Step propagandists, all of whom wrote papers that agreed that 12-Step quackery was wonderful. None of them actually did any real research — no valid clinical randomized controlled studies to test whether 12-Step meetings work to reduce drinking — they all just parroted the same lines about "finding associations" between meetings and abstinence.

    Again, foisting quack medicine and cult religion on sick people, and lying about how well it works, is a really low, vile, despicable crime.

    By the way, didn't you notice who published this paper? Look at the bottom of all of the even-numbered pages. It says: "TURNING POINT MONOGRAPH 02". "Turning Point Alcohol & Drug Centre" is a treatment center in Melbourne, Australia. This paper was put out by a treatment center to justify their business of selling cult religion as a quack cure for drug and alcohol addiction.

  2. The second paper: Gossop_et_al_2007_Attendance_and_outcomes.pdf

    Speaking of "finding associations", that is what these people are doing, too.


    This study investigates the relationship between frequency of attendance at Narcotics Anonymous and Alcoholics Anonymous (NA/AA) meetings and substance use outcomes after residential treatment of drug dependence. It was predicted that post-treatment NA/AA attendance would be related to improved substance use outcomes.

    "It was predicted" by whom? That is another example of the propaganda trick of Use of the Passive Voice.

    Again, the authors are starting off by trying to prove some wishful thinking. They are not objectively testing reality to determine the truth. They have already decided what they want the results to be, and now they will manipulate the facts to get their desired conclusion:


    Using a longitudinal, prospective cohort design, interviews were conducted with drug-dependent clients (n = 142) at intake to residential treatment, and at 1 year, 2 years and 4—5 years follow-up. Data were collected by structured interviews. All follow-up interviews were carried out by independent professional interviewers.

    Again, the authors are not using a randomized sample of drug addicts; they are surveying people who have already decided to quit their bad habits, and who are now attending a training school that will teach them to go to 12-Step cult meetings.


    Abstinence from opiates was increased throughout the 5-year follow-up period compared to pre-treatment levels. Clients who attended NA/AA after treatment were more likely to be abstinent from opiates at follow-up. Abstinence from stimulants increased at follow-up but (except at 1-year follow-up) no additional benefit was found for NA/AA attendance. There was no overall change in alcohol abstinence after treatment but clients who attended NA/AA were more likely to be abstinent from alcohol at all follow-up points. More frequent NA/AA attenders were more likely to be abstinent from opiates and alcohol when compared both to non-attenders and to infrequent (less than weekly) attenders. Conclusions NA/AA can support and supplement residential addiction treatment as an aftercare resource. In view of the generally poor alcohol use outcomes achieved by drug-dependent patients after treatment, the improved alcohol outcomes of NA/AA attenders suggests that the effectiveness of existing treatment services may be improved by initiatives that lead to increased involvement and engagement with such groups.

    Do you notice what is missing from those statements? There is not a word about how they tracked down and located addicts and ex-addicts for five years. If they only found those people who were easy to find, because they were still attending NA/AA meetings at known locations, then they will "discover" that 100% of the clean and sober people are attending NA/AA meetings. Such "results" are of course hopelessly biased and meaningless.

    How did the authors track down and question the people who were not attending 12-Step meetings, and determine whether they were clean and sober? Nowhere in this paper did the authors answer that question.

    By the same goofy logic, if you only question people at A.A. and N.A. meetings about bank-robbing and child-molesting activities, you can "discover" that 100% of the bank robbers and child molesters are attending A.A. and N.A. meetings. Well, that's what your data will say. You can honestly report, "One hundred percent of the bank robbers and child molesters whom we interviewed were attending 12-Step meetings."

    Furthermore, there is no mention of "spontaneous remission". The authors made no attempt to calculate the expected improvement from people simply "maturing out" of addictions, and to subtract that from the improvement that they attribute to treatment and 12-Step meetings.

    In reality, there is every reason to believe that a very large percentage of the "treatment graduates" are spontaneous remitters who matured out. They quit drinking and doping by their own choice, and then voluntarily went to "treatment", where they were told that they had to go to a whole lot of 12-Step meetings or they would die, by people who pretended to be "the experts on addiction". The clients who believed all of that garbage, and obeyed orders the best, and kept themselves clean and sober the most, were awarded with the title "graduate". Then the authors of this paper interviewed some of those graduates, and assumed that all improvements were due to attending 12-Step meetings. The authors gave no credit to people taking care of themselves and choosing to improve their own lives by using their own intelligence and will power.

    The authors did not even consider the idea that doping and drinking causes people to not go to 12-Step meetings. So sobriety causes meeting attendance, rather than meeting attendance causing sobriety.

    In an obscure paragraph on pages 123 and 124, the authors admitted that their study was invalid and biased:

    The present study has a number of limitations. The use of a naturalistic design and the lack of random allocation to NA/AA may have allowed confounding of results due to a selection bias in the characteristics of those who attended NA/AA. However, no relationship was found between pre-treatment attendance at NA/AA meetings and substance use outcomes. Also, the possible influence of possible confounding factors was controlled by covariate adjustment during the analyses. Further research should make a more detailed investigation of factors related to attendance and engagement with NA/AA, the temporal relationship between meeting attendance, lapses, and other treatment attendance, and an exploration of the mechanisms through which NA/AA atten- dance supports or enhances substance use outcomes.

    The statement that they corrected the bias with "covariate adjustment during the analyses" is a bunch of academic-sounding B.S. When they don't know what the bias is, and have not measured it, then they don't know how much to "correct for it", so they cannot just magically tweak a few numbers in their equations and turn invalid results into wonderfully accurate answers.

    This is another example of "Garbage In, Garbage Out."

    The statement that "no relationship was found between pre-treatment attendance at NA/AA meetings and substance use outcomes" is especially revealing, because it means that going to NA/AA meetings before "treatment" didn't help the patients to quit drugs and alcohol. These authors just documented the fact that 12-Step meetings do not work. And then the authors also failed to show that going to A.A. and N.A. meetings after "treatment" makes people get or stay clean and sober.

    The authors concluded their paper by showing tables of numbers that said that the longer people had been going to N.A. meetings, the more they had stable, full-time jobs. That is the propaganda trick of Irrelevant Conclusion (Ignoratio Elenchi). What the authors ignored is the fact that the longer people have been off of drugs and alcohol, the healthier they are and the more they are able to get and keep stable full-time jobs. Going to the meetings of a cult religion has nothing to do with it.

    The real sequence of events is simple and obvious:

    1. People get sick and tired of always being so sick and tired from the damage caused by drugs and alcohol.
    2. People decide to quit drinking and doping and live better lives.
    3. They do quit their addictions, with or without the help of a detox center.
    4. Many of those people go into "rehab" because somebody told them that it would help them.
    5. The "rehab" teaches people to go to the meetings of a cult religion, and threatens them with death, "Jails, Institutions, or Death", if they don't go.
    6. So, after rehab, a lot of those people go to those 12-Step meetings.
    7. Those people also stay off of drugs and alcohol, and month by month, and year by year, their health and their lives improve. And their careers improve. And they are able to get and keep full-time jobs.
    8. The 12-Step cult claims that it made those people get better.
    9. When some people relapse and go back to drugs and alcohol, the 12-Step organization claims that it had nothing to do with it, it wasn't in control of their lives, those people made their own choices, everybody has to do it for himself.

    Notice that in the bibliography, the authors cited Moos, or Moos and Moos, or Humphries and Moos, or Humphries, thirteen times. All that the Moos team does is crank out a whole lot of 12-Step propaganda that is all invalid. They have never conducted one honest randomized longitudinal controlled study to prove whether A.A. really works. It's all academic-sounding drivel that "finds associations" between going to 12-Step meetings, and good things happening, just like this paper's "association" between going to N.A. meetings and getting full-time employment. We have talked about the Moos and Humphries team before, here, and here, and here.

    UPDATE: 2013.01.26:
    The International Journal of Mental Health and Addiction also analyzed Moos and Humphries' so-called "test" of A.A. versus CBT at the Palo-Alto Veterans' Center, and they found that the Humpheys-Moos study was invalid, erroneous, badly done, and downright deceptive and faked. They concluded that A.A. did more harm than good, and responsible health care professionals should not refer clients to A.A. Look here:

    Speaking of citations in the bibliography, these authors also cited the author of the next paper, Timko. Why it's a regular self-congratulatory circular back-patting club. They all cite each other, and tell each other that they are right, and congratulate each other for being so brilliant, while they all sell cult religion as a quack cure for drug and alcohol problems.

    And surprise, surprise, the authors stated on page 123:
    "These results are consistent with the findings of other studies [27,34,35]."
    Gee, I wonder why.

    Remember that drug and alcohol "treatment" is a $20 billion per year industry. That is a lot of money. So of course the industry has its pundits and "experts" who crank out advertisements for the industry, proclaiming that quack medicine is really wonderful, trying to get more paying customers in the doors, and trying to get more government grants for "helping" those poor addicts. Since all that the treatment centers have to sell is 12-Step meetings and A.A. fairy tales and Frank Buchman's theology, they want everybody to hear that 12-Step meetings are great medicine.

  3. The next paper:
    Timko et al 2006 Intensive Referral.pdf

    Intensive referral to 12-Step self-help groups and 6-month substance use disorder outcomes

    Christine Timko, Anna DeBenedetti & Rachel Billow

    Center for Health Care Evaluation, Department of Veterans Affairs Health Care System and Stanford University Medical Center, Palo Alto, CA, USA



    This study implemented and evaluated procedures to help clinicians make effective referrals to 12-Step self-help groups.

    Right there, the authors revealed that their real goal is to find better ways to recruit people into a cult.


    Randomized controlled trial.

    Now this is good. Really. I'm not being sarcastic. A randomized controlled study is the proper way to test things, and discover the truth. And, presumably, what the authors will discover is the most effective way to do cult recruiting.

    I expect that the results of this test will actually be valid, and will be valuable information for the Scientologists and Moonies who also want to improve their recruiting techniques.

    So let's read on and see what works to get people to join cults and stay in cults.


    Out-patient substance use disorder treatment.

    Note that this is a population of sick people who have already decided to change their lives for the better. The fact that they are in outpatient treatment means that they are willing to change, which makes them vulnerable to somebody changing them.


    Individuals with substance use disorders (SUDs) entering a new treatment episode (n=345) who were assigned randomly to a standard referral- or an intensive referral-to-self-help condition.

    Okay, so there is the choice: "Standard Referral" or "Intensive Referral". Apparently, "Standard Referral" means that somebody tells them to go to A.A. meetings, while "Intensive Referral" means that somebody assigns them a mentor — a sponsor — who holds their hand and tells them to "Go to Meetings, Read the Big Book, and Work The Steps!"


    Self-reports of 12-Step group attendance and involvement and substance use at baseline and a 6-month follow-up.

    We have to assume that all of those self-reporters told the truth. However, if any of them were court-ordered, you can bet that they always declared that they were clean and sober.


    The intensive referral intervention focused on encouraging patients to attend 12-Step meetings by connecting them to 12-Step volunteers.

    That is called "Mentoring", and it is a standard cult recruiting and indoctrination technique. An old-timer member of the cult takes a newcomer under his wing and teaches him the ways of the cult, and watches him like a hawk, and makes sure that he doesn't drift away from the cult. That is also known as "The Buddy System", and the way that several other cults do it is described in the Cult Test, here.


    Among patients with relatively less previous 12-Step meeting attendance, intensive referral was associated with more meeting attendance during follow-up than was standard referral. Among all patients, compared with those who received standard referral, those who received intensive referral were more likely to be involved with 12-Step groups during the 6-month follow-up (i.e. had provided service, had a spiritual awakening and currently had a sponsor). Intensive referral patients also had better alcohol and drug use outcomes at 6 months. Twelve-Step involvement mediated part of the association between referral condition and alcohol outcomes.

    It comes as no surprise that those newcomers who got the most intense attention and indoctrination — i.e. "brainwashing" — might stay in the cult the most. That is obvious and inevitable. But watch out. Here, the authors are basically lying. At the end of this paper they explain that their "intensive referral" technique did not work, and did not cause the patients to go to more 12-Step meetings, and did not reduce drug and alcohol consumption. So that statement above, about good outcomes, is a flat-out lie.

    The declaration that those patients who got the most intense indoctrination had "spiritual awakenings" is laughable. How did they scientifically measure whether somebody really had a spiritual experience, or a "spiritual awakening"? How did they distinguish between a genuine "spiritual awakening" and somebody who was just self-deluded and indulging in wishful thinking?

    What constitutes a "spiritual awakening"?

    • Is it yammering a whole lot of cult religion slogans?
    • Is it declaring that one has finally found God and is now "saved"?
    • Is it declaring that God is answering one's prayers and bringing the goodies?
    • Is it intense belief in fairy tales?
    • Or is it seeing lights?
    • Or is it hearing a ghostly voice during Step 11 séances?
    • Or is it getting funny feelings?

    The idea that those who got the most intense indoctrination drank and doped less has not been demonstrated in any randomized longitudinal controlled study. The authors are saying that it works, but their own results from this experiment, described further down in the paper, say that it doesn't really work. The authors are simply not telling the truth here.


    The brief intensive referral intervention was associated with improved 12-Step group involvement and substance use outcomes even among patients with considerable previous 12-Step group exposure and formal treatment. Future 12-Step intensive referral produces should focus on encouraging 12-Step group involvement in addition to attendance to benefit most effectively.

    Conclusion: Mentoring and intense brainwashing seems to work to recruit cult members, and keep them for a while.
    But again, that statement about "improved 12-Step group involvement and substance use outcomes" turns out to be a lie.

    Further down in the paper, we find this statement.

    Project MATCH found that out-patients in a Twelve-Step Facilitation (TSF) treatment condition, which encouraged AA attendance, had more AA attendance and involvement during treatment and at a 1- and 3-year follow-ups than did clients in a cognitive behavioral (CB) therapy or motivational enhancement therapy condition [8-10].

    That is a bunch of bull. Project MATCH was totally invalid, a very badly designed study without a control group. For starters, the clients were paid to come to the meetings. That is not Alcoholics Anonymous. I have never seen the A.A. Group Secretary standing at the door, handing out $20 bills to people as they walked into the meeting room. Of course you can get a lot of alcoholics to come to the meetings if you give them booze money.

    Then the paid subjects were exposed to one of three badly-implemented "treatments": 12-Step meetings, or Cognitive Behavioral Therapy, or Motivational Enhancement.

    And Project MATCH did not find that 12-Step groups did good things. It found just the opposite: That it didn't matter whether people went to 12-Step meetings, or Cognitive Behavioral Therapy, or Motivational Enhancement; the results were all the same. (And largely invalid, because without a control group, you can't measure what improvement any treatment might have caused.) Read more about Project MATCH here.

    Then, the authors assumed that people attending group meetings at the one- or three-year points was a good thing. No it isn't. It means that some people never graduate from the A.A. cult. A.A. always teaches people that they will die drunk in a gutter if they leave A.A.; that they can't leave; that if they leave A.A. their fate will be "Jails, Institutions, or Death".

    SMART and Cognitive Therapy and Motivational Enhancement, on the other hand, all teach that you will learn the techniques that they have to offer, and then leave the group and get on with your improved life. Their goal is not to keep people in a cult for the rest of their lives.

    So declaring that the victims of the 12-Step indoctrination don't recover and get out of the cult is certainly nothing to brag about.

    Now, for the most important stuff:


    Follow-up comparisons of standard to intensive patients on attendance and involvement

    We compared patients assigned to the standard or intensive referral condiiton on idices of 12-Step group attendance between baseline and 6-month follow-up. Results are presented in Table 1. The standard and intensive groups did not differ on the proportions who attended a 12-Step group meeting, the number of 12-Step meetings attended or the number of weeks of 12-Step group attendance.

    Wow! Are you reading that? They just declared that their results were invalid, and the experiment was a failure. At the start of this paper, in the Abstract, they declared that "intensive referral" — meaning intensive recruiting and indoctrination techniques — caused the patients to attend more A.A. meetings. In the abstract, they wrote: "...intensive referral was associated with more meeting attendance during follow-up than was standard referral." But now, in the Results, they say the opposite. Let me repeat that sentence, because it's one of the most important lines in this whole phony paper:

    The standard and intensive groups did not differ on the proportions who attended a 12-Step group meeting, the number of 12-Step meetings attended or the number of weeks of 12-Step group attendance.

    So, contrary to the bragging in the Abstract at the start of the paper, "intensive referral" did not cause the alcoholics and addicts to go to more 12-Step meetings.

    The authors continued, declaring these results:

    On involvement, patients in the intensive condition were more likely than patients in the standard condition to have provided service during a meeting, have had a spiritual awakening and currently have a sponsor (Table 1). Overall involvement scores were higher on average for intensive patients. Unexpectedly, on average, patients in the intensive condition worked a fewer number of Steps during the 6 months (Table 1).

    Oh, that's rich. The sponsor told the newcomer to wash out the coffee pot, make coffee, set up the chairs, and sweep the floor after the meetings, and that's "Service". And the authors assume that getting the patients to "do Service" is somehow a good thing. That has nothing to do with recovery from addictions.

    And again, the claim that patients "have had a spiritual awakening" is absurd. The authors sure didn't define "spiritual awakening", or tell us how they measured it to see if the clients really had one. Getting a bunch of confused people to declare that "Oh I had a spiritual experience while listening to the voices in my head during Step 11" is not recovery from addictions.

    It comes as no surprise that the "Intensive" group got more sponsors, considering that they were assigned a sponsor (called a "12-Step volunteer") at the start of the experiment.

    Finally, the single most important question is:
    "Did that 'intensive referral' really cause the patients to drink less alcohol or take fewer drugs?"

    I can believe that if you assign a baby-sitter to alcoholics, a guard who will monitor the alcoholics day and night and keep them from drinking, that the alcoholics will drink less alcohol — just as long as the baby-sitter stays around and guards them.

    But does that really work on a practical basis? What results did these experimenters get?

    At 6 months, intensive patients were more likely to be abstinent from drugs (78.2%) than were standard patients (69.5%) (Χ2=2.67, P<0.05). Intensive and standard patients did not differ significantly on 6-month abstinence from alcohol (76.4% and 70.1%, respectively; P<0.12); they also did not differ on abstinence from both alcohol and drugs (64.0% and 55.1%, respectively, P<0.06). Again, these results held when the number of out-patient sessions attended during treatment was controlled in analyses.

    Wow again! Holy moly and Jeez Louse! No difference in the amount of drinking, and no difference in the combined "drug and alcohol" consumption. They just claimed a small reduction in the "drugs only" category.

    Again, this bears stressing:

    • Intensive and standard patients did not differ significantly on 6-month abstinence from alcohol...
    • they also did not differ on abstinence from both alcohol and drugs...
    • At 6 months, intensive patients were more likely to be abstinent from drugs (78.2%) than were standard patients (69.5%)...

    So, NO reduction in the alcohol consumption, NO reduction is the consumption of drugs and alcohol together, and only a measley 8.7% difference in the drugs only category? That is not much to brag about. And yet, the authors declared victory in the Abstract at the beginning of this paper.

    And who only takes drugs? Personally, I can't think of a single addict who didn't also have a beer with his drugs, now and then. Where do you even find people who only take drugs and don't drink any alcohol? There aren't very many of them. And the authors of this report did not tell us what percentage of the clients were "drugs only". What they did say, on page 681, was that 45.9% of the clients were alcoholics, and then they listed a whole bunch of drugs, and the percentages of patients who used them, and then they also declared that 41.6% of the patients used multiple drugs. I guess that might include drugs and alcohol — it depends on their definitions, which they didn't explain. But we get no number for the "drugs only" people, so that we cannot even know how many "drugs only" people allegedly took fewer drugs. When the number of patients in that category is really small, an 8.7% difference could be a statistical anomaly. There is no reason to believe that this "intensive referral" trick worked on the "drugs only" people, even a little bit, when it didn't work at all on either the alcoholics or the "alcohol plus drugs" people.

    So, by the authors' own admission, the vast majority of the patients showed no improvement from this "intensive referral" trick of assigning mentors to the patients. The whole routine of "intensive referral" proved to be useless and a failure. But that wasn't what the authors said at the beginning of their paper. They bragged about "improved substance abuse outcomes".

    Not only that, their numbers are very unreliable. Notice those funny little terms like "P<0.05". That is a statistical statement. What that means is "how reliable or doubtful these numbers are." Think of the "P-value" as a "doubt factor". The smaller the P-value, the better the numbers are, and the more you can believe them. Really good numbers have a P value that is very small, like one one-thousandth, "P<0.001", or even one ten-thousandth, "P<0.0001". Really bad, totally worthless, numbers have a P-value like one-tenth "0.1".

    Here is the scale:

    • P value > 0.10 — little believability
    • 0.05 < P value <= 0.10 — some believability
    • 0.01 < P value <= 0.05 — moderate believability
    • 0.001 < P value <= 0.01 — strong believability
    • P value < 0.0001 — very strong believability

    When the authors declared that their numbers have P-values like 0.05 or 0.06 or 0.12, that isn't good. That means that there is lots of room for error in their numbers. The scale says that "P > 0.10" means "little believability".

    You can read more about P-values here.

    And I don't believe their numbers at all. They are basically claiming that the treatment centers from which they drew their test patients had roughly a 70% success rate with alcoholics and drug addicts, no matter whether the clients got "standard" or "intense" referral. They claim success rates that range from 55% to 78%. Nobody in the world gets that kind of a success rate. If they got that kind of success rate, they would win the Nobel Prize in medicine because they just discovered a cure to most of the world's addiction problems. They would be the richest and most famous and successful treatment center in the world.

    But they aren't.

    So somebody is cooking the books.

    This so-called "report" turns out to be totally worthless, a hoax. Intense mentoring and brainwashing does not work to cure drug and alcohol addiction. They started off by bragging that it did work, and then at the end, they admitted that it didn't work.

    I wonder why Stanford University and the Stanford Medical School and the Veterans' Administration allow their names to be used in the promotion of such quack medicine and fake science.

  4. The next paper is really just a slide show:

    12-step participation among polysubstance users
    Longitudinal patterns, effectiveness, and (some) mechanisms of action

    Alexandre B. Laudet, Ph.D

    Research Society on Alcoholism, June 2008, Washington DC

    So what is the "Research Society on Alcoholism"? I never heard of that one before. It sounds like another A.A. front group. It probably is, considering that the goal of the author is to sell 12-Step treatment. That is blatantly obvious. As you page through these slides, you see that it is nothing but a commercial for the 12-Step religion.

    First off, the author failed to actually conduct a proper study with a control group. He just assumed that going to A.A. or N.A. meetings does great things, and attributed all improvement in recovering patients to the 12-Step group.

    There was no control group of recovering addicts who did not go to 12-Step meetings, to see how well they did without Alcoholics Anonymous or Narcotics Anonymous. The test subjects were not selected randomly. In fact, the author cherry-picked recovering people who had anything from one month to ten years of sobriety before the so-called "study" started. To take people who have 10 years of sobriety, and send them to A.A. meetings, and then claim that they are sober because of A.A. involvement, is ridiculous and fraudulent.

    On the very first page of text (page 2), the author declared that his goal was to get more people to go to 12-Step meetings:

    We will also briefly address some mechanisms of action, patterns of attendance and one possible strategy to enhance affiliation.

    This document is not a study of what works to get people off of drugs and alcohol, it is a 12-Step group recruiting strategy.

    Also on that page, the author used Frank Buchman's favorite propaganda trick, Appeal to Numbers (Argumentum ad Numerum):

    Millions of 12-step members worldwide continue attending meetings, some for multiple years after achieving abstinence, yet the effectiveness of this practice has not been empirically examined

    The fact that millions of people have joined a cult religion at one time or another does not make it a good cult religion.

    Then the author said of A.A.: "...the effectiveness of this practice has not been empirically examined". That isn't true. A.A. has been repeatedly tested in valid controlled studies, and A.A. was proven to be a failure. Look here.

    On the next page, the author reveals how he recruited subjects for his "test":

    Media recruited formerly substance dependent persons in NYC (N= 354)

    So, what, he advertized for ex-addicts in the newspaper? Did he also send invitations to 12-Step group meetings?

    Then, on the next page, page 4, the author revealed how biased his sample of ex-addicts really was:

    Almost all have used formal addiction treatment services and 12-step fellowships

    So the author didn't have any control group of clean and sober ex-addicts who didn't waste their time on 12-Step meetings.

    So he wasn't really trying to find out what works to keep ex-addicts clean and sober. If he was, he would have also studied people who found happiness without either drugs or cult religion.

    Notice the rest of the characteristics of the group that he recruited to show that "12-Step groups work":

    • Primarily members of inner-city ethnic, under-served minorities
    • Long & severe history of (primarily) crack and/or heroin dependence
    • Almost all polysubstance users
    • Abstinent from one month to 10+ years at baseline
    • 31% HepC+ and 24% HIV+

    So he got a bunch of inner-city, minority-race crack and heroin ex-addicts to participate in a test, probably by paying them. And a whole lot of them were suffering from AIDS and Hep C. That is certainly not your typical A.A. meeting.

    The graphics on the next two pages say that the majority of the ex-addicts stayed off of drugs for the duration of the test. That is believable, considering the fact that they had already quit their addictions months or years before the "test" started.

    Notice the false premise here:

    1. Get a bunch of ex-addicts who quit their addictions months or years ago.
    2. Send them to 12-Step meetings.
    3. Declare that the 12-Step meetings are keeping them clean and sober.

    Then the next slide, page 7, seems to be from another slide show. Suddenly the author is talking about some study of 12-Step meetings as aftercare, sending treatment center patients to 12-Step groups after they get out of treatment. This so-called "paper" is not even a coherent set of slides from one project. Page 7 says things like:

    • 314 consecutive admissions recruited at two large publicly funded outpatient programs
    • 36 clients remained in treatment < 30 days and were dropped from the study
    • 250 clients re-interviewed at treatment end (90% re-contact) who constitute the prospective study cohort

    That has nothing to do with the group of minority-race inner-city crack and heroin ex-addicts that he was just talking about on the previous three slides.

    Then the author asks on page 8,
    ACT ONE: Does it work?
    Does what work? He hasn't even declared what he thinks he is testing.

    Then on page 10 the author states what he considers measures of 12-Step participation, all of the usual things like "go to meetings", and:

    • Having a sponsor
    • Sponsoring someone
    • Reading recovery literature
    • Having a home group
    • Considering oneself a 12-step member
    • Doing service
    • Working the steps
    • Contacting 12-step members outside of meetings; and
    • Socializing with other members outside of meetings.

    He missed the most entertaining one, which the previous paper listed: "Having a spiritual awakening".

    The next page declares that he considers success to be not using substances. That is reasonable.

    Then on page 13 the author declared:
    Twelve-step fellowships foster abstinence from polysubstance use
    without a shred of evidence to support that statement. This is just a propaganda slide show. He hasn't even conducted a test, and he is declaring the results.

    Page 14 talks about "sustained abstinence" without stating who was surveyed, the inner-city minority-race crack and heroin addicts, or the treatment center patients, or somebody else. Likewise, pages 15 and 16 talk about "odds of sustained remission", again without even saying what group was surveyed, or when, where, or how.

    At slide 19, the author leaves the realm of reality and fully embraces the delusional world of cult religion:

    Twelve-step participation enhances Life Meaning and Purpose

    Oh really? When did anybody ever show that practicing an old pro-Nazi cult religion from the nineteen-thirties enhances the meaning of Life? This is bullshit.

    Need I continue? This is just a bunch of propaganda slides that somebody jumbled together from various slide shows.

    I will note one more thing:
    Slides 51 and 52 talk about having on-site A.A. meetings at treatment centers, and how the author claims that such on-site meetings reduce relapse in the treatment center "graduates". Again, this has nothing to do with the study of the minority-race ex-addicts who were recruited through the media that we started with. This is yet another piece of propaganda with all of the relevant facts missing, like:

    • What treatment centers were studied? When, and where, and how?
    • How well were they financed?
    • How were the clients recruited?
    • What was the cost to the clients?
    • Did the clients pay for the "treatment" themselves, or was it health insurance, or a government? (City, State, or Federal)
    • Were the clients "high-bottom" or "low-bottom"?
    • What was the "graduation" rate?
    • What percentage of the patients who started the "treatment program" were clean and sober a year later? Not just the "graduates", all of them?
    • What about having resident SMART meetings at the treatment center? Did he test for that? How well did that work? Or how about SOS, or Lifering, or Women For Sobriety, or HAMS (Harm Reduction), or MM, or any support or help besides 12-Step religion?

    And what happened to all of those minority-race ex-addicts in the inner city?

    You see, this slide show is not even a coherent report of one study or test. This is just a bunch of unrelated slides from the collection of a professional 12-Step quack medicine salesman.

  5. And the final paper:

    Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators

    Felicia W. Chi1, Lee A. Kaskutas2, Stacy Sterling1, Cynthia I. Campbell1 & Constance Weisner1,3

    Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA,1
    Alcohol Research Group, Emeryville, CA, USA2
    and Department of Psychiatry, University of California, San Francisco, CA, USA3


    Twelve-Step affiliation among adolescents is little understood. We examined 12-Step affiliation and its association with substance use outcomes 3 years post-treatment intake among adolescents seeking chemical dependency (CD) treatment in a private, managed-care health plan. We also examined the effects of social support and religious service attendance on the relationship.

    We analyzed data for 357 adolescents, aged 13—18, who entered treatment at four Kaiser Permanente Northern California CD programs between March 2000 and May 2002 and completed both baseline and 3-year follow-up interviews.

    Measures at follow-up included alcohol and drug use, 12-Step affiliation, social support and frequency of religious service attendance. Findings At 3 years, 68 adolescents (19%) reported attending any 12-Step meetings, and 49 (14%) reported involvement in at least one of seven 12-Step activities, in the previous 6 months. Multivariate logistic regression analyses indicated that after controlling individual and treatment factors, 12-Step attendance at 1 year was marginally significant, while 12-Step attendance at 3 years was associated with both alcohol and drug abstinence at 3 years [odds ratio (OR) 2.58, P < 0.05 and OR 2.53, P < 0.05, respectively]. Similarly, 12-Step activity involvement was associated significantly with 30-day alcohol and drug abstinence. There are possible mediating effects of social support and religious service attendance on the relationship between post-treatment 12-Step affiliation and 3-year outcomes.

    The findings suggest the importance of 12-Step affiliation in maintaining long-term recovery, and help to understand the mechanism through which it works among adolescents.

    It is easy to refute this one: NO CONTROL GROUP. The authors just watched some recovering alcoholics and ex-addicts, and assumed that their improvement was due to attending 12-Step meetings. They did not study any group of successful ex-addicts who didn't go to 12-Step meetings, to see how well that works.

    This is just another one of those phony papers that "finds associations" by running a statistics program on a computer. If you do the same study, examining ex-alcoholics and ex-addicts who go to Baskin Robbins and eat ice cream, you can "find an association" between eating more ice cream and continued sobriety.

    It's simple: the addicts who are spending all of their money on drugs and alcohol do not go to Baskin Robbins and eat ice cream. On the other hand, the successfully recovered alcoholics and addicts who have some loose change in their pockets do occasionally stop in at Baskin Robbins and eat some ice cream. So, by the brain-damaged logic of these authors, ice cream is a cure for drug and alcohol problems.

    You can come to the same conclusion as the authors did:

    The findings suggest the importance of Baskin Robbins ice cream in maintaining long-term recovery, and help to understand the mechanism through which it works among adolescents.

    You can even "find an association" between length of time that somebody has been attending Baskin Robbins ice cream socials, and length of sobriety. It's simple: when the addicts were spending all of their money on drugs and alcohol, they didn't go to Baskin Robbins. But when they quit the drugs and alcohol, they started going to Baskin Robbins, and having some ice cream. So the longer people have been going to Baskin Robbins, the longer they have stayed clean and sober. Thus, a propagandist can write:

    "There is a positive correlation between continued attendance at Baskin Robbins ice cream socials, and continued sobriety. Regular attendance at Baskin Robbins is associated with lengthy sobriety. There is also a positive correlation between the number of times a recovering addict goes to Baskin Robbins in a month, and his level of sobriety. The most clean and sober people attended Baskin Robbins the most times. Therefore, counselors should consider Baskin Robbins an important part of any addict's recovery program."

    Similarly, the authors claim that going to 12-Step meetings "is associated with" continued clean and sober living. It's the same bad logic: The relapsed addicts and alcoholics are out looking for a fix, not going to 12-Step meetings. On the other hand, some of the recovered alcoholics and addicts waste their spare time going to 12-Step meetings. So it appears that going to 12-Step meetings must have something to do with continued sobriety — more clean and sober people are at the 12-Step meetings — and the authors try to claim a connection: That attendance at 12-Step meetings is "important" to recovering alcoholics and addicts.

    That is a common propaganda trick. It's called Confusion of Correlation and Causation. You just reverse the cause-and-effect relationship, and claim that meeting attendance causes sobriety, rather than that drug and alcohol consumption cause non-attendance, and sobriety then causes attendance.

    If you think realistically for even a few minutes, you can see how adolescents who are slipping every so often won't want to go to 12-Step meetings. When they do go to the meetings, some proud character is invariably announcing (bragging) that he has two or three years sober. Somebody else who just slipped and nibbled last weekend doesn't want to announce that she has only a couple of days clean and sober. That is too embarassing to have to do again and again. Worse yet, the group secretary asks at the start of each N.A. meeting,

    "Can we see a show of hands of those people who have a year or more clean and sober, to show that this program works?"

    And a few proud hands go up. Then the group secretary asks,

    "Can we see a show of hands of those people who are in their first 30 days of clean and sober living?"

    And the slipper is humiliated by having to raise her hand for all to see, telling everyone that she just lost all of her clean and sober time. So the slippers and relapsers make a quick exit, and don't come back to get humiliated again, and the next thing you know, it seems that almost all of the people at the meeting are clean and sober.

    Then some pundit announces that the meetings are making the people get clean and sober, which is obviously untrue.

    Most of the rest of the paper is just the usual boiler-plate stuff. I'll just hit a few highlights:

    • The authors did not even try to correct for the obvious bias the comes from using "rehab" as a 12-Step training course and recruiting agency. The whole purpose of the so-called "treatment" was to get people to go to 12-Step meetings after "graduation". 12-Step treatment centers teach that you must go to 12-Step meetings, or your fate will be "Jails, Institutions, or Death". It is no big surprise that many people who sincerely wanted to stay clean and sober, and who believed the indoctrination, went to 12-Step meetings while they were keeping themselves clean and sober.

    • The authors completely ignored the affect of spontaneous remission. That is, the "self-healers". The authors did not even admit that there is such a thing as real self-help. The authors tried hard to imply that all recovery was due to 12-Step cult religion activities.

    • On the 2nd page:

      ...At base-line, all 419 adolescents completed a computerized self-report and a paper-and-pencil questionnaire. We conducted telephone interviews at 6 months and 1 and 3 years after intake, with response rates of 92%, 92% and 85%, respectively. This study analyzed data of those completing the 3-year follow-up (n = 357).

      Again, we have the problem of them finding and questioning the easy-to-locate people, like the people who were still going to local 12-Step meetings. They have no information on those fortunate people who quit both drugs and the 12-Step cult, and went their own way, to live happy successful lives without cult religion.

    • On the third page, page 929, the authors stated:

      We assessed previous 6-month TSA at 3 years using questions adapted from the Alcoholics Anonymous (AA) Affiliation Scale, a brief instrument developed to measure AA affiliation across a variety of AA experiences with robust validity across diverse populations and settings [39].

      So they let the 12-Step cult religion write the questionaire for them? That is hardly scientific. They are allowing Alcoholics Anonymous to define what "successful affiliation" amounts to? Shades of Tom Cruise promoting Scientology while jumping up and down on the couch.

    • On the fourth page, page 930 of the publication, this is good for a laugh:

      Two activities — having had a spiritual awakening/conversion experience, and having sponsored anyone — were not associated with alcohol or drug abstinence (not shown); the other five — considering themselves a member, having called a member for help, having a sponsor, reading literature, or performing service activities — were associated with alcohol and drug abstinence (all P < 0.05) (Table 1).

      Wow! Spiritual awakenings did not reduce drug and alcohol consumption??!! That is big. That is really big. That directly contradicts all of Bill Wilson's ravings in the Big Book about how you must have a spiritual experience (which Bill then renamed to "spiritual awakening" after people complained that they weren't seeing the White Light, or seeing God, or getting the big "Spiritual Experience", or any of that, from practicing the 12 Steps).

      And sponsoring people didn't increase sobriety either? But that also directly contradicts the results of a previous study of sponsorship in Narcotics Anonymous that found that sponsoring people in N.A. did keep the sponsors clean and sober, even though it didn't help the newcomer sponsees any. Look here.

      And then what they associated with success is pretty ridiculous:

      • People considering themselves a member? That causes sobriety? You've got to be kidding.

      • And having a sponsor increases sobriety? The previous study that I just mentioned found just the opposite — that having a sponsor did not help — and that study was a real randomized longitudinal controlled study, which this piece of tripe is not.

      • And "reading literature, or performing service activities"? Reading the Big Book and making coffee increases sobriety? This is lunacy.

    • In the bibliography, we see the familiar list of the usual suspects: Moos and Moos and Humphreys and Timko... The whole gang telling each other that 12-Step religion really works good.

Okay, that is all five papers that you asked me to refute, and there was not a single properly-done scientific paper among them. It was all just bad logic and false inferences, and reversal of cause and effect, and irrelevant conclusions, and citing other fraudulent papers as evidence, and worse.

Have a good day.

== Orange

*             [email protected]        *
*         AA and Recovery Cult Debunking      *
*          http://www.Orange-Papers.org/      *
**   The so-called "recovery industry" has more quacks
**   than a flock of ducks.

May 19, 2009, Tuesday: Day 19, continued:

Canada Goose family with goslings, fleeing
Carmen's Family, fleeing from a bully
There is a more dominant male, just off-screen to the right, who is driving the other geese off of the beach, because he has the mistaken idea that he can get all of the oatmeal for himself if he owns the beach. He doesn't understand that the oatmeal does not just automatically come with the territory. When a bully does that, I just hide the oatmeal, and wait for him to lose interest and go away, and then I feed the babies.

Carmen is the small gosling in the middle, whose head is obscured by the father's wingtip.

You might notice that the mother, the adult goose in the upper left, is missing the feathers on her right wingtip. That is normal; this is the molting season. The geese will shed their entire coat of feathers and grow all new ones during the summer. (That is logical; you sure don't want to shed your coat of feathers during the winter.)

Canada Goose family with goslings, playing
Carmen's Family, fleeing from a bully
The bully's efforts were for naught, because I didn't give him any oatmeal.

[The story of Carmen continues here.]

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