I recall reading a book where a guy used these meds to lose weight. One thing he found was that because he was overeating due to depression, removing his appetite left him a bit stuck because his coping mechanism had been taken away. I would worry that if you're drinking due to an emotional issue, exposing that issue so immediately could have serious consequences if it didn't come with some serious support.

Yeah IIRC the current state of the addiction medicine model is that the drug use of addicts is maladaptive but that there is a real illness or suffering that at one point it gave relief from, or the user thought it would. So someone who gets addicted to opioids after knee surgery is in the same category, doing the same thing, as an alcoholic who started drinking so they wouldn't have nightmares about their abusive childhood. Or whatever. The addict may not always even know explicitly but there is a reason they initially started using in this way.

If you get someone off their normal drug, they a) have none of the other tools or coping mechanisms to deal with the initial problem, having failed to develop them during the years of using drugs instead and b) are grappling with the full and unattenuated experience of whatever caused them to start using in the first place.

People newly detoxed from a long addiction are particularly vulnerable to new addictions and need a lot of support and resolve to develop the intrapersonal emotional skills they've been neglecting. And in some cases picking up a new addiction is the less harmful option. I'm not particularly a fan of AA (but not anti either) but it turns out there was wisdom in their common advice for newly dry alcoholics to not worry about their cigarette or coffee or candy intake. Smoking won't kill you this week but drinking might, you can deal with the nicotine addiction next year.

Which is why GLP-1 are of such interest to some. Anecdotal reports aren't hey, I stopped binge eating but now I'm addicted to gambling, which happens in the world of addiction and addiction treatment. Instead some of the anecdotes are hey I'm not eating as much and I also quit smoking and didn't pick up gambling. Naturally, anecdotes don't prove anything, but there are enough, on this post, even, to warrant further study.

AA is many things. At its heart is a mutually supportive community. For some it works well; it works if you work it. For others, it doesn't. It isn't deep psychotherapy work with a licensed clinician, but the steps do resemble certain pieces of that and lead many to success. The problem is with the numbers, and how success is measured. Someone who's forced into the program, by court order, or by family, and just goes through the motions, counts in the statistics the same as someone that's going of their own volition and is truly committed to their own change.

One of those two people is more likely to succeed in getting dry/clean. The other, less so. It's a shame that both of those people get counted in statistics on AA's efficacy equally.

It's great that it's not replacing one addiction with another. But if, for example, I drink because I had an abusive childhood. Now I can't hide from that via addiction and it's so overwhelming I become deeply depressed and suicidal. So I think for people utilising GLP-1 for an addiction that stems from some particular reason, it might need to be prescribed alongside therapy or something like that.

> Someone who's forced into the program, by court order, or by family

Yeah this is the main problem. AA explicitly requires religious practice, it is only an appropriate approach for people who are already believers or wish to become so.

Not exactly. To adapt with the times, many chapters have adopted a "whatever your higherr power is" attitude. So you do have to have something to refer to, but there's no scripture reading, and it can be things like "other people" or "sunsets" or even "the people running our simulation".

Not all chapters have adopted this, but you can simply not return to a meeting that isn't a good match for you - and there are many reasons, not just religiosity, for a given meeting not being a good match for a given individual.

I used to travel for work (ending with the pandemic in 2020) so I've been to hundreds of distinct AA meeting groups. I would say at that point it was probably still 80%+ of meetings using at least one christian prayer, usually the lord's prayer.

In big cities you can definitely find ones that are more careful about the higher power language but they are still a small minority and so for example if you're newly sober and trying to hit meetings every day, or at odd times, they may not meet all your needs. And if your city is big enough to have a lot of meetings like this and you want them, it probably also has smartrecovery groups which are likely a better fit for a more secular person anyway.

The really interesting thing is finding the little pockets where they're catering to a different community that is a local majority. I've said traditional jewish prayers at AA in skokie il, muslim ones in dearborn mi.

But regardless of your personal higher power, sincerely doing things like "turning your will over to" it or "asking [it] to remove your shortcomings" is religious practice, straightforward, no question. Some people are simply not interested in this at all, no matter how disconnected from any specific tradition.

That's a question for a priest or philosophy professor, and won't be solved in the HN comments section. The underlying principle is that it's a disease that overrides your conscious brain, and you have to give in that fact before you can make progress curing the disease. Like, your brain can be absolutely screaming don't go in that bar, don't go in that bar, and where do you end up? Puking your guts out in that bar's bathroom.

That's hugely shameful when that's the third time that week, and it's only Wednesday. Processing that internally, without coming to grips that it really isn't you doing that seems impossible without "turning your will over" to the god of burritos or whatever else you want as your higher power. That doesn't absolve you of the harm you've caused yourself and others, but it does help you move on to the next step, one of which is up make amends (if it won't cause more harm).

Look, I'm not saying AA is the be-all-end-all of addiction treatment. It isn't. One of the AA things is they say there's no medication for when we're on a thread discussing medication for addiction! But the very first meeting I went to, there was a young woman who was militantly atheist but was years sober and had really turned her life around. If being in the same room as people reciting the Lords prayer will throw you into apoplectic fits, don't go. If you're suffering and need help, and are able to be in the same room though, I do honestly and fervently believe it's worth trying, if only because ozemoic isn't cheap while AA meetings are free to attend.

I thought it was pretty clear reading my comment but let me be explicit: I didn't go to thousands of AA meetings out of anthropological curiosity. I know what addiction is like and what AA has to offer.

My point was that AA is religious, and so is not an appropriate activity for the state to compel participation in. You were saying it's not religious, and now you're saying well, it doesn't matter that it is. I think it does.

I'm a (more or less) lifelong christian fwiw. I'm not speaking about my own discomfort but I have observed that people without a preexisting religious practice, or a desire to acquire one, do not have high success rates in AA.

Apologies, I wasn't trying to have you feel like you needed to state that explicitly.

My personal opinion is still that there exist meetings and chapters that aren't religious. There are also some that absolutely are. You're free to disagree that non-religious ones don't exist. More to the point though, I don't think ratholing on an HN comment thread on the exact degree of the religioslity of "turning your will over to" the god of "really neat looking leaves" vs "it's spiritual, not religious", vs no, it's actually religious, even if we were able to reach some common ground; I don't think that's going to change underlying psychology or nature of addiction.

If all someone ever gets from going to meetings is how much they hate Christianity, yeah, they're not going to get relief and aren't likely to succeed. But if someone's able to get over that hump and find the right meetings where it's not too overbearing for them, I know it's possible for people to succeed.