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The Last of the Ayn Rand Acolytes

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Alexander Sammon writes in the New Republic:

Eight rules governed the original Ayn Rand clubs that proliferated across college campuses in the 1960s, as they sought to seed Objectivism—Rand’s philosophical glorification of laissez-faire capitalism and heroic individualism—in the minds of impressionable youth. And of these eight, only two rules could ever be mentioned publicly: 1) Ayn Rand is the greatest human being who has ever lived, and 2) her novel Atlas Shrugged is the greatest human achievement in the history of the world.

For the Randian faithful, this pair of diktats has withstood the test of time. At this year’s Objectivist Conference, the world’s largest annual gathering of Rand acolytes, everyone seemed to be in compliance. Take Emily Bujold, 26 years old. She was once an avowed environmentalist. She didn’t own a car or eat meat, and had even signed a pact to never have a child, so as not to help perpetuate a rapacious species. But a chance encounter with Rand’s wisdom rocked her world. “Now I know that the only solution is to celebrate and encourage development,” she told me.

Bujold was among the 500 pilgrims who made the trip this June to the conference, held this year in Cleveland, Ohio. The organizers at the Ayn Rand Institute stressed that the location was significant: Cleveland was the city Rand chose for the fictional Patrick Henry University in Atlas Shrugged, where a penniless but ideologically unimpeachable John Galt first made his mark before going on to lead the resistance against collectivism. It’s also, they pointed out, the first major American city to produce commercial-grade steel. But the choice of Cleveland was tinged with irony as well. The once-robust Rust Belt metropolis has been ravaged by a real-life version of Randian corporate overlordship—its factories closing, its people fleeing, its scraps fed to a subprime mortgage machine.

This was the grim setting for a nearly week-long celebration of Rand’s genius that coincided with the fiftieth anniversary of her clarion call for a capitalist-aligned cultural and aesthetic movement, The Romantic Manifesto. Thrumming in the background was a related, similarly unnerving trend for Objectivists: The romance of the movement has lost a good deal of its cachet in an unequal, austerity-battered America—particularly when it comes to pulling in the young recruits who were once the backbone of the Rand insurgency. All the kids these days are becoming socialists and communists. Only 45 percent of young Americans view capitalism positively, compared with 51 percent who profess a fondness for socialism. They want higher taxes, regulations, a Green New Deal. Their thousand-page tome of choice isn’t Atlas Shrugged; it’s Marx’s Capital (or perhaps Thomas Piketty’s Capital in the Twenty-First Century).

Objectivism has a serious youth problem, and the conference’s organizers were quite aware of it. They offered a discount rate for those under 30, a talent show, and extracurricular activities like “late night jams.” It made me wonder: Is Rand’s hyper-capitalist philosophy—which has influenced some of the most powerful political and economic giants of recent history, from Ronald Reagan and Alan Greenspan to Mark Cuban and Steve Jobs—running out of juice? There was only one way to find out. I would have to attend the conference’s various panels on the virtue of selfishness, the evils of regulation, and the greatness of capitalism’s dark patron saint, and try to fraternize with the next class of Paul Ryans in the making. So I went into the Objectivist sanctums of Cleveland, sporting an Ayn Rand tote bag outfitted with an “I ❤ fossil fuels” pin, to gauge the reach of Rand’s cult of unbridled capitalism on today’s political scene.


Ayn Rand might not have become the world-conquering figure we know today were it not for an eager teenager. In the late 1940s, Nathan Blumenthal sent Rand a series of fan letters, proving his dedication to her work by functionally memorizing the 750-page novel The Fountainhead, then her most popular title. In 1950, as a 19-year-old, he netted an invitation to Rand’s house. And once they were better acquainted, she anointed Blumenthal, who changed his last name to Branden, as her proselytizer-in-chief.

It was Branden who elevated Rand’s profile, hosting lectures and presentations on her writing across the country. When Atlas Shrugged was published in 1957, it was unsparingly savaged by critics on the right and left, not only for its soulless vision of a world whose highest aspiration was personal pocket-stuffing, but also for its melodramatic plot, wooden characters, and didactic and interminable philosophizing. “I can recall no other book in which a tone of overriding arrogance is so implacably sustained,” wrote National Review critic Whittaker Chambers—certainly no pinko—at the time. “Its shrillness is without reprieve. Its dogmatism is without appeal.”

But Branden’s propaganda campaign helped turn Rand’s novel, against all odds, into a word-of-mouth best seller. Thanks to his efforts—which included the establishment of an Objectivist newsletter, an Objectivist magazine, a nationwide lecture series, book clubs, movie nights, and an annual gala—the Rand student movement ten years later numbered 3,500 card-carrying members across 50 U.S. cities.

After Branden and Rand parted ways in 1968—the two Objectivists were having an extramarital affair that blew up over Branden’s relationship with another woman—Rand named Leonard Peikoff, a onetime student, her true heir. When Rand died in 1982, Peikoff inherited her estate and set about rehabilitating a legacy that had grown stagnant since Rand’s 1960s heyday. In 1983, the first Objectivist Conference was held in San Diego. Two years later, the Ayn Rand Institute was formally founded. Its mission was to turn a new generation into apostles of no-holds-barred laissez-faire capitalism—a savvy marketing move at the height of the Reagan revolution.

“The first program of the Ayn Rand Institute was focused on young people,” said former director Yaron Brook. “From the beginning we understood we’re going to have to appeal to young people at the point in their life when they’re making big choices.” True to that aim, the ARI began donating 400,000 copies of Rand’s novels to advanced-placement high school programs each year. It also awarded big cash prizes for Rand-themed essay contests (in 2018 alone, ardent young Objectivists raked in a cool $130,000 for such broadsides).

Over the decades, the Objectivists’ full-court offensive bore fruit in the culture at large. Everyone from Peter Thiel to Jeff Bezos to the members of the Canadian power trio Rush got a taste of Rand’s philosophy. Even Hillary Clinton claimed to have had a Rand phase.

To this day, Objectivism continues to appeal to a certain kind of precocious youngster: contrarian, brash, frustrated with the status quo but uncertain of where to direct that frustration. At the opening ceremony of this year’s conference, the ballroom at the Hilton Cleveland Downtown was buzzing with fresh-faced capitalist devotees sipping wine and beer and declaiming their love of Rand’s work. I struck up a conversation with two young Objectivists, Jonathan Brajdic and Michael Beardsley, both recent graduates of nearby Ohio State. They hadn’t known each other previously; each had assumed he was the only Objectivist on campus, and their meeting had the feel of a reunion of spiritual twins separated at birth. “I was introduced to Rand by a roommate,” boasted Jonathan. “It changed my life forever.” “It either changes your life or puts into words everything you’ve always felt,” replied Michael.

My first conversation with the Objectivist youth was a challenge. Like other ideological movements, Randism brims with a jargon of authenticity, tailored to reinforce the sense of belonging for young initiates. Jonathan had studied architecture, which made him, according to Michael, “our own Howard Roark” (the strident, world-hating hero of The Fountainhead who blows up a public housing complex because it was compromised by government regulation). Aspiring venture capitalist Michael was more of a Hank Rearden (a 20-hour-workday-pushing inventor-investor hero of Atlas Shrugged). When I told them I was writing about this conference for a magazine, their enthusiasm faltered. It went without saying: I had just outed myself as an Ellsworth Toohey, The Fountainhead’s villainous newspaper journalist. I assured them I was open to their ideas, but I was already in a hole.

That wasn’t my only mistake. When I asked Michael how long he’d been into conservative politics, he clarified that . . .

Continue reading.There’s much more—and it’s one weird movement.

Written by LeisureGuy

14 August 2019 at 2:11 pm

How to distract an Egyptian god

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Written by LeisureGuy

14 August 2019 at 10:19 am

Posted in Cats, Daily life, Religion

“Dying the Christian Science way: the horror of my father’s last days”

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Religion, as a genus in the meme-sphere, evolves in some surprising directions (just as do lifeforms—cf. the peacock). In the Guardian Caroline Fraser describes one variant and the real-world consequences:

When I was a baby, my grandfather delighted me by playing a game. He made a fist sandwich, fingers laced together and hidden in his palms, showing me his thumbs closed upon them. Slowly, he would say, “Here’s the church, and here’s the steeple,” raising his index fingers together to form a peak. Then, throwing his thumbs apart, he flipped his interlaced fingers over, wriggling them and crying out, “Open the doors and see all the people!”

My grandfather was a Christian Scientist. His mother had been a Scientist. His only child, my father, was a Scientist. I was raised to be a Scientist.

Now I’m delighted by a different kind of game: counting the churches as their doors close. In 20 years, drastic changes have taken place, but the most arresting is the church’s precipitous fall. It’s getting harder and harder to see all the people, because they’re disappearing.

The early popularity of Christian Science was tied directly to the promise engendered by its core beliefs: the promise of healing. The overwhelming majority of those attracted to the movement came to be healed, or came because a husband, wife, child, relative or friend needed healing; the claims of Christian Science were so compelling that people often stayed in the movement whether they found healing or not, blaming themselves and not the church’s teachings for any apparent failures.

The teachings were radically simple. The founder and leader of the church, Mary Baker Eddy, taught that disease was unreal because the human body and the entire material world were mere illusions of the credulous, a waking dream. Those who awoke and knew the “Truth” could be instantaneously healed. (Eddy was big on capitalised generalities; “Life”, “Love” and “Spirit” were among her other “synonyms” for God.)

What was the “Truth”? We memorised it in Sunday School, the “Scientific Statement of Being”, which assured us that “there is no life, truth, intelligence, nor substance in matter”. Eddy’s definition of man was even more stark: “Man is not matter; he is not made up of brain, blood, bones, and other material elements.” We were instructed to repeat as needed for whatever ailment came along, from canker sores to cancer. The trick lay in the application: allow no hint of doubt, neither aspirin nor vitamin, a dogma so dire it was taken to absurd lengths. During the height of the London fad for the faith, in 1911, novelist VS Pritchett was indoctrinated into the mysteries by his father after “dying Cousin Dick” leapt from his deathbed, “miraculously cured”. Soon after, Pritchett, a lad of 11, was forced to walk to school on a sprained ankle.

As Pritchett discovered, Cousin Dick’s results were impossible to replicate in the real world, and the consequences of Eddy’s strictures – she demanded “radical reliance” on her methodology to the exclusion of all else – quickly caused havoc. Newspapers and prosecutors noticed the casualties, especially children dying of unreported cases of diphtheria and appendicitis. In the early years of the church, this touched off battles with the American Medical Association, which tried to have Christian Science healers, or “practitioners”, arrested for practising medicine without a licence. Since practitioners did nothing but pray, however, their activities were protected by the US constitution. Reacting with righteous zeal, Church leaders doubled down for decades, furtively slipping protections into the law and encouraging insurance companies to cover Christian Science “treatment”. Since it cost very little, the companies cynically complied.

As a result, by the 1970s – a high-water mark for the church’s political power, with many Scientists serving in Richard Nixon’s White House and federal agencies – the church was well on its way to accumulating an incredible array of legal rights and privileges across the US, including broad-based religious exemptions from childhood immunisations in 47 states, as well as exemptions from routine screening tests and procedures given to newborns in hospitals. The exemptions had consequences: modern-day outbreaks of diphtheria, polio and measles in Christian Science schools and communities. A 1972 polio outbreak in Connecticut left multiple children partially paralysed; a 1985 measles outbreak (one of several) at Principia College in Illinois killed three.

In many US states, Scientists were exempt from charges of child abuse, neglect and endangerment, as well as from failure to report such crimes. Practitioners with no medical training (they become “listed” after two weeks of religious indoctrination) were recognised as health providers, and in some states were required to report contagious illnesses or cases of child abuse or neglect, even as their religion demanded that they deny the evidence of the physical senses. Practitioners, of course, have no way of recognising the symptoms of an illness, even if they believe it existed, which they don’t.

A whole system of Christian Science “nursing” sprang up in unlicensed Christian Science sanatoriums and nursing homes catering to patients with open wounds and bodies eaten away by tumours. There, no medical treatment was allowed to interfere with prayer. Assigned only the most basic duties – feeding and cleaning patients – Christian Science “nurses” are not registered, and have no medical training either. Instead, they engage in bizarre practices such as leaving food on the mouths of patients who cannot eat. They provide no assistance for those who are having trouble breathing, administer no painkillers, react to no emergencies. “Do not resuscitate” is their default. But some of these facilities, and the incompetent care they provide, are covered by Medicare, the US’s national healthcare insurance programme.


Still, by this point, few people know or care what the Christian Scientists have been up to, since the average person can’t tell you the difference between a Christian Scientist and a Scientologist. The decline of the faith, once a major indigenous sect, may be among the most dramatic contractions in the history of American religion. Eddy forbade counting the faithful, but in 1961, the year I was born, the number of branch churches worldwide reached a high of 3,273. By the mid-80s, the number in the US had dropped to 1,997; between 1987 and late 2018, 1,070 more closed, while only 83 opened, leaving around a thousand in the US.

Prized urban branches are being sold off by the score, converted into luxury condominiums, museums and Buddhist temples. The branch I attended, on Mercer Island, near Seattle, is now Congregation Shevet Achim, a Modern Orthodox synagogue.

Worldly erosion eats away at the remainder. New York’s Third Church on Park Avenue is still open for spiritual business, but is leased for events during the week, sparking complaints about blocked traffic, paparazzi and partygoers attending celebrity galas in the four-storey neo-Georgian sanctuary. The phrase “God is Love” is traditionally affixed to an interior wall of every branch, but during secular events the words are concealed behind a faux-slate panel, lest they detract from, say, a runway show of Oscar de la Renta resort wear. Alcohol and coffee, shunned by Church members since Eddy’s day, are brought in by caterers.

The slide into irrelevance has been inexorable. The number of practitioners has fallen to an all-time low of 1,126, and during the last decade the Sentinel magazine has lost more than half its subscribers. The Monitor, the public face of the Church, has become a kind of zombie newspaper, laying off 30% of its staff in 2016. It is now available as a five-days-a-week emailed newsletter, or a thin print weekly that has been bleeding subscribers.

Principia, the Christian Science educational institution (a separate entity from the Mother Church), has shed so many students that its future is in question. Its college enrollment was down to 435 in 2018, the St Louis Post-Dispatch reported, while its school had 400 students, with just eight in the first-grade class. With an endowment of $680m, one official noted, “We are going to run out of kids before we run out of money. There just aren’t enough Christian Scientists on the planet.” . . .

Continue reading. There’s much more, and some of it is grim indeed. Lord, deliver us from “Christian” “Science.”

Written by LeisureGuy

10 August 2019 at 10:35 am

Unmarked buildings, quiet legal help for accused priests

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The Catholic church seems to be corrupt at its core. Martha Mendoza, Juliet Linderman, and Garance Burke report for AP:

The visiting priests arrived discreetly, day and night.

Stripped of their collars and cassocks, they went unnoticed in this tiny Midwestern town as they were escorted into a dingy warehouse across from an elementary school playground. Neighbors had no idea some of the dressed-down clergymen dining at local restaurants might have been accused sexual predators.

Full Coverage: The Reckoning

They had been brought to town by a small, nonprofit group called Opus Bono Sacerdotii. For nearly two decades, the group has operated out of a series of unmarked buildings in rural Michigan, providing money, shelter, transport, legal help and other support to hundreds, perhaps thousands, of Catholic priests accused of sexual abuse across the country.

Again and again, Opus Bono has served as a rapid-response team for the accused.

When a serial pedophile was sent to jail for abusing dozens of minors, Opus Bono was there for him, with regular visits and commissary cash.

When a priest admitted sexually assaulting boys under 14, Opus Bono raised funds for his defense.

When another priest was criminally charged with abusing a teen, Opus Bono later made him a legal adviser.

And while powerful clerics have publicly pledged to hold the church accountable for the crimes of its clergy and help survivors heal, some of them arranged meetings, offered blessings or quietly sent checks to this organization that provided support to alleged abusers, The Associated Press has found.

Though Catholic leaders deny the church has any official relationship with the group, Opus Bono successfully forged networks reaching all the way to the Vatican.

The AP unraveled the continuing story of Opus Bono in dozens of interviews with experts, lawyers, clergy members and former employees, along with hundreds of pages of documents obtained through Freedom of Information requests.

In recent months, two of the group’s founders were forced out after Michigan’s attorney general found that Opus Bono had misused donated funds and misled contributors. A third co-founder, a priest, was abruptly removed from ministry earlier this month after the AP began asking about an allegation that he had sexually abused a child decades ago.

Still, since 2002, Opus Bono has played a little-known role among conservative Catholic groups that portray the abuse scandal as a media and legal feeding frenzy. These groups contend the scandal maligns the priesthood and harms the Catholic faith. [Apparently the group is totally unaware of how Opus Bono harms the Catholic faith. – LG]

Opus Bono established itself as a counterpoint to the Survivors Network of those Abused by Priests and other groups that have accused the church of trying to cover up the scandal and failing to support victims of clergy misconduct. Opus Bono focuses on what it considers the neglected victims: priests, and the church itself.

“All of these people that have made allegations are very well taken care of,” Opus Bono co-founder Joe Maher said in a radio interview, contending that many abuse accusations lodged against priests are false. “The priests are not at all very well taken care of.”

Opus Bono’s roots reach back almost two decades to a sex abuse scandal that convulsed The Assumption of the Blessed Virgin Mary Church, a grand stone structure set amid Detroit’s crumbling brick blight.

For 25 years, the Rev. Eduard Perrone presided there. Inside the church, commonly known as Assumption Grotto, glossy Opus Bono brochures tout the pastor’s role as the group’s co-founder and spiritual lifeblood. Stern and imposing, the 70-year-old Perrone is a staunch conservative; he refused to marry couples, for example, if he thought the bride’s dress was too revealing.

Earlier this month, his parishioners were shocked when Perrone was removed from ministry after a church review board decided there was a “semblance of truth” to allegations that he abused a child decades ago. Perrone told the AP that he “never would have done such a thing.”

In the years before Perrone helped start Opus Bono, he and Assumption Grotto took in at least two priests who had been accused of sexual misconduct at dioceses in other states. One of them later admitted to molesting as many as 50 children in the 1980s and ’90s, according to court documents in Texas. . .

Continue reading. There’s MUCH more.

The Catholic church has lost its moral authority, at least in my view.

Written by LeisureGuy

29 July 2019 at 1:24 pm

Religious Republicans use this design for their cross-stitching

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Written by LeisureGuy

1 July 2019 at 2:11 pm

Posted in GOP, Politics, Religion

Why Jessica Biel Is Wrong about Science and Vaccines

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James Hamblin writes in the Atlantic:

One morning in 1934, panicked passengers jumped from the deck of the SS Morro Castle as it sank just off the coast of New Jersey. The ocean liner had caught fire, and the passengers had rushed to grab personal flotation devices. But some improperly wrapped the life preservers around their necks. As they fell and hit the water, the torque snapped their spines.

Personal flotation devices save exponentially more lives than they cost. Of the catastrophic boating accidents that occur daily, 84 percent of people who drown were not wearing one. But etch the details of this horrific wreck sceneinto one’s mind, and a person might become a life-preserver skeptic. Our basic tendency toward short-term thinking means we judge risk based on whatever is in front of us. We draw anxiety disproportionately from wherever we happen to be focusing our attention.

The same psychology applies throughout public health. At the moment, much attention in the U.S. is being paid to vaccines—rather than the diseases they prevent. This week, the actor Jessica Biel drew fiery eyes for lobbyinglegislators in California to kill a bill that would standardize the process of exempting children from required vaccinations. Biel, perhaps best known for her leading role in 2006’s The Illusionist, expressed concern for the well-being of a friend’s child. She has responded to accusations of being “anti-vax” by contending in an Instagram post that she “believes in vaccinations,” but wants to protect personal freedom: “I believe in giving doctors and the families they treat the ability to decide what’s best for their patients.”

Like life preservers and everything else, vaccines do come with some fleeting risk of unintended adverse outcomes: mostly rashes or fevers, and in extremely rare cases, seizures. But these risks pale in comparison with those of the diseases vaccines prevent. Before the advent of vaccination, measles alone killed some 6,000 children in the United States every year.

This year has already seen more measles cases than any other since the disease was declared eliminated two decades ago. The trend stems from low rates of vaccination, which are making exemptions from vaccine requirements a flash point. California has triggered a reckoning with why exemptions exist at all—and why belief came to factor so heavily into a question of science. When is a health issue a matter of belief, and when is it simply wrong? When is it so wrong that it’s neglect?

No federal law requires vaccination. But every state mandates that in order to send a child to public school—to have that child sit in close quarters with other children all day, every day—parents must take preventive measures to ensure the child does not carry certain dangerous infections. Requirements are implicit in the legal precedent that withholding vaccination constitutes “medical neglect” of a child. Legally, for example, it’s considered neglect to let a cut on a child’s arm get infected and then refuse antibiotics. If that infection had been airborne, as with measles, declining treatment as a child gasps for air would also be textbook neglect. It has been deemed neglect in cases where infectious diseases could have been easily prevented, but weren’t.

Researchers at Ohio State recently reviewed cases across the country from 1905 to 2016 and found that a majority of the time, refusing vaccination was found to be neglect. There was a curious caveat, though. In states with “religious exemptions,” parents did not have to follow public-health mandates to vaccinate their children against measles and other diseases if the parents cited “genuine and sincere religious beliefs.” The Ohio State researchers found that in these states, vaccine refusal did not constitute neglect—or it was considered neglect only if someone’s belief was deemed insufficiently “sincere.”

Religious exemptions have slowly expanded in the United States, to the point that now, in almost every state, parents can opt out of school requirements—and leave a child open to catching and spreading lethal diseases to other children—if doing so is guided by what the state considers a sincere belief. In such cases, the same behavior is not neglect.

Exemptions have expanded to include “personal or philosophical belief” exemptions as well, which are currently offered in 17 states. When the standard is sincerity of belief, the thinking goes, it shouldn’t have to be drawn from a major religion (or even a minor one).

Accordingly, the number of people taking up belief-based exemptions has been steadily increasing, and rates of vaccination declining. The constitutionality of vaccine requirements is well established, and courts have found states are not obligated to grant religious exemptions. Nevertheless, the overall effect of such respect for the concept of personal belief has been that, gradually, vaccine requirements have become requirements in name only.

The return of measles, though, is forcing a breaking point. In 2015, a measles outbreak was traced back to a single child at Disneyland. California health officials saw that the outbreak happened not simply because of one unvaccinated child, but because only 90 percent of kindergartners in the state were fully immunized. To establish herd immunity for measles, a community needs 94 percent of people on board. . . .

Continue reading. There’s much more, including the rise of rogue doctors who sell immunization exemptions.

Written by LeisureGuy

15 June 2019 at 1:40 pm

The Irrationality of Alcoholics Anonymous

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Gabrielle Glaser writes in the Atlantic:

J.G. is a lawyer in his early 30s. He’s a fast talker and has the lean, sinewy build of a distance runner. His choice of profession seems preordained, as he speaks in fully formed paragraphs, his thoughts organized by topic sentences. He’s also a worrier—a big one—who for years used alcohol to soothe his anxiety.

J.G. started drinking at 15, when he and a friend experimented in his parents’ liquor cabinet. He favored gin and whiskey but drank whatever he thought his parents would miss the least. He discovered beer, too, and loved the earthy, bitter taste on his tongue when he took his first cold sip.

His drinking increased through college and into law school. He could, and occasionally did, pull back, going cold turkey for weeks at a time. But nothing quieted his anxious mind like booze, and when he didn’t drink, he didn’t sleep. After four or six weeks dry, he’d be back at the liquor store.

By the time he was a practicing defense attorney, J.G. (who asked to be identified only by his initials) sometimes drank almost a liter of Jameson in a day. He often started drinking after his first morning court appearance, and he says he would have loved to drink even more, had his schedule allowed it. He defended clients who had been charged with driving while intoxicated, and he bought his own Breathalyzer to avoid landing in court on drunk-driving charges himself.

In the spring of 2012, J.G. decided to seek help. He lived in Minnesota—the Land of 10,000 Rehabs, people there like to say—and he knew what to do: check himself into a facility. He spent a month at a center where the treatment consisted of little more than attending Alcoholics Anonymous meetings. He tried to dedicate himself to the program even though, as an atheist, he was put off by the faith-based approach of the 12 steps, five of which mention God. Everyone there warned him that he had a chronic, progressive disease and that if he listened to the cunning internal whisper promising that he could have just one drink, he would be off on a bender.

J.G. says it was this message—that there were no small missteps, and one drink might as well be 100—that set him on a cycle of bingeing and abstinence. He went back to rehab once more and later sought help at an outpatient center. Each time he got sober, he’d spend months white-knuckling his days in court and his nights at home. Evening would fall and his heart would race as he thought ahead to another sleepless night. “So I’d have one drink,” he says, “and the first thing on my mind was: I feel better now, but I’m screwed. I’m going right back to where I was. I might as well drink as much as I possibly can for the next three days.”

He felt utterly defeated. And according to AA doctrine, the failure was his alone. When the 12 steps don’t work for someone like J.G., Alcoholics Anonymous says that person must be deeply flawed. The Big Book, AA’s bible, states:

Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way.

J.G.’s despair was only heightened by his seeming lack of options. “Every person I spoke with told me there was no other way,” he says.

The 12 steps are so deeply ingrained in the United States that many people, including doctors and therapists, believe attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol is the only way to get better. Hospitals, outpatient clinics, and rehab centers use the 12 steps as the basis for treatment. But although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation. Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work.

For J.G., it took years of trying to “work the program,” pulling himself back onto the wagon only to fall off again, before he finally realized that Alcoholics Anonymous was not his only, or even his best, hope for recovery. But in a sense, he was lucky: many others never make that discovery at all.

The debate over the efficacy of 12-step programs has been quietly bubbling for decades among addiction specialists. But it has taken on new urgency with the passage of the Affordable Care Act, which requires all insurers and state Medicaid programs to pay for alcohol- and substance-abuse treatment, extending coverage to 32 million Americans who did not previously have it and providing a higher level of coverage for an additional 30 million.

Nowhere in the field of medicine is treatment less grounded in modern science. A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University compared the current state of addiction medicine to general medicine in the early 1900s, when quacks worked alongside graduates of leading medical schools. The American Medical Association estimates that out of nearly 1 million doctors in the United States, only 582 identify themselves as addiction specialists. (The Columbia report notes that there may be additional doctors who have a subspecialty in addiction.) Most treatment providers carry the credential of addiction counselor or substance-abuse counselor, for which many states require little more than a high-school diploma or a GED. Many counselors are in recovery themselves. The report stated: “The vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.”
Alcoholics Anonymous was established in 1935, when knowledge of the brain was in its infancy. It offers a single path to recovery: lifelong abstinence from alcohol. The program instructs members to surrender their ego, accept that they are “powerless” over booze, make amends to those they’ve wronged, and pray.

Alcoholics Anonymous is famously difficult to study. By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous. No conclusive data exist on how well it works. In 2006, the Cochrane Collaboration, a health-care research group, reviewed studies going back to the 1960s and found that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”

The Big Book includes an assertion first made in the second edition, which was published in 1955: that AA has worked for 75 percent of people who have gone to meetings and “really tried.” It says that 50 percent got sober right away, and another 25 percent struggled for a while but eventually recovered. According to AA, these figures are based on members’ experiences.

In his recent book, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Lance Dodes, a retired psychiatry professor from Harvard Medical School, looked at Alcoholics Anonymous’s retention rates along with studies on sobriety and rates of active involvement (attending meetings regularly and working the program) among AA members. Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent. That is just a rough estimate, but it’s the most precise one I’ve been able to find.

I spent three years researching a book about women and alcohol, Her Best-Kept Secret: Why Women Drink—And How They Can Regain Control, which was published in 2013. During that time, I encountered disbelief from doctors and psychiatrists every time I mentioned that the Alcoholics Anonymous success rate appears to hover in the single digits. We’ve grown so accustomed to testimonials from those who say AA saved their life that we take the program’s efficacy as an article of faith. Rarely do we hear from those for whom 12-step treatment doesn’t work. But think about it: How many celebrities can you name who bounced in and out of rehab without ever getting better? Why do we assume they failed the program, rather than that the program failed them?

When my book came out, dozens of Alcoholics Anonymous members said that because I had challenged AA’s claim of a 75 percent success rate, I would hurt or even kill people by discouraging attendance at meetings. A few insisted that I must be an “alcoholic in denial.” But most of the people I heard from were desperate to tell me about their experiences in the American treatment industry. Amy Lee Coy, the author of the memoir From Death Do I Part: How I Freed Myself From Addiction, told me about her eight trips to rehab, starting at age 13. “It’s like getting the same antibiotic for a resistant infection—eight times,” she told me. “Does that make sense?”

She and countless others had put their faith in a system they had been led to believe was effective—even though finding treatment centers’ success rates is next to impossible: facilities rarely publish their data or even track their patients after discharging them. “Many will tell you that those who complete the program have a ‘great success rate,’ meaning that most are abstaining from drugs and alcohol while enrolled there,” says Bankole Johnson, an alcohol researcher and the chair of the psychiatry department at the University of Maryland School of Medicine. “Well, no kidding.”

Alcoholics Anonymous has more than 2 million members worldwide, and the structure and support it offers have helped many people. But it is not enough for everyone. The history of AA is the story of how one approach to treatment took root before other options existed, inscribing itself on the national consciousness and crowding out dozens of newer methods that have since been shown to work better.

A meticulous analysis of treatments, published more than a decade ago in The Handbook of Alcoholism Treatment Approaches but still considered one of the most comprehensive comparisons, ranks AA 38th out of 48 methods. At the top of the list are brief interventions by a medical professional; motivational enhancement, a form of counseling that aims to help people see the need to change; and acamprosate, a drug that eases cravings. (An oft-cited 1996 study found 12-step facilitation—a form of individual therapy that aims to get the patient to attend AA meetings—as effective as cognitive behavioral therapy and motivational interviewing. But that study, called Project Match, was widely criticized for scientific failings, including the lack of a control group.)

As an organization, Alcoholics Anonymous has no real central authority—each AA meeting functions more or less autonomously—and it declines to take positions on issues beyond the scope of the 12 steps. (When I asked to speak with someone from the General Service Office, AA’s administrative headquarters, regarding AA’s stance on other treatment methods, I received an e-mail stating: “Alcoholics Anonymous neither endorses nor opposes other approaches, and we cooperate widely with the medical profession.” The office also declined to comment on whether AA’s efficacy has been proved.) But many in AA and the rehab industry insist the 12 steps are the only answer and frown on using the prescription drugs that have been shown to help people reduce their drinking.

People with alcohol problems also suffer from higher-than-normal rates of mental-health issues, and research has shown that treating depression and anxiety with medication can reduce drinking. But AA is not equipped to address these issues—it is a support group whose leaders lack professional training—and some meetings are more accepting than others of the idea that members may need therapy and/or medication in addition to the group’s help. . .

Continue reading. There’s much more, and it’s important.

Later in the article:

. . .
The United States already spends about $35 billion a year on alcohol- and substance-abuse treatment, yet heavy drinking causes 88,000 deaths a year—including deaths from car accidents and diseases linked to alcohol. It also costs the country hundreds of billions of dollars in expenses related to health care, criminal justice, motor-vehicle crashes, and lost workplace productivity, according to the CDC. With the Affordable Care Act’s expansion of coverage, it’s time to ask some important questions: Which treatments should we be willing to pay for? Have they been proved effective? And for whom—only those at the extreme end of the spectrum? Or also those in the vast, long-overlooked middle?

For a glimpse of how treatment works elsewhere, I traveled to Finland, a country that shares with the United States a history of prohibition (inspired by the American temperance movement, the Finns outlawed alcohol from 1919 to 1932) and a culture of heavy drinking.

Finland’s treatment model is based in large part on the work of an American neuroscientist named John David Sinclair. I met with Sinclair in Helsinki in early July. He was battling late-stage prostate cancer, and his thick white hair was cropped short in preparation for chemotherapy. Sinclair has researched alcohol’s effects on the brain since his days as an undergraduate at the University of Cincinnati, where he experimented with rats that had been given alcohol for an extended period. Sinclair expected that after several weeks without booze, the rats would lose their desire for it. Instead, when he gave them alcohol again, they went on week-long benders, drinking far more than they ever had before—more, he says, than any rat had ever been shown to drink.

Sinclair called this the alcohol-deprivation effect, and his laboratory results, which have since been confirmed by many other studies, suggested a fundamental flaw in abstinence-based treatment: going cold turkey only intensifies cravings. This discovery helped explain why relapses are common. Sinclair published his findings in a handful of journals and in the early 1970s moved to Finland, drawn by the chance to work in what he considered the best alcohol-research lab in the world, complete with special rats that had been bred to prefer alcohol to water. He spent the next decade researching alcohol and the brain.

Sinclair came to believe that people develop drinking problems through a chemical process: each time they drink, the endorphins released in the brain strengthen certain synapses. The stronger these synapses grow, the more likely the person is to think about, and eventually crave, alcohol—until almost anything can trigger a thirst for booze, and drinking becomes compulsive.

Sinclair theorized that if you could stop the endorphins from reaching their target, the brain’s opiate receptors, you could gradually weaken the synapses, and the cravings would subside. To test this hypothesis, he administered opioid antagonists—drugs that block opiate receptors—to the specially bred alcohol-loving rats. He found that if the rats took the medication each time they were given alcohol, they gradually drank less and less. He published his findings in peer-reviewed journals beginning in the 1980s.

Subsequent studies found that an opioid antagonist called naltrexone was safe and effective for humans, and Sinclair began working with clinicians in Finland. He suggested prescribing naltrexone for patients to take an hour before drinking. As their cravings subsided, they could then learn to control their consumption. Numerous clinical trials have confirmed that the method is effective, and in 2001 Sinclair published a paper in the journal Alcohol and Alcoholism reporting a 78 percent success rate in helping patients reduce their drinking to about 10 drinks a week. Some stopped drinking entirely.

I visited one of three private treatment centers, called the Contral Clinics, that Sinclair co-founded in Finland. (There’s an additional one in Spain.) In the past 18 years, more than 5,000 Finns have gone to the Contral Clinics for help with a drinking problem. Seventy-five percent of them have had success reducing their consumption to a safe level. . .

Written by LeisureGuy

10 June 2019 at 7:08 pm

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