FAA diagnosed substance abuse

AA is spiritual program. Even though we use the term God, it's a god of our understanding more than some bearded white guy in the clouds of heaven! Any power greater than ourselves basically.
 
I have great disdain for governmental reliance on AA. AA has never been shown to have any clinical efficacy. In fact, those who do NOTHING to try to resolve their alcohol problem are just as likely to remain sober than those in AA. Further, given the AA scapegoating of God as the determining factor in substance abuse borders on a blatant first amendment violation in any mandatory governmental use of it.

But, given you're already strung out in due process by the time the FAA sets up arbitrary goals to let you back in, you have to do whatever they want.

As for BAC. Everybody's tolerance is different. Those of us in emergency medicine have seen those DEAD at .20% and we've had those lucid and conversing at .42%. .08 is more of a political limit than anything meaingful. Some would like it at .05 (or lower), back decades ago, you're lucky if you ever seen things less than .010.
 
flyingron said:
I have great disdain for governmental reliance on AA. AA has never been shown to have any clinical efficacy. In fact, those who do NOTHING to try to resolve their alcohol problem are just as likely to remain sober than those in AA. Further, given the AA scapegoating of God as the determining factor in substance abuse borders on a blatant first amendment violation in any mandatory governmental use of it.

But, given you're already strung out in due process by the time the FAA sets up arbitrary goals to let you back in, you have to do whatever they want.

As for BAC. Everybody's tolerance is different. Those of us in emergency medicine have seen those DEAD at .20% and we've had those lucid and conversing at .42%. .08 is more of a political limit than anything meaingful. Some would like it at .05 (or lower), back decades ago, you're lucky if you ever seen things less than .010.
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The most recent stats I am aware of are old ones from when I was preparing for a CASAC examination. Back then, a meta-analysis of what studies were available suggested that about half of people who voluntarily walked into an AA meeting never drank again, and another 25 percent eventually got sober after one or more "slips." The data on those who were forced by courts, parole officers, and so forth to go to AA were much less promising, but I forget the exact numbers.

My impression from talking to many drunks and addicts is that the meeting themselves were helpful, but establishing new friendships with people who didn't drink or abuse other drugs was even more so. The "steps," "traditions," slogans, and so forth seem to form the bases for a social contract of sorts and a common language of shared experiences. A lot of folks talked of the "meetings after the meetings," commonly at all-night diners and sometimes lasting into the next mornings. They just sat, drank coffee, smoked cigarettes (it was allowed back then), and stayed sober.

There also are extensive networks, both "official" and not, to support AA members who are traveling. I doubt there's a corner of the earth where an AA can't find a meeting if he or she needs one, along with the after-meeting support and non-drinking companionship.

In short, it seems to me that the program does work very well if you define the "program" not just as attending meetings, but as taking part in the entire experience of AA, including (and especially) socializing with other sober alcoholics and following the roadmap laid out by the Steps.

As for the spiritual aspects, it's true that AA's roots were in a holiness movement known as the Oxford Group and that the 12 Steps were based on biblical teachings (especially from the Epistle of James). But the definitions of "God" and "Higher Power" as used in the group itself are so loose that only someone looking for an argument would have a problem with them. Most Agnostics and Atheists in AA define the Higher Power as the group, the Steps, or even sobriety itself. The very clarity of thought that increased sobriety brings is, for these people, the higher power that enables them to stay sober.

I know one old man who lives in a very rural area who stays sober by volunteering to attend AA meetings in jails and prisons as an "outside sponsor." He says he doesn't know if his "pigeons" will stay sober once they're released, but helping them keeps him sober. Who am I to argue?

Rich
 
IMO the real problem will be his employment application.
 
I never said people won't find AA helpful in a support way. However, as considering it "medical treatment" the efficacy stats say otherwise. I would encourage those with any sort of substance abuse that are serious about getting clean and sober look beyond just doing 12 step.
 
flyingron said:
I never said people won't find AA helpful in a support way. However, as considering it "medical treatment" the efficacy stats say otherwise. I would encourage those with any sort of substance abuse that are serious about getting clean and sober look beyond just doing 12 step.
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Poor efficacy is a problem with most treatments for substance abuse.

Btw. the FAA doesn't mandate AA. It is just that the folks who authored the HIMSS program wrote it into their proposal. If a different group of shrinks writes up a program using a different treatment modality, there may be other options down the line.
 
AA is successful if you put in the work. The problem is when people don't take suggestions and guidance from others. They aren't willing to change because they don't believe they have a problem. "It's everyone and everything that's the problem."
flyingron said:
I have great disdain for governmental reliance on AA. AA has never been shown to have any clinical efficacy. In fact, those who do NOTHING to try to resolve their alcohol problem are just as likely to remain sober than those in AA. Further, given the AA scapegoating of God as the determining factor in substance abuse borders on a blatant first amendment violation in any mandatory governmental use of it.

But, given you're already strung out in due process by the time the FAA sets up arbitrary goals to let you back in, you have to do whatever they want.

As for BAC. Everybody's tolerance is different. Those of us in emergency medicine have seen those DEAD at .20% and we've had those lucid and conversing at .42%. .08 is more of a political limit than anything meaingful. Some would like it at .05 (or lower), back decades ago, you're lucky if you ever seen things less than .010.
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Where did you get the stats that support your statement about those doing nothing are just as likely to get sober?!
 
weilke said:
Poor efficacy is a problem with most treatments for substance abuse.

Btw. the FAA doesn't mandate AA. It is just that the folks who authored the HIMSS program wrote it into their proposal. If a different group of shrinks writes up a program using a different treatment modality, there may be other options down the line.
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There's a reason any psychiatrist or family physiologist tell patients to go to AA or NA. Because they can't help them! The HIMS doctors are mostly neurological physicians who know the brain and they believe it's a disease that only AA can help with.
 
If anything does help, the person is probably not a full blown alcoholic and doesn't need that much help to see their errors.
 
Jeremy Gardner said:
There's a reason any psychiatrist or family physiologist tell patients to go to AA or NA. Because they can't help them! The HIMS doctors are mostly neurological physicians who know the brain and they believe it's a disease that only AA can help with.
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There is not a single HMS neurologist. just FYI.
 
mtuomi said:
There was a guy in Finland who got done recently for drinking'n'flying. He blew .29. And he made it down safely(in an ultralight...). THAT'S tolerance!

.15 isn't necessarily tolerance, I'm happy and social until around .25(verified) and I don't drink much.
.15 is 15 standard drinks (12 bottles of your usual Bud) in 5 hours for someone my size. That's a heavy evening, but nowhere near morgue numbers. 2.5 per hour for 5 hours.
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Ruh roh rorge. You are tolerant and don't realize it and we've got really good norms on that....the literature sez that 0.20 and still functioning is quite tolerant (and the comparison group was alcohol naieve). Yes there are US populations that are alcohol naieve.....
 
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bbchien said:
Ruh roh rorge. You are tolerant and don't realize it and we've got really good norms on that....the literature sez that 0.20 and still functioning is quite tolerant (and the comparison group was alcohol naieve). Yes there are US populations that are alcohol naieve.....
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Yes, but are you saying it takes long exposure to reach tolerance?
I have an anecdote about that.
 
actually its easier to get a medical back if you already are a professional pilot with a alcohol problem than it is to get a new one . . . . all sorts of programs for the professional pilot - and almost none for the casual pilot. . . .

And my only comment on this is that ANYONE with a 0.15 who is still conscious and able to drive, has had alot of practice with alcohol - thats a tolerance . . .

I have a bac monitor around here - and when I get to .04 I'm feeling it - and at 0.06 I'm wondering if I'm going to be sick. I have not been there in several years now - its not worth feeling that way or not being able to sleep all night -
 
ejensen said:
Interesting Atlantic article on AA.
https://www.theatlantic.com/health/archive/2014/03/the-surprising-failures-of-12-steps/284616/
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The program is NOT a "go to AA and I'm gonna be able to drink like a normal person program." The program works if you work it. It only works if you're honest, willing and open to a new way of life. I was in AA for a year before I decided to fly. The difference: most pilots are ordered to go. It's something they have to get through in order to fly again. They go, get their cards signed and they don't do the steps. They don't change their perspective, they do just enough to get their medical back. They are not in recovery. The stats are stats. All stats have flaws. 33% is huge actually. Especially when your dealing with alcohol, crack, heroine, and meth addicts. If your not in recovery I don't expect ANYONE to understand anything I just said. It's like trying to understand what's it's like to have cancer. You can't, until that day comes.
 
Jeremy Gardner said:
The program is NOT a "go to AA and I'm gonna be able to drink like a normal person program." The program works if you work it. It only works if you're honest, willing and open to a new way of life. I was in AA for a year before I decided to fly. The difference: most pilots are ordered to go. It's something they have to get through in order to fly again. They go, get their cards signed and they don't do the steps. They don't change their perspective, they do just enough to get their medical back. They are not in recovery. The stats are stats. All stats have flaws. 33% is huge actually. Especially when your dealing with alcohol, crack, heroine, and meth addicts. If your not in recovery I don't expect ANYONE to understand anything I just said. It's like trying to understand what's it's like to have cancer. You can't, until that day comes.
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Glad it worked for you.
 
Jeremy Gardner said:
The program is NOT a "go to AA and I'm gonna be able to drink like a normal person program." The program works if you work it. It only works if you're honest, willing and open to a new way of life. I was in AA for a year before I decided to fly.
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Why do you think the 40 year recidivism rate for HIMS is so good (<7%)? What we do get are relapses, which are just a part of the disease. <7% over a lifetime.
The difference: most pilots are ordered to go. It's something they have to get through in order to fly again. They go, get their cards signed and they don't do the steps.
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True, but I literally pall bore my guy who never could win approval. Dry drunks don't make it. With 4 levels of review, a dry drunk's odds are awful: CADC, HIMS psychiatrist, Company Peer monitor, HIMS AME, Dr Alan Sager in Maryland, Charlie Chesanow at the FAA. (Sorry, that's six).
They don't change their perspective, they do just enough to get their medical back. They are not in recovery. The stats are stats. All stats have flaws. 33% is huge actually. Especially when your dealing with alcohol, crack, heroine, and meth addicts. If your not in recovery I don't expect ANYONE to understand anything I just said. It's like trying to understand what's it's like to have cancer. You can't, until that day comes.
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The hard part is sorting out the ones in recovery and the ones not in recovery. And that's what Dr. Rozansky does (among others). He is a TERRIFIC listener...because the verbiage reflects the actual thinking. You can't "outsmart" these guys...you can try but after two hours, there is always a slip.

The reason why HIMS works is it's overwhelming. I have sponsored a good 2 dozen guys and buried one (I knew he was a dry drunk and NEVER recommended him). One of the pilots said after his first year: "at month 4...it was overwhelming. All I do each day is recovery. By the 4th month I can't remember anything about my life except recovery. There isn't any part of my life left except recovery. Somewhere around the 6th month I saw the light..." The reason it sustains is that is runs, commonly five years. I have on guy whose terms are "monitoring for the rest of your professional career in aviation".

So this is not about AA, but it's about AA as a component in "getting it", or seeing the light. But a lot of wisdom exists at AA meetings. A whole lot. The guys in recover can also smell a guy not in recovery.....and from 1000 yards. And that is why we have peer monitoring and peer mentoring.
 
Jeremy Gardner said:
AA is successful if you put in the work.
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Nope, actually it isn't. Twelve step is without any medical or psychological basis. You're just as likely to spontaneously cure yourself without doing anything as compared with rigid adherence of 12 step.
 
flyingron said:
Nope, actually it isn't. Twelve step is without any medical or psychological basis. You're just as likely to spontaneously cure yourself without doing anything as compared with rigid adherence of 12 step.
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And what makes you qualified to say these things if may ask?! Do you work in that field? I've seen hundreds of people in my area stay sober for 30 plus years and never did anything but AA. It's possible and it happens all the time. The steps allow you to acknowledge you have a problem. Pinpoint those problems. Give your will over to the God of your understanding. Take personal inventory, acknowledge your defects, give those problems to your higher power, admit to another human being ALL the wrongs you've ever made (very powerful), make direct amends to those people if it doesn't harm them. The rest is spiritual maintenance. The point is to be self aware and gain a better perspective on why you drank the way you did. Alcohol and drugs aren't the problem...they are the solution to the problem--ourselves!
 
It's in the medical literature. Scapegoating God for your substance abuse problems is hardly valid either religiously or scientifically.
 
Wow. So is it safe to say that you think AA blames God for their problems? Because that's what a scapegoat is. If so, you are way way way off. Let me educate you. Because most alcoholics spend much of their life feeling different, they go in survival mode and build an unclimbable wall of emotions to protect themselves from people, places and things. This creates an false EGO. A big mean one that screams insecurity. One that is full of fear, selfishness, and manipulation.

When someone gets their ass handed to them and they want to quit, they come to us. We then have them start to think that there is something out there bigger than themselves (huge ego.) This might take some time but we tell them if they want we have, they have to do what we do. Because it works. But only in those who are desperate enough and can't stay sober by themselves.

If they are abstinent, at some point (could be months) they should start to believe that there is a Higher Power able to get them back to sanity. The HP is not a scapegoat. It's a belief that he or she has a plan for their life and it's not being a lying, cheating, stealing ass hole who recks their families life. Because that's what addiction does. The HP protects you and gives you the strength needed not to drink. We have to trust that the plan "it" has chosen is going to be a beautiful one. It's faith that everything will be ok as long as you QUIT drinking. Again, you might not understand any of this because you haven't lived it.
 
Jeremy Gardner said:
Wow. So is it safe to say that you think AA blames God for their problems? Because that's what a scapegoat is. If so, you are way way way off. Let me educate you. Because most alcoholics spend much of their life feeling different, they go in survival mode and build an unclimbable wall of emotions to protect themselves from people, places and things. This creates an false EGO. A big mean one that screams insecurity. One that is full of fear, selfishness, and manipulation.

When someone gets their ass handed to them and they want to quit, they come to us. We then have them start to think that there is something out there bigger than themselves (huge ego.) This might take some time but we tell them if they want we have, they have to do what we do. Because it works. But only in those who are desperate enough and can't stay sober by themselves.

If they are abstinent, at some point (could be months) they should start to believe that there is a Higher Power able to get them back to sanity. The HP is not a scapegoat. It's a belief that he or she has a plan for their life and it's not being a lying, cheating, stealing ass hole who recks their families life. Because that's what addiction does. The HP protects you and gives you the strength needed not to drink. We have to trust that the plan "it" has chosen is going to be a beautiful one. It's faith that everything will be ok as long as you QUIT drinking. Again, you might not understand any of this because you haven't lived it.
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This post should be a sticky.
 
AA is a spiritual program. I'm in AA and I don't believe in God but I believe there is something out there that put us here...my Higher Power.
 
Jeremy Gardner said:
AA is a spiritual program. I'm in AA and I don't believe in God but I believe there is something out there that put us here...my Higher Power.
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And that's not God? Call it what you want it is still needing something outside to hang your problems on.
 
I don't know... I just struggle to make sense of that messaging.

When it comes to my life, my future, my actions, or the consequences of my actions (whether good or bad) the highest power is myself, period. I have the highest level of control over every single element of the above. I'm also the biggest critic of myself and my actions. I can't control a damn thing in this world other than myself.

That perspective has always served me fine.

As to BAC, I picked up a good (you have to research what you're buying) breathalyzer awhile back. I've never blown above a .06 on it.

I've certainly seen folks blow a .15 on it that were highly functional in that state. Do they have a tolerance? Well what's a tolerance? They're more tolerant than I am.

Do I believe having a tolerance higher than I do indicates you're an alcoholic or that you have a problem? No.
 
jesse said:
I don't know... I just struggle to make sense of that messaging.

When it comes to my life, my future, my actions, or the consequences of my actions (whether good or bad) the highest power is myself, period. I have the highest level of control over every single element of the above. I'm also the biggest critic of myself and my actions. I can't control a damn thing in this world other than myself.

That perspective has always served me fine.

As to BAC, I picked up a good (you have to research what you're buying) breathalyzer awhile back. I've never blown above a .06 on it.

I've certainly seen folks blow a .15 on it that were highly functional in that state. Do they have a tolerance? Well what's a tolerance? They're more tolerant than I am.

Do I believe having a tolerance higher than I do indicates you're an alcoholic or that you have a problem? No.
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U struggle because you're not in recovery.
 
ejensen said:
And that's not God? Call it what you want it is still needing something outside to hang your problems on.
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This is my last post on this.

If you are not trying to give advice, lend a hand, share ur experience or gain knowledge on here, then why come on here and pick apart comments that you obviously have no real life experience
 
ejensen said:
And that's not God? Call it what you want it is still needing something outside to hang your problems on.
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It reallly does say a lot about ur character to cowardly make comments that don't pertain to the OP. Get a life, a hobby or some common sense and stay out of conversations you know nothing about. Respectively...
 
Jeremy Gardner said:
It reallly does say a lot about ur character to cowardly make comments that don't pertain to the OP. Get a life, a hobby or some common sense and stay out of conversations you know nothing about. Respectively...
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This post says a lot about your character....
 
It's obvious to me that AA works not because of the particulars, but because of the camaraderie, and because if a person sticks with it, that person is finally internally motivated to fix their life, for whatever reason. The camaraderie means you've joined a "tribe", giving you group identity, without which all humans malfunction, and addicts are, almost by definition, shunned outsiders in any group but among other addicts. AA could focus on painting pictures of purple penguins as the steps for all it matters, and it would be just as successful. When a person finally focuses on painting purple penguins rather than escaping into chemicals, and has an intimate group of supportive, understanding buddies, plus has finally the internal motivation (wife left him, lost his business, wants to keep flying, etc.) then it all comes together and he can truly change.

For people like MassPilot's brother, the internal motivation triggered by a stay in jail was sufficient. Pro-AA people are going to argue with me, "No it's the actual 12 steps, giving yourself to a higher power, righting past wrongs, etc." and to that I say, "Yup, you need to believe that for it to work. It's how humans operate in their tribes. It's their collective belief in their system of mythology that is the glue and the magic making it all effective. Nothing wrong with that. Everything right with it; it is hardwired into our nature."

There is no convincing a true believer that any other pathway can work, just like with the more general systems of human mythology (a.k.a. religion, or even scientific paradigms). The problem comes when such a group attempts to force its belief system on the rest of us. But I will fall short of saying the FAA mandating AA violates our Constitutional Bill of Rights, because they mandate it only if you want a pilot's license, and no one has a "right" to a flying career.

Disclaimer: The above is only my opinion. I might be wrong because I've never attended AA; I can barely stand to drink a half glass of wine. But if you count substances involving buttercream frosting, I do understand addiction. Yes I am serious.
 
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