Acamprosate
STAAMFA
Acamprosate:
"The panel reviewed three European trials and one in the United States in
which recovering alcoholics were given either acamprosate or a placebo. The
drug kept more alcoholics from drinking in the three European trials, but it
did not "meet the main effectiveness goals" in the more recent U.S. study,
FDA officials said.
In the European trials, 62 percent of those taking the drug remained
abstinent for a year, while in the United States only 46 percent stayed
sober for a year. In all trials, for those who did not quit drinking, the
drug reduced the number of days they drank during the year. "
It makes me wonder what the US success rates would have been if the studies
isolated for practicing AA's anti-meds bias and incurable disease
proselytizing. A 16% variance between the more successful European outcomes
versus US outcomes is sufficiently significant to warrant further
investigation.
I think perhaps AA would make the most appropriate starting place to
investigate the origins of the deviance.
AL (STUART)
"STAAMFA" <STAA...@yahoo.com> wrote in message
news:nFBF8.20050$eD2.3...@news2.east.cox.net...
I'm not so sure that AA is 'anti-meds'. Where do you get that idea from? In
fact there are references in the text to obtaining outside help where
necessary.
The deviance may in fact be due to design and nothing to do with culture at
all. Could you be so kind as to provide a source for your reference so that
I may peruse them and comment more intelligently. This group sometimes gets
the 'he said she said' syndrome. It would be useful for purposes of
discussion if all involved were on the same page. But then your anti-AA,
anti certain poster bias may have something to do with the direction of the
discussion. You act as if you were a scientist STAAMFA, now show us the
money....
>
>
Sean
> "STAAMFA" <STAA...@yahoo.com> wrote in message
> news:nFBF8.20050$eD2.3...@news2.east.cox.net...
> I'm not so sure that AA is 'anti-meds'. Where do you get that idea from? In
> fact there are references in the text to obtaining outside help where
> necessary.
'Tis yet another nice example of where what the big big says and what
folks actually differ. In my experience being told by a grouper to stop
taking your meds is a cliche. It's as common as coffee and cheap grocery
store cookies.
HOWEVER, I must say, in almost every case I have seen this, there are
other members of the group that will tell ya to listen to your doc. Just
seems to me that they are less vocal/forcefull than the other group,
which tends to spout a party line to the effect of "Doctor's don't
understand our spiritual disease, and unless they are in the proram
themselves they ain't qualified to prescribe ANYTHING to one of us"
That's pretty close to exact words I have heard. In fact, I have heard
similar words come from the meeting chair at meetings of more than one
group. NA more often than AA, I must say.
STAAMFA
"Sean" <postm...@snerts-r-us.org> wrote in message
news:3CEA845C...@snerts-r-us.org...
| 'Tis yet another nice example of where what the big big says and what
| folks actually differ. In my experience being told by a grouper to stop
| taking your meds is a cliche. It's as common as coffee and cheap grocery
| store cookies.
Hi Sean,
Cliché is a nice word for it. It's been my experience that in addition to
directly telling people to stop taking meds the word is spread indirectly in
meetings via numerous members stating their personal stories and how they've
attained happy joyous and blah blah blah but only after ditching the meds,
which miraculously lifted the mental fog of haze inhibiting their spiritual
progression such medication (pretty much any) was causing.
I remember the absolute worst case, among many bad cases, I saw in which a
woman obviously in the manic phase of a bi-polar disorder was citing that
mantra as though it were gospel. After having been encouraged by other
members claiming she didn't need her prescriptions and that they were
probably the source of her problems, and then taking the step of coming off
her meds, against doctor's orders, she firmly needed to believe that it was
the right move even though it was glaringly obvious that it wasn't. Even
in spite of the fact that she was in a great deal of distress she was still
touting the "no meds" party line because she desperately needed group
approval and no doubt thought it was either the only way or at least the
best way to go about getting it.
Chris.R
here" syndrome? Hey, remember the early days of Concord(e)? <G> I did wonder
about the (no) "friends in high places" thing too but suspect (hope?)
medical people are able to get over their recovery aliegances in the name of
science? :-) I did feel that the particular article I saw seemed to suggest
that the US trials did not put much emphasis on being well clear of the last
drink before commencing treatment and/or may have dealt insufficiently with
the multiple and concurrent addictions? I am in fact an "acamprosate
recoveree" (sic) but e.g. it took me two shots... First time I "tried", but
hadn't *really* stopped drinking, so I (voluntarily) and quickly quit taking
the tablets. Second time, I was a lot more careful in following standard
direction of *strict* abstinence before starting, adequate medical treatment
to get over withdrawl FULLY and a backup "therapy". I happened to be in AA
at that time - but don't want to be drawn overmuch on that one. :-) But I do
think though the most significant factor was a complete and total
commitment. If I were to make a personal observation it is rather difficult
to describe the experience of the "non-craving" (or non-anything? :-) but
the drug gave (me) a longer time to fix the assorted crapola associated with
very heavy drinking - and without too many real thoughts about drinking.
Once that was accomplished, then there was/is no a-priori reason to start
drinking again.
HTH, C.
"STAAMFA" <STAA...@yahoo.com> wrote in message
news:nFBF8.20050$eD2.3...@news2.east.cox.net...
Chris.R
C.
"AL (STUART)" <NOS...@telusplanet.net> wrote in message
news:uPfG8.23377$bV3.1...@news0.telusplanet.net...
AL (STUART)
Groupers recommending to other groupers not to take meds is very uncommon up
here in AB, I can assure you. In any event, the TEXT of AA is purported to
be the book entitiled "Alcoholics Anonymous", and that's the refernce I use
when discussing AA.
Point is that most physicians do not grasp the concept of spiritual disease,
and indeed many disagree with the concept entirely, so one would have to
look elsewhere for information on that subject. However, physicians are more
expert in depression, bipolar disorder and so forth amd therefore, a very
good source for information and treatment. What you are doing in the above
is paraphrasing "He said, she said" and maybe that's what you heard in AA
meetings, but as foy myself, and the 50 odd members of a friends home group
who recently discussed this very subject, taking medical advice from each
other (unless we are physicians ourselves) would be folly indeed.
>
AL (STUART)
Anyone who seekd medical advice from someone they met an an AA meeting
clearly needs more than AA. This is nothing but second-hand anecdotal
evidence gentlemen.
>
>
>
>
STAAMFA
"Chris.R"
| I happened to be in AA
| at that time - but don't want to be drawn overmuch on that one. :-) But I
do
| think though the most significant factor was a complete and total
| commitment.
Hello Chris
I agree that it could be any of a number of factors but Acham's Razor
effectively limits the playing field for us. Remember that this is a drug
which considering the nature of human physiology should work equally well on
European humans as it does on US humans. But in studies it's proven not to.
Why not?! We most assuredly could and should investigate social factors.
So where would we begin the investigation? We could go "way" outside the
box and suggest that because the drug wasn't developed in an alcoholic's
back yard they will believe that it's probably not effective and maybe even
harmful thus triggering a nocebo effect in these individuals. Or we could
take the simplest route, and the one that makes the most sense, which is to
take a look a the difference between the way the US handles addiction and
the way Europeans do. What we find almost immediately when we do that is
XA's predominate influence in the US with their faith based healing and
forever diseased proselytizing and the opposite in Europe. I can't say with
one hundred percent certainty that this is "THE" mitigating factor in the
lower success rates for the US studies but what I can say, and have, is that
the variance is significant enough to warrant further study on a
cultural/sociologic as well as the physiological level. My suspicion is
that XA wouldn't like the outcome of such studies at all and for good
reason.
On your above are you asserting that it is your belief that the 16% variance
between the more successful European trials and the less successful US
trials are due to
US participant lack of complete and total commitment?
Chris.R
> On your above are you asserting that it is your belief that the 16%
variance
> between the more successful European trials and the less successful US
> trials are due to
> US participant lack of complete and total commitment?
>
No and certainly not on the part of the participants :-) I do remain
concious of the fact that my reading of the statistics for Acamprosate
treatment always did seem to show quite large "geographical" variations, but
often samples were small. The effect seemed almost invariably to be positive
though often quite variable. My own GP was e.g. prescribing on the basis of
something he "remembered hearing", with the aid of a rather imposing drug
catalogue(?) on his knees <G> Fortunately I'm rather good at understanding
leaflets in pill boxes and we did read and discuss the stuff togeather. One
*could* imagine pills being dispensed in the ubiquitous plastic cup in an
inpatient situation with merely an exhortation to take these to "cure your
alcoholism" and indeed I suspect it may indeed not work too well? But I
think in the UK (where I am) lack of information may be a greater problem
than overt hostility among (typically) non-AA professionals. These GP's may
indeed be imagining alcoholics to be the "province of AA" but I cannot e.g.
recall my own Doc making any significantly pro or anti-AA noises. Fwiw,
about a year after I stopped drinking I did ask him whether he had more
"acamprosate successes" but he had only tried it (unsuccessfully) with one
more patient aside from myself. Sadly I don't think my occasional "lobbying"
is doing much to further the cause.
So yes, I can well imagine that the presentation and information give along
with a prescription of a drugs such as Acamprosate can be crucial for the
success or otherwise of treatement. Certainly I felt that (my own) belief in
the distinct possibility of success was crucial for me but then I am also a
great believer in the (negative) self-fulfilling prophesy :-)
Chris
STAAMFA
"Chris.R" <no...@not.net> wrote in message
news:3ceb2...@mk-nntp-1.news.uk.worldonline.com...
Chris,
After reading your response, and giving it careful consideration, I find
that I'm left
with a host of questions. Here they are:
Large geographic variations (of what? US to UK?)
Small samples (A sample need not be huge so long as it's representative.
Great care and consideration is normally given to ensure proper
representation during experimental design phase. Additionally, the process
of peer review roots out improper or unscientific methods.)
Your GP was prescribing from distant memory (how does this effect US Lower
success rates and European higher success rates in studies where the doctors
are well familiar with this drug?)
Your GP was prescribing from a drug interaction manual (how does this effect
US Lower success rates and European higher success rates in studies where
the doctors are well familiar with this drug?) BTW You're absolutely
correct to always read the drug's indications sheet prior to taking any
medications no matter who prescribes them to you, especially so if you're
taking more than one medication at a time. Most people would be
surprised/horrified to learn how little most doctors know about some of the
drugs they prescribe.
You think the normal way of prescribing for inpatient care probably doesn't
work too well. (why? and how does this effect US/European lower success
rates in studies where inpatients weren't the norm?)
You state that overt hostility comes typically from non-AA (GP)
professionals and that lack of information posses the greater problem in the
UK. (What form does this overt hostility take in the UK from non-AA (GP)
professionals? How wide spread is the overt hostility problem from non-AA
(GP) professionals? Why are non-AA (GP) professionals overtly hostile to
this drug where presumably AA and non-AA specialists are not? Finally, How
does this effect US Lower success rates and European higher success rates in
studies where the participating doctors are neutral regarding this drug?)
You state that UK GP's see alcohol addiction as the province of AA. (How do
you know this with any degree of certainty and how does this effect US Lower
success rates and European higher success rates in studies where presumably
the doctors are neutral regarding this drug. Are you asserting that the 16%
better results for the European studies were in spite of the overt hostility
of UK GPs? )
You state that your GP only had success with one other patient aside from
yourself. (how does your doctor's 2 patient experience with this drug
effect US Lower success rates and European higher success rates?)
You state that the information and the way it's presented [a drug such as
acamprosate] can be a crucial factor to the outcome. (What do you mean when
you state "a drug such as Acamprosate"? I believe but am not certain, that
these were double blind studies. However, even if they weren't the
experimental design phase and the way that proper scientific studies are
carried out ensures that particular attention is paid to the method for and
actual selection of the entire group to ensure all subjects are similar,
then they break them up into control and experimental groups and introduce
the independent variable into the experimental group and the placebo into
the control group. The doctor's function is simply to hand out the pill and
document the effects. This leaves little, if any, room for doctor bias. The
doctors are working off a standard script when dealing with members of
either group. Also one would assume that if non-AA GPs are overtly hostile
to this drug they would not participate in the studies.
AL (STUART)
chiefly centers in the mind.
M. Rita
??? Are you saying that British citizens' minds are fundamentally
different from American citizens' minds??
What happens in the case of resident alien Brits living in U.S. and
vice versa? Does the "problem drinking" and the outcomes of Acamprosate
usage then change? - or are you saying that Brits are GENETICALLY
different (mentally) from Americans????
I think you've really lost it this time, bubbie.
~Rita
AL (STUART)
"M. Rita" <para...@earthlink.net> wrote in message
news:6zsH8.624$AF3...@newsread1.prod.itd.earthlink.net...
>
> "AL (STUART)" <NOS...@telusplanet.net> wrote in message
> news:iH6H8.873$cL4....@news1.telusplanet.net...
> >
> > "STAAMFA" <STAA...@yahoo.com> wrote in message
> > news:H10H8.58796$eD2.1...@news2.east.cox.net...
> > >
> > > "Chris.R" <no...@not.net> wrote in message
> > > news:3ceb2...@mk-nntp-1.news.uk.worldonline.com...
> > >
> > The only shortcoming with all of this is that a problem drinker's
problem
> > chiefly centers in the mind.
> >
> --------------------
>
> ??? Are you saying that British citizens' minds are fundamentally
> different from American citizens' minds??
No doubt about that one, chickie. You can always tell an Englishman but you
can't tell him anything. Ask anyone at any AA meeting. They'll tell you
where its at.
>
> What happens in the case of resident alien Brits living in U.S. and
> vice versa? Does the "problem drinking" and the outcomes of Acamprosate
> usage then change? - or are you saying that Brits are GENETICALLY
> different (mentally) from Americans????
Genetically similar, I'm sure, but a vast difference mentally. I believe
it's probably environmental. Alien Brits living in Canada at any rate,
usually only get to beak off once or twice before some fat guy wearing a
kilt gives them a cultural treatment.
Must be a lack of sun in the UK eh?
>
> I think you've really lost it this time, bubbie.
Seriously maam, I wasn't referring to the continental differences seemingly
demonstrated in these studies, the sources of which the other posters cannot
seem to cite for our benefit. Hell, we don't even know if they were set up
to be comparative, or whether there were differences in the design or the
exection of the respective studies. Seems to me, without a peer review, we
are talking out of the top of our hats at this point'
I was referring to the whole concept of addressing alcohol addiction as a
strictly pharmacological issue. Clearly it is not,
> ~Rita
>
>
STAAMFA
| > The only shortcoming with all of this is that a problem drinker's
problem
| > chiefly centers in the mind.
| >
| --------------------
"M. Rita"
| ??? Are you saying that British citizens' minds are fundamentally
| different from American citizens' minds??
|
| What happens in the case of resident alien Brits living in U.S. and
| vice versa? Does the "problem drinking" and the outcomes of Acamprosate
| usage then change? - or are you saying that Brits are GENETICALLY
| different (mentally) from Americans????
|
| I think you've really lost it this time, bubbie.
His type are so busy trying to prove those who judge AA lacking are wrong
they seldom have time to think about how silly they sound. His above is
laughable not because addiction is so obviously considered a mental
disorder, a fact with which most non-AA's posting here are "well" aware, but
because it's plain he was attempting to be profound and only succeeded in
proving his inability to think logically as well as his profound ignorance
of, not only the subject matter frequently discussed on this newsgroup but
most, if not all, of the people who post in a manner that judges AA
seriously/harmfully lacking. It boggles my mind that he would even attempt
to post such a glaringly obvious observation as though none of us were aware
of it, even in spite of the fact that I've had to bludgeon that simple fact
into too many steppers heads to count. And like a typical stepper he gets
part of the story right and uses that part in a vain attempt to support a
completely, outrageously, illogical conclusion.
If the drug being used is the same for both US and European studies [which
it is] and the US has such a significant variance, to the tune of a negative
16%, than obviously it's not the drug at fault but a social factor at work.
The immediately obvious difference is the predominance in the US of XA
dominated XA eternal disease based counseling from predominantly XA
counselors, and XA eternal disease teaching support group attendance with
their all too frequent negative attitude towards meds.
AL (STUART)
AL (STUART)
>
>
>
> | > The only shortcoming with all of this is that a problem drinker's
> problem
> | > chiefly centers in the mind.
> | >
> | --------------------
>
> "M. Rita"
>
> | ??? Are you saying that British citizens' minds are fundamentally
> | different from American citizens' minds??
> |
> | What happens in the case of resident alien Brits living in U.S. and
> | vice versa? Does the "problem drinking" and the outcomes of Acamprosate
> | usage then change? - or are you saying that Brits are GENETICALLY
> | different (mentally) from Americans????
> |
> | I think you've really lost it this time, bubbie.
>
> His type are so busy trying to prove those who judge AA lacking are wrong
> they seldom have time to think about how silly they sound.
His above is laughable not because addiction is so obviously considered a
mental
> disorder, a fact with which most non-AA's posting here are "well" aware,
but
> because it's plain he was attempting to be profound and only succeeded in
> proving his inability to think logically as well as his profound ignorance
> of, not only the subject matter frequently discussed on this newsgroup but
> most, if not all, of the people who post in a manner that judges AA
> seriously/harmfully lacking.
I take it you agree with my observation that addiction is chiefly mental.
It boggles my mind that he would even attempt
> to post such a glaringly obvious observation as though none of us were
aware
> of it, even in spite of the fact that I've had to bludgeon that simple
fact
> into too many steppers heads to count. And like a typical stepper he gets
> part of the story right and uses that part in a vain attempt to support a
> completely, outrageously, illogical conclusion.
>
> If the drug being used is the same for both US and European studies [which
> it is] and the US has such a significant variance, to the tune of a
negative
> 16%, than obviously it's not the drug at fault but a social factor at
work.
> The immediately obvious difference is the predominance in the US of XA
> dominated XA eternal disease based counseling from predominantly XA
> counselors, and XA eternal disease teaching support group attendance with
> their all too frequent negative attitude towards meds.
Are the two studies identical is all I wanted to know.
>
>
>
>
>
AL (STUART)
>
>
By the way STAAMFA, why can you not respond to me directly, always through
an intermediary, in a stage whisper. Would you also find it difficult to
look me straight in the eye if we were face to face?
Or, have I been snubbed........