
Sobriety startups shaking up the 12-step model - mathgenius
https://www.abc.net.au/news/2019-01-02/inside-the-new-sobriety-start-ups-shaking-the-12-step-model/10671650
======
Quequau
After years and years of struggling with alcoholism and AA, I got sober with
naltrexone using the "Sinclair Method". I followed the treatment plan for a
few weeks and at the end quitting drinking was easy and obvious. That was just
over ten years ago and I haven't had a drink or gone to any meetings since.

I'm only one person and I'm fully aware that the plural of anecdote isn't
data. However, the experience was so drama, and more importantly self-
loathing, free and so effective, that I can't help but feel bitter towards the
proponents of AA who insist on it being a monopoly... especially those in
positions of power in the criminal justice or public health systems because
from my perspective it's a malicious and vindictive stance.

~~~
jyriand
Anyone know if there is something similar to quit smoking? Tried to quit cold
turkey 20 times at least, usually can’t get past the first day.

~~~
mastazi
Vaping did it for me. For some reason that I ignore, you can then, as a second
step, quit vaping very easily (at least for me, it was much easier than
quitting cigarettes). There have been some studies about this, it’s been
speculated that it’s because of the different way you absorb nicotine when
vaping, as opposed to smoking. (Sorry I’m unable to find a link now but I will
try later when I get home). I am now 2 years off the stinkies, and about 9
months off vaping.

~~~
HighPlainsDrftr
10 years ago I quit smoking. I don't recommend doing it this way, but I
started chewing tobacco. I didn't like it, didn't care for the taste, but for
some reason, it let me break the mental habits of having a cigarette every so
often, and the hand movements, etc.

About a year later, I was planning on having Lasik eye surgery. They
recommended no nicotine/caffeine for 24 hours prior and 7 days after. I gave
caffeine up for the next year, and never picked up nicotine again.

There is probably a few reasons why you smoke. Just remember, you probably
like all of them. Start to figure out how to remove and replace them. And keep
trying to quit. At some point it will work.

I probably tried to quit 200 times cold turkey, 2 or 3 times with medication,
and maybe a dozen times with patches.

------
sobernowadays
Hey all HNers that might be wanting to stop drinking, or have trouble staying
sober even though you try!

The community in
[https://reddit.com/r/stopdrinking](https://reddit.com/r/stopdrinking) is
amazing and keeps me and many others on a sober path.

I've soon been sober for a year, and I was on a very destructive path. Would
never have kept at it without that sub.

Here's how it helped me:

1\. In the beginning I was hurting and feeling really isolated - posting semi-
regular helped me vent and people with more sobriety under their belt gave
support directly.

2\. When I've been to occasions (weddings, birthday parties) that include
drinking, I've been able to jump into the chat and find instant support
telling me to not have the first drink.

3\. There's a daily check-in where you post to pledge today's sobriety. In the
beginning I pledged each day.

4\. I have a badge by my name that keeps track of each day I've been sober.
Having to reset that to zero is more motivating than you might believe at
first.

5\. I now comment on other users posts, trying to keep their mood up and push
them to not drink by giving them support.

Also, the community and mods are superb, kind people.

------
randomacct3847
It only hit me in the past few months how ingrained alcohol/drinking culture
is in adult lives. It’s absolutely everywhere (ads, sports events, festivals,
workplace, nightlife, social events). It’s actually crazy how lightly we treat
this addictive, toxic substance that we joke about despite how many people it
kills every year and harms directly and indirectly. At some point I was
unknowingly drinking 4-5 times a week and thinking that was normal or OK. I’ve
mostly just stopped and will only allow myself 1-2 drinks every few months on
a vacation or social event with friends.

~~~
UweSchmidt
It used to be much more ingrained. Factory or construction workers used to
drink during work, and if those old movies are to believe men would pour
themselves drinks all the times.

These days it is mostly acceptable to decline alcohol.

~~~
StevePerkins
It's interesting that you cite factory or construction workers. I'm a first-
generation college graduate, who grew up around skilled (and unskilled) labor.
I've never heard of this being prevalent, even from old-timers discussing how
things used to be way back when. Quitting time is one thing... but the last
environment on earth in which you'd want to drink alcohol is around power
tools or heavy machinery!

My own first thought was "Mad Men"'s portrayal of _privileged office workers_
in the mid-20th century.

Of course, my second thought was my own office in the present day. Has this
culture ever really gone away? I work for a tech startup, and there's a fully-
stocked beer fridge and cocktail bar setup at all times. They're one of the
first things that recruiters show off when I go on interviews to other similar
companies.

Every single company event, or small group outing, basically revolves around
alcohol. I'm not a teetotaler, but I am a parent in my 40's who has kinda lost
interest in drinking, and I'm starting to feel alienated by that part of the
industry's culture. I don't want to feel like I have accept the beer you're
offering me in order to fit in with a team, or give up my evening with my
family to go watch you stand in a circle and get shit-faced in front of your
co-workers.

This is 2019, in our own industry.

~~~
fragmede
_> Has this culture ever really gone away?_

It's possible I'm being naive as to what my coworkers are up to, but the "Man
Men", 3 martini lunch culture has certainly gone away.

It's fair to complain that a company's social events revolve around alcohol,
but, explicitly, when people talk about "company culture" and "good fit",
internal company norms around alcohol are a huge part of it. There are
workplaces that are basically a continuation of college frat houses, down to
the levels of sexual harassment that make Uber look hospitable. There are also
workplaces where everyone goes leaves at 5pm on the dot to get home to be with
their partner/kids, and the Christmas party is a potluck with very limited
amounts of wine.

Pick your poison. The recruiter is there to, well, recruit you, and they can't
know how a given candidate feels about alcohol consumption, so if they too-
gleefully show off their bar - push back! Ask how much people _actually_ drink
- there's a difference between between zero and one beer after work with
coworkers (I just drink a la croix/talking rain while my coworker who does
drink, drinks a beer), vs drinking liquor to excess.

------
mgamache
If you consider addiction as a psychological _and_ physical dependence on a
chemical what healthcare professional would design a program like AA? Seven of
the 12 steps involve God. It also reinforces the 'moral failure' stigma
attached to the person. You drink too much for a reason, not because you are a
bad person. It's likely due to genetic and environmental factors. ohh and you
can die from withdrawal (unlike most other addictions).

[https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443....](https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2008.02203.x)

[https://www.aa.org/assets/en_US/smf-121_en.pdf](https://www.aa.org/assets/en_US/smf-121_en.pdf)

[https://www.theatlantic.com/health/archive/2014/03/the-
surpr...](https://www.theatlantic.com/health/archive/2014/03/the-surprising-
failures-of-12-steps/284616/)

[https://www.inspiremalibu.com/blog/alcohol-
addiction/7-thing...](https://www.inspiremalibu.com/blog/alcohol-
addiction/7-things-you-might-not-know-about-delirium-tremens/)

~~~
coleifer
> You drink too much for a reason

I don't think that's right. More than anywhere else, it seems like on HN
there's an idea of the infallibility of human rationality. Would anyone in
their right mind a) shoot dirty dope filtered through a cigarette butt, b)
gamble themselves into debt with the mafia, c) overeat to the point they can't
leave the house, d) play videogames compulsively for days on end, etc?

~~~
Tushon
I think that was the point of OP's comment, since you cut the rest of the
statement

> You drink too much for a reason, not because you're a bad person.

the reason here being predisposition, environmental factors, genetics, and/or
current illness

~~~
getsugablitz2
So those factors listed essentially encompass your personality and dictate why
a person does any action.

In that case, how do we hold anyone personally responsible for anything
considering that the reason a person does any action is a result of their
genetics and the environment they grow in?

Not criticizing, just wondering how others reconcile this.

~~~
DoreenMichele
My dad drank heavily while he was in the army. He swore off alcohol when I was
seven, but I never saw him drink to alcoholic levels.

I think he drank to suppress the nightmares from serving in the front lines of
two wars. I think he began tapering off when he left the army when I was
three. I think he did so with no conscious plan. He just didn't need as much
alcohol to push away his personal demons so he could sleep and he probably
just naturally reduced it over time without really thinking about it.

I've got a serious medical condition. I used to take a lot of prescription
medication. I've gotten off all the drugs. It's really normal for me to stop
doing X slowly over time and not really notice it until later. It's common for
me to only really notice a change precisely because I talk a lot about my
medical stuff with my adult sons, so we periodically go over "Oh, yeah, you
used to do X, Y and Z and you don't anymore."

I also spoke once with someone who had a lot of shame surrounding a DUI on
their record. One of the stories they told me: They had surgery for something
and when the doctors opened them up, they found one of the organs necrotic.
This was unexpected and they expressed surprise that this individual was still
alive. They removed the organ in the process of doing this other surgery. The
individual quit drinking after that, but still saw themselves as a bad person
and an alcoholic rather than someone who was managing a terrible and life
threatening medical condition with alcohol until surgery happened to resolve
it.

I'm convinced that this type of thing is much more common than is generally
recognized.

------
pgt
It seems plausible that the complex set of control systems that govern our
survival became intimately intertwined with various alkaloids over a few
million years, "outsourcing" production of raw building blocks to plants. One
example is the way in which sulforaphane from broccoli (via glucosinolate
glucoraphanin) reduces symptoms of autism in the presence of myrosinase
(present in mustard). [^1]

Specifically, on the topic of addiction: "Ibogaine-treated rodents exhibit
attenuated opioid withdrawal symptoms, and diminished self-administration of a
variety of drugs of abuse, including opioids, cocaine, nicotine and alcohol.
Anecdotal evidence suggests that ibogaine is also anti-addictive in humans."
[^2]

Meta-analysis of randomized controlled trials show that a single dose of LSD
had a beneficial effect on alcohol misuse (OR, 1.95, 95% CI, p=0.0003). [^3]

As we get better at modelling our own bodies, hopefully we can start to
selectively replace or suppress some of our out-dated control systems to
reduce suffering and increase efficiency while retaining our survivability.

Citations:

\- [^1]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672987/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672987/)
\- [^2]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382526/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382526/)
\- [^3]:
[https://www.ncbi.nlm.nih.gov/pubmed/22406913](https://www.ncbi.nlm.nih.gov/pubmed/22406913)

~~~
ThrustVectoring
"Reduces the symptoms of autism" isn't what you'd naively think it is. Autism
symptoms are often more accurately described as "the sorts of things autistic
people do while distressed." In other words, I suspect that the main effect is
stress reduction of some sort, rather than autism reduction.

------
max76
I want to see data driven novel approaches to addiction management. The
12-step model has dismal success rates [0]. Virtually all of the novel
programs and facilities either do not report a success rate or their reported
rate is highly suspicious. There are some exceptions [1]. The global addiction
market is $4 billion and growing [2]. Any company working in the addiction
space should keep accurate records of their success rate and push to improve
that rate, because beating AA/NA's success rate at scale would be worth a
large portion of the addiction market.

[0] [http://articles.latimes.com/2011/mar/03/news/la-heb-sheen-
aa...](http://articles.latimes.com/2011/mar/03/news/la-heb-sheen-aa-20110302)
[1] [https://www.drugabuse.gov/publications/principles-drug-
addic...](https://www.drugabuse.gov/publications/principles-drug-addiction-
treatment-research-based-guide-third-edition/evidence-based-approaches-to-
drug-addiction-treatment) [2]
[https://www.transparencymarketresearch.com/addiction-
treatme...](https://www.transparencymarketresearch.com/addiction-treatment-
market.html)

~~~
Scaevolus
Very few studies have proper control groups.

[https://slatestarcodex.com/2014/10/26/alcoholics-
anonymous-m...](https://slatestarcodex.com/2014/10/26/alcoholics-anonymous-
much-more-than-you-wanted-to-know/)

> In conclusion, as best I can tell – and it is not very well, because the
> studies that could really prove anything robustly haven’t been done – most
> alcoholics get better on their own. All treatments for alcoholism, including
> Alcoholics Anonymous, psychotherapy, and just a few minutes with a doctor
> explaining why she thinks you need to quit, increase this already-high
> chance of recovery a small but nonzero amount. Furthermore, they are equally
> effective after only a tiny dose: your first couple of meetings, your first
> therapy session.

~~~
turingcompeteme
> most alcoholics get better on their own.

These statements and studies show how little the average person, even a
doctor, understands about alcoholics. Anyone who's attended an AA meeting or
worked with alcoholics can easily tell you what's so crazy about these types
of studies:

AA is full of people who, by definition, cannot quit on their own. Other than
some court-ordered cases, every single person in AA has already tried and
failed to quit on their own. It's a nonsense comparison.

You are comparing a group of people who have never tried quitting before, with
those who have already spent years failing to quit on their own. Of course the
first group does better! The second group is filled with more serious
conditions. If they were able to quit on their own they would have never tried
AA.

------
thelasthuman
For something supposedly so good on it's own, religion really does try it's
best to target vulnerable people. Naive children, desperate people, people who
have lost someone, people sick with addiction (referencing the submitting to
the higher power step).

Whatever helps during trying times I guess. It just seems to me if religion
was so great on its own, it would be approached in a calm rational manner
targeted at mature adults with no driving force behind it.

~~~
rsyring
That's a pretty broad brush to paint all of religion with.

There are plenty of rational arguments for Christianity for those willing to
do due diligence:

[https://www.thegospelcoalition.org/article/countering-a-
dist...](https://www.thegospelcoalition.org/article/countering-a-distortion-
christianity-as-intellectual-suicide/)

~~~
driverdan
> There are plenty of rational arguments for Christianity

No there aren't. Faith, by its very definition, is irrational.

~~~
thanatropism
The subject matter of faith may be irrational, but faith-based communities
have benefits that ratheists miss out on.

~~~
yarrel
All communities have benefits that those they exclude and other miss out on.

But I'm not joining a communist cell just for the comradeship.

------
sverige
I would consider myself to be an expert of sorts on AA. I was a member for
over 20 years, attended at least 4000 meetings, have read everything ever
published by AA World Services (and even held private study groups with folks
to discuss these books). I served at every level except national.

I left AA when I became a christian 15 years ago. (Yes, I started AA young, as
a teenager.)

All that is background for these strongly held opinions:

1\. AA is decidedly not christian. If anything, it is a mere cult with some
christian trappings and actually some occult underpinnings. No one ever heard
the gospel at an AA meeting. It's not synonymous with christianity.

2\. AA's recovery rate is abysmal, and actually less successful than just
doing nothing about addiction. There is lots of room for providing much more
effective help for people with addictions.

3\. The practice of forcing people to attend AA meetings under court order
should be stopped entirely.

I know that most here are likely not christian and some are openly hostile.
That's a completely different discussion than helping addicts to recover.

A good resource for the many failings of AA can be found at the Orange Papers
site. It seems the original site is down, but I believe someone has mirrored
it elsewhere. Lots of info on the strange origins of AA there.

------
walrus01
The christian part is a barrier for atheists and agnostics that would
otherwise be OK with participating in Alcoholics Anonymous.

[https://en.wikipedia.org/wiki/History_of_Alcoholics_Anonymou...](https://en.wikipedia.org/wiki/History_of_Alcoholics_Anonymous)

~~~
bsagdiyev
I'm not sure why, it may be a regional thing but I attend meetings in support
for someone else and there are plenty of people who do not believe in God and
state as such. I believe the third step even agrees, though I may be
misinterpreting it: "Made a decision to turn our will and our lives over to
the care of God as we understood Him."

The "as we understood Him", while most likely still referring to God, is what
is used to mean whatever works for you even if it isn't God but something you
can believe in as much to help you, which then opens the door for substituting
God in the later steps for your version (or not) of him.

My personal opinion is that I find the program a bit cultish and don't agree
that telling people they are helpless is the right way to help them, but
that's my opinion and I respect that the program works for some people.

~~~
coleifer
> I find the program a bit cultish

I have shared in meetings that I sometimes think AA/NA is a cult. Everyone
understood. And over time I've come to see the importance of the word
"Anonymous", which is found in the name (obviously) but also in the
traditions, and means exactly this: that everyone is equal within the group.
There is no "great leader", nobody that is "right", nobody that is "wrong". It
is about sharing one's experience -- the things one has done, the actions one
has taken -- which speak for themselves.

> and don't agree that telling people they are helpless is the right way to
> help them

The actual word is "powerless", not "helpless". And this powerlessness
describes:

\- the addict's inability to stop despite earnest and sincere desire.

\- the inability, once clean for a short time, to keep from returning to drug
use

Before I started attending 12-step, I had read the Bible, Marcus Aurelius, Tao
Te Ching, various self-help books, The Power of Now, How to Win Friends and
Influence People, and on and on and on. I had within me all the beliefs and
understanding needed to live in a good way, in accordance with my principles.
In short, to live with dignity. And yet I could not live according to my own
principles. This wasn't just about drug use...it was about being patient,
kind, tolerant, loving, helpful. I think that's the root of the powerlessness
talked about in AA/NA. What I've found is that, with the belief in a higher
power, I'm able to go to bed with a sense of dignity most days.

------
beatpanda
There's an extremely instructive lesson for programmers in the success and
persistence of Alcoholics Anonymous. It's still around because:

* It's free * It's decentralized * It works

Is it the absolute best and most efficient method for treating addiction?
Maybe not, but unless you have another method that works, which also does 1
and 2, it probably won't become as pervasive and long-lasting as AA.

How does this apply to programmers? Look at every dumb project that ever tried
to "disrupt" email. That's a field littered with dead bodies. Email survives.
Why? See above.

------
gammateam
The AA 12-step program was so strange when I accompanied my friend to one

I had no idea it was so religious

I found this to be a bug, not a feature

It is interesting to see other methods being tried instead of masquarading the
12-step programs longevity as absolute validation

------
TheSoberTruth
"The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the
Rehab Industry"
[https://smile.amazon.com/dp/B00FIMWI1O/](https://smile.amazon.com/dp/B00FIMWI1O/)

> _An exposé of Alcoholics Anonymous, 12-step programs, and the rehab
> industry—and how a failed addiction-treatment model came to dominate
> America._

> _AA has become so infused in our society that it is practically synonymous
> with addiction recovery. Yet the evidence shows that AA has only a 5–10
> percent success rate—hardly better than no treatment at all. Despite this,
> doctors, employers, and judges regularly refer addicted people to treatment
> programs and rehab facilities based on the 12-step model._

> _In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes
> the deeply flawed science that the 12-step industry has used to support its
> programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern
> of errors, misjudgments, and biases. He also pores over the research to
> highlight the best peer-reviewed studies available and discovers that they
> reach a grim consensus on the program’s overall success._

> _But The Sober Truth is more than a book about addiction. It is also a book
> about science and how and why AA and rehab became so popular, despite the
> discouraging data. Dr. Dodes explores the entire story of AA’s rise, from
> its origins in early fundamentalist religious and mystical beliefs to its
> present-day place of privilege in politics and media._

> _The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of
> clinical practice, as well as firsthand accounts submitted by addicts
> through an open invitation on the Psychology Today website. These stories
> vividly reveal the experience of walking the steps and attending some of the
> nation’s most famous rehabilitation centers._

> _The Sober Truth builds a powerful response to the monopoly of the 12-step
> program and explodes the myth that these programs offer an acceptable or
> universal solution to the deeply personal problem of addiction. This book
> offers new and actionable information for addicts, their families, and
> medical providers, and lays out better ways to understand addiction for
> those seeking a more effective and compassionate approach to this treatable
> problem. […]_

~~~
TheSoberTruth
If a 12 steps program works or has worked for you, that's wonderful.

People who want to change so that they can handle their life without the
trouble are welcome to attend.

There are many types of therapy. In art therapy alone, what've we got here:
music, dance, writing, film, drawing, writing about problems and lists of
solutions for each and for all of them (maybe only for yourself and then for
others), etc.

Problem:

Solutions:

-

-

\- create a list of things that are reinforcing the [un]desired behaviors

\- create a plan for doing something different with/about identified triggers
(problems)

(I just thought of this and decided to share)

Healing the underlying PTSD (and high blood pressure and very complex anxiety
partly resulting from having adapted counterproductive coping strategies and
defense mechanisms) is the objective of a number of randomized controlled
clinical trials.

Developing evidence-based treatment programs requires randomization and
controls. [https://en.wikipedia.org/wiki/Evidence-
based_medicine](https://en.wikipedia.org/wiki/Evidence-based_medicine)

~~~
TheSoberTruth
An evidence-based parenting book I read recently (Kazdin) strongly emphasised
ABC for understanding behavior: Antecdents, Behaviors, and Consequences

It also emphasized that far more effective than punishment is _reinforcing the
positive opposite_.

What do you plan to do with your time that has positive ROI (return on
investment) for yourself, your family and friends, and/or your community?

------
geggam
People who abuse substances are attempting to escape their reality because
they feel powerless to change it. Educating people how to change their life is
the cure.

That or changing society so people aren't powerless to fix their own destiny.

Until that happens the chemical people are addicted to is irrelevant. They can
use any number of drugs to include sugar in a way that is detrimental to their
health and will do so.

~~~
normal_man
This is overly simplistic. People may start to abuse substances because of a
feeling of powerlessness, depression or some other form of unhappiness, but
once addicted, a person's life can improve and the use will continue until the
psychological connections are broken and rewired.

~~~
geggam
Having been addicted I find complicating things to add to the issue.

Simplest method to fix it is to address the underlying issues starting with
the biggest first.

As a note. You cannot fix this for other people they have to want to fix it
and change.

------
james_s_tayler
Ok, but how can I quit drinking Coca-Cola?

Tried like 10+ times now. It's not even Coke, it's sugar. Just such a powerful
grip. Always relapse when a stressful time comes. Feels just the same as
alcohol or cigarettes to me, but I don't feel justified in saying it's a real
problem on the same level. I feel like it is though.

Anyone else?

------
empath75
Most people with substance abuse problems “grow out of it” with no outside
help at all.

[https://www.google.com/amp/s/www.psychologytoday.com/us/arti...](https://www.google.com/amp/s/www.psychologytoday.com/us/articles/200405/the-
surprising-truth-about-addiction-0%3famp)

Just from personal experience partying with lots of drugs and drinking in the
rave scene when I was in my 20s and djing and promoting, the vast vast
majority of people just got tired of it one day and quit — or it interferes
with their jobs or their families and they did the right thing and stopped
eventually.

12 steps’s entire thing about how once you’re an addict you’re going to be one
for the rest of your life is just wrong.

~~~
turingcompeteme
These articles are silly, and don't understand alcoholism. They give a few
examples of successful ways that people have quit on their own, and since lots
of people did it that way, then it must be more effective than treatment.

They miss the blindingly obvious point that every single person in treatment
has already tried and failed those "self-help" ways. Treatment is a final,
desperate, step for alcoholics, once all those self treatment methods have
failed. You can't compare the two, and the first treatment has already failed
for the second group.

It's like saying Tylenol is a more effective treatment than going to the
hospital, because more people get better that way. Of course they do - because
they have a less serious problem.

~~~
empath75
But 12 step is barely better than doing nothing at all, even in this groups.

------
vertline3
Sobriety startup, that's a great idea! Fixing problems, and using the fast
speed of startup culture. I'm not sure if they can fix it, but it seems like
unique idea.

------
whiddershins
The headline is misleading, it barely references 12-steps, basically
clickbait.

~~~
markatkinson
What more would you like it to mention? I just read the article and it was
about startups that are introducing newer and cheaper options for people who
may have used the 12 step program, exactly what the headline insinuates.

Maybe it was changed since you commented?

~~~
chasil
12 steps has a 10% success rate.

Naltrexone or nalmafene have a 75% success rate.

Why are we even having this conversation?

~~~
chasil
This is the COMBINE study:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945872/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945872/)

Thus, the results of the COMBINE study demonstrated that a pharmacotherapy,
like naltrexone, when given with medical counseling that emphasizes taking
medications as prescribed, can yield clinically significant outcomes (reduced
drinking/increased abstinence) that are either as compelling, and under some
conditions, more compelling than those observed with specialty behavioral
therapy. One important implication of the COMBINE results is that naltrexone
with MM can be delivered in healthcare settings where traditional specialty
treatment is unavailable.

~~~
chasil
The foremost pronent of naltrexone (or nalmafene where it is not available) is
Claudia Christian:

[https://www.youtube.com/watch?v=6EghiY_s2ts](https://www.youtube.com/watch?v=6EghiY_s2ts)

