What We Get Wrong About “Alcoholism”

[♪ INTRO] Alcohol problems are no joke. Excessive drinking can have a wide range of
consequences, and it can lead to other diseases, like liver
disease, heart disease, and cancer. It’s also incredibly common and seriously undertreated,
affecting millions of people worldwide. And to make matters more complicated, there
are a lot of stereotypes and stigma surrounding alcohol that prevent both understanding
and adequate care. For one thing, though we usually refer to
“alcohol abuse” or “alcoholism,” psychiatrists and other medical professionals now
formally use the term alcohol use disorder, or AUD. That’s because previous definitions didn’t totally capture
the spectrum of symptoms that AUD can include. But also, the way we think about treatments
doesn’t always represent the full story. Here in the United States,
common treatments include rehab and those anonymized,
12-step group therapy programs. But those are far from the only treatments
for alcohol use disorder, nor are they necessarily the most effective. What many people don’t realize is that there
are so many ways to treat AUD. So many, in fact, that doctors and patients have
choices when it comes to treatment and recovery. It’s not all about checking into rehab or
starting a 12-step program; there’s tons of stuff. So here are some of the ways that we can treat AUD. The term “alcohol use disorder” officially
comes from the Diagnostic and Statistical Manual of Mental
Disorders, or DSM, the manual psychiatrists use to diagnose mental
illnesses. The 5th edition of the DSM lists 11 criteria
for AUD, including having cravings for alcohol, continuing to drink even though you suspect
it might be causing problems, and actually having job or life problems caused
by drinking. But patients don’t have to check all 11
boxes. If they meet at least 2 criteria, medical
professionals may diagnose them with mild AUD. And if they meet more than 2, doctors may
bump up that diagnosis to moderate or severe. Before we talk about what’s involved with
AUD treatments, though, we should establish what doctors actually
want as a result of that treatment, the outcomes, to use the medical jargon. Most of the time, the treatment goal is abstinence,
for patients to stop drinking entirely. But that’s not always the case, and in some
circumstances, it may be appropriate to try and shoot for
more moderate, controlled drinking habits. That can come up when patients don’t want
to, or don’t think they can, stop drinking completely. Because ultimately, it’s more important to engage these
folks in treatment, even if it means compromising. Like anything else, it’s something to be
figured out between a patient and their doctor. But regardless of what the goal is, there’s
a wide range of behavioral treatment programs that can be
applied to alcohol use disorder. At least in the U.S., the most well-recognized
are probably those 12-step programs. One example is Alcoholics Anonymous, but there
are others, some based on religious or spiritual beliefs,
and others that are more secular. Either way, doctors refer to such programs
as 12-step facilitation. But despite the number of people who go through
these programs, there’s not actually much evidence about
how well they work, because these things are really hard to study. Scientists have looked at them, but their
research often examines such a range of outcomes that it’s hard to compare one paper to another. Also, the programs are anonymous. And it’s kinda hard to recruit study participants
when you don’t know who they are. One 2006 review sorted through the literature
about these programs, and it actually suggested that none of the
studies out there provided convincing evidence in favor of the
12-step approach. The most encouraging thing they could offer
was one study, which did find some indication that AA might help get patients
into treatment and keep them there. That doesn’t mean these programs are bad,
though, just that the research is a bit fuzzy. Outside of studies, many patients have reported
that the support provided by group therapy is helpful, so many doctors keep twelve-step programs
on the table. Now, treatments like this aren’t the only
kind of behavioral intervention. Behavioral interventions can cover all kinds
of things, from a brief meeting with a primary care doctor
to residential rehab programs. But unfortunately, the story surrounding them
is the same. It’s really hard to study for various reasons, so there’s not much clear evidence about
whether or not they work. Groups like the World Health Organization
keep recommending them, though, because they provide psychological and social
support, which is definitely something. So if these programs work for people, they
are definitely worth it. Regardless, there are forms of behavioral
treatment that do have some pretty good
evidence that back them up. Cognitive behavioral therapy, for example,
is a form of therapy that focuses on helping people identify and change unhelpful
thoughts and behaviors. It’s been shown to be effective for substance
abuse time and time again in the medical literature, and patients respond well to it. Brief interventions are also highly effective
for alcohol use, maybe surprisingly. These are exactly what they sound like: short, one-off
meetings with patients for as little as 5 minutes. Studies have shown that even such a minimal
treatment can decrease heavy drinking 20 to 30%, and have measurable benefits up to 2 years
down the line. They’re targeted at people whose behavior
represents a risk of developing alcohol problems, rather than those who already have some form
of dependence, which might help explain why a short conversation
can be so effective. Because of their one-off nature, brief interventions
are a way to reach people who show up to a hospital or their doctor’s
office for whatever reason, so doctors consider them the first line of
treatment. But while therapy in all its various forms can
really help people, it’s also not the only option. In the US, there are a handful of drugs that
are approved to treat alcohol use disorder, including naltrexone, disulfiram, and acamprosate. Naltrexone is available in both pill and injectable
forms, and it was originally designed to treat opioid
dependence. But it also helps treat alcohol dependence, probably by decreasing the amount of dopamine
released in the brain in response to alcohol. Since dopamine is associated with a pleasant,
rewarding feeling, naltrexone makes it feel less rewarding to
drink. Multiple studies have shown that naltrexone
reduces both a return to binge drinking and a return to any drinking in patients who
have quit alcohol. Though the size of the effect isn’t as big
as doctors might like. AUD isn’t just about the cravings, though. Chronic alcohol use and dependence also produce
a host of changes in the brain, and acamprosate aims to change them back. For example, alcohol can mess with the signaling
done by the neurotransmitter NMDA, which is involved in learning and memory. Acamprosate helps modulate that signaling, so it can
help patients maintain abstinence from alcohol. Studies show it helps people avoid taking
up drinking again, although it doesn’t prevent a return to
binge drinking in particular, which is defined as having more than 4 or
5 drinks in a day. Finally, disulfiram is a bit different. It’s been approved for decades, ever since
the 1940s. And instead of your brain, it works in your liver. It blocks aldehyde dehydrogenase, one of the
enzymes responsible for breaking down alcohol. And if that sounds bad, it is! It’s bad on purpose. When aldehyde dehydrogenase doesn’t work properly, it leads to a buildup of a chemical called
acetaldehyde in the body. And that leads to flushing, nausea, vomiting,
palpitations, and occasionally worse symptoms like heart problems, though it’s not clear
how common those are. Basically, if you’re taking this medication
and you drink alcohol, you will get sick, and it will not be nice. The idea is that people will quickly learn
to avoid the adverse reaction. Unfortunately, when study patients aren’t
told whether they’re getting disulfiram or a placebo, it doesn’t seem to make much difference
to their alcohol use. Although there is evidence to suggest it’s more effective
when used under a doctor’s supervision than without. Of course, these are just drugs used in the U.S. The European Union has also approved a drug
called nalmefene to help people with alcohol dependence drink less. It works quite a bit like naltrexone, and it can reduce the number of days that
people binge drink compared to a placebo. And in the US, some drugs for other conditions
can also be used to treat AUD, like gabapentin, which is used for seizures. But more studies are needed to determine their
effectiveness. All in all, there are a lot of safe, potentially
effective drug options out there, but alarmingly, researchers have estimated
that only 9% of people who could stand to benefit from them are actually
getting them. Plenty of people receive behavioral treatments, but it seems like a lot more people could
be getting these drugs. There are likely a number of reasons for that,
but it’s also worth keeping in mind that there’s no rule that says you have
to pick just one of these things. Medicine and behavioral intervention together
has also been shown to be effective, like in the 2006 COMBINE study. This was a randomized controlled study of
almost 1,400 patients that explored several questions about the relationship between drug and behavioral
therapy for alcohol use. The researchers wanted to know things like whether drugs can be effective independently
of treatment by a specialist, and whether specialist treatment could be
improved by adding drugs. They looked at how many days patients went
without drinking, as well as how long it took patients to have a day
where they drank heavily after beginning treatment. And they tested both naltrexone and acamprosate. Most groups received what the researchers
called medical management: a basic, 9-session treatment designed to be
administered by a primary care doctor. But some also received more specialized counseling
referred to as combined behavioral intervention. People in all treatment conditions showed
improvement, which is great! You don’t want to see your study population
get worse if you can help it. Patients taking naltrexone, receiving a behavioral
intervention, or both all fared better than patients receiving a
placebo or medical management alone. However, the combination of naltrexone and therapy
didn’t fare any better than either treatment by itself. The authors suggest this could actually be
beneficial for some patients. If they didn’t have access to therapy, seeing a primary care doctor and receiving
naltrexone could still help them. And this really drives home the idea that
doctors want to see people get better. The goal isn’t to promote one treatment over
another; it’s to get people into any treatment at all. In fact, some researchers have suggested that
informing patients of all of the options could give them more independence and control
over their own treatments. And that could help tear down the stigma against
seeking help in the first place. This episode of SciShow is brought to you
by our patrons on Patreon. Having people support this show means that
we can tackle complicated topics like this. We really appreciate everybody who’s able
to support us, whether you started this month, or you’ve
been doing it for years. If you wanna see some of
the perks that are available, or just help us make good science content
on the internet, check out patreon.com/scishow. [♪ OUTRO]

100 thoughts on “What We Get Wrong About “Alcoholism””

  1. I was a Substance Abuse counselor for a while at a CBCF where we used Cogitive Behavioral Therapy. Cool to see it mentioned in this video!

  2. I learned as a young adult that if you took extra vitamin C when you went drinking, you wouldn't get as drunk. It is well known that alcoholics tend to be chronically low on B-1. This information is available on the NIH.gov website. How can any medical professional advocate for drugs without first replenishing what's been used up? This isn't even mentioned?

  3. Alcoholics Anonymous may help alcohol problems a little, but boy do the people who go have a nicotine problem. I’ve never seen so many people smoking at once until the end of a meeting

  4. What has worked best for my alcoholism has been Cannabis. It sucks that that option isn't available for me.

  5. I am on Naltrexone for Alcohol abuse, gambling, and binge eating. It really changes behavior. Eating until one is sick is not something worth doing if there is no tickling of the reward centers.

  6. Since I feel as I've been through some similar things, I can say that AA is absolutely without a doubt the first best defense…..if you can't stay sober there and fully give yourself to the ideas and the practices, then by all means get tricky on the addiction, but don't think for one second that this video will keep you clean or give you ammunition against AA. It is still the best way for the majority of alcoholic to stay sober.

  7. Hohohoooo boy, I can see a lot of triggered AA cultists going up in arms over this. Finally, the truth is closer to our reach, and maybe one day we will have an actual medical treatment for this medical disorder

  8. Wow I'm really disappointed. For 25 years I struggled with alternate forms of treatment for my "AUD". 8,543 days without a drink because the 12 Steps AA and it's members and the God of my understanding Teach me how to live sober. Because if a drunk horse thief just stops drinking they are still a horse thief. Recovery is learning new behaviors so that drinking is no longer an issue. AA combines abstinence, CBT, identification theory, and suggests that professionals can also be a part. By no means does AA have a monopoly but I sure wish I hadn't wasted those 25 years trying the other methods. They sure didn't work for me…it's not just a drinking problem-it's a living problem. I'm so grateful for AA the 12 Steps and the God of my understanding. With out them I'm not sure I'd be here and if I was I'm pretty sure I wouldn't be sober happy joyous and free. Twelve steps and of course these comments can be edited by anyone so my sincere attempt at trying to share my experience strength and hope…

  9. "Alcohol use disorder"? ALCOHOL USE DISORDER? PLEASE don't put "ALCOHOLISM" through the peecee newspeak word grinder. That is TOTALLY uncalled-for. There' nothing wring with the word ALCOHOLISM — many clinical terms have that suffix.

  10. I watched my adult friends struggle with alcoholism since I was about eight years old.
    Many warned me not to drink at all. Some would say this is hypocritical, but this bit of advice saved me the grief they endured.
    Thank you for your video.

  11. I get that this video is serious, but the quote marks around "Alcoholism" makes the title sound really sarcastic.

    Next up:
    5 myths about the so-called "opioid crisis"
    What's the deal with this whole "fentanyl epidemic"?
    How truly effective are "vaccines"?

  12. I drink at least 5 times a week, more than 5 drinks at a time. I don't know how to stop because it's the only time I'm not unhappy. It doesn't feel like a problem because it doesn't disrupt my life

  13. I watched my adult friends struggle with alcoholism since I was about eight years old.
    Many warned me not to drink at all. Some would say this is hypocritical, but this bit of advice saved me the grief they endured.
    Thank you for your video.
    It is best never to drink alcohol at all.

  14. Alcoholism is serious stuff of course but it is interesting to hear what amount of alcohol different countries consider too much. 4 drinks in a day=binge in the US apparently. In Finland 24 drinks a week for men and 16 for women are considered limits for high risk level. Moderate risk level is 14 for men and 7 for women weekly. Personally I think it's more risky to drink one beer each day than for example to drink 5-7 every Friday and be sober 6 days a week. Maybe it's just me old weekend drinker making excuses 🙂

  15. CBT really works for alcoholism. If every time you have a drink you get your cock and balls tortured, you soon stop.

  16. My mom takes Gabapentin (not for seizures or alcohol abuse) and let me tell you, it's one hell of a drug that I hope none of you have to take.

  17. Alcohal is a drug, one of the most dangerous drugs. And booze drinkers to extreme are drug addicts. And just plain casual drinkers are still drugies.

  18. Had a buddy who failed the 12 step programs, he wanted to drink a lot more when surrounded by religious people trying to force beliefs on him. Left every rehab because they wouldn't let him smoke… he said he didn't want to quit smoking, he said it was hard enough with no smokes. I thought if was just an exuse. Finally, he found a place in Georgia that let him smoke and bang, he stayed the whole time, stayed sober for awhile and doesn't binge to this day

  19. So many evidence=based options!

    I wonder if AA has finally stopped insisting that they're the only thing that works? (Because if you managed to quit drinking without AA you were never an alcoholic to begin with.)

  20. Exceptional reporting on this hard topic of excessive Alcohol use.
    I was not aware of drugs used to deter alcohol binging.
    The causes of alcoholism is indeed hard to determine. Thank you for a well done report on Alcohol use disorder.

  21. Alcohol Use Disorder….I can't help struggling with that. Does that mean there's also Heroin Use Disorder or Crystal Meth Use Disorder? Or are those just plain old addictions? Alcohol Use Disorder sounds like alcoholism is something completely different from being dependant on other substances. It feels like another way to seperate alcohol from other drugs just because it's 'socially acceptable' while it's just your average hard drug.

  22. I've seen more than a few raging alcoholics quit by taking up smoking pot, including my brother. several acquaintance I know quit hard drugs the same way. I wish they would study why this happens, weed could be a very good addiction treatment.

  23. Thank you for talking about Naltrexone! It is a lifesaver. A truly amazing drug for reducing alcohol cravings, and needs vastly more attention.

  24. I have known a few alcoholics, and one of the most effective treatments I've seen is cannabis. It just changes their life for the better. They are healthier, happier, and more productive. The US needs to get their head out of their ass and legalize it fully.

  25. Sugar is a drug too!
    You can get addicted to it, have withdrawals, have cravings, and it is also bad for you.

  26. my mate goes to AA – he says meetings are mainly in church basements – they drink together there which keeps them of the streets – he seems better – give it a try!

  27. An alcoholic will never quit drinking until they are ready no matter how many times they go to rehab.
    Rehab is awesome, but in the end no one can keep you sober but yourself.
    I am nine and a half years sober.
    You just have to be strong, it gets easier and easier as time goes by. I rarely even think about alcohol anymore and I was a full-blown alcoholic for decades.

  28. This subject is just supporting the incompetent medical profession and the privileged minority that do not have any true skills in trying to find out why there is alcoholism. The main problem is that none of these "professionals" are trying to find out why there is alcoholism. They only want their opinion to be inflicted on those that they deem there inferiors. If you want to help fix the problem you might want to find out why instead of persecuting the true victims (the alcoholics).

  29. "Funny" story, when a person i know worked with AUD patients at a certain facility outside of town, they used Disulifram, but many kept on sneaking alcohol in the rehab centre anyway. This of course led to them vomiting etc, but it didn't cause associations with the alcohol for one patient, instead, everytime that patient drove by the rehab centre, s/he threw up, years later.

  30. GP Doctors (general practitioners) do not receive enough training about alcoholism during med school, although maybe that is changing ? Anyone here in med school ?

  31. To everybody whining about the booze ad: YouTube uses one or more advertising programs. These respond to keywords. So a video on alcoholism gets alcohol ads; a video debunking a woo-woo claim gets advertising for woo-woo, and so on.

  32. If you are really advocating moderation to alcoholics, you have completely missed the mark and are doing a disservice to anyone who suffers from it.

  33. I had diabetes for years without knowing it. Years later I began drinking. I needed alcohol to sleep or I could not sleep at all. I did not want to take any pills or go to a doctor. Years later I removed one food from my diet and my glucose levels dropped from a 20 to a 3.2. After that I felt terrible after one beer so I stopped drinking without even realizing. My sleep became normal and I almost forgot….my blindness went away. My memory got better and my ferocious appetite went away. The diabetes directed me to drinking and after removing sodium nitrate my glucose dropped so low that drinking was uncomfortable so I stopped drinking.The removal of what caused me to start drinking caused me to stop drinking. In other words according to me…sodium nitrate is the cause of most addiction and the removal of it will direct a person away from addiction like it did for me. Haven't had a drink in 4 years nor do I crave it.

  34. If you only knew how ridiculous that sounds when you say we are going to use drugs to cure alcoholism…. anybody who thinks this way is broken

  35. i't's the AMA that made IT a "DISEASE" like CANCER as
    a MEDICAL Tx~as it's a MONEY MAKER$$$$$$$$$$$$$$$$

  36. There is a group of people who are extremely addicted to alcohol and who have memory lapses and continue to drink even with SEVERE damage to their lives. This group needs 12 step programs because they MUST stop drinking alcohol! No "moderation" is going to help. The 12 step process may not help everyone, but the alternatives are death or prison.

  37. How come you didn't mention LSD and magic mushrooms? They've both shown incredible results in early testing and are two of the safest substances you can take.

  38. I’m an alcoholic. I know I am, I’m drunk right now. I feel like for me (I live I TN), that I could ditch alcohol by therapeutically using weed. Unfortunately I work a job with random drug testing, and I’m unable to even consider exploring that option.

  39. You need a new definition for binge drinking……4 drinks in a day…….that means many many people that are not alcoholics are considered binge drinkers

    Just like tobacco, if you cut back on use, later you will catch up……you must quit

    AA is mostly people that say they have quit, but in reality they have just hidden their drinking……and when it falls apart it becomes they fell off the wagon

  40. These principles apply to all drug addictions. We need to be treating addiction as a health issue and not a moral or criminal issue.

  41. I didn't bother to listen to this. I'm drunk right now, and steadfastly getting drunker. I have 12 litres of strong red wine on my kitchen table and the floor next to it. I get falling over drunk between 13 and 14 nights per fortnight. Why ? You don't know. Nor does this privileged silly sci show idiot.

  42. How about an episode on fishing? Specifically the ones that got away and what happens to the hooks still stuck in them.

  43. Could you just slow down just a tad? So much information at high speed and volume is hard to take in. I tried the .75 speed setting, and that's too slow, so just a pinch of a slow-down would be very nice (calming!)

  44. Most people do not present problems because they can afford to hide it. I was astonished, being associated with a community alcohol support team , what a huge middle class problem it is even though the perception is its mostly the archetypical `drunk`. This is true of all drug users in my experience . Most never present themselves as a problem unless a medical crisis ensues.

  45. It's funny how psychiatrists always advise people to take drugs in combination with therapy and cast shade on any other methods. At least AA is free last time I checked. Any method that a person decides to use is going to most likely help them since they are choosing to do something. That conscious choice is a powerful step toward recovery. Though this statement would be next to un-testable in a scientific study, I've personally seen it play out many times.
    As someone who's seen many members of my family fall to this disease, it is not just psychological. There's huge social components as well, which aren't being addressed at all by SciShow. Like, what should a loved one do that is most effective at helping those struggling? Again, probably extremely difficult to test. Science loses its utility in the face of complex human issues. But we need to be honest about the reasons people drink, and how we can all make a healthier world by offering other solutions or just being able to speak openly with these vulnerable people.

  46. One of my best friends got drunk very heavy from age 13-17. Then she got a boyfriend and stopped drinking almost completely, even after they broke up, she didn't have a drinking problem anymore. I guess she just had to get over the habit of drinking regularly out frustration.

  47. We got to do something about the “more alcohol=more cool” culture. Im not saying we need teens/students to abstain or stick to a quota, but there’s a more=better mindset in the younger groups and it’s dangerous. ‘Lightweights’(IE those who understand their limits/enjoy in moderation) are ridiculed while ‘tanks(problematic drinkers/alcoholics) are celebrated for drinking so much. Should be the opposite IMO; cheer on the ones that can enjoy themselves with no/little drinks. Not suggesting we shame drinkers, just stop shaming those who don’t chug it

  48. Sounds like an ad for the pharmaceutical industry. Alcoholism is a psychological- social problem, and your approach is terrible at dealing with them.

  49. Thank you for highlighting the multitude of options available. AA/12 Step has had a monopoly on treatment for far too long and it has harmed WAY more people than it has helped.

  50. Ive never heard or met a Doctor who has successfully cured/helped or healed any patient beyond pills and repeat visits…

  51. Yes there are physiologically addictive chemicals/substances, but it’s often ignored how a lack of fulfillment, meaning, and passion in life is usually the primary cause of the addiction (alcohol or other drugs are unhealthfully used in an attempt to provide the missing fulfillment).

  52. In my opinion, it ain't a disease if you choose to keep the disease going by your actions.
    Being a drug addict is not a disease either.

  53. I don't know why they call it 'Alcohol abuse'. Alcoholics don't abuse alcohol; the alcohol abuses them.

  54. Can you answer why our societies still look at alcohol better than marijuana even though it’s proven that alcohol is actually worse in almost every way

  55. I have 22 years of abstinence under my belt its the best way to achieve peace within when your a problem drinker AA has been helpful just way to much religious dogma IMHO BEING AN ATHIEST …I get to live a life beyond my wildest dreams in all areas health, wealth …

  56. There is also the aspect that many who have AUD have lost everything, family, job, and friends do to AUD. Therefore these people don't have the money and in many cases health insurance so there options can be limited. AA is free along with many other programs but not going to your doctor, so many who suffer do so without a doctor's assistance. So studying individuals can be hard in the US just because of this, yet another reason to have free or low-cost health insurance. If there is a person with health insurance, there are many options including inpatient and outpatient both are just fine but there is better if you can pay for it. Once again your life is worth more if you can pay for it in the United States. Over in real countries that care about there people like Canida, France, England, Spain, and most of the countries that are not "third world" alcoholism is treated very differently. In Canida, there is a treatment center based on a little is better than a lot. This place makes there own wine, with a doctor overseeing the operation people are given housing and a path off the streets. This is a new program in Canida, from what I read it has been open now for a couple years and is showing great promise. If you want to see and learn about this place, a Canadian channel called "The Fifth Estate" posted it to Youtube. This channel is run by CBS I believe. One final note, if this program had been in Michigan twenty years ago I knew it would have saved my mother's life.

  57. As with your SciShow Psych episodes that talk about psychotropic drugs (and really because of them), this episode comes across to me as having red flags: the phrases used in the discussion on how these drugs work “in the brain”.

    There are a lot of risky presumptions being used to justify chemical treatment in this field (human behavior). We can safely (in terms of public health) say “we think that dark matter probably answers this mathematical problem”. Relying on “probably” is not as safe when the subject/field is human health.

    Another phase is “helps modulate that signaling”… which sounds like it comes straight out of a pharmaceutical corporation’s own marketing materials. (actually, it sounds a lot like Star Trek Voyager’s meaningless technobabble, often using “modulate” and “phase” in increasingly meaningless ways) If you are simplifying something more specific and actually verified in independent studies, you should probably use the more specific info and language in this moment.

    As a society, we are struggling under a lot of presumptions and myths around the chemical intervention of human behavior. People have taken to deeply believe in what is actually nothing more than presumption, unproven hypothesis, marketing, and myth. Between medicalization of undesirable human behavior (including things that by no means should be treated with chemical intervention, such as grief / mourning), and the capitalist economy that pharmaceuticals are developed to serve, a LOT more care and independent analysis is needed when presenting these subjects to general audiences.

    It is worth pointing out that these cultural beliefs around chemical psychiatric treatment are so deeply driven into the public consciousness that the culture often violently reacts to any criticism of these treatments (and their claims of efficacy), no matter the source of the criticism or the language used. “You’re a scientologist” or “you’re also an anti-vaxxer, aren’t you?” and other such “you’re against science, so why would anyone listen to you” commentary is used to attack the credibility of the person making the criticism, rather than any critique of the arguments (ad hominem attacks are treated as logical errors for good reason).

    Most of your viewers are NOT going to go read all the sources you link to in your video description to make sure that they interpreted your presentation as accurately as possible. It is your responsibility to take more care in your presentation. You're also not labeling each declaration with the appropriate citations within the presentation (Wikipedia is actually a great model for this, and despite the criticisms leveled against Wikipedia as a source of knowledge, it has actually had a positive cultural impact in terms of people learning to say “cite your source!”).

  58. Bill Wilson was a womanizer and a conman. There is no such thing as a God. I attended AA for 20 years. It's power is in its group therapy.

  59. The 12 step program is highly scientific.
    The first step is to admit you're a powerless loser and the third already mentions the word 'god'.
    My non-scientific, one step approach:
    1. Quit drinking

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