Treatment Options for Alcohol Abuse

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The various treatment therapies for alcohol abuse work in different ways for different individuals. One thing about treatment, however, is perfectly clear:  the longer a person stays away from alcohol, the more likely he or she will be able to remain sober.

Factors That Affect Alcoholism Treatment

The form of alcohol abuse and alcoholism treatment an individual receives depends on a number of significant factors:

  • The resources available in the person's community.

  • The personal health care coverage of the individual.

  • Whether the individual wants to involve himself or herself with traditional alcoholism approaches or alternative treatment options.

  • Whether the individual has the financial resources for the treatment of choice

  • The severity of the individual's condition.

Traditional Alcohol Abuse and Alcoholism Treatment

There are a number of traditional alcoholism treatment approaches that are relatively well established.

Detoxification.  Alcohol detoxification is the process of letting the body rid image: young lady angry about boyfriend's abusive drinkingitself of alcohol while managing the withdrawal symptoms in a safe environment.  This form of treatment is usually done under the supervision of a medical practitioner and is often the first step in an alcoholic treatment program.

Behavioral Treatments such as Alcoholics Anonymous, Motivation Enhancement Therapy, and Cognitive Behavioral Therapy. 

Interestingly, a study administered by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that each of these behavioral treatment therapies greatly reduced drinking in patients the year after treatment. 

The NIAAA, nonetheless, did not conclude which program was the "most effective."

Alcoholics Anonymous (AA).  Alcoholics Anonymous is a mutual support program for recovering alcoholics that is based on the 12-steps of recovery that are needed in order stay sober.  Help and support are provided by the meetings that meet on a regular basis.  While AA has proven to be an effective therapeutic approach, most practitioners outside of AA, as well as many people within AA, find that Alcoholics Anonymous works best when combined with other forms of treatment, including medical care and psychotherapy. 

Recent research demonstrates that the drugs most likely to produce effective results when treating alcohol withdrawal symptoms are the benzodiazepines: the shorter-acting benzodiazepines such as Serax and Ativan or the longer-acting benzodiazepines like Valium and Librium.

Motivation Enhancement Therapy (MET) is a systematic therapeutic approach that is almost diametrically opposed to AA in that it uses motivational strategies to activate the client's own change resources.  Some of the key characteristics of MET are the following:

  • image: young woman in pain from excessive drinkingProviding feedback regarding the personal risks or damage associated with the abuse.

  • Helping the client achieve self-efficacy or a sense of optimism.

  • Emphasis on taking personal responsibility for positive change.

  • Providing the client with a number of alternative change options.

  • Receiving clear advice to make healthy changes.

  • Therapist empathy.  
On average, an alcoholic who doesn't stop drinking can expect to decrease his or her life expectancy by at least 15 years.

Cognitive Behavioral Therapy (CBT).  There are several forms of cognitive behavior therapy.  Most of them, however, have the following commonalties:

  • Homework is a central feature of CBT.

     

  • CBT uses the Socratic Method that is based on the asking of questions for insight.

     

  • CBT is structured and directive.

     

  • CBT approaches are based on the cognitive model of emotional response.  That is, if we change the way we think, we can act and feel better, even if the situation doesn't change.

     

  • CBT usually has therapeutic sessions that are briefer and fewer in number than most other forms of therapy.  
Several studies have shown that about half of alcoholics who have successfully undergone detoxification will relapse within 6-12 months. Remaining alcohol-free is a very difficult task for most alcoholics.

  • CBT is based on stoic philosophy.  CBT does not tell clients how they should feel.  Rather, this form of therapy focuses on helping clients learn how to think more logically and effectively.

  • CBT is a mutually shared effort between the therapist and the client.

  • CBT is based on an educational model that views most emotions and behavioral reactions as learned responses.  Thus, the therapeutic goal in to help the client unlearn undesirable reactions and emotions and replace them with new and more positive ways of feeling and reacting.

  • CBT theory and techniques rely on the Inductive Method.  This method has clients look at their thoughts as hypotheses (or suggested explanations) that can be tested and questioned.  If clients discover that their hypotheses are incorrect, they can then change their thoughts and feelings to be more in line with reality.

  • In CBT a solid therapeutic relationship is necessary but not the primary focal point for effective therapy.
Depression is a common cause of alcoholism as the depressed person seeks a way out of their problems or a relief from insomnia. Unfortunately, alcohol is itself a depressant, so the problem is only compounded.

Therapeutic Medications.  This treatment approach centers on the client taking doctor-prescribed medications such as naltrexone (ReViaT) or disulfiram (Antabuse) in an attempt to help prevent the person from returning to drinking after he or she has consumed alcohol. Antabuse is a drug given to alcoholics that elicits negative effects such as vomiting, flushing, nausea, dizziness, and vomiting if alcohol is ingested.  Antabuse is& effective mainly because it is a strong deterrent.  Naltrexone (ReViaT), on the other hand, targets the brain's reward circuits and is effective because it reduces the craving the client has for alcohol.

A strong social support system and early medical or psychiatric intervention may also help prevent the escalating consumption of alcohol so characteristic of alcoholism.

Outpatient Counseling.  There are various approaches to counseling that teach alcoholics how to become aware of the emotional and situational hot buttons that trigger their drinking.  Armed with this information, clients can then learn about different ways in which they can cope with their feelings and situations that do not include the use of alcohol.  These types of therapies are typically offered on an outpatient basis.

The view that the personality of an alcoholic exists before the onset of the disease is most strongly articulated by those who advocate a concept known as the "addictive personality." According to supporters of this theory, the addictive personality is a distinct psychological
trait that predisposes particular
people to addictions.

Counseling.  Because the recovery process is so intimately tied to the support the client receives from his or her family, numerous alcohol dependency programs include family counseling and marital counseling as key components in the treatment process.  Such therapeutic programs, moreover, may also provide clients with essential community resources, such as parenting classes, job training, legal assistance, financial management classes, and childcare courses. 

When person is addicted, he or she no longer takes alcohol or drugs to have fun or to get high. Rather, the addicted person needs the alcohol or the drugs in order to function on a daily basis. In fact, in many instances, the addicted person's everyday life centers around satisfying his or her need for the substance on which he or she is hooked.

Alternative Alcohol Abuse and Alcoholism Treatment

Although the research findings are not clear, there are some alternative treatment approaches for alcohol abuse and alcoholism that are becoming more mainstream and widely used. Examples include "Drumming out Drugs" (a form of therapy that employs the use of drumming by clients), the holistic and naturalistic approaches employed by Traditional Chinese Medicine, and various vitamin and supplement therapies have been proposed as "natural" ways to treat alcohol abuse.  As promising as these alternative approaches are, more research is needed to establish the effectiveness of such therapeutic approaches to alcohol abuse and alcoholism.

The overriding plan of action when experiencing a possible alcohol overdose situation is this: Do not take chances when someone's life is at stake. If you suspect that a person has alcohol poisoning or is overdosing on alcohol, get immediate medical assistance, even if the person is underage.

Treatment Options for Alcohol Abuse:  Conclusion

Different treatment options for alcohol abuse work in diverse ways for different people.  Like any chronic disease, however, there are varying degrees of success regarding treatment.  For instance, after treatment, some individuals abstain from drinking and remain sober.

Others who seek treatment, however, experience relatively long periods of sobriety and then experience a drinking relapse.  And still others who abuse alcohol cannot abstain from drinking for any sustainable time period regardless of what kind of treatment they receive.  With treatment, however, one thing is certain:  the longer an individual stays away from alcohol, the more likely he or she will be able to remain sober.

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Alcohol abusers who require surgery also have an increased risk of postoperative complications, including infections, bleeding, insufficient heart and lung functions, and problems with wound healing. Alcohol withdrawal symptoms after surgery may impose further stress on the patient and hinder recuperation.

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