Treatment Options for Alcohol Abuse

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Not all people who abuse alcohol are alcoholics.  There comes a time, however, when the line between alcohol abuse and alcohol addiction becomes blurry as the person looses more control over the frequency and the amount of alcohol he or she consumes. 

Fortunately, no matter where a person is on this "problem drinking" continuum, however, there are effective treatment options for alcohol abuse and alcoholism.

Traditional Alcohol Abuse and Alcoholism Treatment

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

Detoxification.  Alcohol detoxification is the process of letting the body rid itself of alcohol while managing and controlling 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.

A study administered by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that each of these behavioral treatment therapies significantly reduced drinking in patients the year after treatment.  The NIAAA, however, was not able to state which behavioral therapy was "the most effective."

Factors Affecting Treatment Options

The form of alcohol abuse and alcoholism treatment you receive depends on a number of factors:

• The severity of your condition
• The resources available in your community
• Whether you want to involve yourself with traditional alcoholism approaches or alternative treatment options
• Your personal health care coverage
• Whether you have the financial resources for the treatment of choice

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.

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: 

• Helping the client achieve self-efficacy or a sense of optimism
• Providing feedback regarding the personal risks or damage associated with the abuse
• Emphasis on taking personal responsibility for positive change
• Receiving clear advice to make healthy changes
• Providing the client with a number of alternative change options
• Therapist empathy

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

• CBT is structured and directive.
• CBT uses the Socratic Method that is based on the asking of questions for insight.
• 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.
• Homework is a central feature of CBT.
• CBT usually has therapeutic sessions that are briefer and fewer in number than most other forms of therapy.

• In CBT, a solid therapeutic relationship is necessary but not the primary focal point for effective therapy.
• 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.
• 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.

Therapeutic Medications.  This treatment approach centers on the client taking doctor-prescribed medications such as the benzodiazepines for treating alcohol withdrawal symptoms and naltrexone (ReViaT) or disulfiram (Antabuse) to help prevent the person from returning to drinking after he or she has alcohol consumption.

For instance, antabuse is a drug given to alcoholics that elicits negative effects such as dizziness, flushing, vomiting, and/or nausea if alcohol is ingested.  Antabuse has been proven to help prevent relapses and is effective mainly because it is such 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.

Outpatient Counseling.  There are various approaches to counseling that teach alcoholics and alcohol abusers 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.

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.

Alternative Alcohol Abuse and Alcoholism Treatment

Although the research findings are not clear, there are some alternative treatment approaches for alcohol abuse and alcohol addiction 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.

Treatment Options for Alcohol Abuse:  Conclusion

Diverse treatment options for alcohol abuse and alcoholism work in different ways for different people.  Like any chronic disease, however, there are varying degrees of success regarding treatment.  For example, some people who abuse alcohol "see the light" after therapy and choose to abstain from drinking.  Others experience relatively long periods of sobriety, and then have a drinking relapse (such as binge drinking).  And still other alcoholics and alcohol abusers cannot refrain from drinking for any sustainable period of time.

With treatment, however, one thing is certain:  the longer an individual refrains from drinking alcohol, the more likely he or she will be able to remain sober.

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