Treatment of Alcoholism
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Similar to other diseases, alcoholism can be overcome with proper treatment, prevention, and increased research efforts.
Stated differently, as serious as alcoholism is, fortunately it can be treated.
The treatment of alcoholism usually entails a combination of doctor-prescribed medications, counseling, education, training,
and support to help the alcoholic abstain from drinking alcohol.
An Essential Question: What is Alcoholism?
Alcoholism, also known as alcohol addiction and alcohol dependence, is a
progressive debilitating disease.
This means that alcoholism gets increasingly worse as the alcoholic continues to drink. Alcoholism is a disease that
has received extensive research and includes the following four identifiable symptoms:
- Physical dependence: withdrawal symptoms such as anxiety, headaches, nausea, perspiration, and “the
shakes” when abstaining from alcohol.
- Craving: having a strong urge or need to drink.
- Tolerance: the need to drink greater amounts of alcohol in order to feel a “buzz” or to get “high.”
- Loss of control: an inability to stop drinking after the first drink.
The Treatment of Alcoholism: An Overview
Not unlike other diseases and illnesses, alcoholism can be overcome with prevention, quality alcoholism treatment, and increased
research efforts.
By providing more individuals with access to effective alcoholic treatment, the
costly drain on society and the financial, physical, and emotional liability alcoholism places on families can be significantly
minimized.
Indeed, recent research strongly shows that successful prevention and professional quality alcohol treatment programs result in
significant reductions in heart disease, crime, HIV, cancer, strokes, traffic fatalities, unwanted pregnancy, and child abuse.
Furthermore, quality alcohol and drug treatment improves health, quality of life, and job performance while at the same time
reducing drug use, family dysfunction, and involvement with the criminal justice system.
As debilitating as alcoholism is, fortunately it can be treated. The treatment of alcoholism usually involves a combination
of counseling and doctor-prescribed medications to help an alcoholic stop drinking. Even though most alcoholics need professional
assistance to recover from their addiction, research has demonstrated that with support and quality alcoholism treatment, many alcoholics are
able to refrain from drinking and restore their lives.
| A clear relationship exists between alcohol use and grade point average (GPA) among college students. Students
with GPAs of D or F drink three times as much as those who earn As. |
The Treatment of Alcoholism: Withdrawal Symptoms
A wide variety of different techniques exist for treating alcohol withdrawal symptoms. While some of these treatments
use drugs, many, however, do not. Indeed, according to current research findings, the safest way to treat mild withdrawal
symptoms is without drugs. Such types of non-drug detoxification efforts use screening and comprehensive social support
throughout the entire withdrawal process. Other non-drug detoxification programs, additionally, use vitamin therapy (especially thiamin)
and proper nutrition and when treating mild withdrawal symptoms.
| Sixty-seven percent of eighth graders and 83 percent of tenth graders believe that alcohol is readily available to
them for consumption. |
Mild to Moderate Withdrawal Symptoms
The following represents mild to moderate physical withdrawal symptoms that typically occur within 6 to 48 hours after the last
alcoholic drink:
- Sleeping difficulties
- Abnormal movements
- Nausea
- Enlarged or dilated pupils
- Clammy skin
- Tremor of the hands
- Looking pale
- Rapid heart rate
- Vomiting
- Loss of appetite
- Pulsating headaches
- Sweating (especially on the palms of the hands or on the face)
- Involuntary movements of the eyelids
Severe Withdrawal Symptoms
The following is a list of severe symptoms that typically occur within 48 to 96 hours after the last alcoholic drink:
- Fever
- Visual hallucinations
- Severe autonomic nervous system overactivity
- Black outs
- Muscle tremors
- Delirium tremens
- Convulsions
- Seizures
| In spite of the debate in the medical, neurobiological, and psychological research communities about the existence
as well as the character of the addictive personality, it is, however, observable and verifiable that brain functions contribute
to different addictions. Building on this perspective, many researchers currently believe that the predisposition to
addiction is more accurately a combination of psychological, biological, and environmental factors. |
The Treatment of Alcoholism: Traditional Programs
There are a number of traditional alcohol treatment options that are relatively well established. The following alcoholism
approaches and programs will be discussed: Detoxification, Behavioral Treatment, Therapeutic Medications, Outpatient Alcoholism
Treatment and Counseling, Residential Alcoholism Treatment Programs and Inpatient Alcohol Rehab, and Family and Marital Counseling.
| Nearly one-fourth of all persons admitted to general hospitals have alcohol problems or are undiagnosed alcoholics
being treated for the consequences of their drinking. |
Detoxification. Alcohol detoxification is the process of letting the body rid itself of alcohol while
managing the withdrawal symptoms in a safe environment. Alcohol detox treatment is typically done under the supervision of a medical doctor
and is frequently employed as the first step in an alcoholism treatment program. Due primarily to the relatively long time-frame for the
Detox process, these approaches are typically part of an inpatient alcohol rehabilitation program.
| According to one study, 68% of those people who come to a trauma center have an alcohol or drug problem. |
Behavioral Treatments. These rehab methodologies focus on initiating change in an alcoholics' behaviors
and actions. Examples include Alcoholics Anonymous, Motivation Enhancement Therapy, and Cognitive Behavioral Therapy. It can be noted
that a study that was recently undertaken by the National Institute on Alcohol Abuse and Alcoholism discovered that each of these behavioral
treatment approaches greatly reduced drinking in patients the year after treatment. Although all of these programs were determined to be
"successful," none of them was classified as "the best" alcoholism treatment program.
| 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. |
Alcoholics Anonymous (AA). Alcoholics Anonymous is a mutual support program for recovering alcoholics that is
based on the 12-step recovery process that is required in order to remain sober. Assistance and support are provided by the meetings that
convene on a regular basis. Is Alcoholics Anonymous the best choice for the treatment of alcoholism? While Alcoholics Anonymous has
established itself as an effective therapeutic recovery approach, most practitioners outside of Alcoholics Anonymous, as well as many members
within AA, think that Alcoholics Anonymous works best when combined with other forms of treatment such as psychotherapy and medical care.
Motivation Enhancement Therapy(MET) is a systematic therapeutic approach that is almost exactly the opposite
of Alcoholics Anonymous, philosophically speaking, in that it uses motivational techniques to elicit the client's change
processes. Some of the main characteristics of MET are the following:
| In the United States during 2004, 16,694 deaths occurred as a result of alcohol-related motor-vehicle
accidents. This amount was roughly 39% of all traffic fatalities. This amounts to one alcohol-related death every 31
minutes. |
Cognitive Behavioral Therapy (CBT). There are several forms of cognitive behavior therapy. Most of them,
however, share the following characteristics:
- 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 uses the Socratic Method that is based on the asking of questions for insight.
- Homework is a central feature of CBT.
- CBT is a mutually shared effort between the therapist and the client.
- In CBT, a solid therapeutic relationship is necessary but not the primary focal point for effective therapy.
- CBT is structured and directive.
- CBT usually has therapeutic sessions that are briefer and fewer in number than most other forms of therapy.
- 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 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 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.
| Individuals with drinking problems or alcoholism at any time in their lives suffer income reductions ranging from
1.5 percent to 18.7 percent depending on age and sex compared with those with no such diagnosis. |
Therapeutic Medications. Numerous alcoholism researchers claim that alcohol dependent individuals who
cannot continue their sobriety need to receive therapeutic medications to manage and treat their alcohol withdrawal symptoms. Not only
this, but individuals who are addicted to alcohol are less likely to experience possible brain damage and/or seizures when they receive various
alcoholism medications.
Current alcoholism research shows that the drugs most likely to produce effective results when treating alcoholism withdrawal
symptoms are the benzodiazepines. Examples include the longer-acting benzodiazepines such as Librium and Valium and the shorter-acting
benzodiazepines such as Ativan and Serax . Traditionally, medical doctors have used a progressive decrease in doses over the
time-frame of the withdrawal process when using benzodiazepines. Additionally, since the shorter-acting benzodiazepines do not remain
in the person's system for an excessive amount of time and due to the fact that they allow for measurable and observable dose reductions, more
than a few alcoholism researchers have asserted that intermediate to short half-life benzodiazepines need to be used when treating withdrawal
symptoms.
| The following represents some of the negative consequences of drinking alcohol and the fertility of the father:
killing off the sperm-generating cells in the testicles and abnormal liver function and a rise in estrogen levels that, in turn,
affect sperm development and hormone levels. |
Another aspect of alcoholism treatment with therapeutic medications focuses on various prescribed drugs such as naltrexone
(ReViaT) or disulfiram (Antabuse) that are administered by a doctor in an effort to help prevent the individual from returning to drinking after
he or she has experienced a relapse and ingested alcohol. Simply put, in this intervention approach, doctors prescribe drugs to treat a
person's dependency. For example, antabuse is a drug given to alcoholics that triggers negative effects such as vomiting, dizziness,
nausea, and flushing if alcohol is consumed. Not surprisingly, antabuse is effective precisely because it is a such a strong deterrent.
Naltrexone (ReViaT), from a different perspective is effective because it targets the brain's reward circuits and reduces the craving the client
has for alcohol.
Outpatient Alcoholism Treatment and Counseling. These approaches usually employ counseling that
teaches alcoholics how to become aware of the psychological and situational "hot buttons" that trigger their drinking behavior.
Equipped with this information, alcoholics can then learn about different ways in which they can cope with circumstances that do
not include the drinking of alcohol. These treatment approaches to alcoholism, unlike the detox programs, are
usually offered on an outpatient basis.
| In many instances characterized by dysfunctional living conditions, the result is that the codependent person or
persons develop habitual self-defeating ways of coping in order to survive. If this vicious cycle is not broken, the
codependents eventually become out-of-touch with their own emotions. |
Residential Alcohol Treatment Programs and Inpatient Alcohol Rehab. If there's a need for alcohol AND drug
abuse treatment, if outpatient and support-oriented programs such as Alcoholics Anonymous are ineffective, if an individual needs alcohol
poisoning treatment, or if the individual's withdrawal symptoms are extreme, the person typically needs to enroll into a hospital or a
residential alcohol treatment facility in order to receive inpatient alcohol rehabilitation. Such programs are earmarked for alcoholism
inpatients and usually include doctor-prescribed medications to help the alcoholic through detox and through the alcohol withdrawal process in a
safe manner.
Family and Marital Counseling. Due to the fact that the recovery process is so intimately related to the
support the alcoholic receives from his or her family, a number of alcohol dependency programs include marital counseling and family therapy as
essential aspects in the treatment protocol. Such therapeutic approaches, furthermore, may also provide clients with much needed community
resources such as financial management courses, parenting classes, legal assistance, childcare courses, and job training classes.
The Treatment of Alcoholism: Alternative Approaches
Although the research findings are inconclusive, there are many alternative treatment programs for alcohol abuse and alcoholism
that are becoming more available and widely used. Examples of such "natural" forms of alcoholism treatment include the holistic and naturalistic
approaches employed by Traditional Chinese Medicine, "Drumming out Drugs" (a form of therapy that employs the use of drumming by clients), and
various vitamin and supplement therapies. As encouraging as these alternative programs have been, additional research, however, is
needed to evaluate their effectiveness and to find out if they offer long term alcoholism treatment success.
| Since no level of alcohol consumption during pregnancy has been proven safe, the March of Dimes strongly urges
pregnant women to refrain from all alcohol, including beer, wine, wine coolers, and hard liquor during their entire pregnancy AND
also while nursing. |
The Treatment of Alcoholism: Conclusion
Even though a cure for alcoholism has not been discovered, various alcoholism programs have been employed in the treatment of
alcoholism that have helped people recover from alcohol dependency. In a word, there is a lot of information that is available both
online and offline concerning the treatment of alcoholism. Some people ask the following question regarding
alcoholism: "Concerning the treatment of alcoholism, which approach is the best"? Like any chronic
disease, there are different degrees of success regarding alcoholism treatment.
For instance, some alcoholics experience relatively long periods of sobriety after receiving treatment, and then have a
drinking relapse. On the other hand, some alcoholics, after treatment, abstain from drinking and remain sober. And still
other alcoholics cannot refrain from drinking for any sustainable period of time, regardless of the type of treatment to which they have been
exposed.
It is interesting to point out, however, that all of these treatment outcomes occur on a regular basis with every known type
of alcoholism therapy. Regarding the treatment of alcoholism, however, one thing is certain: the longer a person
abstains from drinking alcohol, the more likely he or she will be able to remain sober.
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| Recent research demonstrates that it is important to treat every person who is experiencing alcohol
withdrawal. It can be pointed out, however, that approximately 95% of the people who quit drinking alcohol suffer from
mild to moderate withdrawal symptoms and can normally be treated on an outpatient basis by a healthcare professional.
The remaining 5% of people who experience withdrawal symptoms, however, suffer symptoms so severe that they must be treated
in a hospital or in an alcohol rehabilitation facility that specializes in detoxification. |
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