Treatment Options for Alcohol Abuse
Treatment Options For Alcohol Abuse
Treatments for alcohol abuse are quite varied in keeping with the multiple perspectives of the condition itself. Counselors approaching the condition as a medical disease will recommend different treatment processes and goals than, for instance, those approaching the condition as one of social choice. Most treatments focus on helping abusers completely discontinue their alcohol intake, as well as providing life training and/or social support to help them resist a return to alcohol use. Since alcohol abuse involves many factors which encourage a person to continue drinking (psychological/social, physical, and neurochemical), all of these factors must be addressed in order to successfully prevent a return to active alcohol use.
The most common approach to alcohol abuse treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcohol abuse typically supports an abstinence-based approach, as studies have shown that the vast majority of people who abuse alcohol cannot learn to drink in moderation.
The effectiveness of alcohol abuse treatments vary from successful to counterproductive. When considering the effectiveness of treatment options, it is important to consider the percentage of those who drop out of a program, not just those who complete it. Most programs can boast a high cure rate for those who complete it because most people only complete a program if it works for them. It is also important to consider not just the percentage of those reaching sobriety but how many of those experience relapsing.
Here are the most common treatment options for alcohol abuse:
Detoxification
Detoxification (commonly referred to as “detox”) is the process of eliminating alcohol drinking and giving the drinker’s bodily system time to re-adjust to the absence of alcohol. Drugs that have similar effects to alcohol are used to ease the withdrawal symptoms, which can actually be deadly in extreme cases if left untreated. The most often used drugs are sedative-hypnotics, such as diazepam or clonazepam. Less frequently, barbiturates such as phenobarbital are used. Many weeks after alcohol intake has completely stopped individuals may still suffer from milder withdrawal symptoms; sleep is generally the last function to return to normal.
Detoxification is not a treatment for alcohol abuse itself, but is simply a treatment of the physiologic effects of ongoing abuse of alcohol. It provides an initial path for an abuser to stop drinking in the first place. Detoxification treatments without supplemental help for the patient to continue abstinence have a very high rate of relapse.
Detoxification often takes place within an inpatient environment, but some programs do offer outpatient detoxification.
Group therapy and psychotherapy
After detoxification, various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues leading to alcohol abuse, and also to provide the recovering abuser with relapse prevention skills.
In the mid-1930s, the mutual-help group-counseling approach to treatment began and has become very popular. Alcoholics Anonymous is the best-known example of the support group movement. Other groups that provide similar self-help and support without AA’s spiritual focus include LifeRing Secular Recovery, Smart Recovery, Women For Sobriety, and Rational Recovery.
Medications
Medications for alcohol abuse are most often used to supplement a person’s willpower and encourage abstinence.
Antabuse (disulfiram), for instance, prevents the elimination of the chemical acetaldehyde. This causes severe discomfort when alcohol is ingested, effectively preventing the abuser from drinking in significant amounts while they take the medication. Heavy drinking while on Antabuse can result in severe illness and death.
Naltrexone has also been used because it helps curb cravings for alcohol while the person is on it. Both Antabuse and Naltrexone are used to encourage abstinence. The have, however, been demonstrated to cause a rebound effect when the user stops taking them.
Pharmacological extinction (also called the Sinclair Method)
Pharmacological extinction is the use of opioid antagonists [e.g. naltrexone] combined with normal drinking habits in order to eliminate the craving to consume alcohol. While standard naltrexone treatment uses the drug to curb craving and enforce abstinence, pharmacological extinction targets the endorphin-based neurological conditioning. Our behaviors become conditioned when we do something and endorphin bathes our neurons, and that conditioning is reversed when we do that thing and we don’t receive the endorphins. This method involves the alcohol abusers going about their normal drinking habits (limited only by safety concerns).
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