Treating Alcoholism

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Similar to other diseases, alcoholism can be overcome with quality treatment, prevention, and substantially more research.  As serious as alcoholism is, however, the good news it that it can be effectively treated.  Treating alcoholism typically includes a combination of counseling and prescribed medications to help an individual quit drinking.

In fact, this combination may be the current best treatment scenario.  Stated differently, after treating people and helping them overcome their addiction via medications, counseling can then teach them how to make the necessary lifestyle changes that will help them avoid relapse without medications.

A Basic But Essential Question:  What is Alcoholism?

Alcoholism, also known as alcohol dependence and alcohol addiction, is a debilitating disease that increasingly gets worse as it advances.

Alcoholism has been studied extensively and includes the following four identifiable symptoms.

• Loss of control: an inability to stop drinking after the first drink
  
  
• Tolerance:  the need to drink greater amounts of alcohol in order to feel a “buzz” or to get “high.”
  
  
• 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.

Treating Alcoholism: A General Overview

Similar to other diseases, alcoholism can be overcome with prevention, professional treatment, and increased research efforts. By providing more people with access to effective alcoholism treatment, the costly drain on society and the physical, financial, and the psychological hardships that alcoholism places on families can be significantly minimized.

As critical and damaging as alcoholism is, fortunately it can be treated.  Treating alcoholism typically consists of a combination of counseling and doctor prescribed medications to help a person stop drinking.  Even though most alcoholics need professional help to recover from their addiction, research has demonstrated that with support and quality alcoholism treatment, many individuals are able to quit drinking and reclaim their lives.

Treating Alcoholism: Withdrawal Symptoms

There is a wide variety of different techniques that are available for treating alcoholism withdrawal.  While many of these treatment methodologies use medications, more than a few, however, do not.  Indeed, according to the current research literature, in many instances, the safest way to treat mild withdrawal symptoms is without medications. 

Such non-drug detoxification approaches use screening and extensive social support throughout the entire withdrawal procedure.   Other non-drug detoxification programs, moreover, use proper nutrition and vitamin therapy (especially thiamin) when treating mild withdrawal symptoms.

Mild to Moderate Alcohol Withdrawal Symptoms

The following list represents mild to moderate alcohol withdrawal symptoms that usually take place within 6 to 48 hours after the last alcoholic drink: 

• Sweating (especially on the palms of the hands or on the face)
• Nausea
• Clammy skin
• Sleeping difficulties
• Rapid heart rate
• Vomiting
• Loss of appetite
• Pulsating headaches
• Tremor of the hands
• Abnormal movements
• Looking pale
• Enlarged or dilated pupils
• Involuntary movements of the eyelids

Severe Alcohol Withdrawal Symptoms

The following is a list of severe alcohol withdrawal symptoms that typically occur within 48 to 96 hours after the last alcoholic drink:

• Visual hallucinations
• Severe autonomic nervous system overactivity
• Delirium tremens (DTs)
• Fever
• Black outs
• Convulsions
• Seizures
• Muscle tremors  

Traditional Forms of Treating Alcoholism

There are a number of traditional alcohol treatment options that are relatively well established, widely available, and currently used.  The following alcoholism remedies 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.

Detoxification.  Alcohol detoxification is the process of letting the body naturally rid itself of the alcohol that has been ingested while managing the withdrawal symptoms in safe surroundings.  Alcohol detox treatment is usually done under the guidance of a medical doctor and is often the first step used in an alcoholism treatment program.  Due mainly to the relatively long time-frame for the detox process, these therapeutic protocols are usually part of an inpatient alcohol rehabilitation program. 

Behavioral Treatments, such as Alcoholics Anonymous, Motivation Enhancement Therapy, and Cognitive Behavioral Therapy, focus on changing the behavior of the alcoholic.  Interestingly, a study that was conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that each of these behavioral treatment approaches substantially reduced drinking in patients the year after treatment.  In spite of the fact that all three of these programs were considered "successful," none of them could be classified as "the best" way of treating alcoholism by the NIAAA. 

Alcoholics Anonymous (AA).  Alcoholics Anonymous is a mutual support program for recovering alcoholics that has its foundation on the 12-step recovery program that is needed in order to stay sober.  Help and support are supplied via the many meetings that convene on a regular basis. Is Alcoholics Anonymous the best approach for treating alcoholism?  While Alcoholics Anonymous has demonstrated that it is an effective therapeutic method, most practitioners outside of Alcoholics Anonymous, as well as many members within Alcoholics Anonymous think that Alcoholics Anonymous is most effective when it is combined with other types of treatment such as medical care and psychotherapy. 

Motivation Enhancement Therapy(MET) is a systematic therapeutic approach that is almost the total opposite of Alcoholics Anonymous, therapeutically speaking, because it uses motivational strategies to trigger the client's own change responses.  Some of the main features that typify MET are the following:

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

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

• Homework is a central feature of CBT.
• CBT is a mutually shared effort between the therapist and the client.
• CBT is structured and directive.
• 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 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.
• 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 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.  A number of research scientists and practitioners strongly feel that chronic alcoholics who cannot maintain their sobriety should receive drug therapy to manage and control their withdrawal symptoms.  It is important to emphasize, by the way that by using medications, individuals who are addicted to alcohol are less likely to experience possible brain damage and/or seizures.

Recent alcoholism research demonstrates that the medications that are most likely to elicit 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 Serax and Ativan.  Traditionally, medical practitioners have used a progressive decrease in doses during the entire withdrawal process when using benzodiazepines.  Moreover, due to the fact that the shorter-acting benzodiazepines do not stay 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, a number of alcoholism practitioners and researchers have asserted that intermediate to short half-life benzodiazepines should be used for treating alcoholism withdrawal symptoms.

Another major component of alcoholism treatment with therapeutic drugs centers on the employment of particular medications such as naltrexone (ReViaT) or disulfiram (Antabuse) that are administered by a healthcare practitioner in an attempt to help prevent the person from returning to drinking after he or she experiences a relapse. Stated simply, this type of alcoholism treatment is based on doctor prescribe medications that are used to treat a person's alcoholism dependency.  For instance, antabuse is a medication given to alcoholics that elicits negative effects such as vomiting, flushing nausea, and dizziness if the person consumes alcohol.  Not surprisingly, antabuse "works" basically because it is a such a powerful deterrent.  Naltrexone (ReViaT), from an entirely different therapeutic perspective, is effective because it targets the brain's reward center and reduces the craving the alcoholic has for alcohol.

Outpatient Alcoholism Treatment and Counseling.  There are different counseling approaches that teach alcoholics how to become aware of the situational and emotional "hot buttons" that trigger their negative drinking behavior.  Armed with this information, alcoholics can then learn about different ways in which they can deal with their feelings in circumstances that are alcohol-free.  Not surprisingly, these types of alcoholism treatment are mainly offered on an outpatient basis. 

Residential Alcohol Treatment Programs and Inpatient Alcohol Rehab.  If the person's withdrawal symptoms are excessive, if there's a need for alcohol AND drug abuse treatment, if outpatient and support-oriented programs such as Alcoholics Anonymous are not effective, or if a person needs alcohol poisoning treatment, the individual probably needs to enroll into a alcoholism hospital or a residential alcohol treatment facility and receive inpatient alcohol rehab.  Such programs are earmarked for alcoholics and typically include doctor-prescribed medications to help the person get through the detoxification process and the alcoholism withdrawal treatment protocol in a safe manner. 

Family and Marital Counseling.  Since the recovery process is so thoroughly associated to the support the patient receives from his or her family, many alcoholism programs include family therapy and marital counseling as essential components in the treatment process.  Such therapeutic approaches, furthermore, also provide clients with essential community resources, such as legal assistance, childcare courses, job training, parenting classes, and financial management classes.

Treating Alcoholism: Alternative Approaches

Although the findings in the research literature are not conclusive, there are some alternative treatment approaches for alcoholism and alcohol abuse that are becoming more acceptable and more available.  Examples include "Drumming out Drugs" (a form of therapy that employs the use of drumming by patients), various vitamin and supplement approaches, and the naturalistic and holistic approaches employed by Traditional Chinese Medicine, all of which have been proposed as "natural" ways of treating alcoholism.  

As promising as these alternative methodologies are, substantially more research, however, is needed to determine their effectiveness as well as their long term alcohol treatment success rates. 

Treating Alcoholism:  Conclusion

Given the fact that a cure for alcoholism has not been developed, it is encouraging to note that different alcoholism treatment programs and approaches have been effectively used to help people recover from alcohol dependency.  In a word, there is a lot of "good" information available both online and offline about treating alcoholism. 

When it comes to a topic that is so critically important in the lives of numerous individuals, people are certain to ask the following question regarding treating alcoholism:  "What is the best alcoholism treatment when a person's life in on the line"?  Like any chronic disease or illness, there are different degrees of success regarding alcoholism treatment.  For example, some individuals cannot refrain from drinking for any sustainable period of time, regardless of the type of treatment they receive.  On the other hand, some alcoholics, after treatment, abstain from drinking and remain sober.  And still others, moreover, experience relatively long periods of sobriety after receiving treatment, and then suffer a drinking relapse.

One point that needs to be emphasized, however, is the fact that all of these treatment outcomes are common with every known type of alcoholism treatment.  The key, therefore, is to find a treatment program that you believe in and one that "works" for you.  Simply put, the best method of treating alcoholism in the world amounts to little if you don't want to quit drinking and you don't follow the treatment protocol.

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