Alcoholism Treatments

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Not unlike other diseases, alcoholism can be overcome with different alcoholism treatments, prevention, and increased research efforts.

Stated differently, as critical as alcoholism is, the good news is that it can be effectively treated.  Most traditional alcoholism treatments include a combination of drug therapy and counseling to help a person stop drinking.

An Essential and Foundational Question:  What is Alcoholism?

Alcoholism, also known as alcohol dependence and alcohol addiction, is a progressive debilitating disease that includes the following four 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 get "high" or to feel a “buzz.”
  
  
• Physical dependence:  withdrawal symptoms such as nausea, "the shakes," anxiety, headaches, and perspiration when refraining from alcohol.
  
  
• Craving:  having a strong urge or need to drink.

Alcoholism Treatments:  A Basic Overview

As serious as alcoholism is, fortunately it can be treated.  The various types of alcoholism treatments usually include a combination of counseling and medications to help a person abstain from drinking. 

Even though most alcoholics need professional assistance in order to recover from their addiction, research has shown that with quality treatment and support, many alcoholics are able to stop drinking and reclaim their lives.

By providing more individuals with access to top-rate alcoholism treatments, the costly drain on society and the psychological, physical, and financial burdens that alcoholism places on families can be greatly minimized.  

Indeed, research studies show strong evidence that effective alcoholism prevention efforts and successful alcoholism treatments result in significant reductions in HIV, cancer, child abuse, hearth disease, child abuse, crime, strokes, unwanted pregnancy, and traffic fatalities.

Not only this, but effective alcoholism treatments improve job performance, quality of life, and health while at the same time reducing family dysfunction, drug use, and involvement with the criminal justice system. 

Alcoholism Treatments: Withdrawal Symptoms

A number of different approaches and programs exist regarding alcoholism treatments and especially the treatment of alcohol withdrawal symptoms.  While medications are used in a number of withdrawal treatment settings, other forms of therapy are drug free.  Indeed, according to recent research findings, the safest way to treat mild withdrawal symptoms is without drugs.

Such non-drug detox approaches use comprehensive social support and screening throughout the entire withdrawal process.  Other non-drug detoxification approaches, furthermore, use proper nutrition and vitamin therapy (especially thiamin) for treating mild withdrawal symptoms.

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:

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

Severe Withdrawal Symptoms

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

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

Alcoholism Treatments: Traditional Approaches

There are numerous alcoholism treatments that are considered traditional, or "mainstream" therapies.  The following alcoholism treatments will be discussed:  Therapeutic Medications, Residential Alcoholism Treatment Programs and Inpatient Alcohol Rehab, Detoxification, Behavioral Treatment, Outpatient Alcoholism Treatment and Counseling, and Family and Marital Counseling.

Therapeutic Medications.  In this treatment approach, the alcoholic takes doctor-prescribed drugs such as naltrexone (ReViaT) or disulfiram (Antabuse) to help prevent him or her from returning to drinking after he or she has ingested alcohol.  More specifically, with this approach, doctors prescribe medications to treat alcoholism.  For instance, antabuse is a drug given to alcoholics that elicits negative effects such as vomiting, flushing, nausea, or dizziness if alcohol is ingested.   Antabuse obviously "works" because it is a strong deterrent.  Naltrexone (ReViaT), on the other hand, employs and entirely different approach by targeting the brain's reward circuits and effectively reducing the craving the alcoholic has for alcohol. 

Residential Alcohol Treatment Programs and Inpatient Alcohol Rehab.  If there's a need for alcohol AND drug abuse treatment, if an individual needs alcohol poisoning treatment, if the individual's withdrawal symptoms are severe, or if outpatient programs or support-oriented programs such as Alcoholics Anonymous are ineffective, the person typically has to enroll in a residential alcohol treatment facility or into a hospital and receive inpatient alcohol rehab treatment.  Programs such as these are earmarked for alcoholism inpatients and usually include doctor-prescribed drugs to help the person get through the detoxification and the alcohol withdrawal treatment process in a harm-free environment.

Detoxification.  Alcohol detoxification is the process of letting the body rid itself of alcohol while managing the withdrawal symptoms in a safe atmosphere.  Alcohol detoxification treatment is usually done under the supervision of a medical doctor and is frequently employed as the first step in alcoholism treatments.   Due to the relatively long time frame involved in many detoxification procedures, these programs are typically part of an inpatient alcohol rehab program. 

Behavioral Treatments such as Alcoholics Anonymous, Cognitive Behavioral Therapy, and Motivation Enhancement Therapy.  In a recent study performed by the National Institute on Alcohol Abuse and Alcoholism, it was discovered that each of these three behavioral treatment approaches significantly reduced drinking in alcoholics one year after treatment.  Even though all three of these programs were considered "successful," none of them, however, could be classified as "the best" treatment for alcoholism.

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 to stay sober.  Help and support are provided by the meetings that convene on a regular basis. Is Alcoholics Anonymous one of the best alcoholism treatments?  While Alcoholics Anonymous has proven to be an effective alcoholism treatment program, many practitioners outside of Alcoholics Anonymous, as well as many people who are members of Alcoholics Anonymous, think that Alcoholics Anonymous works best when combined with other forms of therapy such medical care and psychotherapy.

Motivation Enhancement Therapy(MET) is a systematic therapeutic method that is almost 180 degrees different from Alcoholics Anonymous in that it uses motivational techniques to activate the client's own change processes.  Some of the key characteristics of MET programs are the following:

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

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

• CBT is structured and directive.
• Homework is a central feature of CBT.
• CBT is a mutually shared effort between the therapist and the client.
• 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.
• CBT uses the Socratic Method that is based on the asking of questions for insight.
• 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 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 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.  

Outpatient Alcoholism Treatment and Counseling.  There is a variety of counseling approaches that teach alcoholics how to become aware of the situational and emotional "hot buttons" that trigger their drinking responses.  Armed with this information, alcoholics can thus learn about different ways in which they can cope with situations that do not include the use of alcohol.  Unlike detox programs, approaches such as these are usually offered on an outpatient basis. 

Family and Marital Counseling. Since the recovery process is so intimately related to the support the alcoholic receives from his or her family, a number of alcoholism treatments include family therapy and marital counseling as key aspects in the therapeutic process.  Such therapies, moreover, also provide alcoholics with essential community resources, such as childcare classes, legal assistance, parenting classes, financial management courses, and job training skills. 

Alcoholism Treatments:  Alternative Therapies

Although the research findings are not conclusive, there are numerous alternative treatment approaches for alcohol abuse and alcoholism that are becoming more mainstream, more widely used, and more available.  The following therapies are seen as "natural" alcoholism treatments and include: the holistic and naturalistic approaches employed by Traditional Chinese Medicine, various vitamin and supplement therapies, and "Drumming out Drugs" (a form of therapy that employs the use of drumming by clients).  As promising as these alternative therapies are, additional research, nevertheless, is needed to evaluate their effectiveness and to see if these alcoholism treatments offer long term success. 

Alcoholism Treatments:  Conclusion

Like any chronic disease, there are different levels of success concerning alcoholism treatments.  For example, some alcoholics cannot stop drinking alcohol for any sustainable period of time regardless of the type of treatment they have received.  Other alcoholics, on the other hand, experience a relatively long period of sobriety after receiving treatment, and then have a drinking relapse.  And finally, some alcoholics, after treatment, refrain from drinking and remain sober.  What is intriguing about this is that all of these treatment outcomes occur with all alcoholism treatments!  When it comes down to the basics, however, one thing is unmistakable:  the longer an individual refrains from drinking alcohol, the more likely he or she will be able to remain sober and avoid alcoholism treatments.

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