Treatment: Alcoholism

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Not unlike other illnesses and diseases, alcoholism can be overcome with prevention, professional alcoholism treatment, and increased research endeavors.

As hazardous and unhealthy as alcoholism is, however, it can be effectively treated.  Treatment for alcoholism usually consists of a combination of doctor-prescribed medications, counseling, support, and education to help an individual abstain from drinking and start on the road to alcoholism recovery.

Treatment: Alcoholism-- A General Overview

By providing more individuals with access to effective treatment for their alcoholism, the costly drain on society and the psychological, physical, and financial burdens that this disease places on families can be significantly minimized or reduced.

In fact, according to the research literature, professional alcoholism treatment and prevention generate significant reductions in crime, cancer, unwanted pregnancy, hearth disease, HIV, child abuse, strokes, and traffic fatalities.

In addition, successful treatment for alcoholism and drug abuse improves an individual's health, quality of life, and job performance while at the same time reducing involvement with the criminal justice system, drug abuse, and family dysfunction.

As dangerous and destructive as this disease is, fortunately alcoholism can be treated.  Treatment for alcoholism typically includes both counseling and medically prescribed drugs to help an individual stop drinking.  Even though most alcoholics need assistance to recover from their addiction, research has provided strong evidence that with support and effective alcoholism treatment, many individuals are able to refrain from drinking and reclaim their lives.

A Simple but Necessary Question:  What is Alcoholism?

Alcoholism, also known as alcohol dependence and alcohol addiction, is a progressive debilitating disease that includes the following four symptoms.

• Tolerance: the need to drink greater amounts of alcohol in order to get "high" or to feel a “buzz.”
• Craving: having a strong urge or need to drink.
• Physical dependence: withdrawal symptoms such as headaches, perspiration, nausea, "the shakes," and anxiety when abstaining from alcohol.
• Loss of control: an inability to stop drinking after the first drink.  

Treatment: Alcoholism--Withdrawal Symptoms

When a heavy drinker suddenly stops drinking alcohol, he or she frequently suffers from alcohol withdrawal symptoms such as feeling nervous, depression, headaches, and rapid heart rate. With or without professiona alcoholism treatment, these symptoms can take days or weeks before the body returns to "normal."

Many different approaches are available for treating alcoholism withdrawal.  While some of these therapeutic methodologies employ medications, many, in contrast, do not.  It can be pointed out, in fact, that according to the research literature, the safest way to treat mild withdrawal symptoms is without medications.

Such non-drug detoxification therapies are effective because they employ comprehensive social support and screening all through the withdrawal process.  Other non-drug detox approaches, furthermore, use vitamin therapy (especially thiamin) and "good" nutrition for treating mild withdrawal symptoms.

Mild to Moderate Withdrawal Symptoms

The following typifies mild to moderate physical withdrawal symptoms that normally take place within 6 to 48 hours after the last alcoholic drink has been consumed:

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

Severe Withdrawal Symptoms

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

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

Treatment: Alcoholism--Traditional Approaches

There is a number of mainstream alcoholism treatment approaches that are considered "traditional" methodologies.  The following alcoholism treatment therapies and programs will be discussed:  Outpatient Alcoholism Treatment and Counseling, Detoxification, Behavioral Treatment, Therapeutic Medications, Residential Alcoholism Treatment Programs and Inpatient Alcohol Rehab, and Family and Marital Counseling.

Outpatient Alcoholism Treatment and Counseling.  There are more than a few approaches to counseling that teach alcoholics how to become aware of the situational and psychological "hot buttons" that trigger their drinking.  Equipped with this knowledge, individuals can thusly learn about different ways in which they can deal with circumstances that do not include the drinking of alcohol.  It comes as no surprise that approaches such as these are commonly offered on an outpatient basis.

Detoxification.  Alcohol detoxification is the process of letting the body rid itself of alcohol while managing the withdrawal symptoms in a harm-free environment.  Alcohol detox treatment is usually done under the supervision of a healthcare practitioner and is often the first step utilized in an alcoholism treatment intervention.  Due to the fairly extensive time constraints involved in detoxification programs, this traditional alcoholism approach is typically part of an inpatient alcohol rehabilitation program.

Research has shown that individuals who start drinking at an early age, for instance at 13 years old or younger, significantly increases the likelihood that they will experience alcohol problems later in life.

Behavioral Treatments such as Cognitive Behavioral Therapy, Motivation Enhancement Therapy, and Alcoholics Anonymous focus on changing the person's drinking behavior.  It is worth mentioning that according to a study undertaken by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), each of these three behavioral treatment approaches substantially reduced drinking in patients the year after treatment.  Even though all three of these programs were determined to be "successful" by the NIAAA, this agency, however, did not categorize one of these approaches 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-step recovery program that is seen as necessary for members to stay sober.  Help and support are provided by the meetings that convene on a regular basis. Is Alcoholics Anonymous the best strategy for the treatment of alcoholism?  While Alcoholics Anonymous has proven to be an effective alcoholism treatment approach, numerous practitioners outside of Alcoholics Anonymous, as well as many people within Alcoholics Anonymous, find that Alcoholics Anonymous works best when combined with other forms of therapy, such as psychotherapy and medical care.

Motivation Enhancement Therapy(MET) is a systematic therapeutic approach that is almost the total opposite of Alcoholics Anonymous in that it uses motivational strategies to activate the client's own change mechanisms. Some of the main characteristics of MET are the following:

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

Cognitive Behavioral Therapy (CBT).  There are several forms of cognitive behavior therapy.  Most of them, however, have the following common 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 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.
• CBT uses the Socratic Method that is based on the asking of questions for insight.
• CBT is structured and directive.
• 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 usually has therapeutic sessions that are briefer and fewer in number than most other forms of therapy.
• Homework is a central feature of CBT.
• In CBT, a solid therapeutic relationship is necessary but not the primary focal point for effective therapy.
• 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.  In this treatment approach, the alcoholic takes doctor-prescribed medications such as disulfiram (Antabuse) or naltrexone (ReViaT) in an effort to help prevent the person from returning to drinking after he or she has ingested alcohol.  Stated differently, with this approach, doctors prescribe medications (drugs) to treat alcoholism. 

For example, antabuse is a drug given to alcoholics that elicits negative effects such as nausea, dizziness, flushing, or vomiting if alcohol is consumed.  Obviously, antabuse is effective basically because it is a strong deterrent.  Naltrexone (ReViaT), conversely, targets the brain's reward circuits and is effective because it reduces 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 person's withdrawal symptoms are excessive, or if outpatient programs or support-oriented programs such as Alcoholics Anonymous are not effective, the person usually has to enroll into a hospital or a residential alcohol treatment facility and receive inpatient alcohol rehab treatment.  Programs such as these are targeted for alcoholism inpatients and usually include doctor-prescribed meds to help the person get through detoxification and the alcohol withdrawal treatment process in a safe manner.

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

Treatment: Alcoholism--Alternative Therapies

Although the research findings are not definitive, there are a number of alternative treatment approaches for alcohol abuse and alcoholism that are becoming more mainstream, widely used, and more researched.  Examples include the following therapies that have been proposed as "natural" forms of alcohol abuse treatment:  various vitamin and supplement therapies, the holistic and naturalistic approaches employed by Traditional Chinese Medicine, and "Drumming out Drugs" (a form of therapy that employs the use of drumming by clients).  As promising as these alternative approaches are, more research, nonetheless, is needed to establish their effectiveness and to determine if these forms of treatment for alcoholism offer long term success. 

Treatment:  Alcoholism--Conclusion

Even though a cure for alcoholism does not currently exist, numerous drug and alcohol therapeutic approaches and alcoholism treatment programs, nevertheless, exist that help those who are alcohol dependent recover from their alcohol addiction.  In short, there's a lot of information regarding the treatment of alcoholism that is available both online and offline.  Some individuals who are interested in alcoholism are sure to ask the following question regarding treatment and alcoholism:  "What is the best type of treatment for alcoholism"?   Like any chronic disease, there are different levels and degrees of success concerning alcoholism treatment.

For instance, whereas some alcoholics cannot abstain from drinking alcohol for any sustainable period of time, regardless of what type of treatment they have received, some alcoholics, on the other hand, after treatment, refrain from drinking and remain sober.  And still others who are alcohol dependent experience relatively long periods of sobriety after receiving treatment, and then have a drinking relapse.  It is important to note, interestingly, that all of these treatment outcomes occur with every known type of alcoholism treatment.

In any event concerning alcoholism 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 and avoid treatment for alcoholism. 

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