The approach to Alcoholism Treatment

Alcoholism treatment covers a very wide area as the prevalence of alcohol abuse is extremely wide and the number of practitioners and the collective experience of the condition is also exceptionally broad. Broadly, there are two approaches to alcoholism treatment, the medical approach which views the condition as a disease and the methodology that deals with the condition as a consequence of personal choice.

Alcoholism treatment generally takes the approach of reducing alcohol consumption to the point of complete abstinence and follows this up with developing life strategies to counter the urge to drink backed up by social support in an effort to stop the return to using alcohol. The incidence of relapse for patients suffering from alcoholism is high and the many varying factors influencing the condition need to be addressed in order to prevent relapse.

Detoxification is commonly used in alcoholism treatment, though the effects of withdrawal can be extremely severe for the patient and it needs to be supervised by medical professionals and in a controlled environment. Usually this period of detoxification or detox, is followed by a combinative regime of therapy, self help support and the development of self awareness of the cause and symptoms of the condition in order to cope with disease. The majority of practitioners in alcoholism treatment favor the complete and total abstinence approach, though there are some (a small minority) who do advocate the use of moderation to combat the debilitating and harmful effects of alcohol dependency.

To put the challenge that alcoholism treatment practitioners face into perspective, Dr Mark Willenbring at the National Institute of Alcohol Abuse and Alcoholism reported in February 2007 that “A year after completing a rehab program, about a third of alcoholics are sober, an additional 40 percent are substantially improved but still drink heavily on occasion, and a quarter have completely relapsed.” The challenge for both alcohol dependent individuals and alcoholism treatment providers is enormous.

Detoxification in Alcoholism Treatment

Detoxification or detox, is the complete cessation of alcohol ingestion and is the equivalent of “cold turkey” for drug addicts. Often detoxification is assisted with the use of drugs to alleviate the effects of detoxification, known as withdrawal symptoms which are frequently very severe and it is highly recommended that detoxification takes place under direct medical supervision.

Drugs commonly used in alcoholism treatment are the benzodiazepines closely followed by barbiturates and are administered depending on the detoxification methodology adopted. Typically a detoxification will use a dose of benzodiazephine which is repeated until a sedated state is achieved and this will continue until a baseline dose has been identified. This dosage is the reduced over a period of time dependent upon the severity of intoxication but typically lasts between three and ten days. An alternative is to withhold medication until withdrawal symptoms present themselves, but this is usually only used in cases of mild alcoholism.

Detoxification does not deal with the alcohol dependency itself and alcoholism treatment requires further intervention to prevent a relapse from occurring .

Intervention Strategies in Alcoholism Treatment

Therapy and psychotherapy play a major part in dealing with the underlying social and behavioral aspects of alcohol dependency. Relapses are common and the wide availability of alcohol means that a recovering patient must be equipped with the means to deal with cravings and the urge to return to alcohol use.

There are a large number of self help organizations that provide support and assistance to recovering alcoholics out in the community, probably the most well known being Alcoholics Anonymous and their 12 Steps program for alcoholism treatment that has been adopted as the model by the vast majority of alcohol rehab centers.

Rationing – is one drink one drink too many ?

While the majority of practitioners do not believe in moderation as a response to alcohol dependency, there is a substantial minority that do not believe abstinence is a necessity. Moderation Management is a program that practices this approach and cites that while the majority of alcoholics cannot limit their alcohol intake in a rational fashion they do return to a pattern of moderate alcohol consumption.

The use of medication in alcoholism treatment

Medication is not considered to be necessary in alcoholism treatment, however there are several medications that are often prescribed to compliment the regime that is being implemented. Physical symptoms of detoxification are usually alleviated by the use of medication as has already been noted, but after the return to sobriety there may still be physical distress caused as a result of damage caused by alcohol use. More relevant is the use of medications in the prevention of relapses and we shall look at these in more detail here.

Antabuse is used to stop the body from breaking down acetaldehyde, itself a by product of the oxidation of alcohol by the liver. It is the acetyldehyde that is the cause of a hangover, and Antabuse ensures that the acetyldehyde continues in the body thereby increasing the intensity and duration of the hangover feelings. This in turn acts as a deterrent against further alcohol ingestion as the addict feels too ill to drink further however heavy drinking while using Antabuse during alcoholism treatment can result in death.

Campral or Acamprosate, stabilizes the chemical balance that would be affected by alcoholism in the brain of the addict. It was approved by the Food and Drug Administration in 2004 even though its’ precise method of working is not known. Though it appears to be highly effective it usually used in conjunction with other prescribed treatments such as naltrexone.

Why is Alcoholism Treatment important ?

The impact on individuals and society as a whole is enormous. Alcohol influenced criminal activity alone accounts for billions of dollars of cost to the taxpayer, while alcohol use accounts for hundreds of thousands of injuries and fatalities every year in drink driving incidents. The cost of not providing alcoholism treatment is greater than just a monetary calculation and the social ills of alcoholism are well documented.