Alcoholic Treatment

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Not unlike other diseases, chronic alcoholic behavior can be overcome with quality alcoholic treatment, prevention, and increased research efforts.

In spite of the dangers associated with excessive and abusive alcoholic behavior, however, the good news is that alcoholic treatment is available and effective.

The critical point in this conversation, nonetheless, is the following:  in order for alcoholism treatment to be successful, the alcoholic needs to want to stop drinking and start the recovery process.

A Basic But Significant Question:  What is Alcoholism?

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

• Craving:  having a strong urge or need to drink.
  
  
• 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 get a "buzz."
  
  
• Physical dependence:  withdrawal symptoms such as anxiety, perspiration, headaches, "the shakes" and nausea when refraining from alcohol.

Alcoholic Treatment:  An Overview

Similar to other medical conditions, alcoholic behavior can be prevented and treated. 

By providing more people with access to quality alcoholic treatment, however, the costly drain on society and the physical, psychological, financial burdens this disease places on families can be significantly minimized.

Indeed, researchers have uncovered strong evidence that successful prevention and quality alcoholic treatment programs result in significant reductions in crime, child abuse, unwanted pregnancy, HIV, traffic fatalities, heart disease, cancer, and strokes.

In addition, effective drug and alcohol treatment improves job performance, quality of life, and heath while at the same time reducing drug use, family dysfunction, and involvement with the criminal justice system.

Alcoholic treatment programs usually employ a combination of medications and counseling to help an individual refrain from drinking. Even though most alcoholics need professional help to recover from their disease, research has shown that with support and alcoholic treatment, many people are able to abstain from drinking and reclaim their lives.

Alcoholic Treatment:  Withdrawal Symptoms

A number of various techniques exist for treating alcoholic withdrawal symptoms.  Even though many of these treatment approaches use medications, a number of alcoholic therapies, however, do not.  Indeed, according to recent research findings, the safest way to treat mild withdrawal symptoms is without drugs.

Such non-drug detox approaches use screening and comprehensive social support throughout the entire withdrawal process.  Other non-drug detox approaches, moreover, use vitamin therapy (especially thiamin) and proper nutrition when 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
• Vomiting
• Enlarged or dilated pupils
• Involuntary movements of the eyelids
• Nausea
• Rapid heart rate
• Clammy skin
• Pulsating headaches
• Sweating (especially on the palms of the hands or on the face)
• Sleeping difficulties
• Abnormal movements
• Looking pale
• Tremor of the hands

Severe Withdrawal Symptoms

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

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

Traditional Forms of Alcoholic Treatment

There are a number of traditionally-based alcoholic treatment programs that are relatively well established and available.  The following alcoholic treatment programs, all of which are considered "traditional" therapies, 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 a process that helps the body rid itself of alcohol while managing the withdrawal symptoms in a harm-free atmosphere.  Alcoholic detox treatment is usually done under the supervision of a doctor and is frequently employed as the first step in an alcoholic treatment program.  Due to the length of time needed, detoxification programs are usually part of an inpatient alcoholic rehab program.

Behavioral Treatments such as Cognitive Behavioral Therapy, Motivation Enhancement Therapy, and Alcoholics Anonymous.  Interestingly, a fairly recent study performed by the National Institute on Alcohol Abuse and Alcoholism discovered that each of these behavioral treatment approaches significantly reduced drinking in patients the year after treatment.  Even though all of these programs were considered "successful," however, none of them was classified as "the best" alcoholic treatment program.

Alcoholics Anonymous (AA).  Alcoholics Anonymous is a mutual support program for recovering alcoholics that is based on the 12-step recovery process that is used to stay sober.  Help and support are provided by the regularly scheduled meetings.  Is Alcoholics Anonymous the best form of alcoholic treatment?  While Alcoholics Anonymous is an effective therapeutic approach, most practitioners outside of Alcoholics Anonymous, as well as many AA members, feel that Alcoholics Anonymous works best when combined with other forms of treatment such as psychotherapy and medical care.

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

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

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

• Homework is a central feature of CBT.
• 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.
• In CBT, a solid therapeutic relationship is necessary but not the primary focal point for effective therapy.
• CBT is structured and directive.
• 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 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 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.
• CBT uses the Socratic Method that is based on the asking of questions for insight.

Therapeutic Medications.  This treatment approach is based on the client taking doctor-prescribed medications such as naltrexone (ReViaT) or disulfiram (Antabuse) in an effort to help prevent the person from returning to drinking after he or she has consumed alcohol.  In short, in this therapeutic approach, medical doctors prescribe drugs to treat alcohol dependency. For instance, antabuse is a drug given to alcoholics that triggers unpleasant effects such as vomiting, nausea, dizziness, and flushing if alcohol is ingested.  Because it is a strong deterrent, it comes as no surprise that Antabuse is effective.  Naltrexone (ReViaT), on the other hand, targets the brain's reward circuits and is effective because it reduces the craving the alcoholic has for alcohol.

Outpatient Alcoholism Treatment and Counseling.  There are various approaches to counseling that teach alcoholics how to become aware of the psychological and situational "triggers" of their problem drinking.  Armed with this information, alcoholics can then learn about different ways in which they can cope with situations that do not include the use of alcohol. These types of alcohol treatment methodologies, unlike detoxification programs, are usually offered on an outpatient basis. 

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

Family and Marital Counseling.  Due to the fact that the recovery process is so intimately associated to the support the person receives from his or her family, numerous alcoholic addiction programs include marital and family counseling as essential components in the treatment process.  Such therapeutic approaches, moreover, may also provide alcoholics with essential community resources such as legal assistance, childcare courses, financial management classes, job training, and parenting classes.

Alternative Alcoholic Treatment Therapies

Although the research findings are not definitive, some of the alternative treatment approaches for alcohol abuse and alcoholism that are becoming more widely employed and available.  The following therapies are seen as "natural" forms of alcohol abuse treatment and include "Drumming out Drugs" (a form of therapy that employs the use of drumming by clients), the naturalistic and holistic approaches used by Traditional Chinese Medicine, and various vitamin and supplement therapies. As promising as these alternative alcoholic treatment approaches are, additional research is needed in order to establish their effectiveness and to evaluate whether they provide long-term alcoholic treatment success.

Alcoholic Treatment:  Conclusion