What is alcoholism treatment?The nature of treatment depends on the severity of an individual's alcoholism and the resources that are available in his or her community. Treatment may include detoxification (the process of safely getting alcohol out of one's system); taking
doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReVia™) to help prevent a return to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach recovering alcoholics to identify situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. Any of these treatments may be provided in a hospital or residential treatment setting or on an outpatient basis.
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Because the involvement of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with vital community resources, such as legal assistance, job training, child care, and parenting classes.
Most alcoholics and alcohol abusers enter treatment reluctantly because they deny that they have a problem. Health or legal problems may prompt treatment. Intervention helps some alcoholics recognize and accept the need for treatment. If you're concerned about a friend or family member, discuss intervention with a professional. A wide range of treatments is available to help people with alcohol problems. Treatment is tailored to the individual. It may involve an evaluation, a brief intervention, an outpatient program or counseling, or a residential inpatient stay.
Treatments for alcoholism include detoxification programs run by medical institutions. These may involve stays of a number of weeks in specialized hospital wards where drugs may be used to avoid withdrawal symptoms. After detoxification, various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues leading to alcohol dependence. Aversion therapies may be supported by drugs like Disulfiram, which causes a strong and prompt hangover whenever alcohol is consumed. Naltrexone may improve compliance with abstinance planning. The standard pharmocopeia of anti-depressants, anxiolytics and other psychotropic drugs treat underlying mood disorders, neuroses and psychoses associated with alcoholic symptoms.
Another treatment program is based on nutritional therapy. Many alcoholics have insulin resistance syndrome, a metabolic disorder where the body's difficulty in processing sugars causes an unsteady supply to the blood stream. While the disorder can be treated by a hypoglycemic diet, this can affect behaviour and emotions, side-effects often seen among alcoholics in treatment. The metabolic aspects of alcoholism are often overlooked, resulting in poor treatment outcomes.
In the 1900s the self-help group-counselling approach to treatment became increasingly successful and remains so today, with Alcoholics Anonymous possibly being the best-known example of this movement.
The first step in treatment is to determine whether you're alcohol dependent. If you haven't lost control over your use of alcohol, your treatment may involve reducing your drinking. If you're dependent on alcohol, cutting back is inappropriate and ineffective, and abstinence must be a part of your treatment goal. If you aren't dependent on alcohol but are experiencing the adverse effects of drinking, the goal of treatment is to reduce alcohol-related problems, often through counseling or a brief intervention. A brief intervention usually involves alcohol-abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavioral modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
Many residential alcoholism treatment programs in the United States include abstinence, individual and group therapy, participation in Alcoholics Anonymous (AA), educational lectures, family involvement, work assignments, activity therapy and the use of counselors — many of whom are recovering alcoholics — and professional staff.
Here is what you might expect from a typical residential treatment program:
- Detoxification and withdrawal. Treatment may begin with a program of detoxification, usually taking about four to seven days. You may need to take sedating medications to prevent delirium tremens or other withdrawal seizures.
- Medical assessment and treatment. Common medical problems related to alcoholism are high blood pressure, increased blood sugar, and liver and heart disease.
- Psychological support and psychiatric treatment. Group and individual counseling and therapy support recovery from the psychological aspects of alcoholism. Sometimes, emotional symptoms of the disease may mimic psychiatric disorders.
- Emphasis on acceptance and abstinence. Effective treatment is impossible unless you accept that you're addicted and unable to control your drinking.
- Drug treatments. An alcohol-sensitizing drug called disulfiram (Antabuse) may be a strong deterrent. Disulfiram won't cure alcoholism nor can it remove the compulsion to drink. But if you drink alcohol, the drug produces a severe physical reaction that includes flushing, nausea, vomiting and headaches. Naltrexone (ReVia), a drug long known to block the narcotic high, also reduces a recovering alcoholic's urge to drink. Unlike disulfiram, naltrexone doesn't make you feel sick soon after taking a drink.
- Continuing support. Aftercare programs and AA help recovering alcoholics abstain from alcohol, manage relapses and cope with necessary lifestyle changes.