Facing the facts about alcoholism can be very difficult. Feelings of anger, shame and inadequacy may make resisting the impulse to drink seem impossible. Fighting strong cravings and miserable withdrawal symptoms are too much for alcoholics and their families to handle alone. Strained relationships, deteriorating work situations and damaged health are some of the many reasons to seek help. Fortunately, the variety of treatments available make it possible to take an individualized approach to uncontrolled drinking.
Medications
Often a necessary component of treatment for alcoholism, sedatives can ease withdrawal symptoms and prevent seizures. Acamprosate (Campral) may decrease cravings. Antibuse is designed to break the pattern of alcoholism by making clients violently ill if they drink. Psychiatric medications that treat underlying conditions, such as mood or anxiety disorders, may help maintain sobriety. In a U.K. study, 558 alcohol-dependent clients were given either placebo or acamprosate. By the end of the second week, only 57 percent of subjects were taking at least 90 percent of their tablets. Despite poor compliance, cravings and anxiety were reduced in the treatment group.
Brief Interventions
Brief interventions, such as motivational enhancement therapy and motivational interviewing, help initiate change by identifying a desire to quit drinking. Clients in a "precontemplation" stage may be receptive to seeking treatment when negative consequences of drinking are skillfully brought to light.
Treatment Planning
Treatment planning helps clients set short- and long-term measurable goals. Actions such as journaling feelings, visiting family, going to court, keeping medical appointments, looking for work and making arrangements to reduce debt can seem overwhelming unless condensed into bite-sized tasks.
Group Therapy
In group therapy, peer acceptance and feedback can reduce the social stigma associated with alcohol dependence. Isolation and keeping secrets are characteristic of alcoholism; the group process requires commitment, participation and accountability.
Cognitive Behavioral Therapy
According to Jean Kinney, author of "Loosening the Grip," one of the most effective counseling methods is cognitive behavioral therapy. By assisting clients to understand self-sabotaging thoughts, beliefs and behaviors, CBT identifies triggers that lead to relapse, such as the idea that going to a bar to see old friends is harmless. Therapists can help a client gain awareness and choose to avoid high-risk situations. CBT helps clients take the power out of situations that used to trigger drinking and reduce vulnerability to relapse. CBT can be incorporated into other modes of treatment.
Alcoholics Anonymous
Twelve-step programs such as AA welcome participants and provide education about alcoholism. Sponsorship of newcomers by those who have practiced the program to solve their own problems provides round-the-clock encouragement. According to the book "Alcoholics Anonymous," one alcoholic talking to another is a formula that has brought this free program much growth and success since 1935. The AA approach to sobriety is "one day at a time." Suggested actions involve honesty, amends and helping others. The atmosphere in meetings varies from seriousness at the devastation caused by alcoholism to rollicking laughter at the humor of alcoholic thinking.
References
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, DSM-IV; American Psychiatric Association. 2000
- Loosening the Grip: Jean Kinney, 2005
- Alcohol and Alcoholism, United Kingdom Multicentre Acamprosate Study (UKMAS), Chick J, et.al., Mar-Apr 2000, 35(2)
- Alcoholics Anonymous; AA World Services, 2002
