In 1944, the U.S. Public Health Service officially designated alcoholism as a disease, and as of 2010, that designation remains the conventional wisdom, though not without controversy. There is debate about the science of an alcoholism diagnosis as well as how best to treat people so afflicted. While there are therapies offered that approach alcoholism as a curable condition, there are still some options for those following the traditional path that favor treatment without a long-term stay at a rehab facility.
Outpatient Counseling
As an alternative to inpatient rehab, outpatient counseling provides much of the same instruction, though the level of control over the patient is severely limited. It is a much more self-motivated approach than residential therapy. Effective programs take into account the specifics of the individual, but most that specialize in the treatment of alcoholism incorporate the Twelve Steps, which serve as the foundation of Alcoholics Anonymous and other support groups. Alternative methods include psychoanalysis, motivational enhancement therapy and cognitive behavior therapy. These approaches focus on the consequences of alcoholism and how to change the behavior that leads to relapse.
There are limits to outpatient counseling, most notably the absence of a medically supervised detoxification period to combat withdrawal. Symptoms of withdrawal include tremors, vomiting, seizures, hallucinations, rapid heart rate, sweating and delirium. Whether the patient chooses to believe that alcoholism is a disease or a psychological issue, severe cases of withdrawal can be fatal. Alcoholics seeking outpatient therapy as an alternative to rehab should strongly consider a five-day detox program first. At the very least, consult a doctor and see if an outpatient, administered detox plan is right for you.
Online Therapy
Groups similar to outpatient counseling centers thrive online. They offer forums where members can interact, online conferences and counseling sessions and archives of literature on the nature of alcoholism and its treatment. Many offer live interactions with groups and individual therapists as part of the program. As with outpatient therapy centers, online counseling offers little in the way of alcohol withdrawal treatment, so a medically supervised detox, either in a detox center or under the care of a doctor, is recommended for severe abusers.
Cure Centers
Doctors and therapists who regard alcoholism as a social, psychological or behavioral problem rather than a disease have necessarily devised alternative therapies that treat alcoholics based on that assumption. Books such as "The Alcoholism and Addiction Cure," "The Cure for Alcoholism," and "Alcoholism: The Cause, the Cure," offer a variety of approaches ranging from holistic to psychological, and many of the authors are associated with a corresponding cure center. "The Alcoholism and Addiction Cure" is associated with the Passages Treatment Center in Malibu, California. As with any treatment plan, these alternative therapies can be right for some individuals and not for others, so you should research a number of options before committing to a specific cure center.
Drug Therapy
Drugs are a major component of successful withdrawal mitigation. These often include drugs from the benzodiazepene family like valium, which act on receptors in the brain in ways similar to alcohol. Alcoholics are often hypertensive, so blood pressure medication is administered during detox and as needed after detox is complete. Anxiety medications like MAO inhibitors can help keep the patient calm during the transition.
In a study published in the June 9 issue of the "Archives of Internal Medicine," lead author Bankole Johnson claims topiramate reduces an alcoholic's desire to drink heavily and "improves the physical and psychological health" of patients who take it. Johnson compares the possible impact of topiramate to the changes in depression therapy brought on by the release of Prozac in 1987.
