In 2007, the "Archives of General Psychiatry" published a study by lead researcher Deborah S. Hasin, indicating that at some point, 30 percent of Americans have a problem with alcohol abuse or dependence. Of those with alcohol dependence, according to the study, only 24 percent ever received treatment. In his book, "Shame, Guilt, and Alcoholism," author Ronald Potter-Efron explains that when these emotions are excessive, it triggers a craving for mood-altering substances.
Behavioral Therapy
The National Institute on Drug Abuse reports that individual and group counseling are the most commonly used methods for treating substance abuse. In cognitive-behavioral therapy, patients are helped to recognize, avoid and cope with the feelings that cause cravings. In an article funded by the Illinois Department of Human Services' Office of Alcoholism and Substance Abuse, Ronald M. Kadden, from the University of Connecticut School of Medicine's department of psychiatry reported that the primary task of cognitive-behavioral therapy is to identify the specific needs drugs and alcohol are used to meet, and then help develop skills to provide a healthy alternative to meeting those needs.
Medication
In 2005, "American Family Physician" published an article by Steven H. Williams, indicating that medications that can help address mood disorders like depression, shame and guilt include selective serotonin reuptake inhibitors, SSRIs, such as Prozac. Williams goes on to report that studies of patients with depression and alcohol dependence who were treated with SSRIs had fewer drinks and fewer drinking days compared to those on a placebo. Naltrexone, a newer medication recently approved by the FDA for the treatment of alcohol dependence, reduces craving. Craving is a feeling with direct links to depression and mood disorders, which include feelings of guilt and shame.rnWhile there are a variety of medications available to help treat mood and anxiety disorders, addiction specialists stress that medication alone is not the way to treat alcohol abuse and dependence. According to NIDA, medication combined with counseling are an important element in treating substance problems. In an article published by "Social Work Today," written by Jennifer Van Pelt, some addiction specialists fear that medication alone could allow self-help programs and therapy to be overlooked.
Motivational Interviewing
Motivational interviewing, MI, is a process that helps a patient explore and resolve their feelings of ambivalence toward getting treatment. Ambivalence is a characteristic common to patients with high levels of shame and guilt, reports Guy Undrill of the Crisis Resolution and Home Treatment Team. In MI, counselors are specially trained to coax you out of negative thinking, while encouraging you to create your own successful path for achieving recovery. MI is now included in SAMHSA's National Registry of Evidence-based Programs and Practices. Harvard Health Publications reports that MI works as well as other alcohol treatment programs and is often quicker and less expensive.
References
- Archives of General Psychiatry: Prevalence, Correlates, Disability, and Comorbidity of Alcohol Abuse and Dependence
- The Washington Post: Third of Americans Have Alcohol Problems at Some Point
- NIDA: Treatment Approaches for Drug Addiction
- Cognitive-Behavioral Therapy for Substance Dependence
- Social Work Today: New Form of Medication for Alcohol Dependence Shows Promise
