Dear Friends and Associates:
I recently had a lady call me who was clearly upset. She described her life as chaotic, frustrating, and miserable. What she wanted to talk about was how to take control of her life. What we ended up talking about was alcohol abuse and being dependent on booze.
Her bottom line:
Does alcoholism treatment work?
I was very upfront with her when I said: it depends on the treatment and the goals. It also depends on each patient’s knowledge of the problem and his or her belief system. Belief system? What-do-you-mean, belief system? she demanded. I told her that the overwhelming number of physician and lay people, too, view alcoholism as a disease, and long term alcohol use as a chronic disease. Interestingly, recent polls show that most medical students are given very little formal education on addictive problems, and most have been indoctrinated in a single-minded view that alcoholism is an anomaly “an illness”. They are taught to believe alcoholism is a disease and that is what they teach their patients.
The physicians’ training encourages them to see the progressive levels of addiction and the subsequent impact on failing health as a predictable disease process. Of course, they are also taught the other possible causes of alcoholism such as it is a behavior problem learned through environmental factors, and the possible genetic-linked component . Sort of an alcohol study of: disease versus behavior versus genetics.
However, the real diversity in opinion among physicians is not whether alcoholism is a disease or a learned behavior.
The number one question is: how treatable is this problem?
Can you treat it? How do you treat it? When do you treat it? Is it a medical problem? Is it a social problem? Is it a moral or legal or psychiatric problem? How best do you fix it?
And, that is the same question that my lady telephone caller had.
Does alcohol treatment work?
Alcohol treatment has been around since the Druids fermented honey, and the Egyptians brewed beer. After 3,000 or 10,000 years, why is there still a problem believing or even asking if -- traditional treatments are effective? Why do we question the effectiveness? After all, if alcoholism is an illness surely it can be identified, a medicine can be found to help the problem and it like many forms of heart disease, cancers and stomach problems -- can be cured or at least put into remission. Right? Well, that’s where the debate and the shouting starts.
Traditional thinking says this (alcohol abuse/dependency) reformation can be accomplished in only one-way: Do not ever drink again. Never. If you ever, ever drink one little sip, you will become a hopeless, quivering falling down drunk. Once an alcoholic, always alcoholic. That is what has been said for 60 years.
But, is this really true?
For anyone who has ever experienced
· the terror of a mean drunk
· the heartache of a automobile accident caused by a drunk driver
· a family torn apart by an alcoholic
· a child left behind
the traditional thinking of never drink again is the only thinking that makes sense.
You want to believe that it is true. The sad reality is that the traditional way of treating alcoholics “shame, jail, fines, divorce, loss of health, group meetings, 12 Step”
has not worked !!!!!.
People, including those in the legal profession, question the effectiveness of traditional treatment programs for several reasons. One has to do with what is called the “recidivism rate”. This simply means the number of times someone has promised to quit and started binging again, or the number of times someone is admitted into a substance abuse facility.
Secondly, treatment options “ traditional or alternative” -- tend to be controversial.
Third, until the last decade, there had been no realistic way for someone to control his or her craving for alcohol that did not involve “white knuckles and cold sweats”. The only options for some was to attend daily meetings.
What a happy world this would be if no one ever became addicted, or if there was a “one size fits all” treatment, or a “magic pill” that would eliminate the desire for alcohol. Treatment is complicated because each of us has a wide range of needs, emotions, circumstances and goals. Following are a few of the basic elements of successful treatment programs. Here, we define the word “successful” as meeting the clients’ goals.
A really good treatment program individualizes the services offered to the client (and his or her family or supportive network) and the services have a long term aftercare component that is also individualized.
A really successful treatment program recognizes that there are a variety of ways that we can define being “successful”. For many people, successful need not be defined as life-long abstinence. Successful may be reducing alcohol to defined amounts (just as a weight-conscious person will limit his or her ice cream or cookies to a weekly or even monthly allowance).
A really good alcohol treatment program recognizes that alcohol abuse is an equal opportunity disease. Alcohol affects people of all walks of life, professions, ages, and affects women as equally as men.
A really good treatment program recognizes that 99 percent of all clients have a dual diagnosis that needs to be treated concurrently with the alcoholism; depression, anxiety, fear, marital problems, anger management, personality and mood disorders.
A really good treatment program uses treatment providers who have attained at least a masters level degree or higher. MD, ARNP, PhD, LCSW, and LMHC are skilled in addiction logy and case management.
A really good treatment program should be forward-looking to current advances in medicine and therapy. It should not exist by repeating what has been done in the past that has not worked for the majority of the people who have tried and failed and failed again using the “traditional methods”. Traditional methods generally mean short or long-term inpatient or residential treatment facilities, immediate abstinence, rapid detox, punitive methods involving jail, loss of driver’s license, punitive fines, large group meetings, and peer counseling provided by nonprofessionals.
The Alternative Treatment Method providers are forcing those who have followed conventional, traditional treatment to reassess their thinking. They have been given new information, new therapy options, new medications or new ways to use old medications and having tremendous successes. Some of these include:
Harm reduction - is a catch all phrase that has been used to describe nontraditional methods of reducing the amount of alcohol consumed. Many a patient has heard his or her doctor say, “You need to cut back on your drinking and give your liver a rest”. That is a harm reduction phrase. You weren’t told to stop; although that suggestion was implied.
An example of a harm reduction treatment program would be the “Sinclair Method”.
The Sinclair Method uses medications to control the craving, defined goals in reducing/controlling drinking and behavioral/motivational/coaching therapies. We have developed a Medication Management and Therapy Workbook that you can use ON YOUR OWN WITH OR WITHOUT A THERAPIST and teach yourself how to CONTROL OR ELIMINATE ALCOHOL USE.
TO PURCHASE THIS PROGRAM (CLICK HERE).
Recovery Options - is a phrase signaling that physicians and clinicians are working together to offer a combination of treatments that may include naltrexone/Campral therapy, outpatient detox, acupuncture, massage, hypnotherapy, and focused intensive psychotherapy to reduce or eliminate alcohol use. Clinical studies are showing extremely positive results.
In fact, the future is very promising for medications such as Naltrexone and Campral that address brain chemistry and addictive behaviors. These are not the “old” medications that prevent the alcoholic from drinking by making him or her violently ill (Antibuse). Rather, the new medications reduce the craving associated with “uncontrollable” desire to binge. Other medications enhance the anti-craving effect and give additional longer-term suppression. Medication combined with behavioral modification therapies is proving that the thinking and destructive behaviors associated with drinking are significantly reduced or eliminated.
There is an excellent article in Research Update, July 2001, entitled “Alcohol, Drugs and the Brain”. It can be found on the internet. It details the concept of “reward pathways” of the brain where dopamine has its greatest impact. In research studies, even anticipating (thinking/craving) alcohol increases dopamine levels. The article details that dopamine is one of the primary neurotransmitters that is involved in addiction.
The enjoyment derived from using alcohol involves the opiate system of the brain. Neurons in the brain release endorphins when alcohol is present. Certain prescription medications that are FDA approved or available only in a clinical trial, block the reinforcement from endorphins. Research articles published by Dr. David Sinclair from 1973 through 1997 show that year-by-year researchers began to more thoroughly understand the cycle of drinking and the related behaviors.
One of the key discoveries is that effective treatment comes from understanding the cause of the behavior and that drinking is a learned behavior. Each time a person drinks, the alcohol causes some neurons in the brain to release endorphins that reinforces the drinking behavior, as well as the craving, feelings and thoughts about alcohol. Each year drinking becomes stronger until eventually alcohol can dominate one’s life.
Today’s advanced treatment programs are not the same as what was offered previously as standard care. When you combine the medical treatment component, behavioral modification and rational emotive therapies with a compliant patient you can end the chaos, end the frustration and rebuild your life. This is what our Comprehensive Program (CLICK HERE) offers to you.
Where many people fail their treatment programs, and the treatment program fails them is that expectations and goals are not clearly defined in the beginning of the program and they are not realistic. The Right Treatment Program does work when it meets your individual needs, reduces or eliminates the craving and treats the underlying emotional issues.
The information in these books can be individualized to meet your needs. The treatment programs which it may be used with are:
Sinclair Method using FDA approved medications and counseling, allows the client to slowly reduced their alcohol consumption to a social level.
Pennsylvania Model uses the University of Pennsylvania protocol for medication, detox, abstinence, and counseling
Minnesota Model uses abstinence, psychotropic medications, group meetings, residential referral and case management
In-home Detox in-home or residential detox with intensive counseling, medication management and telephone aftercare.
According to SAMHSA, in 1999 more than 105 million Americans aged 12 and older reported that they had used alcohol at least once during the previous 30 days, and more than 45 million reported binge drinking, meaning they had more than 5 drinks at one time. The excessive use of alcohol is a common family problem. IF YOU WOULD LIKE TO START YOUR ALCOHOL REDUCTION OR ELIMINATION PROGRAM TODAY, CLICK HERE TO ORDER THE MEDICATION MANAGEMENT AND THERAPY WORKBOOK.
Good luck in your NEW journey to sobriety.
Sincerely,
Beverly Rayfield, BS, CADC
Order by Phone: 941-321-4104
Order by Mail:
Neuro Assisted Recovery
8400 S Tamiami Trail
Sarasota, FL 34234