Treatment of Alcoholism
Similar to other diseases, alcoholism can be overcome with proper treatment, prevention, more relevant
educational programs, and increased research efforts.
Fortunately, as serious as alcoholism is, in most instances, it can be successfully treated.
Treating alcoholism typically includes a combination of counseling, education, support, prescribed
medications, and follow-up rehab to help an individual quit drinking.
In fact, this combination may be the current best treatment scenario.
Stated differently, after treating people and helping them overcome their addiction via medications,
education, and support, counseling and follow-up rehab can then teach them how to make the necessary lifestyle
changes that will help them avoid an alcohol relapse and remain sober.
What is Alcoholism?
Alcoholism, also known as alcohol addiction and alcohol dependence, is a progressive debilitating disease.
What this means is that alcoholism gets increasingly worse as the alcohol dependent person continues to
Alcoholism is a disease that has received extensive research and includes the following four identifiable
- Physical dependence: withdrawal symptoms such as anxiety, headaches, nausea,
perspiration, and "the shakes" when abstaining from alcohol.
- Craving: having a strong urge or need to drink.
- Tolerance: the need to drink greater amounts of alcohol in order to feel a "buzz"
or to get "high."
- Loss of control: an inability to stop drinking after the first drink.
The Treatment of Alcoholism: An Overview
Not unlike other diseases and illnesses, alcoholism can be overcome with prevention, education, quality
alcoholism treatment, and increased research efforts.
By providing more individuals with access to effective alcoholic treatment, the costly drain on society and the
financial, physical, and emotional liability alcoholism places on families can be significantly minimized.
Indeed, recent research strongly shows that successful prevention and professional quality alcohol treatment
programs result in significant reductions in heart disease, crime, HIV, cancer, strokes, traffic fatalities,
unwanted pregnancy, and child abuse.
Furthermore, quality alcohol and drug treatment improves health, quality of life, and job performance while at
the same time reducing drug use, family dysfunction, and involvement with the criminal justice system.
As debilitating as alcoholism is, fortunately it can be treated.
The treatment of alcoholism usually involves a combination of counseling and doctor-prescribed medications to
help an alcoholic stop drinking.
Even though most alcoholics need professional assistance to recover from their addiction, research has
demonstrated that with support and quality alcoholism treatment, many alcoholics are able to refrain from drinking
and restore their lives.
Alcohol Withdrawal Symptoms
A wide variety of different techniques exist for treating alcohol withdrawal symptoms. While some of these
treatments use drugs, many, however, do not.
Indeed, according to current research findings, the safest way to treat mild withdrawal symptoms is without
Such types of non-drug detoxification efforts use screening and comprehensive social support throughout the
entire withdrawal process.
Other non-drug detoxification programs, additionally, use vitamin therapy (especially thiamin) and proper
nutrition and when treating mild withdrawal symptoms.
Mild to Moderate Alcohol Withdrawal Symptoms
The following represents mild to moderate physical withdrawal symptoms that typically occur within 6 to 48 hours
after the last alcoholic drink:
- Sleeping difficulties
- Abnormal movements
- Enlarged or dilated pupils
- Clammy skin
- Tremor of the hands
- Looking pale
- Rapid heart rate
- Loss of appetite
- Pulsating headaches
- Sweating (especially on the palms of the hands or on the face)
- Involuntary movements of the eyelids
Severe Alcohol Withdrawal Symptoms
The following is a list of severe symptoms that typically occur within 48 to 96 hours after the last alcoholic
- Visual hallucinations
- Severe autonomic nervous system overactivity
- Black outs
- Muscle tremors
- Delirium tremens
Traditional Alcohol Treatment Programs
There are a number of traditional alcohol treatment options that are relatively well established.
The following alcoholism approaches and programs will be discussed:
- Behavioral Treatment
- Therapeutic Medications
- Outpatient Alcohol Treatment
- Residential Alcohol Treatment Programs
- Family and Marital Counseling
Detoxification. Alcohol detoxification is the process of letting the body rid itself of alcohol
while managing the withdrawal symptoms in a safe environment.
Alcohol detox treatment is typically done under the supervision of a medical doctor and is frequently employed
as the first step in an alcoholism treatment program.
Due primarily to the relatively long time-frame for the Detox process, these approaches are typically part of an
inpatient alcohol rehabilitation program.
Behavioral Treatments. These rehab methodologies focus on initiating change in an alcoholics'
behaviors and actions. Examples include Alcoholics Anonymous, Motivation Enhancement Therapy, and
Cognitive Behavioral Therapy.
It can be noted that a study that was recently undertaken by the National Institute on Alcohol Abuse and
Alcoholism discovered that each of these behavioral treatment approaches greatly reduced drinking in patients
the year after treatment.
Although all of these programs were determined to be "successful," none of them was classified as "the best"
alcoholism treatment program.
Alcoholics Anonymous (AA). Alcoholics Anonymous is a mutual support program for recovering
alcoholics that is based on the 12-step recovery process that is required in order to remain sober.
Assistance and support are provided by the meetings that convene on a regular basis.
Is Alcoholics Anonymous the best choice for the treatment of alcoholism?
While Alcoholics Anonymous has established itself as an effective therapeutic recovery approach, most
practitioners outside of Alcoholics Anonymous, as well as many members within AA, think that Alcoholics
Anonymous works best when combined with other forms of treatment such as psychotherapy and medical care.
Motivation Enhancement Therapy(MET) is a systematic therapeutic approach that is almost exactly the
opposite of Alcoholics Anonymous, philosophically speaking, in that it uses motivational techniques to
elicit the client's change processes.
Some of the main characteristics of MET are the following:
- Providing feedback regarding the personal risks or damage associated with the abuse
- Receiving clear advice to make healthy changes
- Therapist empathy
- Providing the client with a number of alternative change options
- Helping the client achieve self-efficacy or a sense of optimism
- Emphasis on taking personal responsibility for positive change
Cognitive Behavioral Therapy (CBT). There are several forms of cognitive behavior therapy.
Most of them, however, share the following characteristics:
- CBT is based on an educational model that views most emotions and behavioral reactions as learned
responses. Thus, the therapeutic goal in to help the client unlearn undesirable reactions and emotions and
replace them with new and more positive ways of feeling and reacting.
- CBT uses the Socratic Method that is based on the asking of questions for insight.
- Homework is a central feature of CBT.
- CBT is a mutually shared effort between the therapist and the client.
- In CBT, a solid therapeutic relationship is necessary but not the primary focal point for effective
- CBT is structured and directive.
- CBT usually has therapeutic sessions that are briefer and fewer in number than most other forms of
- CBT approaches are based on the cognitive model of emotional response. That is, if we change the way we
think, we can act and feel better, even if the situation doesn't change.
- CBT is based on stoic philosophy. CBT does not tell clients how they should feel. Rather, this form of
therapy focuses on helping clients learn how to think more logically and effectively.
- CBT theory and techniques rely on the Inductive Method. This method has clients look at their thoughts as
hypotheses (or suggested explanations) that can be tested and questioned. If clients discover that their
hypotheses are incorrect, they can then change their thoughts and feelings to be more in line with
Therapeutic Medications. Numerous alcoholism researchers claim that alcohol dependent
individuals who cannot continue their sobriety need to receive therapeutic medications to manage and treat their
alcohol withdrawal symptoms.
Not only this, but individuals who are addicted to alcohol are less likely to experience possible brain damage
and/or seizures when they receive various alcoholism medications.
Current alcoholism research shows that the drugs most likely to produce effective results when treating
alcoholism withdrawal symptoms are the benzodiazepines.
Examples include the longer-acting benzodiazepines such as Librium and Valium and the shorter-acting
benzodiazepines such as Ativan and Serax.
Traditionally, medical doctors have used a progressive decrease in doses over the time-frame of the withdrawal
process when using benzodiazepines.
Additionally, since the shorter-acting benzodiazepines do not remain in the person's system for an excessive
amount of time and due to the fact that they allow for measurable and observable dose reductions, more than a few
alcoholism researchers have asserted that intermediate to short half-life benzodiazepines need to be used when
treating withdrawal symptoms.
Another aspect of alcoholism treatment with therapeutic medications focuses on various prescribed drugs such as
naltrexone (ReViaT) or disulfiram (Antabuse) that are administered by a doctor in an effort to help prevent the
individual from returning to drinking after he or she has experienced a relapse and ingested alcohol.
Simply put, in this intervention approach, doctors prescribe drugs to treat a person's dependency.
For example, antabuse is a drug given to alcoholics that triggers negative effects such as vomiting, dizziness,
nausea, and flushing if alcohol is consumed.
Not surprisingly, antabuse is effective precisely because it is a such a strong deterrent.
Naltrexone (ReViaT), from a different perspective is effective because it targets the brain's reward circuits
and reduces the craving the client has for alcohol.
Outpatient Alcoholism Treatment and Counseling. These approaches usually employ counseling that
teaches alcoholics how to become aware of the psychological and situational "hot buttons" that trigger their
Equipped with this information, alcoholics can then learn about different ways in which they can cope with
circumstances that do not include the drinking of alcohol.
These treatment approaches to alcoholism, unlike the detox programs, are usually offered on an outpatient
Residential Alcohol Treatment Programs and Inpatient Alcohol Rehab. If there's a need for
alcohol AND drug abuse treatment, if outpatient and support-oriented programs such as Alcoholics Anonymous
are ineffective, if an individual needs alcohol poisoning treatment, or if the individual's withdrawal symptoms are
extreme, the person typically needs to enroll into a hospital or a residential alcohol treatment facility in order
to receive inpatient alcohol rehabilitation.
Such programs are earmarked for alcoholism inpatients and usually include doctor-prescribed medications to help
the alcoholic through detox and through the alcohol withdrawal process in a safe manner.
Family and Marital Counseling. Due to the fact that the recovery process is so intimately
related to the support the alcoholic receives from his or her family, a number of alcohol dependency programs
include marital counseling and family therapy as essential aspects in the treatment protocol.
Such therapeutic approaches, furthermore, may also provide clients with much needed community resources such as
financial management courses, parenting classes, legal assistance, childcare courses, and job training classes.
Alternative Alcoholism Treatment Approaches
Although the research findings are inconclusive, there are many alternative treatment programs for alcohol abuse
and alcoholism that are becoming more available and widely used.
Examples of such "natural" forms of alcoholism treatment include the holistic and naturalistic approaches
employed by Traditional Chinese Medicine, "Drumming out Drugs" (a form of therapy that employs the use of drumming
by clients), and various vitamin and supplement therapies.
As encouraging as these alternative programs have been, additional research, however, is needed to evaluate
their effectiveness and to find out if they offer long term alcoholism treatment success.
Conclusion: Treatment of Alcoholism
Even though a cure for alcoholism has not been discovered, various alcoholism programs have been employed in the
treatment of alcoholism that have helped people recover from alcohol dependency.
In a word, there is a lot of information that is available both online and offline concerning the treatment of
Some people ask the following question regarding alcoholism: "Concerning the treatment of alcoholism, which
approach is the best"?
Like any chronic disease, there are different degrees of success regarding alcoholism treatment.
For instance, some alcoholics experience relatively long periods of sobriety after receiving treatment, and then
have a drinking relapse.
On the other hand, some alcoholics, after treatment, abstain from drinking and remain sober.
And still other alcoholics cannot refrain from drinking for any sustainable period of time, regardless of the
type of treatment to which they have been exposed.
It is interesting to point out, however, that all of these treatment outcomes occur on a regular basis with
every known type of alcoholism therapy.
Regarding the treatment of alcoholism, however, one thing is certain: the longer a person abstains from drinking
alcohol, the more likely he or she will be able to avoid alcohol treatment.