Essay/Term paper: Treatments of alcoholism

Essay, term paper, research paper:  Narrative Essays

Treatments of Alcoholism


Alcoholism can destroy the life of an alcoholic and devastate the alcoholic's
family. But it also has overwhelming consequences for society. Consider these
statistics from the National Council on Alcoholism and Drug Dependence:

*In 1988, alcoholism and problems related to it cost the United States
an estimated $85.8 billion in mortality and reduced productivity;

*Fetal alcohol syndrome, caused by a woman's drinking during pregnancy, afflicts
five thousand infants a year; it costs about $1.4 billion annually to treat the
infants, children and adults afflicted with FAS;

*More than twenty thousand people die annually in alcohol related car accidents.
(Institute of Medicine, 1989)

Clearly alcoholism harms society in numerous ways and it is in society's
best interest to find effective treatments for alcoholics.
The primary goal of all treatments for alcoholism is to get the alcoholic
to stop drinking and refrain from abusing alcohol in the future. The paths to
this goal are diverse. Several factors - biological, social and psychological -
influence why an individual becomes an alcoholic. So treatments vary, depending
upon why the alcoholic drinks and what the physician or therapist believes is
the best method for recovery. Some treatments focus on the physical addiction
of alcoholism. Others emphasize the alcoholic's social or psychological
cravings.
Alcoholics Anonymous and Rational Recovery are two support groups that help
alcoholics recover. Other alcoholics benefit from one-on-one therapy with
counselors, who may help patients understand drinking and change their behavior.
Finally for some alcoholics, the most effective treatments are those that
combine medical treatment with counselling. Such treatments enable the
alcoholic to more easily break the physical addiction to alcohol as they
evaluate their social and psychological reasons for drinking. Two of these
treatments are: Nutritional Therapy and Network Therapy.

Nutritional Therapy

"Alan Dalum was 37 years old and thoroughly convinced he was soon going to
die. Dalum was not dying of cancer, heart disease or any other illness from
which one can leave the world with dignity. Dalum was dying of alcoholism."
(Ewing, 1978) Just when he lost all hope for recovery, Dalum discovered a
center that emphasized the importance of biochemical repair in alcoholism
recovery using nutrients and herbs. Upon learning that Minneapolis, where he
lived, had one of the only programs in the country that employed such methods,
Dalum decided to give the Center's six - week, outpatient program a shot.
The Health Recovery Center (HRC) in Minneapolis claims a 74 percent success
rate (patients still sober one year later) and differs from conventional
programsin several significant ways. First, it focuses on uncovering and
treating physiological imbalances that may be causing alcohol cravings and
throwing the entire body out of whack. For example: hypoglycemia is a common
imbalance found in up to three quarters of alcoholics. The center's philosophy
is simple "Until the body begins getting the essential nutrients it needs,
recovery cannot begin." (Ewing, 1978) They believe that no amount of talk will
stop the cravings, anxiety, depression, mental confusion and fatigue that result
from alcohol's biochemical and neurochemical damage. "There is not time to
obsess over past traumas when you're dying of a major disease. Why do people
persist in believing that the damage done by excess ingestion of alcohol can be
undone with psychological methods alone?" (Ewing, 1978) The Health Recovery
Center is devo ted to the restoration of bodies, minds and spirits that have
been ravaged by alcohol.
Such restoration begins the moment a new patient walks through the door.
After the staff physician takes a thorough medical history and performs the
initial physical exam, the patient is hooked up to an IV solution, out of which
drips high doses of ascorbic acid (vitamin C, a powerful detoxifier), calcium,
magnesium, B vitamins (which help eliminate withdrawal symptoms), evening
primrose oil (a natural anticonvulsant) and a full spectrum of amino acids
including glutamine (an alternative form of glucose that significantly
diminishes cravings). While conventional programs frequently numb new patients
with drugs like Librium and Valium to help ease withdrawals (and later must wean
patients off of them), HRC's formula is entirely natural. "The sum total of it
all is that people go from consuming half a quart of alcohol a day to consuming
none at all - without drugs." (Ewing, 1978)
Following the IV, HRC patients are supplied with bottles of the vitamins
and minerals they have been deficient in for so long and put on a diet that is
free of sugar, salt, caffeine and most importantly, nicotine. This is because
tobacco is cured with cane, beet and corn sugars, which may not only cause
intense cravings in those with hypoglycemia (and render them incapable of
getting the condition under control), but may also stimulate allergic/addictive
reactions in those sensitive to sugar and corn, two of the most common hidden
food allergies. "Sensitivities to corn, yeast, barley and other foods commonly
found in alcoholic beverages are the reason some patients cannot stop drinking."
(Ewing, 1978)
In the ensuing six weeks, HRC patients meet once weekly with a nutritionist,
once weekly for individual therapy with one of HRC's five certified counselors,
and daily for group sessions, at which they talk openly about such subjects as
anger, humor and insecurity. Such sessions are purposely not like conventional
twelve step meetings, at which participants are expected to talk about the power
they believe alcohol has over their lives. Rather, both the group and
individual sessions focus on the here and now. "We call it rational management
therapy. First we make a list of the client's goals, long and short term, and
map out ways they can achieve them. We decide together what they need to work
on and we try to get them to do things that will make them feel good about
themselves." (Ewing, 1978)

In sharp contrast to the AA approach, HRC counselors try to instill in
patients the belief that they are in control of their destinies, that they have
power over alcohol rather than the other way around.

Network Therapy

Twenty years ago, Marc Galanter was appointed as a career teacher in
alcoholism and drug abuse by the National Institute on Mental Health. Galanter
found nothing on the technique of resolving a drinking or drug problem for a
patient who came to the doctor's office.
Since then, researchers in addiction have begun to develop a systematic
understanding of how drug and alcohol dependence wreak their effects on thinking
and behavior. But there are still very few descriptions of a comprehensive
approach that the therapist can apply to addicted patients. "Few therapists
venture beyond recommending to alcoholics that they attend AA or take a long
break from job and family and go away to a rehabilitation hospital." (Stepney,
1987)
Marc Galanter developed an approach that engages the support of a small
group - some family, some friends - to meet with the substance abuser and a
therapist at regular intervals to secure abstinence and help with the
development of a drug free life.
The majority of Galanter's patients (77 percent) achieved a major or full
improvement. They were abstinent or had virtually eliminated substance use and
their life circumstances were materially improved and stable.

Marc Galanter named his therapy network therapy. Family and peers become part
of the therapist's working team, not subjects of treatment themselves. "Social
supports are necessary for overcoming the denial and relapse that are so
compromising to effective care for the substance abuser." (Stepney, 1987)
Together, the group develops a regimen to support the recovery, one that
includes individual sessions as well as meetings with this network. The
therapist continues to meet with the network while the abuser focuses on ways to
protect continued abstinence and on the psychological issues that would allow
the achievement of full recovery. As time goes on, the abuser's abstinence is
secured, the network sessions are held less frequently and individual therapy
continues. "A social network is apparently a necessary vehicle to stabilizing
the cognitive components of patients' recovery, to allow them to deal with the
reality they need to see and to provide the support essential for accepting the
new reality." (Newman, 1987)

The purpose of network therapy is then to create an atmosphere that will
allow an alcohol or drug abuser to experience relief from distress by
participating and moving towards a drug free outlook. After initial sobriety
has been achieved, network sessions often acquire a social quality.
In order to act out a pattern of behavior that is clearly self-destructive,
addicts must adopt a pattern of denial. This denial is supported by a variety
of distorted perceptions: "persecution at the hands of employers, failings of a
distraught spouse, a presumed ability to control the addiction if wanted."
(Newman, 1987) This cognitive set is not only unfounded, but it is also at
variance with the common sense views of the drug free family and friends.
Because of this, intimate and positive encounters with them in the network
produce an inherent conflict between addicts' views and the views of network
members. The addict must resolve this conflict, or cognitive dissonance, in
order to feel accepted in the group. The network therefore creates an ongoing
pressure on the addict to relinquish the trappings of denial.
Typically, addicts deal with this conflict by defensive withdrawal, but if
their network is properly managed, cohesive ties in the group will engage them
and draw them into an alternative outlook. Gradually, they come to accept that
their distress can be relieved by a change in attitude, as denial and
rationalization are confronted in a supportive way. Over time, engagement in
the network allows an addict to restructure the perspective in which the
addiction has been couched.
For addicts, both healthy and faulted attitudes have long coexisted in
conflict with each other and the cognitive dissonance produced by these
contradictions has driven them into a defensive stance. In a proper,
supportive context, a constructive view premised on abstinence and on
acknowledgment of the harmful nature of drug use can emerge. Addicts can
experience a "conversion" of sorts, perhaps gradual, but real nonetheless.
(Johnson, 1980)
There is hardly any disorder more complicated and difficult to treat than
alcohol/drug dependence. Perhaps because alcohol dependence is so complex, it
has attracted various professions and approaches, each having its own notion of
etiology and treatment. The point is that treatment needs to be conceptualized
for the patient as a long term process of years with the principle task for
recovery being to provide the most effective treatment for a given person with a
given problem. But until and unless researchers find a specific biological
cause and cure for alcoholism, treatments will continue to vary, depending upon
the alcoholic and the therapist.

References

Ewing, J. (1978). Drinking. Chicago: Nelson Hall Institute of Medicine. (1989).

Broadening the Base of Treatment for Alcoholic Problems. New York: Bergin
Publishers Inc.

Johnson, V. (1980). I'll Quit Tomorrow. New York: Harper & Row.

Newman, S. (1987). It Won't Happen To Me. Toronto: General Publishing Co.

Stepney, R. (1987) Alcohol. New York: Aladdin Books