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Alcohol Abuse Treatment: What do we do now?
Alcohol abuse treatment for abuse and dependency:
 The
specific form of alcohol abuse treatment will need to be decided on
when it has been determined that an individual is drinking
excessively, and will consider the specific nature, setting, intensity
of the intervention and will seek to address the specific treatment
needs of that individual. The alcohol abuse treatment for a heavy
drinker without evidence of alcohol dependence may be a brief
intervention aimed at only reducing the drinking. In contrast, when
you have an individual who it has been determined is an alcoholic;
there are usually a variety of disabilities associated with the heavy
drinking, so it may be necessary to address both the drinking behavior
and the related problems. Consequently, the best treatment of an
alcoholic is usually conceived to be a model that is multimodal. The
following goals have been identified by First & Tasman in DSM –IV-TR
Diagnosis, Etiology & Treatment for a multimodal approach to alcohol
abuse treatment.
Alcohol Abuse Treatment Goals:
-
Complete
abstinence from alcohol.
-
Stabilize acute
medical (including alcohol withdrawal) and psychiatric conditions,
as needed.
-
Increase
motivation for recovery.
-
Initiate
treatment for chronic medical and psychiatric conditions, as needed.
-
Assist the
patient in locating suitable housing (e.g.., moving from a setting
were drinking is widespread), as needed.
-
Enlist social
support for recovery (e.g., introduce to 12-step program and when
possible, help patients repair damaged marital and other family
relationships).
-
Enhance coping
and relapse prevention skills (including social skills,
identification and avoidance of high-risk situations).
-
Improve
occupational functioning.
-
Promote
maintenance recovery through ongoing participation in structured
treatment or self-help groups.
It should be noted
that while total abstinence is the primary goal for individuals with
alcohol dependence, moderate drinking may be considered as a worthy
goal for persons who abuse alcohol without alcohol dependence.
Initiating the alcohol abuse treatment process:
Following the
initial screening using a tool such as the AUDIT or CAGE, an
individual is usually referred for diagnostic evaluation with a likely
treatment recommendation or a brief intervention with a need for
further monitoring. Brief interventions are usually of a low
intensity and of a short duration. They usually consist of one to
three sessions of counseling and psychoeducation. Their goal is to
provide early intervention before or soon after the onset of
alcohol-related problems. These interventions have the intention of
motivating high-risk drinkers to moderate their consumption of alcohol
enough to assist in care that may be delivered by primary care
practitioners and/or mental health clinicians in outpatient treatment
settings. These interventions are more appropriate for individuals
who meet the criteria for alcohol abuse rather than dependence.
Brief interventions for alcohol abuse treatment:
Over the past
several decades there has been more than 40 randomized controlled
trials conducted to evaluate the effectiveness of brief interventions
for alcohol abuse treatment. The result of the trials has been
summarized in several meta-analysis and integrated literature
reviews. Cumulative evidence has found that clinically significant
effects on negative drinking behavior and alcohol-related problems
have been found to follow these interventions. However, results have
not always been consistent across these studies. Further, these brief
interventions have not been found to be an adequate alcohol abuse
treatment when an individual is alcohol dependent.
From DSM-IV-TR Mental
Disorders: Diagnosis, Etiology and Treatment by Michael B. First and
Allan Tasman
Additional
Information and webpage by
Paul Susic
MA
Licensed Psychologist Ph.D. Candidate
(Health and Geriatric Psychologist)
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