Latest Alcohol Treatment Options

During the past 15 years, increasing awareness of and attention to the problem of alcohol addiction in the U.S. has resulted in many new programs and therapies. The latest alcohol treatment options promises to further expand as a result of the American Recovery and Reinvestment Act of 2009 (the Recovery Act, or ARRA).

The National Institute on Alcohol Abuse and Alcoholism (NIAA), of the National Institutes of Health, is working to invest ARRA funds to help stimulate research advances in the field of alcohol. Areas include comparative effectiveness research (CER), which compares treatments and strategies to improve health, scientific research and facilities, to include the construction of new research and educational facilities as well as groundbreaking scientific research, and community and family support services.

In the meantime, with some 700,000 people in the U.S. receiving treatment for alcoholism on any given day, here is a listing of some of the latest in alcohol treatment options:

Detox
Approximately 95% of alcoholics experience withdrawal symptoms ranging from mild to moderate. These can be treated on an out-patient basis by health care professionals. Some 5% have severe withdrawal symptoms such as shakes, or delirium tremens, requiring detoxification in a hospital of specialized facility. What is detox? It is abstaining from alcohol while in a controlled environment, with close medical supervision for vital signs and withdrawal symptoms. The detox program typically lasts between 3-7 days and is required before any admission to a residential rehab program.

Residential Treatment Programs
With a minimum stay of 30 days (stays of 90 days or longer can be arranged), residential treatment programs provide clients with a “home-like” environment staffed with licensed and credentialed professionals where healing can begin. Included are therapeutic and structured activities, such as counseling, groups, family meetings, alternative therapies, psycho-education, relapse prevention and more. Residential treatment clients attend 18 groups a week, along with a minimum of twice-weekly individual therapy. There’s also family counseling and structured activities like gym and 12-step meetings.

Structured Extended Care Programs are available for clients who have already successfully completed residential treatment. Extended care clients are required to attend 9 groups per week as well as individual therapy, any appropriate family counseling, and two other services in addition to 12-step meetings.

Day Treatment, available for those who are transitioning from residential treatment, allow the client to live at home or in a sober living home while they attend 5-hour daily group meetings, creative therapy, individual sessions with a counselor, and are subjected to random alcohol and drug testing.

Intensive Outpatient Treatment, conducted over a 4-month period, is flexible to accommodate home and work schedules. It is designed to identify and address emotional and behavioral problems that threaten to derail recovery and sobriety. Clients attend groups for 1-2 hours in length, offered five nights a week. In addition, clients meet with counselors individually and are also subject to random testing for drug and alcohol use.

Sober Living Houses - require a client to have abstained for 30 days before admission. Each sober living house has a manager (who’s been sober at least one year), curfews, and random drug and alcohol testing.

Pharmaceutical Approach
First of all, it’s important to note that there’s no magic pill to keep someone from drinking alcohol. There are, however, three drugs that have been approved by the FDA for use in combination with alcohol treatment programs. These are:

• Disulfiram (Antabuse) - which makes a person sick if they drink any alcoholic product
• Naltrexone (Revia) - which reduces craving by blocking alcohol’s effects on the brain
• Acamprosate (Camprol) - which helps alleviate stress and discomfort

Alcoholics Anonymous - AA - 12-Step
Alcoholics Anonymous introduced the 12-step program in the 1930s. Today, it is the most widely used approach to dealing with alcoholism. Meeting in groups, recovery involves following twelve steps. A guide for running the groups evolved into the twelve traditions. 

Cognitive Behavior Therapy (CBT)
Cognitive Behavior Therapy (CBT), which generally takes between 12-16 sessions with a therapist, has been shown to be effective in treating alcoholism and drug addiction - when included as part of a client’s overall recovery treatment program. With CBT, the goal is to teach clients to recognize situations that cause them to want to drink or do drugs, and to help them avoid such circumstances. It also assists them to cope with other behavioral and problems that lead to such abuse.

Different types of CBC include:

• Rational Emotive Behavior Therapy
• Rational Behavior Therapy
• Rational Living Therapy
• Cognitive Therapy
• Dialectic Behavior Therapy

Motivational Enhancement Therapy (MET)
Motivational Enhancement Therapy (MET) begins with the assumption that the client has the responsibility and capacity for change. The therapist works with the client to provide feedback on drinking’s effects, and together they explore the benefits of abstinence, treatment options and design a plan for treatment implementation.

Brief Intervention

Consisting of 1-4 short counseling sessions, brief intervention involves meeting with a trained interventionist (physician, psychologist, or social worker), with the goal of helping to moderate a person’s alcohol consumption and avoid harmful activities such as binge drinking. The therapist does not insist on abstinence from alcohol, although abstinence may be encouraged.

Couples Therapy

A new approach to alcohol treatment is the introduction of Couples Therapy, also known as Behavioral Couples Therapy (BCT). Since the alcoholic doesn’t exist or live in a vacuum, often the person closest to the client is a critical component in the client’s eventual recovery. Comparing individual and BCT therapy, Fals-Stewart and colleagues reported that BCT resulted in significantly lower substance abuse rates at 3 and 6 months post-treatment. Studies also show that adding BCT to a pharmaceutical treatment (like disulfuram) can augment the treatment by decreasing alcohol consumption, improving disulfuram adherence, and benefiting couples’ satisfaction.