Over 100,000 people die every year from alcohol-related causes such as drinking and driving, fires, falls, homicide and suicide. A recent study published in JAMA Psychiatry suggested that despite these staggering statistics, alcohol misuse may be on the rise. Given that alcoholism is a disease with the ability to affect any kind of individual, the effectiveness of modern alcohol treatment methods has been increasingly evaluated in order to tackle this problem head-on to improve the likelihood of recovery and save lives in the process.
While traditionally these treatments have been based highly on clinical experience and intuition, recent studies and evaluations have been analyzed to concede just how effective each method currently is and where the future of alcoholism treatment is heading.
12 Step Programs
The most common form of treatment sought out by alcoholics is the use of a 12-step program such as Alcoholics Anonymous. As of 2016, the program was approaching membership levels of nearly 2 million people worldwide.
A 12 step program outlines 12 requirements in which its members should follow and complete throughout their recovery, and it encourages the use of optional support groups to assist members with making lifelong friends that are said to increase with maintaining their sobriety.
In a recent study that assessed the effectiveness of professional treatment in conjunction with an Alcoholics Anonymous program compared to the effectiveness of Alcoholics Anonymous alone, it was shown that the former achieved better results for the majority of participants.
An alternate study compared Alcoholics Anonymous 12 step program with those using cognitive behavioral programs, as well as with therapy programs that utilize both together. In cognitive behavior programs, patients are assisted with learning new coping mechanisms in order to change their harmful behavioral problems, something that has been seen to be effective for alcohol abuse. The results of the study, which assessed 3000 patients over the course of a year post-treatment, those who were involved in a 12 step program showed a greater likelihood of sustaining abstinence.
The support and involvement of a nonalcoholic spouse with a treatment program have been known to firstly, improve the patient’s likeliness that they will participate in a program and also increase the odds that they’ll continue to work on altering their relationship to alcohol after the program ends.
Motivational Enhancement Therapy
Motivational Enhancement Therapy is based on the opinion that the responsibility to seek behavioral change is required by its patients. In the MET method, patients and therapists work together to review treatment options and design unique plans that showcase and encourage the benefits of abstaining from alcohol. It is said to be the most cost-effective of methods and in one study it was shown to be the easiest method to utilize when convincing patients to enter treatment.
Brief intervention treatments require the participation of physicians to counsel patients over a series of check-ins, usually five or fewer. These are used to assist those at risk of developing alcohol-related health problems by informing the patient about the negative implications of prolonged alcohol abuse and often include a recommendation to enter specialized treatment programs such as 12 step programs or cognitive therapy. In two trials in both Canada and the United States, it was shown that brief interventions not only reduced drinking and alcohol-related problems but also the patient’s’ use of health care services as seen with drinking and driving accidents.
Another study showed that the brief intervention resulted in a significant decline of alcohol misuse with freshman college students who were once considered at risk for alcohol-related problems.
Use of medication to combat alcoholism is a more modern approach to the disease and recent research has showcased its effectiveness both stand-alone and while used in conjunction with traditional therapy methods.
In 1995, use of the drug naltrexone was approved by the Food and Drug Administration as it was believed to be a beneficial aid with regards to preventing relapse from alcoholics who were also undergoing psychosocial therapies like those outlined above. Recent studies, however, show that naltrexone is only effective if consumed regularly and due to the fact that it carries a high rate of negative side effects, it has not been deemed as useful as it was once thought.
In many randomized European trials that followed 3,000 alcoholics, the drug Acamprosate was seen to show much more promise. An analysis of patients using just the drug and those using the drug in conjunction psychosocial treatments determined that the latter were twice as likely to remain abstinent upwards of 1 year.
Further studies and research also suggest that the effectiveness of a drug may pertain to the type of alcoholic that it is treating. As an example, early-onset alcoholics, which mean those who began to drink heavily before turning 25, who used ondansetron based drugs in conjunction with psychotherapy decreased their overall consumption and increased the number of days in which they abstained entirely, but later onset alcoholics did not yield the same results. The drug Sertraline contrarily did appear to reduce overall consumption in later cancer alcoholics but did not seem to generate the same results with early-onset alcoholics.
While old methods of treatment such as the 12-step program continue to show effectiveness in reducing alcohol consumption, the newly developed techniques such as the use of pharmaceuticals and alternative treatment options like cognitive behavioral therapy and motivational enhancement therapy, combined with clinicians accessible to options, are also encouraging significant improvement in the treatment of alcoholism. With further research and studies on the effectiveness of these newer methods, we can better determine what treatment methods are best utilized for specific patients and further close the gap on alcohol-related deaths and illnesses. In addition, with developments in the understanding of alcohols affects on brains and brain-behavior clinicians can continue to fine-tune and develop new methods, treatments and medications that can be used in conjunction with behavioral therapy techniques to improve alcoholics odds of recovery, thereby improving their lives and that of those around them.