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September is National Recovery Month! We celebrate those who have received effective alcohol treatment and achieved recovery from alcohol and drugs.  Unfortunately, the majority of those who need alcohol and drug treatment do not receive it.  While there are successful alcohol treatment methods available, most problem drinkers, including the ones who have formed a dependency on alcohol, change their patterns of drinking without receiving any professional counseling or treatment and do not require professional treatment. They most often use methods of self-help, the support of family and friends, and support groups to recover on their own.

They typically seek outside help after having alcohol-related issues and problems over a prolonged period of time. Their health may be in jeopardy, their finances in disarray and have severely strained relationships after repeated attempts to change their behavior on their own without effective alcohol treatment.

How successful alcohol treatment is may have to do with both how it’s delivered as well as what the treatment is. For example, research shows that cognitive behavioral therapy, motivational enhancement, and twelve step facilitation groups are effective alcohol treatment methods. For example, a national study on the successful treatment for alcohol abuse in the UK found that people can choose the type of treatment that will best suit their needs:

  • 7.1 million people with patterns of harmful or hazardous drinking may find help through short-term interventions provided by general healthcare providers in practically any setting.
  • 1.1 million people dependent on alcohol may find help through a more intensive type of treatment provided by specialists in the field.

Successful alcohol treatment is typically delivered by a skilled practitioner in accordance with the prevailing description of best practices. Assumptions made from current evidence are dependent on the availability of skilled practitioners with the proper training in harm reduction, stages of change and motivational enhancement. A sensible approach to developing a treatment model is to use the stepped care approach.  This involves trying an effective treatment for alcohol abuse in the least restrictive setting first, when feasible.  If this is not working, the next level of care, such as intensive outpatient, should be tried, so that treatment occurs in steps, making the best use of limited resources.

Effective alcohol treatment also requires treating co-occurring psychiatric issues as well. As many as 10% of problem drinkers may be suffering from a major mental illness, up to 50% may have a personality disorder, and up to 80% may be suffering from an Axis I disorder, such as depression or anxiety. Having a psychiatric co-morbidity makes the successful treatment for alcohol abuse a bit more challenging and would likely lengthen the duration of treatment.

Substance misuse is so common among people suffering from both an Axis I and Axis II disorder, that unless people receiving treatment are given a complete diagnosis, they won’t receive adequate treatment. In the effective treatment for alcohol abuse, co-occurring psychiatric disorders are now recognized as the norm so it only makes sense that mental health practitioners and those treating addictions must be trained in providing fully integrated treatments addressing these dual diagnosis disorders.

In conclusion, a practice of treating patients’ psychiatric issues along with their alcohol use disorders is vital to the success of any successful alcohol treatment program and will save on costs in the long run due to the following:

  • Psychiatric co-morbidity is linked with higher amounts of healthcare and social care services being used by the community.
  • Misusing alcohol and drugs serves to exacerbate symptoms of psychiatric problems.
  • Misusing alcohol and drugs is linked with not complying with treatment for mental illness.
  • Misusing alcohol is linked with high rates of suicide.
  • Severe and chronic mental illness necessitates highly specialized practitioners trained in psychiatric co-morbidity.

Conclusions regarding intensive treatments offered in different settings:

  • Outpatient care is certainly less expensive than inpatient or residential care, however certain patients will require inpatient treatment at a residential facility.
  • A residential program under a time limit can be a less expensive intervention.
  • There is strong evidence to suggest that effective treatment for alcohol abuse is available.
  • Intensive outpatient programs have been shown by SAMHSA to be an effective alcohol treatment modality.

Although too many people who need treatment for alcohol or drugs do not receive it, you do not have to be among them.  Successful treatment for alcohol and drug use is available now.

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