Treatments are varied because there are multiple perspectives of alcoholism. Those who approach alcoholism as a medical condition or disease recommend differing treatments from, for instance, those who approach the condition as one of social choice. Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, some prefer a harm-reduction approach.[125]
An analysis in the United Kingdom in 2010 found that overall, alcohol was found to be the most harmful drug to the person consuming and to others. However, this study does not mean that substances other than alcohol have no harmful consequences; heroin, cocaine, and methamphetamine were found to be the most harmful drugs to individuals themselves. In addition, this study did not address the issue of polydrug abuse, which is a common phenomenon in individuals abusing substances. The combination of alcohol and other substances can lead to serious adverse effects, and such combinations were not explored in this study. [12]
For many, beer, wine, and spirits conjure up thoughts of social gatherings and tipsy fun. But alcohol, a depressant, is also associated with damaging behavior and the emotional pain and physical ruin of addiction. Experts debate the benefits and risks of drinking and passionately argue over whether moderation or abstinence is the best option for alcoholics.
Most Twelve Step participants view addiction as a lifelong disease and see the Twelve Steps as their new design for living. When people whose lives have been affected by addiction work the Twelve Steps, they can better sort out the things which they have no control over, and the things for which they are responsible. Group meetings offer a safe place to share one's experience, strength and hope, and to receive support and fellowship.
There are many clues which can lead a doctor to suspect a patient is alcohol dependent, and will not usually require a physical examination. For example, a doctor may suspect alcohol dependence if a patient often asks for a medical certificate for time off work, has a mental health problem (e.g. depression) or physical conditions associated with alcohol consumption (especially liver cirrhosis). In such cases, a good doctor will ask the patient questions about their alcohol consumption patterns, or ask them to complete a questionnaire about alcohol, to assess whether or not their alcohol consumption is presenting a health risk.
The twelve Step programs are well known for their use in recovering from addictive and dysfunctional behaviors. The first 12 step program began with Alcoholics Anonymous (A.A.) in the 1930s and has since grown to be the most widely used approach in dealing not only with recovery from alcoholism, but also from drug abuse and various other addictive and dysfunctional behaviors.
Of men aged 18–25 years, 60% binge drink. (Binge drinking is defined as 5 alcoholic drinks for men [4 for women] in a row.) Binge drinking significantly increases the risk of injury and contracting sexually transmitted diseases. Women who binge drink at this age are at higher risk of becoming pregnant and potentially harming an unborn child. (Any amount of alcohol consumption during pregnancy is risky.) Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) investigated alcohol use patterns on ischemic heart disease in Northern Ireland and France. Regular and moderate alcohol use throughout the week, a typical pattern in middle-aged men in France, was associated with a lower risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Northern Ireland was associated with a higher risk of ischemic heart disease. [17]
Given the malnutrition that many alcoholics suffer from, gradual correction of that condition is also important, both to prevent or correct the consequences of malnutrition (like low thiamine level) and to prevent the potential results of correcting nutrition problems too rapidly. One example of the latter is that people with chronic alcohol-induced low sodium levels in the bloodstream (hyponatremia) are at risk for severe neurological problems due to a loss of the outer, insulating covering of nerve cells in parts of the brain (central pontine myelinolysis) if low sodium levels are corrected too rapidly.

While admitting that the oft-cited success rate of 5 percent “isn’t great,” Dr. Drew Pinsky, a celebrity doctor and addiction medicine specialist argued that “the fact it, [Alcoholics Anonymous] does work when people do it,” saying the real success rate is as high as 12 percent. The American Society of Addiction Medicine speculated that approximately 10 percent of the people who become part of a 12-Step program enjoy long-term success in their recovery. In 2014, AA self-reported that 27 percent of the 6,000 members who participated in an internal study were sober for less than a year; 24 percent retained their sobriety for up to five years, and 13 percent lasted for as long as a decade. Fourteen percent of the study’s participants stayed sober between 10 and 20 years, and 22 percent reported remaining sober for more than two decades.
Relapse can be avoided by getting sufficient aftercare. Oftentimes, aftercare involves a peer support group, ongoing therapy, and even a maintenance medication like naltrexone, which reduces or eliminates cravings. Support from family and friends is also a very important part of sustained recovery, so finding a supportive home environment – through a sober home, moving to a new house, or clearing drugs and alcohol out of one’s existing home – is very important. Working with an evidence-based treatment program can help one gather resources about nearby or online support groups and therapists.

Twelve-step methods have been adapted to address a wide range of alcoholism, substance-abuse and dependency problems. Over 200 self-help organizations—often known as fellowships—with a worldwide membership of millions—now employ twelve-step principles for recovery. Narcotics Anonymous was formed by addicts who did not relate to the specifics of alcohol dependency.[3]

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