Alcoholism - Treatment for Alcoholism

Overall Treatment Goals

The ideal goals of long-term treatment by many doctors and organizations such as Alcoholics Anonymous are total abstinence. Patients who secure total abstinence have better survival rates, mental health, and marriages, and they are more responsible parents and employees than those who continue to drink or relapse. To achieve this, the patient aims to avoid high-risk situations and replace the addictive patterns with satisfying, time-filling behaviors.

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Because abstinence is so difficult to attain, however, many professionals choose to treat alcoholism as a chronic disease. In other words, patients should expect and accept relapse but should aim for as long a remission period as possible. Even merely reducing alcohol intake can lower the risk for alcohol-related medical problems.

Alcoholics Anonymous (AA) and other alcoholic treatment groups are greatly worried by treatment approaches that do not aim for strict abstinence, however. Many people with alcoholism are eager for any excuse to start drinking again. There is also no way to determine which people can stop after one drink and which ones cannot.

Evidence strongly suggests that seeking total abstinence and avoiding high-risk situations are the optimal goal for people with alcoholism.

Inpatient Versus Outpatient Treatment

A number of treatment options now exist for alcoholism. It is first important to determine whether inpatient or outpatient care would best benefit the individual. Inpatient care is performed in a general or psychiatric hospital or in a center dedicated to treatment of alcohol and other substance abuse. It is recommended for the following people:

Those with a coexisting medical or psychiatric disorder
Those with delirium tremens
Those who may harm themselves or others
Those who have not responded to conservative treatments
Those who have a disruptive home environment

Some -- but not all -- studies have reported better success rates with inpatient treatment of patients with alcoholism. In the positive reports, patients who were hospitalized for treatment had fewer complications and re-hospitalizations and longer abstinence rates than patients treated as outpatients. Other studies, however, have shown no difference in results between inpatient and outpatient programs. Given the ambiguity in results and high expense of inpatient treatment, most care providers do not choose inpatient treatment for alcoholics who are not a threat to others or to themselves.

Inpatient Treatment Options. A typical inpatient regimen may include the following stages:

A physical and psychiatric work-up for any physical or mental disorders
Detoxification --this phase involves initiating abstinence, managing withdrawal symptoms and complications, and ensuring that the patient remains in treatment
On going treatment with medications in some cases
Psychotherapy, usually cognitive-behavioral therapy
An introduction to Alcoholics Anonymous (AA)