Alcohol Relapse Prevention

According to a scholarly journal published on the Science magazine website:

Alcoholism is now seen by most experts as a “final common pathway’ arrived at through a multitude of factors including genetic vulnerability, environmental stresses, social pressures, psychiatric problems, and personality characteristics. Although advanced chronic alcoholics look very much alike, the course of the disorder is by no means uniform or predictable.

Physical deterioration, physical and psychological dependency, behavior changes, and general dysfunctionality progress at different rates for different people. . . As Thomas McLellan of the Philadelphia Veterans Administration Hospital says, “absolutely anything you want to say about alcoholics is true about some of them and not true about all of them.”

Finding the right combination of treatment options is critical to preventing relapse, something that is unfortunately very common for users in their first year of sobriety. According to The Recovery Village website, “Less than 20 percent of patients who receive treatment for alcoholism remain alcohol-free for an entire year.”

However, relapse rates dramatically decrease after one year of sobriety. Chances of relapse are less than 15 percent at five or more years of sobriety.

With relapse rates so high in the first year of sobriety, it may be highly beneficial to find effective, long-term treatment after the initial diagnosis and detoxification. According to Medical News Today, the following are recognized treatment options for alcohol use disorder:

• Do-it-yourself: Some people with an alcohol problem manage to reduce their drinking or abstain without seeking professional help. Free information is available on websites, and self-help books can be purchased online.
• Counseling: A qualified counselor can help the person share their problems and then devise a plan to tackle the drinking. Cognitive behavioral therapy (CBT) is commonly used to treat alcohol dependency.
• Treating underlying problems: There may be problems with self-esteem, stress, anxiety, depression, or other aspects of mental health. It is important to treat these problems, too, as they can increase the risks posed by alcohol. Common alcohol-related issues, such as hypertension, liver diseases, and possibly heart diseases, will need to be treated too.
• Residential programs: These can offer expert professional help, individual or group therapy, support groups, training, family involvement, activity therapy, and a host of strategies for treating alcohol abuse. Being physically away from access to temptation is helpful for some people.
• Drug that provokes a severe reaction to alcohol: Antabuse (disulfiram) causes a severe reaction when somebody drinks alcohol, including nausea, flushing, vomiting, and headaches. It is a deterrent, but it will not treat the compulsion to drink or solve the problem in the long term.
• Drugs for cravings: Naltrexone (ReVia) may help reduce the urge to have a drink. Acamprosate (Campral) may help with cravings.
• Detoxification: Medications can help prevent withdrawal symptoms (delirium tremens, or DTs) that can occur after quitting. Treatment usually lasts 4 to 7 days. Chlordiazepoxide, a benzodiazepine medication, is frequently used for detoxification (detox).
• Abstinence: Some people complete detox successfully, but they start drinking again either soon after or some time later. Access to counseling, medical help, support groups, and family support can all help the individual avoid alcohol as time goes on.
• Alcoholics Anonymous: Alcoholics Anonymous is an international fellowship of men and women who have faced problems with alcohol. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere. There are no age or education requirements. Membership is open to anyone who wants to stop drinking.

The National Institute on Alcohol Abuse and Alcoholism offers several tips for selecting the appropriate treatment option:

What kind of treatment does the program or provider offer?

It is important to gauge if the facility provides all the currently available methods or relies on one approach. You may want to learn if the program or provider offers medication and if mental health issues are addressed together with addiction treatment.

Is treatment tailored to the individual?

Matching the right therapy to the individual is important to its success. No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.

What is expected of the patient?

You will want to understand what will be asked of you in order to decide what treatment best suits your needs.

Is treatment success measured?

By assessing whether and how the program or provider measures success, you may be able to better compare your options.

How does the program or provider handle relapse?

Relapse is common and you will want to know how it is addressed.

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