The concept of tailoring treatments to particular types of clients to increase effectiveness has been appealing to researchers both in terms of its logical plausibility and as a possible explanation for the reason why no one intervention has universal effectiveness. However, despite this, there is limited evidence to date that matching people with alcohol misuse or dependence to treatment approaches demonstrates effectiveness. However, it is the consistency rather than the size of this correlation that is most striking because a correlation of 0.25 would suggest it could account for only 6% of the variance in the outcome. Specific studies of the role of the alliance in drug and alcohol treatment programmes have been conducted. Luborsky and colleagues (1985), Connors and colleagues (1997) and Ilgen and colleagues, (2006) reported a relationship between treatment outcomes, but others (for example, Ojehagen et al., 1997) have not.
- Within the NHS, teams tend to consist of different disciplines including nurses, counsellors, medical practitioners and, less often, other professions such as psychologists and occupational therapists.
- For example, clients are encouraged to develop a list of activities they could engage in to distract themselves until a craving passes.
- Aside from their utility as analgesic drugs, opioid-like compounds are often found in cough suppressants, anti-nausea, and anti-diarrhea medications.
- Relationships may deteriorate, as their social circle narrows to other drug or alcohol users.
Alcohol dependence treatment:
But alcohol is a nervous system depressant and easily alters behavior, culminating in some cases in the emotional pain and physical disintegration of alcohol addiction, colloquially known as alcoholism. Experts continue to debate the benefits and risks of drinking and passionately argue over whether moderation or complete abstinence is the best option for those who struggle with alcoholism. People with severe or moderate alcohol use disorder who suddenly stop drinking could develop delirium tremens (DT). It can be life-threatening, causing serious medical issues like seizures and hallucinations that require immediate medical care.
Children and young people
Relapse represents a major challenge to treatment efforts for people suffering from alcohol dependence. To date, no therapeutic interventions can fully prevent relapse, sustain abstinence, or temper the amount of drinking when a “slip” occurs. For some people, loss of control over alcohol consumption can lead to alcohol dependence, rendering them more susceptible to relapse as well as more vulnerable to engaging in drinking behavior that often spirals out of control. Many of these people make numerous attempts to curtail their alcohol use, only to find themselves reverting to patterns of excessive consumption. The GDG used the NICE antisocial personality disorder guideline (NICE, 2008a) review of family interventions and multisystemic therapies for the treatment of conduct disorder in evaluating the effectiveness of multicomponent interventions for children and adolescents.
3.5. Public health impact
This is of particular concern because alcohol presents particularly serious consequences in young people due to a higher level of vulnerability to the adverse effects of alcohol. Heavy drinking in adolescence can affect brain development and has a higher risk of organ damage in the developing body (Brown et al., 2008). There is a wide range of other environmental factors that predispose to the development of alcohol-use disorders (Cook, 1994). These include the affordability and availability of alcohol, high consumption rates in the general population, occupational risk factors (such as working in the alcohol or hospitality industries), social pressure to drink, and religious- and culturally-related attitudes towards alcohol.
Physical and psychological dependence
Furthermore, no significant difference was observed between cue exposure and emotional cue exposure in reducing the amount of alcohol consumed at 6- to 12-month follow-up. In line with this, no significant difference was observed between moderation-oriented cue exposure and behaviour self-control training in reducing alcohol consumption when assessed at 6-month follow-up. It must be noted that effect physiological dependence on alcohol sizes were small and the results of a single study cannot be generalised. Around one third of people presenting to specialist alcohol services in England are self-referred and approximately one third are referred by non-specialist health or social care professionals (Drummond et al., 2005). The majority of the remainder are referred by other specialist addiction services or criminal justice services.
- These arguments often rely on misdirection—moving the focus onto someone or something else.
- The literature reviewed in this section is focused on a reduction or cessation of drinking and hence assesses any outcomes pertaining to this.
- About 33% of people treated for AUD suffer no additional symptoms, and thousands have reduced their drinking consumption to fit within healthy limits, even if they relapse a few times before they get to that place.
- Traditionally, services have been provided by teams where the detoxification and counselling aspects of treatment have been fairly clearly separated.
- These costs include expenditures on alcohol-related problems and opportunities that are lost because of alcohol (NIAAA, 1991).
Relapse Prevention
- Therefore, treatment staff need to be trained to identify, monitor and if necessary treat or refer to an appropriate mental health specialist those patients with comorbidity which persists beyond the withdrawal period, and/or are at risk of self-harm or suicide.
- In this guideline these definitions of severity are used to guide the selection of appropriate interventions.
- Just like any other illness, it is ultimately the responsibility of the individual to learn how to manage it.
- Therefore, each client should develop a set of emergency plans for confronting any unforeseen situations that may arise.
Risk factors
- Whatever the reason for them, behavioral deficits are considered to be a significant obstacle to recovery from alcoholism (Miller and Hester 1989).
- People who are alcohol dependent and who have recently stopped drinking are vulnerable to relapse, and often have many unresolved co-occurring problems that predispose to relapse (for example, psychiatric comorbidity and social problems) (Marlatt & Gordon, 1985).
- This compound is processed further into smaller molecules, such as β-endorphin and adrenocorticotropic hormone (ACTH).
- Finally, clients are offered behavioral marital counseling as a means of reducing stress at home, improving communications within the family, and enhancing support for sobriety.
- With the possible exceptions of aversion therapy and cue exposure therapy, these various approaches have been found to be both effective and cost-effective.