Approximately 90% of the alcohol addicted people in treatment relapse.
Today I’m going to provide information on how to improve alcohol addiction recovery rates.
It’s called Moderation.
Moderation rather than abstinence as a method of keeping one’s “disease” in check is becoming an option in the emerging area of alternative methods of treatment of alcoholism.
In certain cases, ‘moderation’ is the best way for people who currently feel they drink too much, to get their drinking under control.
I realize I could be going against the engrained brain right now because for many decades organizations and programs as well as the medical community have touted the idea that “alcoholism is an incurable disease, with abstinence as the only way to “treat” the disease.
But I disagree.
So, let’s look at how that ‘idea’ got started.
It’s called influence and influence is big, I know I was in advertising for 20 years. Companies every day create a problem that their product solves. And that is what happened with term “alcoholism”.
Early in the 20th Century, the validity of the disease concept was often debated in medical circles. However, in 1956 the American Medical Association proclaimed alcoholism an “illness,” then in 1966, a disease. The decision was embroiled in controversy. Historically, Marty Mann one of the first female members of AA was pro-disease model and according to the Baldwin Research Institute, manipulated information and doctors into agreeing with the disease concept. Mann also helped start the Yale School of Alcohol Studies). She used her position as founder of the National Counsel for Alcoholism to promote the disease concept. The founder of National Institute of Alcohol Abuse and Alcoholism (NIAAA), R. Brinkley Smithers, and financier of the modern alcoholism movement, was a major contributor to, and promoter of, the disease concept as well. It was his money that actually funded the Yale studies. Smithers was also responsible for gaining insurance coverage for patients in treatment (hence the 28 day program model).
Acceptance by the medical community was the only way this could happen; alcoholism had to be a medical problem (a disease) in order for medical insurance to pay for programs. We can see the influence of these “advances” everyday in treatment programs. Today, treatment is a multi-billion dollar industry, with insurance paying the lion’s share of the costs. **
DEPENDENCY VS DISEASE
Let’s set the idea that alcoholism isn’t a disease, then what is it?
What about being ‘temporarily alcohol dependent’? Let’s define dependent.
According to Webmd.com, you might be dependent on alcohol if you have three or more of the following
- You cannot quit drinking or control how much you drink.
- You need to drink more to get the same effect.
- You have withdrawal symptoms when you stop drinking.
- You spend a lot of time drinking and recovering from drinking
- You have tried to quit drinking or to cut back the amount you drink but haven’t been able to.
- You continue to drink even though it harms your relationships and causes physical problems.
From a behavior change therapist point of view these are treatable. TELL HOW I WOULD DO THIS. There is no difference between someone trying to quit smoking or someone with a food addiction. There are always physical, emotional and mental aspects to all dependencies and when you address all three, behavior naturally changes and the body becomes healthy again. It is our natural state to be healthy.
Helping the person overcome an addiction, no matter the substance, is possible when you get to the source of the dependency. What ‘need’ is the substance attempting to fill is the first question to ask. If someone you know drinks every day, there is most certainly an emotional reason why. And subsequently the body has become addicted to the chemical response. But that is a learned response. Anything learned can be un-learned.
When helping the dependent person see their “addiction” in terms of a “dependency” it shifts them to the idea that when they confront the emotional issues triggering the dependency, there is a new response.
People, who are labeled as having an incurable disease, usually conform to the standards that labels indicate, whether the diagnosis is correct or not. It’s dangerous ground that is commonly tread upon by treatment professionals and organizations today.
If this disease is incurable that person is then always an alcoholic even if they are not drinking. That hardly seems fair. Most dry drunks turn to over-smoking, all day coffee drinking or violent behavior. Calling it a disease strips the dependent individual from self-empowerment and thus the ability to get well.
Moderation vs Abstinence
When you take the alcohol dependent person away from the environment where the substance and emotional triggers are prevalent and place them in a 28-day treatment program, there is short-term success. However if the underlying emotional causes that lead to drinking are not addressed, that person may go back to drinking when triggered. It is called relapse and a failure. I don’t believe that is a fair assessment because it leaves the person feeling defeated so they either go in and out of treatment just like a cancer patient on chemo, or resign to drink because it is too hard to quit using only their willpower.
Attempting to give up alcohol completely results in a +-90% failure rate. What can we do about it?
The answer is moderation… But does this work? I have worked with enough people over the years to say, yes it does. So I was delighted when I found this study from 1966.
Dr. Ernest Noble director of the NIAAA and the Rand Corporation jointly— concluded that many alcoholics eliminate alcohol dependence while continuing to drink. [moderation]. However on the morning of the release of the Rand report, the National Counsel for Alcoholism convened a press conference to attack the results. Under pressure from the NIAAA, Noble issued a press release questioning the Rand results and strongly urging, “that abstinence must continue as the appropriate goal in the treatment of alcoholism.”
Abstinence is right for some, but not all. And the “not all” group that gets put in the abstinence group fail, thus the large number of “relapse.” I work with clients in the “moderation area” these are people that drink daily and are worried about the negative consequences of continuing to do so. Releasing the dependence allows a person to be in control of the emotional connection to drinking. My story of how I did this is in my upcoming book, Licking Honey Off A Razor Blade.
NEW MOVEMENT, NEW ALTERNATIVES
Between 1.4 and 2 million Americans seek treatment per year and with recovery rates at only -+ 10% therapists have become frustrated and are developing unique approaches to these very unique people. Things are starting to change.
Excerpt from NY Times: The Center for Motivation and Change uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for people to take.
Excerpt from The Sober Truth by Dr. Lance Dodes
AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors, employers, and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model.
Excerpt from NPR story on Betty Ford Center: For decades, inpatient rehab has been one of the go-to treatments for substance addiction. Nearly two million Americans seek treatment for addiction each year, but there’s a movement in the medical community to change how we perceive the condition — and how to treat it.
Recovery vs Relapse
When you go into the program they tell you Relapse is a part of recovery. And perhaps why the relapse rate is so high.
Relapse is defined as the resumption of alcohol drinking following a prolonged period of abstinence. Events that trigger relapse according to a study by Dr. Howard Becker state “exposure to alcohol-related conditioning, cues or environmental contexts, and stress.” These are the triggers I referred to earlier.
Dr. Becker wrote:
Researchers have been turning their attention to the evaluation of changes in withdrawal symptoms that extend beyond physical signs of withdrawal—that is, to those symptoms that fall within the domain of psychological distress. This new focus is clinically relevant because these symptoms (e.g., anxiety, negative affect, and altered reward set point) may serve as potent instigators driving motivation to drink.”
This is good news.
A NEW WAY TO MEASURE RECOVERY.
Rather than measuring not drinking, why not measure increases in healthier habits like water intake, eating nutritious food, stress management, exercise, and other outlets for increasing serotonin, self empowerment, feeling in control and purposeful.
As a person becomes healthier mentally, emotionally and physically, the desire for alcohol fades.
The online magazine, The Fix published an article about study of addiction recovery and the idea that addiction is about “trapped feelings”. They used caged indoor isolated rats who choose herion when both herion and food where offered, however when free to roam outdoor in a larger space and amongst other rats they choose food (even in the presence of herion) and these where the same “herion addicted” rats.
HYPNOSIS THE ‘ALTERNATIVE’ ALTERNATIVE
WHAT IS HYPNOSIS?
Shifts the focus to the positive. Law of Dominate Effect.
Hypnosis is the main approach to dependency at The Flow Center. Our concept integrates healing into one’s current environment. In some cases we would advise otherwise, however the majority of our clients can achieve freedom from dependency while continuing in their current profession or family setting.
This allows us to remove triggers that are causing the behavior as opposed to moving someone to a separate place only to return to the same situation and trigger the need to drink again.
While in the program we manage anger, stress, frustration, socio economic issues, with hypnosis, family counseling, energy healing, detox and nutritional counseling as well as after care support.
This program emphasizes one’s ability to recognize and take responsibility for their choices, and ultimately to assume responsibility for every aspect of their life. In doing so they move toward a greater connection with their true self, greater connectedness with others and with the world around them.
Real Reasons to Drink From Real Daily Drinkers.
- Dan to calm his anger toward co-workers
- Cliff because of stress of his relationship, couldn’t’ get out, couldn’t stay in
- Bill to deal with job loss worries and aging partner
- Lisa because she didn’t feel worthy
- Nancy to more enjoy the endless social events that dotted her calendar
- Emily because of a learned behavior (watched mom use it to deal with difficulties)
HOWARD C. BECKER, PH.D., is a professor in the Departments of Psychiatry and Neuroscience, Medical University of South Carolina & VA Medical Center, Charleston, South Carolina.
National Institute of Alcohol Abuse and Alcoholism/National Institute of Health
Baldwin research institute and St Jude Retreats. An independent alcoholism and drug addiction research organization
KERA’s Think program with Kris Boyd-Dr. Lance Dodes, The Sober Truth, Debunking the Bad Science Behind 12-step programs and the Rehab Industry (Beacon Press) 4-14-14