The Spiritual Characteristics of New Zealanders Entering Treatment for Alcohol/Other Drug Dependence

This study describes the spiritual experiences, beliefs, and practices of New Zealanders entering intensive treatment for alcohol/ other drug dependence, and seeks to determine factors that influence spirituality in a clinical population. Ninety clients entering three residential treatment programs for alcohol and/or cannabis dependence were interviewed about their spiritual beliefs, behaviors, and experiences, using a broad selection of accepted measures.

A number of associations between aspects of spirituality and gender, ethnicity, age, employment, severity of dependence, and depression were found.

In particular, the more religiously active participants were less severely alcohol/other drug dependent, and depression was negatively associated with beliefs and activity related to 12-step participation.

Research; Michael P. Baker, J. Douglas Sellman, & Jacqueline Horn. The Spiritual Characteristics of New Zealanders Entering Treatment for Alcohol/Other Drug Dependence. Alcoholism Treatment Quarterly, Volume: 24 Issue: 4, 2006 Pages: 137 - 155

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Detoxification from alcohol abuse.

The alcohol withdrawal syndrome (AWS) is a common management problem in hospital practice for neurologists, psychiatrists and general physicians alike.

Although some patients have mild symptoms and may even be managed in the outpatient setting, others have more severe symptoms or a history of adverse outcomes that requires close inpatient supervision and benzodiazepine therapy.

Many patients with AWS have multiple management issues;

• withdrawal symptoms,
• delirium tremens (DT’s),
• the Wernicke–Korsakoff syndrome,
• seizures,
• depression,
• polysubstance abuse,
• electrolyte disturbances and
• liver disease,

These require a coordinated, multidisciplinary approach. Although AWS may be complex, careful evaluation and available treatments should ensure safe detoxification for most patients.

The alcohol withdrawal syndrome; Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:854-862, A McKeon, M A Frye, Norman Delanty.

See also;

• 12-Step Treatment More Effective than Alternative
• Brief-TSF can assist people cease alcohol consumption.
• Alcohol Related Brain Injury

Slaying the Dragon: The History of Addiction Treatment and Recovery in America by William L. White Read more about this title…

Seeking Help Could Quadruple the Likelihood of Abstinence

To quantify the effect of help seeking on recovery from alcoholism, researchers in the United States analyzed data from 4,422 adults who had participated in a nationally representative survey and developed alcohol dependence at least 1 year before their participation.

• Only 26 percent of subjects had ever sought help for their alcohol problems;
• 3 percent participated in a 12-step program only,
• 6 percent in formal treatment only, and
• 17 percent in both. 

Help seekers drank more and had higher lifetime prevalences of other drug use, mood disorders, and personality disorders than did subjects who had not sought help.

In analyses adjusted for potential confounders, help seeking significantly increased the likelihood of any recovery (odds ratio [OR] 2.4) and of abstinence (OR 4.0). Any recovery was defined as, in the past year, having no symptoms of alcohol abuse or dependence and either drinking low-risk amounts* or abstaining.

The odds of recovery were greater for those who had participated in 12-step programs with or without formal treatment than for those who had participated in formal treatment only.

Comments by Peter Friedmann, MD, MPH:

Even though they had more comorbidity and therefore were at risk for worse outcomes, seekers of formal and informal treatment had better odds of recovery from alcohol dependence. This study could not separate the motivation inherent in seeking help from the therapeutic effects of help received. However, help seeking—regardless of the patient’s level of readiness—should be encouraged. 

Research Reference: Dawson DA, Grant BF, Stinson FS, et al. Estimating the effect of help-seeking on achieving recovery from alcohol dependence. Addiction. 2006;101(6):824–834.

Brief-TSF can assist patients cease alcohol consumption.

Substance Use Disorders American Dental Association.

Research tells us that dentists are no more-or less-likely to develop substance use disorders (alcohol or drug abuse or dependence) than the general population. In other words, 10-15 percent of dentists will have a drug and/or alcohol problem sometime in their lives.

Substance use disorders are part of the human condition, and touch as many as one in four American families.

What IS different for dentists and other health professionals than for the general population is the public trust that goes with the privilege to practice, and the responsibility to obey the state dental practice acts and controlled substance regulations.

An untreated substance use disorder in a dentist can not only threaten the dentist’s life and family stability, but place patients, and the practice itself, in jeopardy.

More at; American Dental Association

The interplay between help seeking and alcohol related outcomes: divergent processes for professional treatment and self-help groups.

Summary:
This study examined the influence of self-selection on the duration of professional treatment and participation in Alcoholics Anonymous (AA) and the influence of social causation on alcohol-related outcomes.

A sample of alcoholics was surveyed at baseline and 1, 3, and 8 years later. Participants completed an inventory at each survey that assessed participation in treatment and AA since the last assessment and alcohol-related functioning.

There were divergent processes of self-selection and social causation with respect to the duration of participation in professional treatment and AA.

Individuals with more severe alcohol-related problems obtained longer episodes of professional treatment, but this self-selection process was much less evident for AA.

Longer participation in professional treatment in the first year predicted better alcohol-related outcomes, but the duration of subsequent treatment was not associated with better subsequent outcomes.

In contrast, longer participation in AA consistently predicted better subsequent alcohol-related outcomes.

The findings are consistent with a need-based model of professional treatment, in which more treatment is selected by and allocated to individuals with more severe problems, and an egalitarian model of self-help, in which needs play little or no role in continued participation.

Rudolf H. Moos and Bernice S. Moos. The interplay between help-seeking and alcohol-related outcomes: divergent processes for professional treatment and self-help groups. Drug and Alcohol Dependence 75(2):155-164, August 2004.

12 Step Programs Offer Broad Benefits, Study Says

A study of Alcoholics Anonymous and other 12-step oriented self-help programs finds that they can help most people recover from alcoholism, even those who are not religious or have mental-health problems.

The Pacific Institute on Research and Education (PIRE) reported that researchers tracked a group of 227 alcoholics over three years and found that those who had attended AA or other self-help programs after treatment had higher rates of abstinence, and drank less if they did relapse.

The results cut across gender and religious lines and held regardless of psychiatric history or whether the patient had previously attended AA or other similar programs.

"Here’s a widespread, chronic disorder that seems to respond well to an inexpensive resource — mutual-help groups such as AA," said study co-author Robert Stout, Ph.D., director of the Decision Sciences Institute at PIRE. "Not only do we need to get more addicts engaged in these groups, but we also need to gather evidence on this issue and make sure that the public, policy-makers and practitioners know about it."

Added co-author John F. Kelly: "There is a clear dose-response relationship: If you don’t go to any meetings, you have the worst outcomes. If you go to a few, you have a little bit better outcome, and if you go to a lot, you have an even better outcome." Kelly is the associate director of the Massachusetts General Hospital/Harvard Addiction Research Program.

The study was published in the August 2006 issue of Alcoholism: Clinical and Experimental Research.

Brief-TSF intervention training; how best to get alcoholics to AA.

Injury Risk Highest Among Binge Drinkers

Binge drinkers have a higher risk of alcohol-related injury than chronic, heavy drinkers, the Health Behavior News Service reported Feb. 22.

Binge-drinking women who otherwise drink in moderation had seven times the risk of injury as nondrinkers, while binge-drinking men increased their injury risk sixfold.

"It’s not only the amount of alcohol consumed that shapes the risk for injury, but also the usual consumption pattern," said study author Gerhard Gmel of the Swiss Institute for the Prevention of Alcohol and Drug Problems. "At highest risk are those who usually consume moderately but sometimes binge drink. This is true for both sexes."

The study was based on records from 8,736 people admitted to hospital emergency departments; researchers examined the relationship of injuries to average weekly alcohol consumption, binge-drinking episodes, and the amount of alcohol consumed prior to admission.

Gmel warned against prevention that focuses only on chronic drinkers, saying that many binge drinkers will be missed.

The research appears in the March 2006 issue of the journal Alcoholism: Clinical and Experimental Research.

From; Join Together Online

A NATURALISTIC COMPARISON OF OUTCOMES AT SOCIAL AND CLINICAL MODEL SUBSTANCE ABUSE TREATMENT PROGRAMS.

Since the 1970s, much of the public treatment system in California has been based on a social model orientation to recovery for alcoholics, but there has been minimal research on program outcomes. This article reports on follow-up interviews conducted with a representative sample of 722 people who had entered treatment about a year earlier in public and private programs, including publicly-funded social model detoxification and residential programs, and clinical model programs in hospitals and HMO clinics.

higher levels of 12-step program involvement during follow-up, which strongly predicted an absence of alcohol problems

• Social model clients came to treatment with more severe legal and employment problems, whereas those seeking treatment at clinical programs reported more severe family problems.
• At follow-up, clients at both types of programs reported attending a similar number of Alcoholics Anonymous (AA) meetings, but social model clients reported going to more Narcotics Anonymous (NA) meetings and being involved in more AA activities.
• Social model clients were less likely than clinical model clients to report problems with alcohol or drugs at follow-up, but the odds of reporting other problems (e.g., medical, psychological, legal, family/social) were similar.

The program effect for better alcohol outcomes at the social model programs was partially explained by their clients’ higher levels of 12-step program involvement during follow-up, which strongly predicted an absence of alcohol problems.

• Social networks supportive of abstinence also were predictive of reporting no alcohol problems at follow-up.

In contrast, subsequent detoxification treatment events between baseline and follow-up were associated with a higher odds of reporting alcohol, drug, psychiatric and family/social problems at follow-up.

These findings are consistent with the growing body of literature reporting higher rates of abstinence among those who are able to construct more positive social networks, and who attend and become involved in 12-step programs during and following treatment.

It is important that these results be replicated, as they suggest that social model programs are successful in engaging their clients in AA activities and in NA meeting attendance, and could represent for some an effective alternative to clinical model treatment programs.

Research; LEE ANN KASKUTAS, LYNDSAY AMMON, CONSTANCE WEISNER. A NATURALISTIC COMPARISON OF OUTCOMES AT SOCIAL AND CLINICAL MODEL SUBSTANCE ABUSE TREATMENT PROGRAMS. International Journal of Self Help and Self Care; Volume 2, Number 2 / 2003-2004, 111 - 133

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The aim of this study was to test the validity of the CAGE questions as a measure of severe drinking in subjects at drop-in centers for the homeless, using biological markers of acute liver reaction to alcohol as the “gold standard.”

A sample of homeless men and women in Copenhagen were invited to participate in a study of health problems. Subjects were interviewed and blood samples were taken and screened for indicators of

• liver dysfunction (gamma-glutamyltransferase [ GT],
• mean corpuscular volume [MCV],
• alanine aminotransferase [ALAT], and
• alkaline phosphatase [Alpase]), and
• hepatitis C [HCV].

Scores on CAGE correlated strongly with years of heavy drinking (rho = 0.43, p < 0.001), and while years of drinking did not correlate with biomarkers after controlling for multiple hypothesis testing, CAGE correlated with GT, Alpase and ALAT, but not MCV.

The correlations held even among those without HCV, but subjects with HCV + and CAGE > 1 had quite extreme values on liver markers.

Findings suggested that the CAGE was able to identify homeless drinkers whose drinking was significantly associated with increases in biomarkers associated with heavy drinking.

The CAGE as a Measure of Hazardous Drinking in the Homeless. Morten Hesse; Henrik Thiesen. American Journal on Addictions, Volume 16, Issue 6 November 2007 , pages 475 - 478

Brief-TSF can assist patients cease alcohol consumption.

AA works with bipolar disorder

A follow up study on alcoholics with and without coexisting affective disorder Three-hundred male alcoholics were selected from consecutive admissions to hospital. They were divided into three target populations:

• primary alcoholics;
• alcoholics with unipolar affective disorder; and
• alcoholics with bipolar affective disorder.

After three follow-up interviews over a 2-year period after hospital discharge, the three sub- groups reported differences in frequency of mood change, amount of treatment received, and hospital attendance, although there were no clear-cut differences in items associated with their alcoholism.

There were, however, some indications that bipolar patients functioned at a better level during the follow-up period, particularly those who were older, had a previous history of longer periods of abstinence, and maintained more frequent contact with Alcoholics Anonymous (AA) and their family doctor.

K O’Sullivan, C Rynne, J Miller, S O’Sullivan, V Fitzpatrick, M Hux, J Cooney and A Clare. (1998), A follow up study on alcoholics with and without coexisting affective disorder. The British Journal of Psychiatry 152: 813-819 (1988)