On any given day in the United States, one million people are in treatment for alcoholism or drug addiction. It is not getting into treatment, however, that makes the difference. Instead, it is what a person gets out of treatment. The fact that many people do not find success in treatment on their first attempt is due in part to a lack of understanding about what makes effective treatment.

The ten effective elements of treatment are;

1. There is no treatment formula that will work for everyone.

2. Medically supervised withdrawal is only one step in addiction treatment; alone it will do little.

3. Length of treatment counts

4. Drug addiction is a multidimensional problem, and treatment needs to address all of an individual’s needs

5. Counseling (individual and/or group) is a critical part of effective addiction treatment.

6. Medications are an important part of treatment for many people.

7. Drug testing during treatment is important.

8. Alcoholics and addicts with mental health disorders should be treated for both at the same time.

9.Addiction Treatment works even for people who don’t choose it of their own free will.

10. Don’t give up.

As with other chronic illnesses, relapses can occur during or after successful treatment episodes. Addicted individuals may need lengthy treatment and more than one time in treatment before they can enjoy long-term abstinence and full restoration to a drug free life. The period after treatment is just as important as being in treatment. Finding support and continuous work to stay drug free will be necessary. A slip or relapse is just an indicator that more work, and possibly more treatment, is necessary. Don’t give up.

Full story at Recovery Today

See also;

• AA and Treatment Work Better Together
• AA Offers Recovery Not Religion
• If you have healthcare training this manual may help.

Brief Intervention as a Bridge to AA

Brief Intervention Is Insufficient for Medical Inpatients With Unhealthy Drinking

Data show that brief intervention reduces consumption and consequences among outpatients with unhealthy, but not dependent, alcohol use. To assess whether brief interventions work among medical inpatients with unhealthy drinking,* researchers randomized 341 of such patients to a 30-minute session of motivational counseling in the hospital or to usual care.

Most subjects had alcohol dependence, were unemployed during the previous 3 months, used other drugs, and had substantial psychiatric symptoms. Almost half were hospitalized for an alcohol-related medical diagnosis.

At 3 months among subjects with alcohol dependence, similar proportions of the intervention and control groups received alcohol assistance (e.g., specialty treatment) (49% and 44%, respectively).

At 12 months among all subjects, decreases in alcohol consumption did not significantly differ between the groups (e.g., adjusted mean decreases in drinks per day, 1.5 for intervention subjects and 3.1 for usual care subjects).

Comments:

Unlike most brief intervention studies in outpatients, this study enrolled a predominantly alcohol-dependent sample with major comorbidities—a group reflective of the treatment-resistant population identified when screening occurs in inpatient settings. The study suggests that screening, assessment, and brief counseling are necessary but not sufficient to change alcohol consumption in this population. Although the findings are disappointing, this study underscores that alcoholism—like cancer, atherosclerosis and other complex diseases—will not succumb to simple solutions.

References: Saitz R, Palfai TP, Cheng DM, et al. Brief intervention for medical inpatients with unhealthy alcohol use: a randomized controlled trial. Ann Intern Med. 2007;146(3):167–176.

• Brief-TSF extends brief intervention to lifelong recovery.

What can be confidently said about AA in general and about the role of spirituality in AA in particular?

• First, there is convincing evidence that alcoholism severity predicts later AA attendance.
• Second, atheists are less likely to attend AA, relative to individuals who already hold spiritual and/or religious beliefs. However, belief in God before AA attendance does not offer any advantage in AA-related benefits, and atheists, once involved, are at no apparent disadvantage in deriving AA-related benefits.
• Third, the spiritually-based principles of AA appear to be endorsed in AA meetings regardless of the perceived social dynamics or climate of a particular meeting, eg, highly cohesive or aggressive.
• Fourth, significant increases in spiritual and religious beliefs and practices seem to occur among AA-exposed individuals.
• Fifth, in spite of much discussion to the contrary there is little evidence that spirituality directly accounts for later abstinence.

We are finding, however, that spirituality has an important indirect effect in predicting later drinking reductions. Specifically, in the past 20 years a number of effective methods have been developed to facilitate initial AA attendance. Such as Brief-TSF.

Interventions that lead to initial increases in spirituality appear to lead to sustained AA affiliation, which, in turn, produces sustained recovery over time.

Research; Tonigan JS. Spirituality and alcoholics anonymous. South Med J. 2007 Apr;100(4):437-40.

See also;

• What About This Spiritual Awakening Thing?
• 12-Step Treatment More Effective than Alternative
• Bill W.Biography
• 12 Steps and Post Traumatic Stress
• Psychology Books

Women Physicians and Addiction.

Doctors get addicted just like other people and female doctors have earlier addiction and develop worse medical conditions.

Researchers compared case histories of 969 male and female (13%) substance dependent doctors. Their conclusions; “These findings suggest different characteristics between male and female impaired physicians which may have implications for identification and treatment of this population.”

The comparison revealed that females;

• Were younger by 4 years (mean 40 years)

• Had 15% more medical problems (49%), and

• 13% more psychiatric issues (76%)

• More past suicidal ideation (52% v 30%), and

• Current suicidal ideation (11% v 5%)

• Had attempted more suicides (20% v 5%) while intoxicated, and

• Had attempted more suicides (14% v 2%) while clean or sober

• Mainly abused alcohol, but

• Were more likely to use hypnotics (11% v 6%)

• Employment and legal problems (65% and 18% respectively) were similar in both genders

Research report; Women Physicians and Addiction. Martha J. Wunsch, Janet S. Knisely, Karen L. Cropsey, Eleanor D. Campbell, Sidney H. Schnoll. Journal of Addictive Diseases, Volume: 26 Issue: 2

Bloggers comment; This research mainly parallels sex differences in the general population which shows that women suffer earlier addiction and greater medical problems.

Nine Elements of Effective Alcohol Treatment for Adolescents

In evaluating a broad spectrum of treatment programs and approaches, researchers have identified common themes among the treatments that are most effective in helping teens. Drug Strategies, a Washington-based nonprofit research institute that promotes more effective approaches to the nation’s drug problems, found these key elements in an extensive review.

http://www.ensuringsolutions.org/resources/resources_show.htm?doc_id=336617&cat_id=989

Publisher

• Ensuring Solutions to Alcohol Problems
• George Washington University Medical Center
• Website: http://www.ensuringsolutions.org/

The Process of Reconnecting: Recovery from the Perspective of Addicted Women

This study examined women’s experiences with addiction to drugs and/or alcohol and their process of recovery. The techniques of in-depth interviews and participant observations were employed to elicit the perspectives of the women. The study consisted of 12 participants, 6 who were currently involved in a 90-day community-based drug and alcohol treatment program and 6 who had more than five years of recovery.

Grounded theory method guided data collection and analysis. The women in this study described experiences of connectedness and disconnectedness throughout their lives, their addiction, and their recovery. The researcher constructed a substantive theory and model to explain this process of connectedness and disconnectedness.

The findings support that making connections and establishing healthy relationships play a significant role for women in achieving sobriety and maintaining recovery.

Research; The Process of Reconnecting: Recovery from the Perspective of Addicted Women. Carolynn Masters & Dorothy S. Carlson. Journal of Addictions Nursing, Volume 17, Issue 4 December 2006 , pages 205 – 210

Alcohol Screening and Brief Intervention in Primary Care Settings

Michael F. Fleming, M.D., M.P.H.

Primary care practitioners are in a unique position to identify patients with potential alcohol problems and intervene when appropriate. Screening, the process by which practitioners can identify at-risk drinkers, can be followed by one-time or repeated short counseling sessions, known as brief interventions, which are designed to help the patient reduce drinking and minimize related problems. Varied levels of screening and brief intervention can be implemented in the primary care setting, depending on patient and physician factors. Although screening and brief intervention are valuable tools, they are underutilized in primary care practices. Strategies that may help increase physicians’ use of these techniques in the primary care setting include skills-based role-playing, performance feedback, clinical protocols, clinic-based education, and training by credible experts.

Full text available at; http://pubs.niaaa.nih.gov/publications/arh28-2/57-62.htm

Al-Anon offers new life

AA’s 12-Step Recovery Program

Alcohol and Anxiety

Alcohol Problems Database

Alcoholic Defence Mechanisms

Alcoholics Anonymous and Nursing

An Introduction to Medication for Alcohol Dependence

Anti-craving Drugs

Binge Drinking & Brain Damage

Brain Damage & Cirrhosis

Brief-TSF Description

Brief-TSF Learning Objectives

Characteristics of Children of Alcoholic

Controlled drinking?

Counselling and the 12 Steps of AA

Counsellor Characteristics

Craving Reduction

Depression & 12-Step Programs

Effects of Gambling Addiction

Elderly Substance Abuse

Families, Mental Health & Alcohol abuse

Female Victims of Child Abuse

Five Alcoholism Subtypes

Free Training Alcoholism Anti-craving Medications

Gender Matching Hypothesis in Alcohol Treatment

Healing through Social and Spiritual Affiliation

How Alcoholics Anonymous is changing

How do alcoholics get to AA?

Humility and Surrender

Nutritional Therapy in Alcoholic Liver Disease

Painkiller abuse

Phases of Recovery from Alcoholism

Readiness to Change Profiles

Recovery through the Twelve Steps

Research Evidence for TSF

Risky Partners and Domestic Violence

Slogans for everyday life in AA

Spiritual Assessment

Spirituality in Alcoholism Recovery

Stages of an Eating Disorder

Strategies for Dealing With Denial

Symptoms of alcoholism

The 12-Steps Promote Acceptance of Addiction

The Personality Traits of Alcoholics

Treating Alcoholism as a Chronic Disease

TSF Description

Twelve step programs

What about partners of alcoholics?

Women and the Twelve Steps of AA

World view change in Adult Children of Alcoholics

• Subscribe to Twelve Step Facilitation by e-Mail

Prevalence of alcohol and drug use in a highly educated workforce.

This study examined alcohol and licit and illicit drug use in a highly educated medical related workforce.

A comprehensive health survey of a 10% random sample of a workforce (n = 8,567) yielded a 60% response rate (n = 504) after accounting for 15 undeliverable surveys.

• Many respondents reported past-year use of alcohol (87%).
• Thirteen percent of respondents consumed three or more drinks daily; 15% were binge drinkers.
• Twelve percent of the workforce was assessed as having a high likelihood of lifetime alcohol dependence;
• 5% of respondents met criteria for current problem drinking.
• Overall, 42% reported using mood-altering prescription drugs (analgesics, antidepressants, sedatives, or tranquilizers).
• Eleven percent reported using illicit drugs (cocaine, hallucinogens, heroin, or marijuana) in the past year.

Significant relationships were found between gender, age, ethnicity, and occupation with some measures of alcohol consumption and use of mood-altering drugs.

These results indicate prevention and early intervention programs need to address use of mood-altering substances (including alcohol) in highly educated workforces.

Research; J Behav Health Serv Res. ;29(1):30-44. Prevalence of alcohol and drug use in a highly educated workforce. Matano RA, Wanat SF, Westrup D, Koopman C, Whitsell SD.

See also;

• Brief-TSF is designed to address these issues.

Staying Sober: A Guide for Relapse Prevention by Terence T. Gorski, Merlene Miller Read more about this title…

• Early detection, including screening and brief interventions (for nondependent problem drinkers)
• Comprehensive assessment and individualized treatment plan
• Care management
• Individually delivered, proven professional interventions
• Contracting with patients
• Social skills training
• Medications
• Specialized services for medical, psychiatric, employment or family problems
• Continuing care
• Strong bond with therapist or counselor
• Longer duration (for alcohol dependent persons)
• Participation in support groups
• Strong patient motivation

Research Sources: McLellan, T.A. 2002; Miller,W.R. 2002; National Institute on Drug Abuse. 1999; Project MATCH Research Group. 1997.

Active participation in a support group can contribute to long-term recovery.

Project MATCH and other studies in the 1990s definitively proved that AA can be an active ingredient of treatment both during a professional intervention and afterward, depending on the patient’s type of therapy.

Patients who joined the AA fellowship or who had an AA sponsor after receiving twelve step facilitation therapy had better abstinence records than those who received an intervention but did not continue their AA participation upon completion.

Other research indicates AA participation may be less effective for patients who receive cognitive behavior therapy because the programs have different goals that may confuse patients.

What researchers still don’t understand, however, are the precise mechanisms of AA participation.

While AA affiliation is associated with self-efficacy, motivation and coping efforts, all significant predictors of good outcome following a professional intervention, some studies have shown that patients who adopt more of the fellowship’s basic tenets – such as acknowledging that alcoholism is a disease, admission of their powerlessness over alcohol and working the twelve steps of the program – relapse at the same rates as patients who adopt very few.

This suggests that the active ingredient may be less about AA per se than continuing participation in support groups that promote a lifestyle inconsistent with the problematic use of alcohol and other drugs.

From; www.ensuringsolutions.org

Brief-TSF is designed to support active participation in Alcoholics Anonymous.