Biomarkers in Alcohol Misuse: Their Role in the Prevention and Detection of Thiamine Deficiency
In Western countries alcohol misuse is the most frequent cause of thiamine (vitamin B1) deficiency (TD) and consequent neuro-impairment.
Studies have demonstrated that between 30 and 80% of alcoholics are thiamine deficient, and this puts them at risk of developing the Wernicke–Korsakoff (WK) syndrome.
The relative roles of alcohol and TD in causing brain damage remain controversial and it is important to try to determine the role played by each factor.
Animal studies support an additive effect of alcohol exposure and TD, and indicate the potential for interaction between alcohol and TD in human alcohol-related brain damage.
Early diagnosis of alcohol-related TD is therefore an important aspect of effective intervention and treatment.
Alcohol biomarkers provide a direct and indirect way of estimating the amount of alcohol being consumed, the duration of ingestion and the harmful effects that long-term alcohol use has on body functions.
Appropriate use of these markers is very helpful when considering a diagnosis of alcohol-related TD.
Research report; Rosanna Mancinelli, and Mauro Ceccanti. Biomarkers in Alcohol Misuse: Their Role in the Prevention and Detection of Thiamine Deficiency. Alcohol and Alcoholism 2009 44(2):177-182;
While the war on drugs continues to attract world attention, it is often overlooked that alcoholism remains a major worldwide health concern. No matter what your expertise, the Handbook of Alcoholism can help you acquire the necessary skills to treat problem drinkers and alcohol-dependent patients. In three sections;
Patient Care,
Research, and
Useful Data and Definitions
this comprehensive handbook not only addresses the underlying psychological problems of alcoholism, but helps you to better diagnose and treat the non-psychiatric medical disorders caused by the disease.
New medications for addiction treatment can significantly improve treatment outcomes for many patients, especially when combined with counseling, support and aftercare.
This free online course helps addiction treatment counselors understand how these medications work with the brain mechanisms involved in alcohol dependence, and how medications can be part of a comprehensive treatment program that helps patients regain control over their lives.
Main Presentation, Part 1 An overview of alcohol dependence, focusing on the epidemiology of alcohol dependence, diagnosing alcohol dependence and misuse, and the effects of alcohol on the brain. We also introduce medications for alcohol dependence.
Main Presentation, Part 2 Psychosocial interventions for the treatment of alcohol dependence; how medication and psychosocial intervention impacts abstinence; and patient readiness for change.
Case Studies Examples of real-life situations that may be faced when counseling patients for alcohol abuse, designed to illustrate how both psychosocial support and medications can work together to help patients maintain abstinence.
Patient Education Materials (PDF, 372K) These full-color materials are designed to educate and assist patients with alcohol dependence.
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.
Whether clients or counselors, students or teachers, we are all imperfect human beings. We are here because we have a yearning to grow.
And the strongest motivator for growth is pain. When we are significantly harmed or deprived mentally, emotionally or physically and have no safe people or role models to help us understand and rebound or heal, our mind creates defense mechanisms and coping strategies to hide our real pain and vulnerability.
This may serve us well over a short time period, but backfires in a longer time frame. When we become habituated to our means to hide painful reality, we forget our true self behind the fabrications.
Psychotherapy is a unique relationship, a kind of connection that is unlike any other kind of relationship a person has in their life. In some ways, it can be more intimate than our most intimate relationships, but it also paradoxically values a vestige of professional distance between therapist and client.
Therapists, alas, are just as human as the clients they see and come with the same human foibles. They have bad habits, as we all do, but some of those habits have the very real potential of interfering with the psychotherapy process and the unique psychotherapy relationship.
So without further ado, here are twelve things you wish your therapist didn’t do — some of which may actually harm the psychotherapeutic relationship.
Showing up late for the appointment.
Eating in front of the client.
Yawning or sleeping during session.
Inappropriate disclosures.
Being impossible to reach by phone or email.
Distracted by a phone, cell phone, computer or pet.
Expressing racial, sexual, musical, lifestyle and religious preferences.
Bringing your pet to the psychotherapy session.
Hugging and physical contact.
Inappropriate displays of wealth or dress.
Clock watching.
Excessive note-taking.
Full story and expansion of these annoyances at PsychCentral
Professional Interventions That Facilitate 12-Step Self-Help Group Involvement.
Facilitating patients’ involvement with 12-step self-help organizations, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), is often a goal of substance abuse treatment.
Twelve-step-facilitation (TSF) interventions have been found to be more effective than comparison treatments in increasing patients’ 12-step group involvement and in promoting abstinence.
Future TSF evaluation research should address the effectiveness of incorporating TSF interventions with cognitive-behavioral treatment methods, the relative impact of brief versus extended TSF interventions, and the cost-effectiveness and health care cost-offset of TSF interventions within managed health care systems.
Although the United States has developed an extensive array of professional alcohol treatment services over the past 30 years, the peer-led, voluntary fellowship known as Alcoholics Anonymous (AA) continues to be the most widely accessed resource for people with alcohol problems (McCrady and Miller 1993).
This article discusses the rationale for interventions that facilitate alcohol-dependent patients’ affiliations with AA and related mutual-help organizations (e.g., Narcotics Anonymous [NA]).
The article also reviews recent research comparing those interventions with other treatment methods.
Research; Professional Interventions That Facilitate 12-Step Self-Help Group Involvement. Journal article by Keith Humphreys; Alcohol Research & Health, Vol. 23, 1999
See also;
Twelve Step Facilitation is designed to support people returning to their community
Five-year follow up for sobriety in a cohort of men who had attended an Alcoholics Anonymous programme in India.
BACKGROUND: There are little data from India on the long term follow up of patients with alcohol dependence who have undergone a de-addiction programme.
A cohort of patients who completed a detoxification and de-addiction programme based on the Alcoholics Anonymous model were followed up for a period of 5 years.
METHODS: A cohort design was used. A community outreach programme of a de-addiction centre was the setting for the study.
One hundred and eighty-two patients who completed a detoxification and de-addiction programme based on the Alcoholics Anonymous model were followed up. Sobriety at 5 years’ of follow up was the outcome measure.
RESULTS: One hundred and fifty-one (83%) patients were followed up at 5 years.
The majority (90; 59.6%) did not change their alcohol consumption and
a small minority (25; 16.5%) remained completely sober over the 5-year period.
Sobriety at 1 year was significantly associated with complete abstinence at 5 years (chi2 = 53.8; df = 1; p < 0.001).
More patients coming from distant places (RR 0.84; 95% CI: 0.71, 0.98; p < 0.03) and
those with health workers in their localities (RR 0.81; 95% CI: 0.68, 0.96; p < 0.01) were completely abstinent.
These variables were also significantly associated with sobriety even after adjusting for other confounders using logistic regression.
CONCLUSION:. The results of the 5-year outcome are modest.
More patients coming from distant places and those with health workers in their localities remained completely abstinent suggesting the possible role of the individual’s motivation and the need for continued community support in maintaining sobriety.
Research; Kuruvilla PK, Jacob KS. Five-year follow up for sobriety in a cohort of men who had attended an Alcoholics Anonymous programme in India. Natl Med J India. 2007 Sep-Oct;20(5):234-6.
See also;
Twelve Step Facilitation is designed to support people returning to their community
I’ll Quit Tomorrow: A Practical Guide to Alcoholism Treatment
Nine Elements of Effective Alcohol Treatment for Adolescents
Anger Management For Dummies (For Dummies (Psychology & Self Help))
Facilitating patients’ involvement with 12-step self-help organizations, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), is often a goal of substance abuse treatment. 
