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Alcoholics Respond Best to Meds Plus Psychotherapy

Posted in Alcoholism Treatment

AlcoholDependentWomenMayHaveDecisionMakingDifficultyAlcoholism is commonly treated with options that include medication, support group participation and some form of counseling or psychotherapy. In many cases, these counseling or psychotherapy efforts last for a fairly extended amount of time. In a study published in November 2013 in the journal Alcohol and Alcoholism, a team of Finnish researchers sought to determine if recovering alcoholics benefit from a combination of medication and a brief intervention with psychotherapy. As their name implies, brief psychotherapeutic interventions take place over a short span of time, rather than over a course of weeks or months.

Alcoholism Treatment Basics

Typically, the ultimate goal of alcoholism treatment is to achieve complete abstinence from alcohol use (although some modern programs seek only to reduce alcohol intake to a lower, safer level). The U.S. Food and Drug Administration has approved three medications for use in supporting this goal: naltrexone, disulfiram and acamprosate. Naltrexone helps limit alcohol consumption and reduce cravings by blocking alcohol-related pleasure responses inside the brain. In the presence of alcohol, disulfiram produces highly unpleasant bodily sensations that can limit willingness to take a drink. Acamprosate lowers alcohol cravings by restoring some of the brain functions that typically decline in people affected by alcoholism.

The psychotherapeutic approach commonly used for treating alcoholism is known as behavioral therapy. During behavioral therapy, patients/clients learn how to do such things as understand their underlying motivations for drinking, recognize the situations that trigger alcohol consumption, develop the coping skills needed to respond to those situations without drinking and self-limit their overall alcohol consumption. Depending on his or her particular circumstances, a recovering alcoholic may receive therapy individually, with a spouse or partner, with his or her family, or in a group with others going through the recovery process. Some therapists use traditional therapeutic methods that require their patients/clients to attend a number of sessions over a fairly lengthy amount of time. However, others use some form of brief intervention.

Brief Intervention Basics

Therapists and other mental health professionals use the term brief intervention to describe a range of therapeutic approaches that take place in a short span of time rather than over the extended periods of time required for many forms of traditional psychotherapy. In some cases, these interventions take place in a face-to-face setting with a client/patient. However, they may also include the use of computer programs, booklets, pamphlets or other media that don’t rely on direct interactions between therapists and the individuals receiving treatment.

Usefulness in Alcoholism Recovery

In the study published in Alcohol and Alcoholism, researchers from five Finnish institutions assessed the effectiveness of a combination of medication and brief psychotherapeutic intervention as a treatment for people recovering from alcoholism (alcohol dependence). The 243 participants in the study were all voluntarily receiving treatment for alcohol dependence in an outpatient (non-hospitalized) program. A third of these participants took disulfiram, while another third took naltrexone; the remaining third of the participants took acamprosate. The members of all three of these groups also received a brief intervention-modified form of a psychotherapeutic approach called cognitive behavioral therapy (CBT). The method used for this intervention was a booklet detailing the CBT techniques used to modify an alcoholic’s dysfunctional, drinking-related reactions to stressful situations.

Each of the three groups received 12 weeks of medication-based treatment and the CBT booklet. For up to a year, the members of each group also received additional, periodic doses of medication. The researchers evaluated the mental and physical well-being of the study’s participants two and a half years after the year of additional treatment came to an end. They concluded that the acamprosate/brief intervention group, disulfiram/brief intervention group and the naltrexone/brief intervention group all experienced important reductions in their overall level of alcohol intake. All three of the groups also experienced additional beneficial effects such as improved sleep, lower reported levels of pain and improved mood (including a significant drop in depression symptoms). The members of all three groups also substantially lowered their participation in smoking; however, the disulfiram/brief intervention group decreased its smoking levels considerably more than the other two groups.

Significance

Based on their findings, the authors of the study published in Alcohol and Alcoholism concluded that, in combination with any of the three medications approved for alcoholism treatment, brief psychotherapeutic intervention aids the recovery process, brings important relief to recovery-related depression and helps promote a sense of wellbeing in its recipients.