Alcoholics Anonymous is the most widely used treatment for alcoholism. It is mandated by the courts, accepted by mainstream medicine, and required by insurance companies. AA is generally assumed to be the most effective treatment for alcoholism, or at least “an” effective treatment. That assumption is wrong.

We hear about a few success stories, but not about the many failures. AA’s own statistics show that after 6 months, 93% of new attendees have left the program. The research on AA is handily summarized in a Wikipedia article. A recent Cochrane systematic review found no evidence that AA or other 12 step programs are effective.
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The 1992, the National Institute on Alcohol Abuse and Alcoholism’s National Longitudinal Alcohol Epidemiologic Survey studied 42,000 Americans. 4500 had been dependent on alcohol at some time in their lives. Of these, only 27% had had treatment of any kind, and one-third of those who had been treated were still abusing alcohol. Of those who had never had any treatment, only one-quarter were still abusing alcohol. George Bush is a well-known example of someone who stopped drinking on his own without attending AA and without admitting that he was an alcoholic.

To me what matters is finding solutions that work. It is known that the success rates for treating addiction are not great no matter what treatments are used. We certainly should be doing more study of the effectiveness of various treatment methods to improve the success rates people experience. The impact on people’s lives is too large to rely on whoever markets better to end up being the deciding factor.

Related: How Effective is Drug Addiction Treatment? from the NIH – Combination Strategy to Treat Alcohol Dependence – Results of 4 Year Study of Women in Drug Treatment

Green-Milon’s apparent success in overcoming her addictions is all too rare, experts say. Only about a tenth of the 24 million Americans who need drug treatment get it, according to the National Institute on Drug Abuse, and at least half of them relapse.

Part of the challenge, scientists say, is that addiction, like heart disease, high blood pressure and diabetes, is a chronic condition; it changes the chemistry of the brain. But there’s another hurdle that’s getting attention: treatment programs, with their voice-mail systems and multiple forms to fill out, aren’t very patient-friendly, especially to people whose lives present many barriers to staying in treatment.

A national program, based at UW-Madison, is trying to change that by bringing process improvements to drug treatment. The Network for the Improvement of Addiction Treatment, or NIATx, attempts to get addicts into treatment quicker and retain more of them by making the programs more appealing.
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24 million Americans need treatment for illicit drug or alcohol problems.
2.5 million get the treatment they need.
The economic cost of substance abuse exceeds $500 billion a year (including alcohol and tobacco; for just illicit drugs, it’s $181 billion).

The NIATx (formerly know as the Network for the Improvement of Addiction Treatment) at the University of Wisconsin – Madison is focused on improving the success of addition treatment.

Use what you learned in Walk-through exercises (See the NIATx Conducting a Walk-through guide for guidance) to identify problems in processes within your organization from the clients’ point of view. Consider changes to test based on that experience. Prior to starting, you should decide the parameters of the change project, including where (e.g., location) you wish to introduce the change, as well which clients (e.g., level of care, population) you expect to impact.

The PDSA Cycle is an efficient way to learn what will work in your organization, and should be the foundation of every change you make. The PDSA Cycle begins with a Plan, and ends with Action based on the learning gained from the Plan, Do, and Study phases of the cycle

They also offer many case studies on improvement successes by treatment centers.

Related: How Effective is Drug Addiction Treatment? – Center for Substance Abuse Treatment – Methods to Treat Addiction

McLean Hospital researchers, along with colleagues from 11 other study sites nationwide, report that the medication naltrexone and up to 20 sessions of alcohol counseling delivered by a behavioral specialist are equally effective treatments for alcohol dependence when delivered with structured medical management in the Journal of the American Medical Association.

Results from the National Institutes of Health-supported Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study show that patients who received naltrexone, specialized alcohol counseling, or both demonstrated the best drinking outcomes after 16 weeks of outpatient treatment. All patients also received Medical Management, an intervention that consisted of nine brief, structured outpatient sessions provided by a health care professional. Contrary to expectations, the researchers found no effect on drinking of the medication acamprosate and no additive benefit from adding acamprosate to naltrexone.

“This was the largest clinical trial looking at the effectiveness of pharmacologic and behavioral treatments for alcohol dependence ever conducted and the results are promising,” said Roger Weiss, clinical director of the Alcohol and Drug Abuse Treatment Program for McLean Hospital, a Harvard Medical School affiliate. Weiss was also the principal investigator of COMBINE for the McLean study site.

Related: Why Can’t Drug Addicts Quit on Their Own? – Methods to Treat Addiction

Masekela’s message for ‘addictive’ SA

One of the biggest names in world music – trumpeter Hugh Masekela – has said the message behind his latest album Time is to help the fight against drug and alcohol addiction in his native South Africa.

Masekela himself is a recovering addict, having gone into rehabilitation six years ago before establishing an organisation to help those with similar problems in his homeland. And he told BBC World Service’s The Ticket programme that he felt a duty to help others suffering from the same problems.
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“I myself am a recovering addict and alcoholic. Six years ago I came to England, took up counselling, and learned the psychology of addiction.”

Drug-busting Masekela calls a brave new tune

The project, called the Musicians and Artists Assistance Programme of South Africa (Maapsa), is a partnership between several South African celebrities, including musicians Jabu Khanyile and Family Factory, actress Connie Masilo and talkshow host Felicia Mabuza-Suttle. Masekela said: “This organisation will make South Africans aware that addiction is a dynamite powder-keg. In South Africa, people are often praised for being able to drink a lot. They think drinking is something to be proud of.”
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Victor Ntoni, another respected musician, said alcohol and substance abuse among musicians was exacerbated by the increasing exploitation of artists in South Africa.
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Mabuza-Suttle, one of the trustees of Maapsa, said that because she came from a background of alcoholism, she knew about the devastating effects of addiction on families.

Hugh Masekela Biography

As the brutality of the Apartheid state increased, Hugh finally left the country with the help of Trevor Huddleston and his friends Yehudi Menuhin and Johnny Dankworth who got him admitted into London’s Guildhall School of music. Miriam Makeba who was already enjoying major success in the USA later helped him with Harry Belafonte, Dizzy Gillepsie and John Mehegan to get admission to the Manhattan school of Music in New York. Hugh finally met Louis Armstrong who had sent the Huddleston Band a trumpet after Huddleston told the trumpet king about the bank he helped start back in South Africa before deportation.

With immense help from Makeba and Belafonte, Hugh eventually began to record, gaining his first breakthrough with “The Americanization of Ooga-Booga” produced by the late Tom Wilson who had been producer of Bob Dylan and Simon & Garfunkel’s debut successes. Stewart Levine his business partner in Chissa Records went on to produce hit records for Hugh on Uni Records, beginning with “Alive and Well at the Whisky” in 1967 and then “”Promise of A Future” which contained the gigantic hit song “Grazing in the Grass” in 1968.

By the beginning of the 1970’s he had attained international fame, selling out all of America’s festivals, auditoriums and top nightclubs. Heeding the call of his African roots, he moved to Guinea, then Liberia and Ghana after recording the historical “ Home is where Music is” with Dudu Pokwana.

photo from Ritmo Artists

Related: Winehouse to Rehab – Yes, Yes, Yes – Eva Mendes on Rehab

The Discovering Alcoholic is the blog of a “recovering alcoholic clean and sober without relapse since the fall of 94″

I am a member of a substance abuse task force, hold a recovery class every week at a local methadone clinic, always have at least one or two alcoholics/addicts to which I act as a sponsor, and of course there is TDA. I have found through my efforts of attempting to help others that my own spirituality, confidence, and appreciation of life greatly increases.
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The key is to know oneself better, understand what pulls the trigger, and to adapt one’s lifestyle and actions into a preventative maintenance program. And it’s not only about staying sober; When you apply these same lessons and the confidence gained in recovery to other aspects in life (business, relationships, parenting), you cannot but help to feel empowered.

The author does a good job of sharing his journey in daily posts. Here is an example:

These meetings have also been a blessing to my own recovery, but never so much as today. Today was very special, I did not have a great topic, no announcements, in fact I didn’t even speak. This was because today the meeting was not “mine”, it was theirs. A patient (and good friend) led the meeting today and he looks like only one of many that are ready to take up the mantle. So here’s a TDA Salute to a new recovery community and especially to those that have begun to act as beacons in their own right, illuminating the path of recovery for those at sea.

Related: National Alcohol and Drug Addiction Recovery Month – Quitters: USA Alcohol Consumption Declining – Piano Man Rehab

Brett Favre’s addiction to painkillers (1996)

After the seizure had ended and he had come to his senses, Favre looked into a sea of concerned medical faces and saw Packers associate team physician John Gray. “You’ve just suffered a seizure, Brett,” Gray told him. “People can die from those.” Favre’s heart sank. Upon hearing from doctors in the room that his dependence on painkillers might have contributed to the seizure, he thought, I’ve got to stop the pills, I’ve just got to.

Last season Favre went on such a wild ride with the prescription drug Vicodin, a narcotic-analgesic painkiller, that Tynes feared for his life. He scavenged pills from teammates. At least once he took 13 tablets in a night. But on Tuesday of last week, during his final telephone call before entering the Menninger Clinic, a rehabilitation center in Topeka, Kansas [which moved to Florida in 2003], to treat his dependency (and also to evaluate his occasional heavy drinking), Favre told SI that he hadn’t taken Vicodin since the seizure. “I quit cold turkey,” he said, “and I entered the NFL substance-abuse program voluntarily. I don’t want a pill now, but I want to go into a rehab center because I want to make sure I’m totally clean.
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Tynes wiped her eyes. She took a deep breath. She sniffled a few times. “You know,” she said, “he’s changed already. He talks to me again. He takes Brittany and me out. He pays attention to us. A few days ago he hugged me and he thanked me for everything I’ve done, and he said some really nice things to me.”

She wiped her eyes again. “I said, ‘I can’t believe it. The old Brett’s back!’” Time will tell. The true test will start in September.

Time has shown the answer, after struggles for several years, as Brett Favre has continued his amazing NFL career with great success.

Through triumph & tragedy, Deanna and Brett Favre remain a constant

After doctors found severe liver damage in 1996, Brett agreed to enter rehab, and was able to kick his addiction. He and Deanna were married several months later and welcomed daughter Breleigh in 1999, but his problems with substance abuse had not ended. By 1999, Brett had returned to heavy partying, and was abusing alcohol. Deanna contacted a divorce attorney, which helped scare her husband into quitting drinking entirely, according to Deanna.

The 1990s tested their relationship, but Deanna ultimately appreciated that Brett chose to seek help. “He was battling a disease,” she says. “I was trying to support him, and when he started making the right choices by getting the help he needed, that made a difference.”

Life had stabilized for the Favres by 2003: Brett was sober and a Super Bowl-winning icon in Green Bay, and Brittany and Breleigh were healthy and happy. “We were at a good spot in our lives,” Deanna says.

Then, in December 2003, Brett’s father died in a car accident. The following October, Deanna’s 24-year-old brother Casey was killed when his all-terrain vehicle hit a patch of gravel and flipped. Casey had recently overcome his own drug problems, and his girlfriend was eight months pregnant when he died.

In her memoir, Deanna described the loss of her brother as the darkest time in her life, but the darkness would not pass quickly – just days after Casey’s funeral, Deanna was diagnosed with breast cancer at 35.

Related: The Family of Favre Blog (family photo) – Deanna Favre Hope Foundation – Green Bay Press Gazette Favre Tribute (action photo) – Maradona Drug Rehab – Los Angels Drug Rehab Centers

The Feds sent me to Rehab and I learned of Drug Court and wondered why didn’t the Feds have a program similar to this one??!! My prayers were answered and was offered a chance to be the very first participant in a pilot program called PADI (pronounced just as my name sounds!) Court. This program saved my life and allowed me to be with my children. I started dating my husband, got married, and had another daughter. When my daughter was born, I began thinking about what I wanted to pursue for a career. I did some soul searching, and thought about how the Feds saw something in me worth saving and how I may be able to help others the way I was helped (saved). Whenever I thought about possibly being a substance abuse counselor I felt a passion burn within. I knew that is what I needed to do. I went through an accredited program for drug and alcohol counseling training (DACT).

Related: Center for Substance Abuse Treatment – California Drug Rehab Centers – Study: Drug Treatment Success Rates in England

The National Institute of Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks, and when women consume 4 or more drinks, in about 2 hours. Most people who binge drink are not alcohol dependent.

* Approximately 92% of US adults who drink excessively report binge drinking in the past 30 days
* Although college students commonly binge drink, 70% of binge drinking episodes involve adults over age 25
* The rate of binge drinking among men is 2 times the rate of women
* Binge drinkers are 14 times more likely to report alcohol-impaired driving than non-binge drinkers
* About 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks
* About 75% of the alcohol consumed by adults in the United States is in the form of binge drinks
* The proportion of current drinkers that binge is highest in the 18 to 20 year old groups (51%)

Binge drinking is associated with many health problems, including but not limited to

* Unintentional injuries (e.g. car crash, falls, burns, drowning).
* Intentional injuries (e.g. firearm injuries, sexual assault, domestic violence).
* Alcohol poisoning.
* Sexually transmitted diseases.
* Unintended pregnancy.
* Children born with Fetal Alcohol Spectrum Disorders.
* High blood pressure, stroke, and other cardiovascular diseases.
* Liver disease.
* Neurological damage.
* Sexual dysfunction.
* Poor control of diabetes.

Evidence-based interventions to prevent binge drinking and related harms include

* Increasing alcoholic beverage costs and excise taxes.
* Restricting the number of locations that sell alcoholic beverages in a given area.
* Consistent enforcement of laws against underage drinking and alcohol-impaired driving.
* Campus-based strategies to reduce high risk drinking among college students.
* Physician screening, counseling and/or referral for alcohol problems.

Related: Robin Williams Reflects on Rehab – USA Alcohol Consumption Declining

Overall alcohol use—particularly consumption of beer—is declining in the US, according to a new study published in the August 2008 issue of The American Journal of Medicine. Researchers examined 50 years of data and found several changes in alcohol intake but no change in alcohol use disorders. Americans are drinking significantly less beer and more wine, while hard liquor use has remained fairly constant. More people now report that they are non-drinkers. People born later in the 20th century drink more moderately than older people. As we age, our individual alcohol consumption goes down.
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Writing in the article, Yuqing Zhang, DSc, Boston University School of Medicine, and his co-investigators state, “The findings in this study may be considered encouraging in many ways: the average amount of alcohol has decreased in more recently born cohorts, the percentage of the population exhibiting ‘moderate’ alcohol intake has been increasing steadily, and the percentage reporting ‘heavy’ drinking has decreased over time…

Singer Billy Joel spent time at the Betty Ford clinic for alcoholism treatment in 2005.

Billy Joel leaves US rehab clinic

Singer Billy Joel has left a Californian rehabilitation clinic where he was being treated for alcohol abuse. His publicist confirmed that the 55-year-old had now checked out of the Betty Ford clinic, in Rancho Mirage, where he had spent 30 days.

Photo taken on November 14, 2007.

Piano Man Finds Inner Harmony

“I’m just not drinking,” says the Piano Man – who had struggled with a love of bottles of red and bottles of white. “I don’t know if I will never have a glass of wine again for the rest of my life, but right now I am not taking any chances. “There was a time in my life when I was drinking too much, and so I have stopped,”

Related: Piano Man: The Very Best of Billy Joel – 52nd Street – Aging of the Population in Rehab – The Stranger