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

While alcohol was the major sole factor, Mr Pitts said 70 per cent of admissions also listed it as “among their reasons for seeking treatment” and this demonstrated how pervasive alcohol dependence had become across society. It was also viewed as an “easily accessible, socially acceptable and relatively inexpensive drug to self-medicate life’s difficulties and challenges for older people”, he said.

Amphetamine-type substances including ice and ecstasy accounted for 21% of Odyssey House admissions in 2009 (23% in 2008), while heroin and cannabis each accounted for 18% (19% and 18% respectively in 2008).

Methadone accounted for 8% of admissions, while gambling and other drugs like benzodiazepines, buprenorphine, morphine and cocaine accounted for 9%.

Alcoholism remains a huge problem. Rehabilitation programs for those with addictions to alcohol continue to have success but they also continue to have plenty of people in need of treatment. It is not a problem that society has been effective at dealing with. While we have some success there remains much to do.

Related: Top 10 Luxury Rehab Centers – Combination Strategy to Treat Alcohol Dependence – Alcohol Remains a Major Cause of Drug Rehab Admissions

Early experiences with drugs, whether in the womb or as an adult, have ineradicable effects. Drug users often describe a wish to recapture the bliss of their first high. But this goal proves elusive because once the brain has neuroadapted to drugs, it is physiologically and structurally changed. The director of the National Institute on Drug Abuse and many others argue that voluntary drug consumption alters the brain in ways that lead to involuntary drug consumption. The question of whether drug habits are voluntary or not leads us to ask how people get over their addictions, and raises some of the moral issues surrounding compulsive behavior.
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Addiction is not all pharmacology, neurotransmitters, and intrapsychic states; the social settings of drug consumption have powerful effects. They can influence basic brain chemistry–which is one reason Gene Heyman rejects the notion that “addictive behavior is insensitive to persuasion, that there’s an irresistible urge to take the drug.” Heyman agrees that drugs alter the brain, but disputes the idea that they change the brain in ways that make choice impossible–he does not believe, in other words, that neuroadaptation makes drug use involuntary. Exhibit A, he says, is 50 million ex-smokers who have voluntarily ended their intake of nicotine.
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One reason people believe drug use is involuntary is that recovery rates for addicts treated at clinics are quite bad. Within one year of treatment, relapse rates of 67 to 90 percent are common for alcohol, opiate, cocaine, and tobacco users. “But most of the people who become addicted to drugs don’t go to clinics,” says Heyman. “Actually, only 30 to 40 percent go to clinics. Yet this clinic population has greatly influenced our vision and concept of addiction.”

It turns out that addicts who don’t go to clinics have much higher recovery rates.

This is an interesting article with interesting data. Remember the different recover rates for those that go to clinics and those who does not mean going to a clinic reduces the odds of success. It seems reasonable to guess most of those that go to clinics are drawn from the subset that failed to quit without going to a clinic. So it could be that fail to quit on their own then will fail only quit on their own 3% of the time and quit in a clinic 10% of the time (these numbers are not based on anything just an example of what you must consider about the above statistics).

Even though cigarette smoking is the direct cause of 400,000 American deaths annually, while alcohol directly causes only 100,000 deaths, “alcoholism is a major reason that people don’t stop smoking,” says Vaillant. “Those who keep on smoking after age 50 tend to be alcoholics.” In hospitals, alcoholics cost six times as much as other patients. Half of all people who show up in emergency rooms with severe multiple fractures are alcoholics. “But the emergency rooms treating multiple fractures ignore blood alcohol levels,” Vaillant says. “The causal link isn’t made.”

“No other drug of addiction impairs one’s aversion to punishment the way alcohol does,” he continues. “Yes, compulsive gambling impairs your aversion to being poor, and heroin use impairs your aversion to being arrested. But alcoholism goes across the board. When drinking, people are much more likely to engage in all kinds of dangerous, life-threatening behavior–wife beating, child abuse, unprotected sex with strangers, smoking, drunk driving. You can be five foot two and willing to take on anyone in the bar.”

Related: Alcohol is a Major Cause of Drug Rehab Admissions – How Effective is Drug Addiction Treatment? – Methods to Treat Addiction – Why Can’t Drug Addicts Quit on Their Own?

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

Alcohol has again topped harder drugs like ice and heroin as the addiction which drives the most Australians into crisis rehab. Seventy per cent of people admitted to the major not-for-profit rehab centre Odyssey House, based in Sydney, in the past financial year listed alcohol as among their reasons for seeking treatment.

For almost one in three (29%), alcohol was their primary addiction – up from 28% in 2006-07 and 20% in 2005-06. Amphetamines such as speed, ecstasy and ice accounted for 23% of Odyssey’s admissions in 2007-08 followed by heroin (19%).

Too many people continue to fall victim to alcohol and drug addiction. A big challenge for modern society is to do a better job of helping people lead healthier lives and avoid the ravages of caused by addition to drug and alcohol.

Related: How Effective is Drug Addiction Treatment? – Study: Drug Treatment Success Rates in England

I had my last drink nearly 16 years ago, so you’d think I would have assimilated pretty much every bit of unpleasantness associated with clean and sober life in a society that remains thoroughly sodden with alcohol. But I still can’t quite handle the holidays.

It’s not that I’m driven to drink; just to a certain uncomfortable distraction that doesn’t leave until the holiday season thankfully does.
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If I decided to take a drink at a party, I might be able to tough it out for that night, but I know that the next day, another drink would be someplace in my mind. That someplace might be a manageable place, but would it be worth the considerable hassle of having to think twice every time I took a sip?

Besides, my newly wired brain doesn’t really have the interest to try. I’ve worked too hard at this, learned too much, have too much pride in accomplishing something that a lot of folks with this problem don’t – a solid sobriety that has lasted at least as long as my addiction did – to risk a relapse.

Related: Alcohol Rehab Links – Betty Ford Center – 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

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

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