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Alcoholism and the Science of Recovery

Aug 17, 2007
Alcohol rehabilitation is very difficult process that requires a lot of determination. Alcohol has been the most widely used mood-altering substance from earliest recorded history. The idea that alcohol consumption sometimes causes medical, personal, social and other harms is as old as the manufacture and consumption of alcohol itself.

Today more alcohol is consumed than ever before and the World Health Organization (2002) estimates that globally alcohol misuse caused 1.8 million deaths in the year 2000, compared with only 0.2 million from the use of illicit drugs. Alcohol was the third leading cause of preventable death and disability globally (after smoking and high blood pressure) and in some developing regions of the world alcohol is the leading cause of preventable death and disability

Alcohol misuse is also implicated in serious social, economic and legal problems, placing a substantial burden on economically developed and developing countries alike. In counterpoint to these depressing statistics, the last three decades have also seen an explosion of social, psychological and clinical research to identify effective strategies to prevent and treat alcohol-related problems.

This is a very exciting time in the science of treatment for alcohol dependence and problems, a time of uncertainty but also of great promise. It should always be remembered that the scientific study of treatment in this field is a relatively recent phenomenon, with very few outcome studies or controlled trials appearing before the end of World War II.

In the years since then, the volume of scientific work has steadily grown from a trickle to a veritable flood and we are now confronted with a massive number of relevant publications in the scientific literature. More important than quantity, the quality of research, too, has greatly increased over this period; sample sizes, levels of methodological and statistical sophistication, and standards of scientific reporting have all shown marked improvements.

We are now seeing a growing tendency towards multi-centre and cross-cultural research and this can only increase the amount of secure knowledge in the field. The closing years of the twentieth century witnessed the publication of results from the largest and most expensive randomized controlled trial ever mounted, not only of treatment of alcohol problems but of any kind of psychosocial treatment for any type of disorder.

Over the past decade, the treatment outcome research has consistently shown that there are effective treatment approaches for alcohol problems. These approaches include brief interventions and motivational interviewing, social skills training, community reinforcement, behavior contracting, relapse prevention and some aversion therapies. The commonality among these treatment approaches is the focus on actively engaging the client in the processes of suppressing use and teaching alternative coping skills. Research has also indicated that some of the more typical US treatment components are not effective and often show no improvement or worse outcomes when compared to well-articulated interventions.

In the end, it's the person's desire and determination that counts the most. The patient needs to want to be healed, and that's the single most important premise for successful alcohol rehabilitation.
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