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Alcohol Dependence Isn't an Equal Opportunity Condition, Nor is One-Size-Fits-All Treatment Effect

Aug 18, 2007
Despite all of the marketing hype to the contrary, those who succumb to alcohol abuse, dependence and addiction aren't equally represented across ages, genders, nationalities, religions, or any other demographic. There are in fact wide variations between different populations and at different times. So, while it is true that it's possible to find an 80 year old, white, Jewish, female alcoholic, you will not find as many of them, either in numbers or percentages, as you will drunken, young, privileged, college fraternity brothers.

What's the point? That there is a great deal of difference between individuals who suffer from the ill effects of alcohol's destructive side, and that treating everyone as being equal results in treatment that helps no one very effectively. If potential clients are being lumped together then at least they should be lumped into groupings that have some validity and usefulness. Not just into one group, alcoholics, in need of the one true 12-Step based treatment.

Additionally, some individuals are capable of reversing their dependence and moderating their alcohol use. It isn't easy to do, is certainly politically incorrect, and nearly universally rejected by American treatment programs who dislike suggestions that complicate matters with accountability.

The questions then become ones about whether or not there are any categories that can be used to treat individuals more effectively. And are there other types of treatment?

The answers, ones which a few facilities acknowledge, are yes, and yes. Even some obvious differences have been noted and occasionally incorporated. Gender comes to mind and it has long been known that effectively reaching women takes different approaches than reaching men. It's not universally true of course, generalizations aren't, but for the most part progress is more certain when gender is taken into consideration.

Other factors are also important. The degree to which alcohol has intruded into a client's life will have an effect on any attempts to moderate, for example. The client's motivation is a primary factor in making change successfully and, no, coercion is not motivation. Support from others is helpful but change remains personal and "others" will always include people, perhaps most of them, with a vested interest in clients' failure.

When you are contemplating and planning change, you will need to catalogue your resources along with your problems. Most programs will only focus on diagnostic labels that justify your supposed appropriateness for their particular program. It is vital that you be at least equally concerned with your strengths, interests, abilities, and future, and advocate for your own self-interest.

Ultimately successful change is up to you, not to any program. You can find invaluable help and significantly shorten to time it takes, the cost, and the uncertainly. But results will be yours. Make sure they are the ones you want, need, and deserve.
About the Author
Dr. Edward Wilson has been developing and providing alternative alcohol counseling, including moderation, sincve 1990. He is the co-founder and Clinical Director of Your Empowering Solutions, Inc, located in S. California. http://www.non12step.com
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