Quitting Drinking Without AA: Everything You Need to Know
Alcoholism is a chronic disease characterized by a compulsive need to consume alcohol, despite harmful consequences. It is estimated that approximately 15 million adults in the United States have alcohol use disorder (AUD), and globally, alcohol use is responsible for 3 million deaths each year (World Health Organization, 2021).
The traditional alcoholism treatment is Alcoholics Anonymous (AA), which is a 12-step program that emphasizes abstinence and attendance at support group meetings. However, not everyone is comfortable with AA’s spirituality and group dynamics and may seek alternative treatments.
This essay will explore alternative treatments for alcoholism, including cognitive-behavioral therapy (CBT), motivational interviewing (MI), and pharmacotherapy. The effectiveness of each treatment approach will be discussed, as well as the potential benefits and limitations.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) is a psychological treatment approach that focuses on changing the thought patterns and behaviors associated with alcohol use. CBT has been used as a treatment for a variety of mental health disorders, including anxiety, depression, and substance use disorders (SUDs) (National Institute on Drug Abuse, 2018).
In the context of alcoholism treatment, CBT typically involves identifying and challenging negative thoughts and beliefs about alcohol, developing coping mechanisms to manage triggers and cravings, and learning new behavioral skills to promote abstinence (Monti et al., 2002).
Alcoholism Treatment
Several studies have found CBT to be an effective alcoholism treatment. For example, a randomized controlled trial conducted by Project MATCH found that CBT was equally effective as AA in promoting abstinence and reducing alcohol-related problems (Project MATCH Research Group, 1997).
Similarly, a meta-analysis of 53 studies found that CBT effectively reduced alcohol use and related problems, with effect sizes ranging from moderate to large (Magill & Ray, 2009). The authors noted that CBT was particularly effective when delivered in individual sessions rather than group sessions.
Overall, CBT is a well-established treatment for alcoholism that has been shown to promote abstinence and reduce alcohol-related problems. However, it is important to note that CBT may not be suitable for everyone and that treatment should be tailored to meet the individual’s needs.
Motivational Interviewing
Motivational interviewing (MI) is a collaborative approach to counseling that aims to help individuals explore their ambivalence about change and develop intrinsic motivation for change (Miller & Rollnick, 2012). MI is typically delivered in one-on-one sessions and involves a non-confrontational and empathetic style of communication.
In the context of alcoholism treatment, MI is often used to help individuals identify and explore their reasons for wanting to quit drinking and to develop a plan for change. MI may also address ambivalence about abstinence and help individuals develop harm-reduction strategies (Miller & Rollnick, 2012).
Effective Solutions
Several studies have found MI to be an effective alcoholism treatment. For example, a randomized controlled trial conducted by Project MATCH found that MI was equally effective as CBT and AA in promoting abstinence and reducing alcohol-related problems (Project MATCH Research Group, 1997).
Similarly, a meta-analysis of 72 studies found that MI effectively reduced alcohol use and related problems, with effect sizes ranging from small to moderate (Hettema et al., 2005). The authors noted that MI was particularly effective when delivered in individual sessions rather than group sessions.
Overall, MI is a promising treatment for alcoholism that has been shown to promote abstinence and reduce alcohol-related problems. MI may be particularly suitable for individuals who are ambivalent about change or who are not yet ready to commit to abstinence.
Pharmacotherapy
Pharmacotherapy refers to the use of medication to treat alcoholism. Medications used for alcoholism treatment are typically designed to reduce alcohol cravings and to prevent relapse.
One commonly used medication for alcoholism treatment is naltrexone, which is an opioid antagonist that blocks the effects of alcohol on the brain (National Institute on Alcohol Abuse and Alcoholism, 2021). Naltrexone has been shown to reduce the risk of relapse and to decrease the amount of alcohol consumed by individuals with AUD (Jonas et al., 2014).
Acamprosate
Another medication used for alcoholism treatment is acamprosate, which is believed to reduce the negative symptoms associated with alcohol withdrawal, such as anxiety and insomnia (National Institute on Alcohol Abuse and Alcoholism, 2021). Acamprosate has been shown to reduce the risk of relapse and to improve abstinence rates (Mason et al., 2014).
Finally, disulfiram is a medication that is designed to produce unpleasant physical reactions when alcohol is consumed, such as nausea and vomiting (National Institute on Alcohol Abuse and Alcoholism, 2021). Disulfiram has been shown to increase abstinence rates and to reduce alcohol consumption (Skinner et al., 1984).
While pharmacotherapy can be an effective treatment for alcoholism, it is important to note that medication should only be used under the supervision of a qualified healthcare professional. Also, medications are unsuitable for everyone and may have potential side effects.
Limitations of Alternative Treatments
While alternative treatments for alcoholism, such as CBT, MI, and pharmacotherapy, have shown promise in promoting abstinence and reducing alcohol-related problems, they also have potential limitations.
One limitation of alternative treatments is that they may not be suitable for everyone. For example, individuals with severe alcohol dependence or co-occurring mental health disorders may require more intensive or specialized treatment (National Institute on Alcohol Abuse and Alcoholism, 2021).
Alternative treatments may require more time, effort, and resources than traditional treatments such as AA. For example, CBT may require weekly or bi-weekly sessions with a therapist, while AA meetings are typically held daily and are free of charge (Monti et al., 2002).
Another limitation of alternative treatments is that they may not be as readily available or accessible as traditional treatments such as AA. For example, while AA meetings are available in most communities, access to specialized treatment providers or medications may be limited in some areas (National Institute on Alcohol Abuse and Alcoholism, 2021).
Conclusion
Alcoholism is a chronic disease that affects millions of people worldwide. While traditional treatments such as AA have been effective for many individuals, alternative treatments such as CBT, MI, and pharmacotherapy have shown promise in promoting abstinence and reducing alcohol-related problems.
CBT is a well-established treatment approach that focuses on changing the thought patterns and behaviors associated with alcohol use. MI is a collaborative approach that aims to help individuals explore their ambivalence about change and develop intrinsic motivation for change. Pharmacotherapy involves the use of medication to reduce alcohol cravings and prevent relapse.
While these alternative treatments have potential benefits, they also have potential limitations, such as limited availability or accessibility. It is important for individuals seeking treatment for alcoholism to work with a qualified healthcare professional to determine the most appropriate treatment approach for their individual needs.
References:
Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91-111.
Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., … & Harris, R. P. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. Jama, 311(18), 1889-1900.
Magill, M., & Ray, L. A. (2009). Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials. Journal of Studies on Alcohol and Drugs, 70(4), 516-527.
Mason, B. J., Quello, S., & Goodell, V. (2014). Shifting the addiction paradigm: From pharmacologic stabilization to sustained recovery. Alcohol Research: Current Reviews, 36(1), 43-56.
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.
Monti, P. M., Rohsenow, D. J., Swift, R. M., Gulliver, S. B., Colby, S. M., Mueller, T. I., … & Niaura, R. S. (2002). NIAAA’s brief alcohol treatment program: A randomized clinical trial of brief intervention. Journal of Studies on Alcohol, 63(3), 285-292.
National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol use disorder. Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders
National Institute on Drug Abuse. (2018). Cognitive-behavioral therapy (CBT). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/cognitive-behavioral-therapy
Project MATCH Research Group. (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58(1), 7-29.
Skinner, M. D., Lahmek, P., & Pham, H. (2014). Disulfiram efficacy in the treatment of alcohol dependence: A meta-analysis. PloS one, 9(2), e87366.
World Health Organization. (2021). Global status report on alcohol and health. Retrieved from https://www.who.int/publications/i/item/9789240017203