Question

In regards to Alcohol Describe and Discuss (meaning explain both strengths and weaknesses) of treatment screening techniques and treatment approaches? In your opinion which are the best approaches?

Answer 1

Alcohol use and abuse pose a serious problem to the user, her/his family and society at large. It is believed that alcoholics use health services four times more than the non-alcoholics (The Harvard Medical School Mental Health Letter, 1987). Alcohol abuse poses both short term as well as long term effects ranging from physiological to behavioral such as lack of motor coordination, balance, speech and vision, short term memory loss, problem solving ability, reduced sexual performance etc.

The treatment program of alcoholism range from traditional hospitalization for the purpose of detoxification to psychological and sociological support groupts such as the Alcoholics Anonymous. Following are some of the treatment approaches:

1. Traditional Hospital Treatment: The initial process of hospitalization offers support by providing medical as well as residential facility program. The process of detoxification can be extremely uncomfortable and painful depending on the level of addiction. The withdrawal symptoms experienced by the individual can lead to serious conditions marked by Delirium Tremens, a condition in which the patient becomes delirious and tremulous. The hallucinations are primarily visual, however, they can be tactile marked by sensations of crawling insects inside the skin.

among the treatments available for alcoholics to choose from is Disulfiram, or antabuse, which discourages drinking by causing violent vomiting if alcohol is ingested. The effecs of the antabuse last about four days. If the patient agrees to take the drug every four days, he is fairly certain not to drink.

Limitations: Most alcoholics drop out of medical programs due to financial burdens, lack of family support and painful treatment procedures, especially due to fear of delirium tremens.

2. Alcoholic Anonymous: AA or Alcoholic Anonymous if the world's largest self help group, founded in 1935 by two recovered alcoholics. An AA chapter runs regular and frequent meetings at which newcomers rise to announce that they are alcoholics and older sober members give testimonials. Members are urged to call one another round the clock when they need companionship and encouragement not to relapse into drinking. Along with AA, two related self help groups are of more recent origin, Al-Anon for the relatives of the alcoholic and Alateen for the children of the Alcoholics. Both aim at providing support and understanding to the family members and children.

Limitations: self motiation to continue with the treatment program at AA is a challenging task for initial programmers. Lack of familial support and social labeling pose challenges. Also, easy availability and non stigmatized approach to small consumption pose greater challege to maintain the resolve to abstain from alcohol.

3. Behavioral techniques using classical and operant conditioning procedures:

a. Aversion therapy: An early article on behavior therapy (Kantorovich, 1930) concerned itself with aversion therapy. With these procedures, a problem drinker is shocked or made nauseous while looking at, reaching for or beginning to dring alcohol. The aversive stimulus may also be vividly imagined or visualized using covert sensitization.

b. Behavioral contracting: making a contract with the alcoholic such as refraining to drink being exchanged with certain rewards such as better living conditions or weekend passes can be a very promising technique.

c. Token economy: maintaining abstinence charts and staying focused on "stictly no alcohol at home or leisure" can help the alcoholic in gathering tokens, which can be exchanged for more appropriate and healthier options such as lunch or dinner coupons, movie tickets, games etc.

Though a combined treatiment plan including medical, socio-economic and psychological support program can prove to be very efficient, more often than not, alcoholics stick to psychological support and AA programs. It is believed that alcoholism is a lifestyle problem and emerges due to psychological issues such as depression, alienation and low self esteem. Hence, psychological techniques are considered to be better treatment options as they not only work at the individual level, they promise more stable and long lasting effects of the treatment.