This article will discuss:
* the terms alcohol abuse, alcoholism, and alcohol addiction as well as drug abuse, drug addiction, and drug dependence
* the acute and chronic health risks of drinking alcohol and using drugs
* treatment for alcohol and drug abuse abuse, alcoholism, and drug and alcohol addiction, including:
*the 12-Step approach (the Minnesota Model: the AA or NA approach)
*a non 12-Step approach (DARA – Drug and Alcohol Rehab Asia: Cognitive Behavioral Therapy)
The American Psychiatric Association has delineated criteria for diagnoses of Drug and alcohol abuse and Drug and alcohol dependency (alcoholism).
Criteria for Drug and Alcohol Abuse:*
1) One or more of the following occurs within a 12-month period:
* Recurrent drug or alcohol use resulting in failure to fulfill major role obligations at work, school, or home
* Recurrent drug or alcohol use in situations in which it is physically hazardous (e.g., driving)
* Recurrent drug or alcohol-related legal problems (e.g., DUIs)
* Continued drug or alcohol use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the drugs or alcohol
2) These symptoms must never have met the criteria for drug or alcohol dependence.
Criteria for drug or Alcohol Dependence:*
Three or more of the following seven criteria occur at any time in the same 12-month period:
* Tolerance: A need for more and more amounts of drugs and alcohol to get intoxicated
* Withdrawal: Getting withdrawal symptoms when suddenly stopping drinking or using after prolonged and heavy drug or alcohol use: e.g., tremors, nausea, sweating, and shakiness
* Drugs or Alcohol is often taken in larger amounts or over a longer period of time than was intended
* Unsuccessful efforts to cut down or control alcohol or drug use
* A lot of time is spent in activities to obtain drugs and alcohol, use, or recover from its effects
* Important social, occupational, or recreational activities are given up or reduced because of drug or alcohol use
* Alcohol or drug use is continued despite persistent or recurrent physical or psychological problems most likely caused or exacerbated by the alcohol or drugs
(*American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV). Washington, D.C.: APA)
The use of the term ‘alcohol or drug addiction’ is sometimes also used, meaning the person can’t control, cut down or stop using, even when drinking alcohol or drug use is negatively impacting his/her life. One does not have to be physically dependent on alcohol or drugs to have an alcohol or drug addiction.
The acute effects of alcohol in larger doses can include dulled mental processes; lack of coordination; slowed reaction time; poor judgment; reduced inhibitions. A large quantity consumed at once can cause death due to respiratory failure.
Heavy consumption over a long period of time can cause decreased sexual functioning; liver disease; increased cancers of the mouth, tongue, pharynx, esophagus, rectum, breast and skin; kidney disease; and ulcers. Severe withdrawal, if not medically supervised, can result in death. During pregnancy, alcohol consumption can cause spontaneous abortion and birth defects.
For a great illustration of the long-term effects of alcohol, scroll down a bit on this web page from Australia-Northern Territory Department of Health.
Treatment for Alcohol Abuse, Alcoholism, and Alcohol Addiction
There are two predominant categories regarding programs of treatment for alcohol abuse and alcoholism: the 12-step model and non 12-step programs as discussed below.
The 12-Step model is the predominate paradigm of rehab programs in the United States, the UK, and other countries– although this is beginning to change as more and more research is being done on the efficacy of 12-step program vs. non 12-step programs, e.g., Cognitive Behavioral Therapy (CBT) based programs. The 12-Step Model is also known as the Minnesota Model because its use originally took hold in Minnesota. The Minnesota Model is based on, and permeated by, the philosophy of Alcoholics Anonymous (AA), and thus the 12 steps used in AA. With the 12 step philosophy, recovery comes through group affiliation with other recovering persons, and changing thought and behavior in accordance with the principles of the 12-steps of AA. Since the inception of AA it has also spawned off NA – Narcotics Anonymous and multiple other support groups.
The Minnesota Model also adheres to the disease model of addiction. The disease model sees alcoholism or drug addiction as a medical illness which is chronic and progressive, with alcohol or drugs as the causal agent. The inability to control drinking or drug use behavior is seen as a symptom, and complete abstinence from alcohol or drug consumption the only means of treatment. Controlled drinking is not possible, as alcoholics are physiologically unable to drink moderately due to the unique effect alcohol has on certain physiological processes. In contrast, many non 12-step programs do not see alcoholism or drug addiction as a disease, rather as a learned behavioral issue; however, for some, complete abstinence from alcohol and drugs is best.
While the 12 Step Model / AA/NA embraces the disease model, there is yet a moral dimension to having the disease and dealing with it—as seen in terminology and principles in the 12 steps, e.g., ‘making amends,’ ‘defects of character,’ ‘personal inventory,’ ‘confessing the nature of our wrongs,’ etc.. Twelve-step programs have a strong Christian religious tone that runs through them. Additionally, with that said, it is thought that recovery only comes with a ‘spiritual awakening.’
Non 12-Step model programs are available, i.e., programs that do not use the 12 steps of AA/NA as their foundation and as guiding principles. And, as mentioned earlier, many non 12-step programs do not see alcoholism as a disease, rather as a learned behavioral issue. DARA – Drug and Alcohol Rehab Asia is an effective alternative to 12-step programs, utilizing Cognitive Behavioral Therapy (CBT) as its primary therapeutic approach. While our program is a non-step program, we do not discourage recovering persons from seeking support in 12-step groups, e.g., Alcoholics Anonymous or Narcotics Anonymous, upon their return home. Some find the social support of a 12-step group and the 12-step philosophy helpful for their recovery.
* Cognitive Behavioral Therapy (CBT): CBT has a strong level of empirical support for the treatment of substance abuse and alcoholism. CBT is a short-term, focused approach to help substance dependent individuals become abstinent from alcohol and other substances. CBT focuses on helping clients to a) RECOGNIZE the situations in which they are most likely to use drugs or alcohol; b) AVOID these situations when appropriate; and c) COPE more effectively with a range of problems and problematic behaviors associated with substance abuse. (group and individual sessions).
* Relapse Awareness: Learning the knowledge and skills to identify the warning signs and signals that may lead to a relapse, and how to deal with them
* Group Education: Topics include, for example: Stress Management; Diet—How Specific Foods are Beneficial in Recovery; The Effects of Alcohol and drugs on our Physical, Social and Mental Health; and Healthy Lifestyle – Healthy Mind
* Art Therapy: A creative activity and process that facilitates insight and resolution of personal issues, reduces stress, increases self-esteem and self-expression, and promotes self-awareness.
* Water Workout: Physical activity and fun in our beautiful pool!
* Your Life Story: a therapeutic activity for insight, change, and healing for efficient alcohol rehab treatment
* Group Sports: e.g., Water Polo, Swimming, Ping Pong, Thai Boxing / Kickboxing / Boxing
* Stress Management: Relaxation techniques and meditation, massage, and physical training
* Excursions: A wide range of activities are available locally, including: a day on the beach, island hopping, deep sea fishing, snorkeling, jungle trekking, as well as visiting temples
* Nutritious and Delicious Meals
* Aftercare: Aftercare plan: We’ll work with you on setting up aftercare for when you return home. We have a large network of aftercare specialists around the world who we regularly work with when it comes to alcohol rehab help. If you come from an area where we cannot locate a suitable therapist, we collaborate with several counselors who specialize counseling on the telephone or via video conference.