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Aversion therapy works by conditioning an individual to experience unpleasant stimuli in association with certain unwanted behaviors. It is based on classical conditioning theory which claims that we not only learn maladaptive behaviors but that we can also unlearn them. The basic assumption is that when unpleasant stimuli are paired with certain actions the individual will begin to associate this unpleasantness with that particular action. Nausea is just one of the possible negative stimuli that may be used for this.
Aversion therapy has been used successfully to treat conditions such as alcohol abuse, smoking, and other maladaptive behaviors. It has been controversially used as a means to treat homosexuality and other sexual tendencies that some might have historically considered deviant. Aversion therapy involving nausea as the negative stimuli is mostly associated with treating alcohol abuse.
Nausea is an unpleasant sensation that most humans prefer to avoid. Behavioral learning theory suggests that we associate certain behaviors with pleasant sensations. Thus an alcoholic can learn to associate alcohol with feeling good. The idea is that it will also be possible to unlearn this association. An alcoholic could learn to associate drinking alcohol with an unpleasant experience like nausea. This will mean that the addiction is easier to defeat. Aversion therapy differs from many other types of treatments for undesirable behaviors because it focuses on the unconscious mind.
There are two types of aversion therapy. Overt sensitization uses drugs to produce an unpleasant symptom when combined with an unwanted behavior. This is most commonly used to treat alcohol abuse. Covert sanitization doesn’t involve any drug but instead relies on the client to use negative visualization or to focus on unpleasant thoughts if the mind turns to the undesirable behavior. Nausea is an overt sensitization technique.
Antabuse has been used to treat alcohol abuse since the early 1950s. This drug can also be written as Antabus but the generic name is disulfiram. The drug works by interfering with the ability of the body to metabolize alcohol. Under normal conditions the body metabolizes alcohol by turning it into a substance called acetaldehyde. This is a highly toxic chemical but the body deals with acetaldehyde by breaking it down into acetic acid which is not harmful to the body. Antabuse interferes with the mechanism that breaks down the acetaldehyde. The chemical can then build up in the body to produce unpleasant symptoms.
High levels of acetaldehyde in the body produce nausea and vomiting as well as other unpleasant symptoms such as vertigo, general body weakness, headache, anxiety, and possibly even chest pain. The fear of developing these symptoms can be enough to deter the individual from drinking while on the drug. Those who do consume alcohol while on the drug will develop an aversion due to negative reinforcement.
Nausea aversion therapy has proved to be a relatively successful method for dealing with alcohol addiction. However, long-term compliance is needed, as the individual may be expected to take nausea-inducing drugs for many years. Alcoholics may just quit antabuse if they wish to return to their addiction. Those who take disulfiram long term have been shown to benefit from it. A nine year study found that half of the people in their study remained abstinent using this type of drug. There have also been attempts to use disulfiram to treat cocaine abuse in recent years, and there have been some encouraging results from this.
Pharmacological agents such as disulfiram have no direct impact on the withdrawal process from alcohol. The individual is also still likely going to have cravings. It is usual for antabuse to be combined with other forms of treatment. The drug may be most suitable for its ability to reduce the risk of relapse.
Ethical concerns have been raised about the morality of deliberately making clients experience unpleasant symptoms. There is also the argument that such treatments only deal with the negative behavior rather than the motivation behind the behaviors. If the reason why the person is abusing alcohol or engaging in other addictive behavior is not dealt with, then they may simply substitute the old undesirable activity with a new undesirable one.
Recent research suggests that aversion therapy alone is not the most effective approach. Treatments that involve taking drugs such as antabuse tend to have high dropout rates. There is interest in creating new drugs that not only cause negative symptoms when mixed with alcohol, but also reward abstinence with pleasant feelings. A new drug might achieve this by increasing the levels of the neurotransmitter serotonin in those who remain abstinent. In sufficient doses, this hormone can create a sense of well being.
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