We Must Do Better with Alcoholism Treatment - Remember Smoking?

We must and can do better to prevent and treat alcohoism and addiction. We have had success with another addiction - smoking. The U.S. reduced smoking rates from nearly 60% in the 1950s to about 20% today. We did it with a collective will to stop that killer and with a focus on prevention and treatment through Public Service Announcements, early education in the school system, and government supported smoking cessation programs.

Alcoholism is the 3rd leading cause of death in the United States and it's an expensive illness both emotionally to those struggling with it and their families. Financially, alcoholism is incredibly costly. "Each year medical problems caused by addiction, along with lost earnings, accidents and crime, cost Americans more than $500 billion."* 

Very troubling to me as an addiction counselor is that the failure rate for long term sobriety is a grim 70%. This is a shocking statistic because treatment success rates have remained virtually unchanged for the 30 years I've been in the counseling profession. The majority of addiction professionals and the medical community treat the problem primarily with behavorial and psychosocial approaches meaning group therapy, 12 Step meetings and education. This is important, but the newly sober brain often can't process or remember well until the brain has had time to heal - 4-12 months for most.

Part of what gets in the way of better treatment is that society still views addiction as a moral rather than a medical issue. But there's plenty of scientific evidence that concludes "...addiction is a chronic, progressive disease of the brain with many simiarities to other chronic diseases such as diabetes, hypertension and asthma..."*

Cutting edge treatment for alcoholism includes medications such as Vivitrol and Campral. Vivitrol is a once a month, extended-release injected medication (naltrexone), approved by the FDA in 2006. Vivitrol reduces the high that someone gets from drinking, and it decreases cravings. Because it's prescribed once a month, it eliminates the daily decision making that goes with Antabuse.  

Another effective medication is Campral approved by FDA in 2004. Campral also reduces cravings and "...restores the balance in certain neurotransmitter pathways altered by chronic use." Campral can accelerate brain healing which normally takes 4-12 months after someone stops drinking. Vivitrol and Campral can be prescribed together to enhance the effects according to Dr. Urschel* and he recommends usage for 18 months on average. 

Society needs to get over judging alcoholics and drug addicts as moral failures, treat addiction as the medical problem it is and spend the right kind of money on prevention, early education and treatment. We can change the course of this disease as we've done with smoking.  


 

*Healing the Addicted Brain by Harold C Urschel, III, MD, MMA, Advances in Addiction and Recovery Magazine Spring 2013