Advances in the Treatment of Alcoholism
Current treatment for alcoholism is based upon an abundance of research regarding effective approaches to helping those dependent decrease their usage or abstain altogether, and further development of more effective treatments are emerging as more research is conducted. As treating alcoholism is difficult because there is no single effective treatment and the disease affects people differently, it is proposed that treatments derive from each patient’s specific needs.
Statistics show that alcohol use disorders, also referred to as AUDs, frequently go untreated. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) in both 2001 and 2002, which calculated alcohol abuse and dependence at 4.65 percent and 3.81 percent, respectively. Using those results, Cohen and colleagues found that just 14.6 percent had ever received treatment. A second study conducted by Dawson and colleagues focused on those whose onset of alcoholism occurred a year before the NESARC study. Concerning treatment, Dawson and colleagues found that just 25.5 percent had ever received such, with 5.4 percent reporting the use of formal treatment, 3.1 percent reporting the use of a 12-step program, and 17 percent reporting the use of both.
In 1989, the NIAAA conducted Project MATCH, where patients were first categorized by certain factors—such as alcohol involvement, cognitive impairment, psychiatric disorders, gender, and motivation to change—and then randomly referred to a 12-week treatment: a 12-step program, cognitive-behavioral therapy, or motivational enhancement therapy. After the treatment was complete, patients were followed for one year at three-month intervals, to track drinking patterns, quality of life, and their utilization of other treatments. As a result, those with low psychiatric severity were found to be best suited with 12-step treatments.6
Peer-run mutual help groups (MHGs) remain effective in aiding those dependent recover, as they are available at peak times of weakness: nights and weekends.1 Also, since members are able to contact each other for support, chance of relapse decreases. However, many do not continue to attend MHG’s, leading researchers to both focus on extended treatments which provide continuous care and reach beyond the traditional methods.1
With the growing use of technology, alcoholism treatments are expanding their availability to cell phones and the Internet. Online social support groups, Internet-based interventions, email, and text messaging all are able to provide supports.1 Gustafson and colleagues report on a cell phone-based support for patients who finish inpatient treatment, called Addiction Comprehensive Health Enhancement Support System (A-CHESS). The technology offers social support, motivation, and coping strategies, which researchers believe will show a reduced number of patients’ drinking days.7
Myers, Roozen, and Smith report the Community Reinforcement Approach (CRA) helps patients convert their lifestyles to healthy and drug-free, through becoming involved in alternate activities. The activities focus the patients on their family and other social relationships as well as their employment. The approach also enlists the help of the patients social relationships to maintain an alcohol-free environment.8
Researchers have also found that cost-effective treatments are the most successful, and the Federal parity legislation and health care reform has allowed more treatments to be so. Stewart and Horgan explain that the Federal parity law has required group health plans that offer mental health and addiction services to cover the services comparably to medical and surgical services, lifting some financial burden from the patient. They believe this will cause changes to private and public insurance plans, as well, and may also expand Medicaid eligibility.9
With treatment for alcohol use disorders improving, multiple approaches are available to fit the needs of many different patients, and they are becoming more affordable and technological as well. This only allows for further improvements in the future.
 Huebner, R.B., Ph.D, & Kantor, L.W., M.A. (2011). Advances in Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/295-299.pdf
 Grant, B.F.; Dawson, D.A.; Stinson, F.S.; et al. The 12month prevalence and trends in DSM–IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug and Alcohol Dependence 74(3):223–234, 2004. PMID: 15194200.
 Cohen, E.; Feinn. R.; Arias, A.; and Kranzler, H.R. Alcohol treatment utilization: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 86(23): 214–221, 2007. PMID: 16919401
 DAwson, D.A.; Grant, B.F.; Stinson, F.S.; et al. Recovery from DSM–IV alcohol dependence: United States, 2001–2002. Addiction 100(3):281– 292, 2005. PMID: 15733237.
 Dawson, D.A.; Grant, B.F.; Stinson, F.S.; et al. Estimating the effect of help-seeking on achieving recovery from alcohol dependence. Addiction 101(6):824–834, 2006a. PMID 16696626.
 Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: Project MATCH post-treatment drinking outcomes. Journal of Studies on Alcohol 58(1):7–29, 1997. PMID: 8979210
 David H. Gustafson, Ph.D.; Michael G. Boyle, M.A.; Bret R. Shaw, Ph.D.; Andrew Isham, M.S.; Fiona McTavish, M.S.; Stephanie Richards; Christopher Schubert; Michael Levy, Ph.D.; and Kim Johnson, M.S. (2011). An e-Health Solution for People With Alcohol Problems. National Institute on Alcohol Abuse and Alcoholism, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/327-337.htm
 Robert J. Meyers, Ph.D.; Hendrik G. Roozen, Ph.D.; and Jane Ellen Smith, Ph.D. (2011). The Community Reinforcement Approach: An Update of the Evidence. National Institute on Alcohol Abuse and Alcoholism, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/380-388.pdf
 Robert Maureen T. Stewart, Ph.D., and Constance M. Horgan, Sc.D. (2011). Health Services and Financing of Treatment. National Institute on Alcohol Abuse and Alcoholism, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/389-394.pdf