1. The online blog Medical News Today posted “More Difficult to Achieve Control Drinking Them to Give up Alcohol Entirely” on 9-19-16. This article reviews recently published research done in sweetened that compared the results for people with alcohol addiction who decided to, with the support of their care provider, pursue total abstinence versus a group who pursued moderation of their drinking, with support of their care provider.
Around 90 percent of patients who were in agreement with their care provider on total abstinence were still sober at the follow-up, whereas only 50 percent who were in agreement with their care provider on controlled consumption treatment had succeeded in controlling their drinking at follow-up.
mhconcierge’s take: this study has serious implications for how mental health professionals should work with patients who are addicted to alcohol. Implications are less clear for working with patients who do not have addiction, but have abuse. In any case, for someone who clearly is addicted, advising moderation clearly would be a disservice.
2. The Keister Health News online newsletter posted “Many Doctors Treating Alcohol Problems Overlook Successful Drugs” on 10-3-16. This article reviews a recent project sponsored by the National Institute of Alcohol Abuse and Alcoholism, a division of the National Institute of Health, which had a panel of experts assess the current status of treatment for alcohol dependency. The goal was to increase awareness of treatment resources in addition to traditional 12-step treatment and aftercare programs. The panel found that medications are underused in the treatment of alcohol use disorder, including alcohol abuse and dependence. The NIAAA group report also notes that these medications can help with a “harm reduction” treatment approach. The KHN report included, “Often, care providers consider complete abstinence the only successful outcome of treatment, yet patients who drink while taking naltrexone get drunk without the opioid-induced reward to reinforce the behavior. The absence of this reward makes drinking less appealing in the future.” One expert is quoted: ““If we can reduce your intake 80 percent and reduce your heavy drinking days a lot, that’s also very positive,” he said. “Some people just aren’t ready. The idea of sobriety is just too big of a concept for them to wrap their head around.” And naltrexone can help patients with either of these goals — abstinence or reduced drinking.”
mhconcierge’s take: For our patients/clients with severe alcohol abuse behavior and who have not had success with traditional 12-step treatment, or are not interested in that approach, referring for a mediation evaluation is worth considering. Offering sobriety or harm-reduction oriented counseling in addition to medication can increase the person’s resources.