Academic journal article Alcohol Research

Advances in Alcoholism Treatment

Academic journal article Alcohol Research

Advances in Alcoholism Treatment

Article excerpt

Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and costeffectiveness of treatment for alcohol use disorders (AUDs). This overview article summarizes the approaches reviewed in this issue, including potential future developments for alcoholism treatment, such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with AUDs and cooccurring disorders, the role of 12step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment. This research will not only reveal new medications and behavioral therapies but also will contribute to new ways of approaching current treatment problems. KEY WORDS: Alcohol use disorders; alcohol dependence; alcoholism; treatment; treatment models; treatment research; treatment issues; costeffectiveness; pharmacotherapy; medication therapy; behavior therapy; emerging technologies; cotreatment; 12stepmodel; continuing care; health care delivery

Alcoholism treatment, as it exists today, rests on decades of research exploring the most effective ways to help people reduce their alcohol use or to stop drinking. That research has paved the way for the development and application of newmethods and therapies and will continue to influence treatment practice in the future.

This article reviews the origins of alcoholism treatment and major studies of behavioral therapies and medications for treating alcohol dependence. It then provides a preview of the topics covered in this issue, including the potential future developments for alcoholism treatment such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with alcohol use disorders (AUDs) and cooccurring disorders, the role of 12step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment.

ORIGINS OF ALCOHOLISM TREATMENT

Alcoholics Anonymous (AA) was founded by Bill Wilson and Bob Smith in Akron, Ohio, in 1935. AA's program of spiritual and character development, the 12 Steps, is based on the premise that turning one's life and will over to a personally meaningful "higher power," is the key to recovery. Another essential idea is that sobriety or recovery depends on the admission of powerlessness with respect to alcohol or other substances of abuse.

The Minnesota Model of addiction treatment was created in a State mental hospital in the 1950s. It was first practiced in a small nonprofit organization called the Hazelden Foundation. In this approach, professional and trained nonprofessional (recovering) staff cooperated in applying the principles of AA. The model called for an individualized treatment plan with active family involvement in a 28day inpatient setting and participation in AA both during and after treatment. Throughout the 1950s, Hazelden took the stance that (1) alcoholism is a disease and not a symptom of an underlying disorder and that it should be treated as a primary condition and (2) alcoholism affects people physically, mentally, and spiritually and that treatment for alcoholism should take all three aspects into account.

Around the same time that AA and Hazelden treatment methods were being refined and popularized, the study of alcohol abuse and alcoholism was expanding. Alcohol research, including the study of alcoholism treatment, found a home at the National Institutes of Health in 1970, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) was founded. …

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