Abstinence is Overrated for Most People Who Want to Drink Less
In 1935 the only treatment for heart disease was nitroglycerin. Penicillin, the only antibiotic that had been discovered, was unavailable to doctors because scientists had not figured out how to mass produce it. Because of that, patients died of simple pneumonia. There was no chemotherapy, biological therapy, or radiation therapy to treat cancer, either. 1935 was also the year Alcoholics Anonymous was founded because there was no treatment for drinking.
A lot of progress has been made in most medical treatments in the las 80 years. But not much has changed in the treatment of alcoholism. For most patients its abstinence and the 12 steps, or nothing. But that’s changing. These are no longer the only two options.
In recent years there have been significant advances in science and medicine offering an understanding of how addiction works within the brain. In just the last decade, scientifically-proven methods have conclusively demonstrated the effectiveness of medication-based programs in helping people reduce or eliminate alcohol use. Naltrexone is one of the primary medications used for this purpose. This drug blocks the effects of internal (endogenous) opiates called “endorphins” in the brain. Naltrexone is a safe, FDA-approved medication proven to help people crave less alcohol and drink less over time.
Recent advances in modern addiction treatment recognizes that addiction to alcohol has both biological and psychological causes. In the past, the only treatment that has been available for alcoholism was attending Alcoholic Anonymous (AA) meetings. The philosophy of Alcoholics Anonymous is that addiction to alcohol is primarily a spiritual disease. AA has been the “go to” to approach for treatment of alcoholism and alcohol abuse since the 1930s. Up until recently, patients who failed the AA approach did not have other options. The program was not able to address the biology of addiction. Its methods do not appropriately consider the brain receptors and reward pathways that are involved in addiction.
Now, new and more effective options are available in the form of medication treatment programs. While AA will always have a place in recovery from alcohol dependence, it is not the right choice for everyone. It is certainly not the only choice when deciding that you’d like to change your drinking habits.
Fortunately, science and medicine has given us this knowledge. We now have medications, such as naltrexone, that can be very effective in helping people to stop or reduce their drinking. There are also a variety of other medications which have shown effectiveness as well: acamprosate, baclofen, topamax. These medications can be used independently or in combination with naltrexone to further reduce cravings for alcohol, and help to reduce or eliminate its use. As part of a comprehensive treatment program that may include such techniques as tracking alcohol consumption and counseling, these medications can be very effective in stopping excessive drinking.
Prescription drugs combined with therapy can assist the recovering alcoholic to achieve sobriety. Roger D. Weiss, MD, professor of psychiatry at Harvard Medical School notes that “medications can sometimes reduce the desire to drink. They can attenuate [weaken] the response that people get to alcohol, to make alcohol use less reinforcing. This can tremendously reduce the amount of alcohol consumed by an individual.”
The Sinclair Method to Reduce Drinking
The Sinclair Method, or TSM, is an evidence based, clinically studied treatment method for people who don’t necessarily want, or need to, remain abstinent to reach their recovery goals. Using naltrexone while continuing to drink naturally decreases your alcohol consumption, reduces cravings and urges to continue drinking, and gradually retrains your brain to not like alcohol. Our comprehensive program utilizing TSM addresses both biological and psychological causes related to alcohol use disorder, and each plan is individualized to help each patient reach their own personal goals, whether it be to moderate your consumption, or gradually work towards complete abstinence.
For more information on The Sinclair Method and how it coincides with modern day addiction treatment, call or text 938-365-HELP (4357).
–Paul Kolodzik, MD, Board Certified Addiction Medicine Specialist
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