08/22/2024
Approximately 10% of individuals addicted to alcohol consume nearly half of all alcohol produced and sold.
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From a clinical perspective, complete sobriety resulting from treatment is considered the safest and most convenient outcome (Gastfriend D.R., 2009).
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However, while clinicians often aim for long-term abstinence, many clients seek temporary abstinence or controlled alcohol consumption.
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Only about half of the clients seeking help actually want to quit drinking entirely. The unwillingness or perceived inability to stop consuming alcohol is often the main barrier to seeking help.
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Rather than stigmatizing (“alcoholism is a deadly and progressive disease!”) or insisting on immediate cessation, it’s crucial to understand the functions of alcohol consumption and the problems it solves for the client.
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For some individuals, is secondary and associated with underlying issues like depression or anxiety.
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For others, it may be the result of social influences, such as friends and colleagues. Some use alcohol as a coping mechanism for stress.
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Given these diverse factors, it’s ineffective to apply a one-size-fits-all approach to addiction treatment. In some cases, reducing alcohol consumption can be a reasonable alternative to complete abstinence.
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Two key questions need to be addressed:
1. Can an addicted person relearn how to control their alcohol use?
2. How can “controlled drinking” be achieved?
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Disclaimer: For those with a long history of addiction or serious genetic predisposition, controlled consumption may be difficult or unattainable.
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The likelihood of success in achieving controlled consumption can be estimated based on drinking patterns:
🔸If 8 or more out of 10 drinking episodes end in a “binge,” the chances of success with controlled drinking are low (about 10%).
🔸If the ratio is 5 out of 10, attempting controlled consumption is possible, but success is not guaranteed.
🔸Therapy can help improve the ratio, potentially reducing binges from 10-12 per year to 1-2 per year, providing significant relief for the individual and their family, as well as financial benefits.
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Controlled alcohol consumption may be achieved through a combination of awareness and behavioral strategies.
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Monitoring frequency and amounts consumed can be both useful and therapeutic. The therapist should be prepared for resistance, help highlight the person’s strengths, and understand the factors that influence drinking behavior.
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To raise awareness, the therapist should explore the following:
1. The perceived benefits of drinking
2. The negative consequences
3. Past considerations of limiting or quitting
4. Previous attempts at control or abstinence
5. The success of these attempts
6. The difficulties encountered
7. The lessons learned from these attempts and experiences
8. Potential strategies for controlling drinking
9. Triggers for "losing control" and how to avoid them
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Behavioral strategies can vary widely. Examples include:
🔹Avoiding alcohol at home
🔹Only drinking in social settings
🔹Drinking only after meals
🔹Taking medication to reduce cravings
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One client successfully reduced their from two bottles per evening 6-7 days a week to 350 ml 4-5 days a week by brushing their teeth before drinking.
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The unpleasant taste of wine after toothpaste served as an effective deterrent, demonstrating how a simple strategy of creating disgust can work well for some individuals.
Q-Medical / D.AvtonomovⒸ
