Alcoholism treatment

Jun 16, 2008 Editorial

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The Minister of Health last week announced that an out-patient Drug Treatment and Rehabilitation Centre will be established in the compound of the Georgetown Public Hospital Corporation.

Treatment for alcoholism will be an integral feature of the centre, according to the ministry’s release, and will include the provision of an Alcoholics Anonymous alternative to substance rehabilitation while promoting abstinence from alcohol and other substances.

Because of the enormity of the alcoholism problem in our country, we would have hoped that the ministry would have included the word “alcoholism” along with “drug” in the name of the institution.

Even though, technically, alcohol may be considered a drug that is not the common usage in Guyana. We do not need any barriers to keep alcohol abusers away from help.

The facilities of the treatment and rehabilitation centre will be launched on June 26 in observance of International Day against Drug Abuse and Illicit Trafficking.

The ministry’s efforts, while long overdue on the scourge of alcoholism, must be encouraged and deepened. The consumption of alcohol in our country has reached epidemic proportions, and the effects on the persons involved and on the social fabric — not to mention the economy — are staggering.

The approach of the ministry to co-ordinate its efforts with the two ongoing private initiatives is commendable, as is its decision to train some fifty primary health care workers and other health workers in “motivational interviewing.”

All studies have shown that the successful treatment for alcoholism has no one silver bullet, and that a multifaceted approach is necessary.

That the centre will be developed with assistance from Dalhousie University of Canada is also positive, since it suggests that the latest techniques and appropriate drugs would be deployed.

Over the last half-century or so, the techniques of alcoholism therapy have traditionally been based on clinical experience and intuition, with little rigorous validation of their effectiveness.

In the past two decades, however, modern methods of evaluating medical therapies have been increasingly applied to alcoholism treatment, and the success rates of treating alcoholics have increased significantly.

In the developed countries, self-help groups are the most commonly sought source of help for alcohol-related problems.

Alcoholics Anonymous (AA), one of the most commonly known self-help groups, outlines twelve consecutive activities, or steps, which alcoholics should achieve during the recovery process.

The ministry announced that the AA approach would be included in its program. Alcoholics can become involved with AA before entering professional treatment, as a part of it, or as aftercare following professional treatment.

The beneficial effects of AA may be attributable in part to the replacement of the participant’s social network of drinking friends with a fellowship of AA members who can provide motivation and support for maintaining abstinence.

In addition, AA’s approach often results in the development of coping skills, many of which are similar to those taught in more structured psychosocial treatment settings, thereby leading to reductions in alcohol consumption.

However, some studies have found that in-patient treatment, with a combination of professional treatment including psychosocial and AA, will achieve better results for more people than AA alone.

The words of one expert in the field indicate that our ministry is on the right track: “Alcoholism clinicians have access today to a wide range of treatment options for their patients.

Some of these treatments, such as 12-step self-help programs, have been around a long time. Others — including brief intervention and various therapies borrowed from other fields, such as motivational enhancement therapy and couples therapy — are relatively new concepts that have been shown to be effective in reducing the risk for alcohol-related problems.

The key change that has occurred, of course, is the advent of alcoholism clinical research, which over the past fifteen years or so has made significant progress towards rigorous evaluation of both existing therapies and newly developed therapies for use in treating alcohol-related problems.

Finally, continued research on alcohol’s effects in the brain and on the links between brain and behaviour, which has already led to the development of medications to reduce craving, is likely to provide clinicians with a range of highly specific medications that will, when used in conjunction with behavioural therapies, improve the chance for recovery and the lives of those who suffer from alcohol abuse and dependence.”

We just have to ensure that we do not drop the ball.

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