Alcohol has a long and storied history in not Just American culture, but in many other world cultures as well. Its use in beverages is believed to have begun almost 10,000 years ago when civilizations in ancient Persia and the Middle East produced a fermented drink from honey and wild yeasts ("An Alcohol History Timeline," 2011). Wine, beer and liquor would eventually follow (in that order), as numerous societies enjoyed the intoxicating effects of the drug.
During the 19th century in the United States, the average American drank 7 gallons of pure alcohol per year ("What in America's History," 2005). This rampant drinking led to temperance movements and reformers that pushed for local and national prohibition. Groups such as the Women's Christian Temperance Union (WEST) would eventually merge with the Anti- Saloon League and form a powerful coalition that elected officials to Congress and put pressure on the government to ratify Prohibition ("What in America's History," 2005).
The National Prohibition Act was subsequently enacted in 1920, outlawing the manufacture, sale, or transportation of alcohol. The Act was repealed 13 years later in 1933, but the message was clear: the effects of alcohol were seen by many as ungenerous and destructive, and these effects needed to be addressed. Today, the problems of alcohol abuse and alcoholism have become almost epidemic in American society, as recent studies have asserted that 53% of adults in the U. S. Have reported that one or more of their close relatives has a serious problem with drinking ("Alcohol Stats," 2013).
Each year in the United States alone, nearly 50,000 cases of alcohol overdose are reported, and in 2009, over 30 million people stated they had driven under the influence of alcohol at least once in the previous year ("Alcohol Stats," 2013). In 2007, the Center for Disease Control and Prevention (CDC) reported over 14,000 alcoholic liver disease deaths and over 23,000 alcohol-induced deaths (not counting accidents and murders) ("Alcohol Stats," 2013). The CDC also reported that in 2006, excessive alcohol consumption cost the United States' economy $223. Billion ("Excessive Drinking," 2014). In an effort to combat the dangers of alcohol abuse and alcoholism, numerous in- patient and out-patient treatment centers are available to those that are seeking help for their affliction. This paper takes a look at four of these treatment options in the rater Cincinnati area. These options include Alcoholics Anonymous, Sojourner Recovery Services in Hamilton, OH, Delbert House in Cincinnati, OH, and Becket Springs in West Chester, OH.
The model of treatment that each facility or program employs will be examined, as well as success rates and recidivism. Additionally, this report will look at the efficacy of various models of alcohol treatment and how successful they are for the patient. Ultimately, it will lend advice as to the optimal treatment strategy one should choose when trying to overcome one's addiction to alcohol. Treatment Review One of the most common and well-known methods of alcohol treatment in the United States is the group-oriented, outpatient design of Alcoholics Anonymous (AAA).
At its core, AAA is a 12-step program that utilizes anonymous group meetings to help facilitate the overarching goal of abstinence for each of its members ("Alcoholics Anonymous 12 Steps," 2010). The 12 steps are divided into four phases: admitting one has an addiction and needs to abstain; submission of the alcoholic's will to "the power of God or a Higher Authority'; making amends to those the individual has armed or wronged in the past; and spreading the message of AAA and its 12 steps to others ("Alcoholics Anonymous 12 Steps," 2010).
By "working the steps" and attending the meetings, the individual is purportedly given a plan and support group to help him or her resist the urge to drink alcohol. According to Lee Ann Gaskets, Drop, of University of California-Berkeley, there is controversy on the research into the capability of AAA. Therefore, she provides "a focused review of the literature on AAA effectiveness" (Gaskets, 2009). Using six criteria to establish a causal link between AAA ND abstinence, Swastikas states that there is some evidence that AAA is an effective course of treatment for someone seeking to quit drinking.
She writes, "rates of abstinence are about twice as high among those who attend AAA, and higher levels of attendance are related to higher rates of abstinence" (Swastikas, 2009). Still, she ultimately concedes that more exhaustive research needs to be completed before judging the effectiveness of AAA. In a separate article entitled "Exposing the Myth of Alcoholics Anonymous," freelance technical writer and attendee of "hundreds of AAA tenting," Stephen Mohr rejects the notion that AAA is an effective mode of treatment for alcoholics.
He writes, "The truth is that the available evidence strongly suggests that AAA treatment provides very little or no long-term help for active alcoholics. Further, there is ample evidence that long-term repeated exposure to this program is actually dangerous to many alcoholics who would fare better if left on their own" (Mohr, 2009). Mohr cites Ass own statistics when establishing the ineffectiveness of AAA, writing, "in 1989 AAA reported that, on average, after six months 3 percent of new attendees had left the program and that after one year only 5 to 7 percent remained" (Mohr, 2009).
Perhaps more damning, Mohr recounts the findings of Harvard psychiatrist Dry. George Valiant. Beginning in 1983 and then every year for eight years afterward, Dry. Valiant followed up on 100 alcoholic subjects admitted to a clinic in Cambridge, MA, and who were subsequently enrolled in Alcoholics Anonymous. He found that only five of the 100 subjects never relapsed back into alcoholic drinking, which was a rate no better than if they had been left to attempt abstinence on their own (Mohr, 2009).
Worse yet, he found that three subjects a year died from their drinking habits, despite being enrolled in the 12-step program (Mohr, 2009). And while these findings were from the asses, the fact that AAA has not changed its approach and/or treatment methods in the 80+ years of its existence indicates that they are still pertinent to today. Moreover, these data suggest that AAA is not only ineffective, but the fact that it is so widely regarded as the premier source of alcohol treatment prevents patients from pursuing more useful modes of treatment - ones that could potentially save the alcoholic's life.
The Becket Springs rehabilitation facility in West Chester, OH, is one of the alternatives to AAA that an individual suffering from alcoholism may consider. Becket Springs offers both in- patient and outpatient services to help meet the needs of the patient. The in-patient program's goal is "to teach [the individual] the tools of recovery and relapse prevention so that [he or she] can create a life worth living" (Patient Handbook, 2). When the patient is first admitted, he or she is assessed to develop an individual treatment plan. The assessment team and the patient will formulate a set of goals to Ochs on during treatment.
The assessment team itself is comprised of a psychiatrist, psychologist, staff nurse, patient care assistant, recreational therapist and social therapist all working together to facilitate the recovery of the patient. Individual treatment includes detoxification (if necessary), medical prescriptions written by a psychiatrist, psychological evaluations with the psychologist, group therapy through "games, crafts, leisure education, creative expression and relaxation training," and individual and family therapy provided by a licensed therapist or social worker (Patient Handbook, 2).
Becket Springs encourages communication between the patient and family throughout treatment, and designates a daily time period for phone calls in addition to a visitation schedule that allows two hour-long visits per week and a family meal during the weekend. Along these same lines, Sojourner Recovery Services, located in Hamilton, OH, is a non-profit organization that provides in-patient and outpatient substance abuse treatment for those addicted and their families.
Sojourners assessment service is a thorough evaluation conducted during a face-to-face session in order to determine the extent of addiction and optimal recovery strategy. The staff at Sojourner takes a holistic approach toward treatment, and offers a diverse array of programs, including: one-on-one counseling, lectures, group therapy, family sessions and discussion groups. The aforementioned staff consists of "experienced counselors, professionals and volunteers - many of whom are recovering from addiction themselves - that genuinely care about each and every person's success" ("Sojourner Recovery," 2012).
Therapy models of recovery include: motivational enhancement to encourage the patient to become receptive to the healing process; "seeking safety' to improve coping skills; "seven challenges" for adolescents seeking recovery; "stages of change" which helps patients progress through the five stages of recovery; cognitive-behavioral, which utilizes the belief that one's thoughts cause one's feelings and behaviors, rather than external people or factors; and acupuncture to help alleviate symptoms and stresses associated with alcohol or drug withdrawal ("Sojourner Recovery," 2012).
The duration of stay for the in-patient program varies according to the needs of the patient, giving the person as much or as little time as he or she needs. The Delbert House in Cincinnati, OH has a few different branches across the city. The Delbert House located in Clifton, OH, is a non-profit organization focused on intensive inpatient treatment of homeless men dealing with substance abuse - namely, alcohol abuse.
According to general manager Chris Weanling, this branch of the Delbert House is a "shelter-plus-care" operation, which attempts to rid patients of their addictions while helping to reintegrate the individuals as functioning units of society (C. Weanling, personal communication, July 21, 2014). They are encouraged to actively seek out employment and permanent residency. The Delbert House models of treatment include self-help classes, group concussions, one-on-one counseling, AAA meetings, and AN meetings (C. Weanling, personal communication, July 21, 2014).
A typical day in the life of a patient starts with a 7:30 a. M. Wake-up call followed with breakfast at 8 a. M. The rest of the morning consists of life-skills classes and chemical dependency education courses. At noon, the patients have lunch, and then attend their various therapy sessions (group and/or individual) in the afternoon. Dinner is served at 5:00 p. M. , and then the patients have some free time before they are required to attend an AAA or AN meeting (C. Weanling, personal communication, July 21, 2014).
The Delbert House does not allow patients to use alcohol or any illicit drugs while they are enrolled, and thus each patient is subjected to a random, periodic urinalysis and/or breath-analysis test. In any given month, five or six patients out of 60 will test positive, with the incidences of positive tests fluctuating from season to season and spiking around a holiday(C. Weanling, personal communication, July 21, 2014). The operation is largely state- funded, with tax dollars making it possible for the Delbert House to help the lives of the men it houses (C. Weanling, personal communication, July 21, 2014).
Given all the models of alcohol treatment (AAA, group therapy, cognitive behavioral, motivational enhancement, acupuncture, etc. ), Just how effective are they at promoting abstinence within the alcohol abuser? As discussed above, the effectiveness of AAA seems dubious at best, and downright dangerous at worst. This is very unfortunate considering the fact that almost all court-appointed rehabilitation for alcohol offenders in Hamilton County involves AAA or an equivalent 12-step program ("Treatment Options," 2009). On the other hand, research on continuous outpatient group therapy seems to indicate its effectiveness.
In J. Kim, et al. 's article, "The Effectiveness of Continuous Group Therapy for Outpatients with Alcohol Dependence," he states that 3, 6 and 12 month abstinence rates of 94 cognitive group therapy subjects "were 56. 4%, 30. 6%, and 16. 9%," respectively (Kim et al. , 2011). The same abstinence rates for 83 subjects in a standard outpatient therapy group "were 28. 6%, 11 . 7% and 5. 2%," respectively (Kim et al. , 2011). He thus concludes that continuous group therapy for outpatients is a practical and effective means of achieving abstinence.
Inpatient group cognitive behavioral therapy (CAB), though, is a little murkier. In their article, "The Effectiveness of an Inpatient Group Cognitive Behavioral Therapy Program for Alcohol Dependence," News and Owe evaluated the effectiveness of attendance at an in-patient CAB program aimed at treating alcohol abuse. The study included 37 males and 34 females that attended 42 CAB sessions in three weeks, with News and Owe gathering evidence on one and three-month follow- ups regarding the drinking habits of the subjects.
The study data indicated that greater attendance at CAB sessions for inpatients did not result in greater abstinence rates, nor did it correlate with a reduction in the quantity of alcohol consumed from he levels of pre-treatment (News & Owe, 2005). Thus, while patients that attended CAB sessions did seem to stand an improved chance of abstinence, News and Owe concluded "this study was unable to provide full support for the effectiveness of group CAB and cognitive models on problem drinking" (News and Owe, 2005).
Another strategy for alcohol recovery is that of acupuncture. Acupuncture is a form of complementary and alternative medicine that uses the penetration of thin needles into specific "occupants" along the skin of the body ("Acupuncture" 2014). Choc and Hang reviewed the efficacy of this approach in their article, "Acupuncture for Alcohol Dependence: A Systematic Review. " After systematically searching nineteen electronic databases for randomized controlled trials, they found eleven studies that involved 1,110 cases.
Though they conclude the results were "equivocal" and that "more research and well-designed, rigorous and large clinical trials are necessary," the data they did discover suggest that there is no difference between acupuncture treatment and "sham treatments" (Choc and Hang, 2009). In a separate study by Karts, Passive, Frederica, Wises and Schneider, thirty-four alcoholics were treated tit acupuncture to assess its effect on withdrawal symptoms.
The study was able to conclude that "acupuncture as an adjunctive treatment to carbonized medication shows promise for the treatment of alcohol withdrawal symptoms" (Karts, Passive, Frederica, Wises, & Schneider, 2002). Thus, while acupuncture may not be helpful for an individual hoping to obtain abstinence, it does look to be promising in helping to relieve some of the anguish of going through withdrawal. In addition to models of therapy, most treatment centers also offer medications to help the patient on their road to recovery. Daniel E.
Jonas, M. D. , M. P. H. , of University of North Carolina, et al. , completed a recent study that analyzed more than 120 different studies as to the effectiveness of various pharmacological pills on the alcoholic, and found that comparative and oral maltreatment showed the greatest potential for decreasing alcohol ingestion Moons et al. , 2014). Dissimilar, an oral medication available since the asses, did not show adequate evidence to support the notion that it can prevent relapse drinking or improve drinking level outcomes Moons et al. 2014). The article goes on to state that the four most effective medications are commemorates, maltreatment, depreciate and maleness, but cautions that patients should share in the decision-making process with the physician, and medication should be taken in conjunction with other modalities of treatment Moons et al. , 2014). Conclusion Judging by national recovery data, it can require a nearly Herculean effort for an alcoholic to successfully abstain from alcohol for a long period of time (years).
The national average for alcoholics that try to remain abstinent for one year without outside help is around 5% ("Alcohol Stats," 2013). Even Alcoholics Anonymous, by its own admission, has a 93% turnover rate in one year. With this in mind, it's important for anybody that is trying to quit to not try to do so alone. The individual should attempt to enroll in either an inpatient or outpatient program at a local recovery facility. In the Cincinnati area, this could include Sojourner Recovery Services in Hamilton, OH, or Becket Springs in West Chester, OH.
Both offer a variety of programs to foster an intrinsic change within the individual, and employs a multitude of treatment models and pharmacological aids that can be blended together for an optimal individual recovery plan. Perhaps most importantly, the person that is trying o recover should actively seek the help from his or her immediate family, if possible. Abstinence from alcohol is very difficult to achieve for an alcoholic, and a strong support system from people close to the affected individual will go a long way to facilitating a successful and long-lasting recovery.