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Mary Jeffery Stevens, LPC, LISW
Private Practice Mental Health Practitioner
Lilley and Associates
1910 Crown Park Court
Columbus, Ohio 43235
(614) 457-8359
While AA and NA continue to be the most widely known ways of getting help for substance abuse, they are no longer the only ways. In fact, so many new techniques are around that it becomes important to know about them in order to both offer clients the most suitable of them and to help steer clients away from the least effective of them.
Alternatives to AA have grown out of both new science arid differences in world-view. One of the best, Women for Sobriety, which offers groups in many areas, grew out of views of the disease of alcohol and of ideology. It posits that the concept of "powerlessness" central to AA is harmful to women and their recovery and offers as alternatives "I have a life-threatening problem that once had me" and "I am responsible for myself and my actions." Women can also benefit from WFS because it allows a freedom that does not always occur in AA groups that are traditionally male-dominated. While WFS does not state directly in its written material that it is based on a feminist ideology, it clearly is. WFS emphasizes a 'whole person' approach, as do many but not all groups and programs.
Rational Recovery is a less wholistic approach. It emphasizes the power of the individual and encourages short-term, if any, group participation. Many Rational Recovery written materials indicate one could be successful going it alone rather than seeking any interactive treatment. Rational Recovery does, positively, emphasize the strengths of the person. Changes in behavior and thinking are emphasized in contrast to WFS which also addresses feeling.
An individual counseling approach might be appropriate for persons who shun groups (for whatever reason). A cognitive-behavioral approach is favored. Much of the cognitive-behavioral approach is used in group treatment settings as well, though less matter-of-factly than might be the case in individual work. Family treatment in traditional counseling would also be beneficial but is not always necessary. A therapist well-versed in family systems models might choose to do only or primarily family work with addicts or alcoholics.
Medical approaches are increasingly influenced by newer research that indicates that the brains of alcoholics and addicts function differently. Antidepressants and other drugs that work on seratonin arid endorphins are successful in some cases. One hypothesis is that changing dysfunctional brain chemistry allows the person to stop self-medicating a disorder. Another possibility is that substance abuse over time alters the brain chemistry. This is particularly true for cocaine. Antabuse is also used as a medical treatment; it induces sickness if an alcoholic drinks. A newer drug, Revia, does not induce illness but blocks the 'buzz' from alcohol and may have some benefit in reducing cravings.
Alternative medicine also provides new approaches. Accupuncture is now being used in formerly traditional medical settings. Accupressure and cranial electro-stimulation (which may be self-administered) work, as does accupuncture on stimulating endorphin production. There has been some research on dietary approaches to alcoholism,. The underlying supposition to these is that certain dietary habits disturb body chemistry and create cravings for alcohol or other drugs.
Hypnosis claims approximately a 50% success rate with addictions. It works by planting a subconscious reminder about not drinking, by helping the person subconsciously identify as a sober person and by helping the persons relate; in situations that might previously have triggered drinking.
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