“No” to rehab?

Alcoholism 01

Alcoholism 01 (Photo credit: Wikipedia)

I was asked by a friend to comment on this article.

Here’s the response I sent him:

Well, he’s got a point. But he’s also gotten a lot wrong, including the name of the NIAAA. It’s National Institute on Alcohol Abuse and Alcohol-ism.
What he’s right about is that not everyone who has an alcohol problem needs or should receive treatment. And, surveys of looking at the prevalence and course of alcoholism and addiction find that large numbers of people experience “natural recovery”, “maturing out” or “spontaneous remission”. Some abstain and others moderate.

He interprets these findings as meaning that anyone who chooses to quit, can.

My interpretation of the findings are that “alcohol dependence” does not equal alcoholism and that conflating the two produces a lot of false positives for alcoholism. The NIAAA article says:

In most persons affected, alcohol dependence (commonly known as alcoholism) looks less like Nicolas Cage in Leaving Las Vegas than it does your party-hardy college roommate or that hard-driving colleague in the next cubicle.

Large numbers of college students meet criteria for dependence but will moderate or quit once they graduate, start careers and form families.

We have the same problem in studies of “recovery”: http://wp.me/p1n5A8-2Em

It’s a lot like the stories of Vietnam veteran spontaneous recoveries from heroin addiction: http://wp.me/p1n5A8-1SO

We also know that lots of alcoholics recover without treatment. (Jim and I did.) Whether your an alcoholic or a heavy drinker, you’re more likely to successfully resolve your problem if you have a lot of recovery capital. His 7 things address a lot of recovery capital domains.

I’m a fan of motivational interviewing, we train staff in it (Though I see it as a tool rather than a solution.) and I agree that a confrontive style is both ineffective and unethical. However, studies don’t find it to be more effective than other approaches. Just this week, a study was published that found few differences between MET (based on motivational interviewing) and counseling-as-usual: http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/a0017045

2 Comments

Filed under Controversies, Mutual Aid, Research, Treatment

2 responses to ““No” to rehab?

  1. I do agree with you…completely.

    It is an individual choice to go to rehab or not.

    And one should make the proper “approach” with professionals to see if they really have a dependancy or not…

    Not every addicts need treatments.

    Myself, am glad to have gotten treatment, but I certainly would never force anyone even pretend that they have a dependency.

    It is to each individual to decide what they are, addicts or not, and if they do need treatment or not.

    Forcing someone to get treated makes things even worse for an addict, that we all know.

    Thanks for sharing…

    Sylvie from Quebec, Canada.

  2. Jason:
    The author’s confusion over the awkward NIAAA moniker is perfectly symptomatic of that agency’s confusion about its core mission. Since the cancellation of the merger with NIDA, NIAAA, in my humble opinion, risks trying to be all things to all drinkers.