o Motivation for abstinence is bound to waver. Renew that
motivation by frequently reminding yourself why you quit in the first
place
o Realize that relapse will occur. Don't use a minor slip-up as an
excuse to resume heavy drinking. Don't get fixated on recording
consecutive days of abstinence. A relapse does not wipe out all that
you've accomplished.
o Join a self-help group. AA is but one, Rational Recovery another.
Recognize that they don't work for everyone, but since they're free,
there's no risk in trying one.
CAN YOU PICK HIM OUT OF A LINEUP?
Most alcoholics, explains Mark Schuckit, are not out on the street;
they are individuals as unique and at the same time ordinary as you and
me. That's one more reason not to apply a uniform treatment. "Alcoholics
have jobs and close relationships, rarely (if ever) develop severe
problems with the law, and many go unrecognized as alcoholics by their
physicians. While most of these people's lives will eventually be
impaired by their substance use, it is amazing how resilient people are."
Other myths about the alcohol abuser;
o Drunks stay drunk. Actually, says Schuckit, most people drink
more heavily on weekends, and start out each day alcohol-free.
o Drinkers can't quit. The truth is, substance abusers have little
or no trouble quitting, and often do. Temporary drying out is easy and
common. The problem is that sooner or later they begin drinking
again.
o Alcoholics can't control their drinking. Actually, most alcohol
abusers can and do control their drinking -- for a short time, and often
after a period of abstinence.
o Alcoholics have a preexisting psychiatric disorder, such as
anxiety or depression, which they are attempting to mediate with alcohol.
The truth: Only about 20 percent of alcoholics suffer from a psychiatric
disorder. And though many claim they drink to combat depression or
sleeplessness, those problems are often caused by drinking and disappear
when drinking stops.
o Alcoholism is genetically determined. In fact, only about 20
percent of sons of alcoholics become alcoholics themselves; the number of
women is even less. And though the risk of alcoholism is higher for
identical than fraternal twins, most children of alcoholics do not become
heavy drinkers themselves. As Schuckit emphasizes, "Predisposition does
not mean predestination."
o Alcoholics drink because their friends do. Although it's true
that we drink more often when our peers drink, the fact is that once a
person begins to drink heavily, light-drinking or nondrinking friends are
likely to fall away, leaving a peer group that consists mostly of other
alcoholics.
o Once an addict, always an addict: therefore alcoholics should not
take any psychotropic drugs, even prescribed medications. A growing body
of research indicates that for some alcoholics, pharmacotherapy can
provide a specifically targeted therapy that helps maintain recovery and
abstinence. The AA model is traditionally distrustful of any
medication.
MYTHOLOGY OR METHODOLOGY?
Bill Wilson, the founder of Alcoholics Anonymous, based his ground
breaking 12-step program on what worked for him. Half a century later
there are 2 million AA members worldwide, half of them in this country,
and many clinicians prescribe attendance. There's no doubt that AA has
helped or even saved the lives of many. Yet the fundamental tenets of the
AA-style self-help movement will always remain unverified -- simply because
the program is anonymous and cannot be formally studied.
According to Emil Jr. Chiauzzi, Ph.D., and Steven Liljegren, Ph.D.,
there is no rigorous scientific evidence to support some widespread AA
teachings. Some of the disputed myths include:
o The most essential step in treatment is admitting alcoholism.
Acceptance of the label "alcoholic" is considered half the battle in
traditional treatment. "Hi, my name is John and I'm an alcoholic," is the
typical opener at AA meetings. Yet researchers find that some individuals
feel demoralized and depressed by labeling themselves the victims of an
incurable, lifelong disease.
o Addicts cannot quit on their own. In fact, say Chiauzzi and
Liljegren, 95 percent of smokers stop without the help of peers or
professionals, even though addicted people themselves consider nicotine
more addicting than alcohol. Although only about 20 percent of alcoholics
recover solo, many may not be tapping their ability to do so.
o AA is crucial for maintaining abstinence. The number of
alcoholics far outnumbers AA members (13 million versus 1 million),
indicating that AA is not for everyone. Any increased propensity for AA
members to stay on the wagon may reflect the fact that alcoholics who are
already committed to recovery, are also more likely to join AA.
o Recovering patients must avoid cues associated with drinking.
Researchers find that systematically exposing the patient to
long-standing cues can dramatically reduce the relapse danger those cues
pose. Using slides, videotapes, and other paraphernalia, researchers
found decreased reactivity among those addicted to heroin, cocaine, and
alcohol. Cue exposure and coping skills may offer alcoholics a helpful
tool in recovery.
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