Alcohol Alcoholics Anonymous

In this section we briefly describe the peer self-help movement organized for helping individuals identified as alcoholics—Alcoholics Anonymous (AA). Because of space limitations we cannot describe in detail the major self-help groups for the treatment of drug problems, called Narcotics Anonymous (NA). NA is analogous to AA, however, and what wc know about AA can be applied readily to NA. 

Alcoholics Anonymous (AA) is a self-help organization for people whose common goal is recovery from alcoholism, and it is the most widely accessed resource for individuals with alcohol problems (McCrady and Miller 1993). The philosophy is based on the concept of alcoholism as a chronic disease that cannot be cured, but one that can be halted by means of complete abstinence. AA has described 12 principles or steps to guide those in recovery. Twelve-step facilitation, a manual-based psychotherapy to promote AA participation (Nowinski et al. 1992), was equally efficacious, compared with cognitive-behavioral and motivational enhancement therapies, in a large study of treatments for alcohol dependence (Project Match Research Group, 1997). 

McCrady BS, Miller WR (eds) Alcoholics Anonymous Oppormnities and Alternatives. New Brunswick, NJ, Rutgers Center of Alcohol Studies, 1993 McCrady BS, Stout N, Noel N, et al Effectiveness of three types of spouse-involved behavioral alcoholism treatments. Br J Addiction 86 1415—1424, 1991 McKay JR, Alterman Al, McLellan AT, et al Treatment goals, continuity of care, and outcome in a day hospital substance abuse rehabilitation program. Am J Psychiatry 151 254-259, 1994... 

Rosenblum A, Magura S, Palij M, et al Enhanced treatment outcomes for cocaineusing methadone patients. Drug Alcohol Depend 54 207—218, 1999 Rychtarik RG, Connors GJ, Dermen KH, et al Alcoholics Anonymous and the use of medications to prevent relapse an anonymous survey of member attimdes. J Stud Alcohol 61 134-138, 2000... 

Determine whether ethanol is a contributing causative factor. If so, reinforce counseling on the need for abstinence and provide appropriate resources to maintain abstinence (e.g., professional counseling, alcoholics anonymous). 

The treatment of drug dependence or addiction is primarily behavioral. The goal of treatment is complete abstinence, and treatment is a lifelong process. Most drug-dependence treatment programs embrace a treatment approach based on Alcoholics Anonymous. 

Alcoholics Anonymous (AA). Online. Available HTTP (accessed 2 April 2003). 

The immediate concern in the treatment of alcoholics is detoxification and management of the ethanol withdrawal syndrome. Once the patient is detoxified, longterm treatment requires complete abstinence, psychiatric treatment, family involvement, and frequently support from lay organizations such as Alcoholics Anonymous. 

Finally, as noted earlier, comorbid substance abuse, particularly with bipolar male patients, is a strong predictor of suicide-related lethality. It is critically important to recognize these complicating disorders and aggressively intervene with appropriate clinical strategies. Referral to Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other related counseling support programs, as well as prescription of naltrexone (Revia) in the appropriate patients, may also help to diminish the risk of serious morbidity (see also the section The Alcoholic Patient in Chapter 14). 

Little has been written in the CAT literature about either the development of service infrastructure or the establishment of mutual self-help groups, although there is a wealth of literature which considers the role of Alcoholics Anonymous and Al-Anon which is of relevance here.38 As with service co-ordination, however, service development is not a task which the community team can undertake in isolation. The support received from service managers and planners is crucial in determining the extent to which such a role can be operationalised. 

Alcoholics Anonymous (AA) is founded. Although the group will have its critics, its quasi-religious group self-help model will prove effective for many people. 

Caroll, Robert T xld. Substance Abuse Treatment. The Skeptic s Dictionary. Available online. URL http //skepdic.com/sat.html. Updated on November 11, 2003. This contrarian approach to substance abuse treatment acknowledges the good intentions of pioneers such as Charles Dederich of Synanon but argues that a number of programs violate human rights. The author questions the role and self-interest of professional interventionists who try to get substance abusers into treatment. He also argues that there is an inherent contradiction between the disease model of substance abuse and the moral approach of 12-step organizations such as Alcoholics Anonymous. 

Al-Anon is a national support organization for family members of alcoholics, and Alateen performs the same function for children of alcoholics. The organization is derived from Alcoholic Anonymous and adapts the 12 steps and other AA traditions to help persons intimately affected by others abuse of alcohol. There are more than 24,000 Al-Anon and 2,300 Alateen groups in 115 countries worldwide. 

Narcotics Anonymous URL http //www.na.org E-mail fsmail na.org Phone (818) 773-9999 P.O. Box 9999 Van Nuys, CA 94109 Narcotics Anonymous started in the late 1940s as an attempt to apply the successful 12-step program of Alcoholics Anonymous to narcotics abusers. Trday the organization holds more than 31,000 weekly meetings in more than 100 countries worldwide. 

---