Most experts assume that in the case of alcohol dependence, the therapy goal of permanent abstinence makes sense. Only if someone has been drinking alcohol for a relatively short period of time in such a way that one can speak of abuse is drinking behavior that is appropriate from a health and social point of view possible as a therapy goal, i.e. not completely abstaining from alcohol.
Controlled drinking
Studies have shown that a small proportion of alcohol dependents, around eight percent, are capable of controlled drinking. However, it is unclear which factors play a role in this and therefore also which patients are capable and which are not. At least some therapeutic institutions offer the possibility of controlled drinking as part of therapy. Those affected must strictly comply with the specifications: For example, the amount of fluids per week is specified and the patient must be abstinent on at least two days per week. However, if the affected person does not succeed in doing this over a certain period of time, the goal of therapy should also be complete abstinence.
Cognitive Behavioral Therapy
Central aspects of behavioral therapy are motivating conversations and measures to prevent relapses. The therapists will first workout goals for the therapy together with the patient and then take concrete steps to achieve these goals. For example, the triggers for high alcohol consumption are worked out.
In addition, the advantages and disadvantages of previous alcohol consumption are worked out and compared to the advantages and disadvantages of abstinence or moderate alcohol consumption.
If the patient has decided on abstinence or controlled alcohol consumption, he practices recognizing internal triggers for possible alcohol consumption in good time and reacting to them differently than before. For this he learns new and functional strategies for coping with stress and an alternative behavior to alcohol consumption. For example, if someone feels the strong craving for alcohol, they could go jogging instead or call a confidant to talk it out.
In exposure and rejection training, the patient practices facing situations in which alcohol plays a role. He learns to deal with the temptation to drink alcohol again and to decline offers or invitations to drink in a socially appropriate manner.
What happens to the doctor or in the addiction advice center?
Rarely is alcohol addiction the real reason for a doctor’s visit, but rather complaints that result from alcohol addiction.
Evidence of increased alcohol consumption can then be found, for example, by asking about the medical history, a physical examination and a blood examination. Which examinations are carried out depends, among other things, on the actual reason for the doctor’s visit and on the existing complications.
Not only doctors, but also advice centers are important points of contact if those affected want to do something about their alcohol addiction –, if only because they suspect it. The feeling that something is wrong with alcohol consumption is enough to start a conversation. Consultants and doctors first ask about the extent of alcohol consumption and personal living conditions. In order for a possible alcohol dependency to be recognized and correctly assessed, it is important that those affected are open to an honest conversation. In order to be able to diagnose alcohol addiction, psychological questionnaires are used. The doctor may take blood, because certain blood levels can also indicate alcohol addiction.
Individuals’ reasons for seeking treatment and their hopes for improvement are also discussed. This is followed by a group agreement on what to do next. There are resources available to help individuals reduce their alcohol intake or quit totally, regardless of the presence or absence of an alcohol use disorder.
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