Comparison of the importance of Alcoholics Anonymous and outpatient counseling to maintenance of sobriety among alcohol abusers

Forgiveness and Alcohol Problems Among People Entering Substance Abuse Treatment

Forgiveness is argued to be highly relevant to problematic substance use, yet supportive empirical evidence is lacking. Findings are presented from a longitudinal study exploring the relationship between religiousness and spirituality (RS) variables and alcohol use disorders. We examined forgiveness of self (ForSelf), of others (ForOthers), and by God (ByGod), hypothesizing positive relationships with RS and negative relationships with alcohol use and consequences, at both baseline (N = 157) and six-month follow-up (N = 126). ForSelf scores were significantly lower than ForOthers and ByGod scores, and ForOthers scores increased modestly over time. ByGod was most consistently associated with other RS variables. ForSelf and ForOthers were associated with alcohol-related variables at both time points, and baseline ForSelf and ForOthers were associated with fewer drinking consequences at follow-up, but not after controlling for other pertinent variables. ForSelf may be most difficult to achieve and thus most important to recovery, thereby preventing full recovery and fostering relapses.

Diagnosis and treatment of alcohol dependence in older alcoholics

Treatment of alcohol dependence among older alcoholic patients should be multidimensional to address as many potential relapse factors as possible. As the literature suggests, alcohol-related disorders often are under diagnosed and under treated. More efforts are needed to identify and improve diagnosis of these disorders in older alcoholic patients. For better outcomes, age-specific programs should be implemented. Furthermore, when treating elderly patients, basic therapeutic principles like respect for privacy and a respectful attitude should be adopted. Adequate medical, pharmacologic, and psychiatric treatment should be provided when appropriate. Medication to reduce cravings should be considered in patients without contraindications to its use. Participation in individual, group, and family therapy and attendance at self-help group meetings such as AA should be encouraged (Table 8). Despite the lack of empiric testing to validate these recommendations in an elderly population, clinical experience suggests that adherence to these recommendations will benefit elderly patients just as it has the general adult population. Research is necessary to explore the benefits of alcohol treatments in elderly patients. Until then, adherence to these recommendations should be the best available approach.

Alcoholics Anonymous: membership characteristics and effectiveness as treatment

Reports published since 1976 were reviewed with respect to the characteristics of alcohol-dependent individuals who affiliate with Alcoholics Anonymous (AA). No "AA personality" was identified inasmuch as systematic differences have not been observed between affiliates and nonaffiliates. Evaluation studies were reviewed with regard to data on AA's effectiveness as treatment, leading to several observations. When "alcoholics" participate in AA in addition to professional treatment, their outcome on drinking and other indices is no worse, and may be better, than that of patients who do not involve themselves in AA. AA involvement tends to be associated with relatively high abstinence rates but with only fairly typical total improvement rates. The effectiveness of AA as compared to other treatments for "alcoholism" has yet to be demonstrated. Reliable guidelines have not been established for predicting who among AA members will be successful. An alcohol-involved person's chances of participating in AA are related to the type of drinking outcome achieved. Caution was raised against rigidly referring every alcohol-troubled person to AA.