Alcoholism treatment is not new, and a look at the medical and practical history is worthwhile. In May 2013, the Diagnostic and Statistical Manual of Mental Illness (Volume 5) was released by the American Psychiatric Society. When referencing alcohol, prior to that Volume, there had been two distinct categories: (a) alcohol abuse and (b) alcohol dependence. DSM V saw these two combined and integrated into a single category referred to as Alcohol Use Disorder, with three sub-categories: mild, moderate and severe.
In nineteen thirty-five, a purely amateur form of self-help alcoholism treatment came about. Alcoholics Anonymous was founded in Akron, Ohio, and their Groups proliferated with such rapidity that it now has a global signature. In many ways, it is the dominant treatment paradigm today. Growing out of that success was a shift in people’s perception away from alcoholism being a shortfall in people’s morality, to widely hypothesizing that it is a ‘disease’.
At Hazelden, the 12 Step Treatment Centre in Minnesota, a whole alcoholism treatment model was founded upon research conducted by a medical scientist by the name of Virginia Davis. She was doing cancer research, and examining the freshly deceased brains of alcoholics from the streets of Houston. One morning in her lab, she looked up from her microscope and said: “You know, I never realized that all those winos used heroin as well as booze.” Her colleagues just laughed at her, “Come on, Virginia, these guys don’t use heroin, they can barely afford cheap liquor”. Virginia shut up and went back to her microscope. However, despite alcoholism treatment being way left-field of her research, she knew she was onto something. She had discovered in the brains of those chronic alcoholics, a substance that is in fact closely related to heroin. This substance, long known to scientists, is called Tetrahydroisoquinoline or (THIQ) for short.
THIQ is created in the brain when a person injects heroin into his or her body, as a bi-product of the breakdown process. In the brain of – specifically – an ‘alcoholic’ drinker, THIQ is also manufactured right there in the brain. But this does not happen in the brain of the normal ‘social’ drinker, by whom alcohol is rapidly eliminated entirely. THIQ has been found to be highly addictive – much more so than morphine. This biochemical similarity between the brains of heroin addicts and alcoholics is fascinating, and would strongly suggest that if the sufferers’ brains were similar, so could addiction and alcoholism treatment be closely related.
An equally interesting point about THIQ also has to do with addiction. There are certain kinds of rats who will simply not consume alcohol. They will refuse to drink it and will literally die of thirst before they would drink water with even a small percentage of alcohol. But, if the rat is injected with even a minute quantity of THIQ, it will immediately drink the alcohol infused water.
Does this make alcoholism a disease? No! It does however illustrate that a person’s organic chemistry is changing all the time the subject is consuming a substance or substances. At this point in time, the disease concept is thought to be very useful therapeutic tool in alcoholism treatment. However, it has fallen out of favour with rigorous scientists, as it does not meet the main etiological (causal) feature of having a clearly identifiable contagion.
When it comes to the whole nature – nurture argument, we at SafeHouse believe that it is neither nature or nurture alone that is the most important variable. Indeed, it is the ‘hyphen’ in between nature and nurture that causes an interplay. Other aspects that reside in the environment, such as attachment and/or maternal deprivation, and family systemic causality have great relevance. There are many factors that are more likely to predispose a subject towards alcohol and substance abuse to medicate the pain of being alive. Science continues to postulate hypotheses, and at the moment alcoholism is accurately described as a brain disorder. When we have a greater body of evidence, perhaps alternate hypotheses will emerge. Alcoholism treatment will continue to evolve and no doubt, new methods will emerge.
For our purposes, here at SafeHouse, the twelve step alcoholism treatment method is, and is likely to remain, a significant part of an eclectic and holistic program. Not least because 12 Step meetings are readily available all over the world, are free, and are of immense assistance to those seeking to maintain a recovery from alcoholism long term after rehab. Conversely, for people who struggle with this model due to the explicit and tacit references to God, there are more secular and cognitive alcoholism treatment approaches such as SMART Recovery. SafeHouse tailors alcoholism treatment using a bio-social-spiritual approach to the individual based on the individuals preferences and differences, and comprehensive autobiographies.