Alternative Alcohol Treatment

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KEY TAKEAWAYS

Replicating the same outcome as traditional alcohol treatment but by different methods can be achieved by:

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Understanding What Traditional Alcohol Treatment Programmes Achieve

Components Of A Traditional Residential
Rehab Programme

How It Contributes To Long-Term Sobriety

Detox

Medication minimises withdrawal symptoms

Group Therapy

Understanding triggers and underlying beliefs of addiction

Personalised therapy

In-depth triggers and trauma addressed for
aftercare planning

Aftercare plan

Plan to continue support groups, therapy or
meetings

Physical health routine

Leads to improvements in mental health

Tackling recovery via a ‘Higher Power’

Massage, reiki and reflexology

Multi-disciplinary approach to recovery

Personal case manager

Consistent support throughout treatment [2]

When An Alternative Alcohol Treatment May Be Necessary

Lack Of Financial Resources For Rehab

Private fully residential rehab programmes can be expensive and NHS-funded places have long waiting lists, causing some to seek out alternative recovery support to quit drinking.

Many Failed Rehab Attempts

Previous trauma can be triggered in rehab group therapy, making personalised therapy a better option.

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Physical Illnesses

Co-occurring illnesses that require intensive treatment, such as dialysis or chemotherapy, mean it is not possible for the patient to attend a fully residential rehab. They may instead attempt alternative treatment options.

PTSD

In group therapy, traumatic experiences discussed in the group may bring up issues that trigger others, meaning personalised therapy may be a better alternative treatment approach.

Schizophrenia

Alcohol worsens auditory hallucinations and paranoia via liver failure; requiring a hospital detox with a psychiatric intervention [3].

Family Responsibilities

Parents who are unable to access childcare during their time at rehab may attempt alternative approaches for alcohol abuse.

52% of those caring for family members suffer from mild alcohol dependence, but cannot attend rehab due to responsibilities. Other approaches may be more appropriate based on time available [4].

Alternative Alcohol Treatment - Complete Programmes

SMART

SMART recovery is a support group consisting of peer-led group recovery meetings, with the main philosophy being:

  • Those seeking recovery can choose what methods of maintaining abstinence work for them from demonstrations in meetings
  • Any alternative groups can be used in conjunction with SMART recovery
  • Participants are free to move on from the programme once a healthy lifestyle has been achieved [5]

This differs from traditional treatment options since:

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LifeRing

LifeRing secular recovery consists of local meetings, daily online meetings and books and pamphlets about treating addiction.

LifeRing recovery is based on the 3-S philosophy, including:

  • Sobriety - must be committed to complete abstinence from alcohol and drug dependence
  • Secularity - discussion of faith or lack of is explicitly excluded during meetings
  • Self-help - choosing the most effective treatments without any specific steps to achieve [6]

This differs from traditional treatment as:

  • LifeRing does not provide detox
  • Traditional rehab may include religious or spiritual discussions
  • LifeRing offers a discussion of experience, not traditional therapy

HAMS

HAMS consists of exclusively online support groups; including online forums, chatrooms, email or Facebook groups and live meetings [7].

The HAMS philosophy consists of the following:

  • Working towards own sobriety goals - either safe drinking, reduced drinking or complete abstinence
  • Promoting harm reduction attitude rather than abstinence

This differs from traditional addiction treatment as:

  • Rehabs encourage an abstinence-based approach, especially during in-patient treatment
  • HAMS does not provide detox
  • HAMS does not provide in-person treatment

Alcoholics Anonymous

Alcoholics Anonymous consists of in-person meetings, with supplementary literature of the Big Book, twelve steps, twelve traditions and AA structure handbook.

The AA philosophy consists of the following 12 steps:

  • Admitting powerlessness over alcohol
  • Believing that a power greater than ourselves can restore sanity
  • Deciding to turn lives over to the care of God
  • Making a moral inventory of our lives
  • Admitted to God, ourselves and others the nature of previous wrongs
  • Ready to have God remove defects in character
  • Ask God to remove shortcomings
  • Make a list of those harmed by alcohol use, and be ready to make amends
  • Make amendments to those harmed where possible
  • Taking personal inventory and admitting wrongs
  • Sought through prayer and meditation to improve contact with God
  • Carrying this message to other alcoholics and continuing with these principles [8]

This differs from traditional treatment as:

  • AA does not provide detox
  • Rehabs allow discussion of spirituality or religion, but it is not a required part of the core programme
  • AA meetings are peer-led rather than professionally led
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Alternative Alcohol Treatment - Individual Approaches, Components, Therapies

Acupuncture

Acupuncture decreases alcohol intake by 15% in those with alcohol use disorder [9].

The potential disadvantage of acupuncture is that progress experienced during treatment may be undone between sessions.

Traditional rehabs use acupuncture as part of a full rehab programme, not as the only approach.

Alternative Detox Agents

Alternative detox agents with a history of success in alcohol recovery include:

  • Gabapentin or Valproate - 2.7% increased abstinence, used for those with diazepine allergies [10]
  • Kudzu - reduction in drinking by 34-57% [11]
  • Ashwagandha - 2% decreased agitation score during alcohol withdrawal [12]

Abbeycare will typically disallow admission for those with diazepine allergies as the risk of seizure is too high. Gabapentin or Valproate is only used in a strictly supervised detox setting or hospital detox.

Nutritional Counselling

Choosing nutrient-dense foods through nutritional counselling, in combination with prescription medication, may improve the efficacy of detox.

62% of alcoholic liver disease sufferers show signs of malnutrition [13].

Combining Alternative Programmes With Alternative Approaches For Optimal Long-Term Outcomes

Client Need

Example
Appropriate
Programmes

Appropriate
Alternative
Individual
Approaches

Missing from
Approach?

Detox

GP prescription,
home detox, hospital detox or ADP team
coordination

Acupuncture

Professional medical
supervision

Personalised therapy

Private therapy, NHS counselling,
counselling training
organisations or
spiritual/religious
therapy

Self-help CBT
worksheets

Lack of professional
supervision

Group therapy

Online groups

Mutual aid groups

Professionally led
treatment with
evidence-led
outcomes

Aftercare plan

Mutual aid groups
and recovery cafes

Sponsor led
supervision

Dependent on one source of support

Physical health
routine

Preferred exercise routine

Yoga or reiki

Unsupervised,
potential for cross
addiction

12 step programme

AA groups

Betel or Salvation
Army

Detox

Mindfulness and
meditation

Preferred for
personal need

N/A

Professional
supervision

Sponsor

Sponsor in the
community with lived experience in recovery

Online sponsor

A personal
relationship with the
sponsor

Alcohol use disorder with eating disorder

SMART or LifeRing

Nutritional
counselling

Medical care and
talking therapy [14]

Mild to moderate alcohol use disorder

HAMS

Acupuncture and supplements

Talking therapy

Harm reduction, not
abstinence

HAMS

Supplements

Detox, addressing
underlying beliefs

Secular,
non-prescriptive
approach

SMART or LifeRing

Self-help CBT
worksheets

Professional input to fulfil needs

Prefers religious or spiritual approach

Alcoholics
Anonymous

Betel or Salvation
Army

Professional
oversight

When Alternative Alcohol Treatment Is NOT Appropriate

Repeated failed detox attempts

65-70% relapse 1 year after undergoing alcohol withdrawal [15].

Relapse is more likely without a structured plan created by a rehab facility.

History of severe withdrawal symptoms

If the patient has a history of delirium tremens, seizures or hallucinations, alternative treatment options are not a substitute for the 24-hour medical assistance provided by a traditional treatment provider.

Alternative treatment is also not appropriate for those with diazepine allergies, as they will run a greatly increased risk of seizure.

Enablers

Friends and family members who are enabling alcoholics may either attempt to sabotage the alternative treatment, or encourage the alcoholic to fall back into old patterns of addiction, making traditional rehab, away from these associations, a better option [16].

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About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

Last Updated: March 24, 2024