The New York Times has a couple of pieces up today focusing on new approaches to treating alcoholism, specifically on broadening people’s understanding of alcoholism to include high functioning alcoholics, and on medical therapies.

Jane Brody’s description of Sarah Allen Benton’s new book, Understanding the High Functioning Alcoholic makes it seem like really old hat. I mean, what article on alcoholism doesn’t start with some variation on the theme: “Guess what! Alcoholics aren’t all skid row bums! They could be your dental hygenist or your yoga teacher! Who knew?” And I guess there’s a lot of 12-Step information in there, too.

But the interview with Dr. Mark Willenbring is more interesting. It seems that his interest is in 1. seeing alcholism as a disorder more like depression, something that exists on a spectrum, which will, 2. allow for more treatment options, including medications, provided by private doctors and psychiatrists. Anyway, go read it.

Of course, I hated this part:

Q. Does this mean that a 12-step program may not be the best treatment for all alcoholics?

A. It’s a tool in our toolbox, but for the past 40 years it’s been the only tool. Unfortunately, even though we have many more tools available, they’re not being used. More than 90 percent of treatment programs in the country right now provide only group counseling and A.A.

Even though we have medications that are efficacious, they’re not being used. People aren’t even being told about them. This is all about using every tool at our disposal. It’s not about A.A. or medication. I treat patients who are taking medications, and I’ll always encourage them to go to A.A., and many are — there’s no incompatibility.

In terms of behavioral treatments, one of the prominent behavioral researchers in this field once said, “I think the glass is half full — if we only had a glass.” We don’t currently have a vehicle for implementing innovative treatments.

No incompatibility? Wha..?

Do you remember, how, over the past eight years, politicians really tiptoed around in their criticism of the administration and the war. All criticism had to be prefaced with a protestation about one’s patriotism and support of the troops, and rarely would any of these people actually use the word “lie,” not because it’s not the correct word, but because they weren’t the ones in control of the conversation.

And except for a notable few, most public commenters are afraid to say anything that would call into question someone else’s unreasonable belief systems. Logic and sense is the scissors to religion’s rock. When taking on a religionist, they have to be very precise and careful — and often, utterly ineffectual — in order to accomodate them and avoid the fire of a thousand suns.

I guess we have a similar situation with AA. It’s heartening to see that addictions specialists are working to evolve the way alcoholism is treated, but they are always so careful not to step on AA’s toes. There’s always the “Don’t get me wrong. AA is the best. We love those guys…” What I hope is that as long as they continue to keep exploring new treatments, these protestations with naturally just become irrelevant.

–ftg

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