Odd tipple alternative therapy for alcoholics

Recovering alcoholics should be allowed the odd tipple, according to new research by British psychologists

Recovering alcoholics should be allowed the odd tipple, according to new research by British psychologists. Their study, which challenges the usual "one drop, one drunk" philosophy behind the treatment of alcoholism, suggests that moderate drinking is a realisable goal for all but the most serious alcoholics.

Irish scientists, however, say the findings should be treated with caution.

"The thorough studies suggest that the enthusiasm for such controlled drinking by alcoholics is not supported by the facts," said Prof Anthony Clare, medical director of St Patrick's Hospital.

As part of the treatment developed by the centre for alcohol and drug studies in Newcastle-upon-Tyne, alcoholics are primed with a drink during therapy and then exposed to drink-related cues.

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In this way, the alcoholic builds a sense of control and an understanding of craving.

The project results were presented at the annual conference in Ennis of the Psychological Society of Ireland at the weekend by a psychologist from the project, Mr Simon Wale.

Research into the effectiveness of treatment "has been coloured by the controversy of whether people who are dependent upon alcohol can successfully engage in moderate and controlled drinking", he said.

"Evidence has built up over the past 30 years which supports the wisdom of offering the goal of moderate drinking to clients, especially to people with mild to moderate drink-related problems."

But Prof Clare said the evidence that alcoholics could return to drinking was "very poor". The total cost of alcohol problems in Ireland was estimated at more than £325 million in 1995, Mr Wale said.

Under the new method of treatment, known as moderation oriented cue exposure (MOCE), a client is gradually exposed to situations that are high-risk. This may involve a member of the therapeutic team visiting a pub with a client.

The MOCE method was contrasted with behavioural self-control training which relied upon self-monitoring of alcohol consumption, limit-setting and drink refusal skills. There were 50 people in each study group.

One of the advantages of the MOCE method is that more people will come forward for treatment, says Mr Wale. "If the only choice is no drinking, many people will not enter services," he told The Irish Times.

But not everyone will be able to control their drinking with the MOCE method and, for these, the only option is total abstinence. "The traditional model works very well for many people. This project, I should add, is another tool for therapists," he said.

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