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RSAT Forum > Monthly Discussion > June 2014: RSAT and Alcohol Abuse View modes: 
NmShifman - 6/6/2014 2:08:20 PM
June 2014: RSAT and Alcohol Abuse

Most of our RSAT inmates also abuse alcohol and some mostly abuse alcohol.  Does the same evidence-based treatment for substance use disorder apply for alcohol use disorder or both?

NmShifman - 6/6/2014 2:13:32 PM
RE:June 2014: RSAT and alcohol abuse
Many persons who suffer from alcohol use disorder may be more prone to be in denial and therefore less ready for treatment. The brain may also be affected differently as a result of alcohol abuse.  We know for examples that once a person's brain cells are damaged by alcohol, the brain can repair itself if the person becomes abstinent within six months of abstinence, however, cognitive function does not always return even when the brain scans appear normal. Not sure if the same is true in regard to other drug abuse. We also know that certain medications acamprosate work for alcohol but not in the treatment of other drugs while naltrexone (oral or injected-Vivitrol) work for alcohol and opioid treatment.  We also know that there is a genetic risk for developing alcohol use disorder that may not be true for other drugs. The genetics of alcohol problems have been studied for over 20 years, and such studies have clearly shown that over 50% of the causes of alcohol dependence are related to the genetic tendency to develop the disease. Family, twin, and adoption studies implicate the hereditary nature of alcohol dependence. Newer findings are showing that neurotransmitter receptors in the brain (for GABA, serotonin, and other chemicals) are somehow involved in the vulnerability of people for the disease.

Andrew R. Klein
Project Director
Advocates for Human Potential, Inc.

NmShifman - 6/6/2014 2:14:44 PM
RE:June 2014: RSAT and alcohol abuse

My approach has always been to address the multiple drunk driving offender as a person in need of alcoholism treatment - thus abstinence is the starting point and immersion into a recovery centered lifestyle is the goal. 

Obviously, EBP's all help in this process. They have put the "evidence data" behind what has been going on for several decades in good alcoholism treatment programs.

Re the brain disease aspects - in a broad sense, we approach it as the same because the addiction pleasure pathways are the same (though specific drugs do cause specific and differential neurotransmitter responses, but in a general sense, its all part of the pleasure pathway and the "addiction as a brain disease that effects behavior" is broad enough to apply is irrespective of the specific addictive drug)

Drunk drivers usually don't view themselves as criminal, though many are so in both thinking patterns and personality type -just haven't got charged or caught, yet. In my view, dunk driver programs that deal with second or multiple offenders should be differentiated by focusing on abstinence and zero tolerance for any use, with a focus on "how to stay sober and build a network of support. For first offenders there can be more openness for an education approach.

Drug programs with other drug offenders emphasize the above but also the criminogenic risk/needs factors more so than a DUI program. I think the key for drug courts is to assess and differentiate whether they are dealing with a person who is a user, abuser, or chronic hard core repeat DD offender.


Stephen K. Valle, Sc.D., M.B.A.,
Licensed Psychologist, LADC I, CADAC
President & CEO, AdCare Criminal Justice Services