Can Alcoholism Be Cured?

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A simple question, but the answer is rather complex. The answer you get depends partly on what we take “cure” to mean.

If abstinence is the goal, then the number of people who successfully stop drinking would get us to yes.

If, on the other hand, we take cure to mean that someone who was an alcoholic can drink in the same way as their non-alcoholic peers, then the answer is no.

What cannot be cured

Experts estimate that at least 20 percent of the risk of developing alcoholism can be tied to a genetic predisposition. Evidence comes from many studies. For example, in one study reported by the New York Times, 30-40 percent of adopted children of alcoholics become alcoholics themselves, regardless of the drinking habits of their adoptive parents. This compares to a 10 percent background rate in the general population.

This genetic propensity toward alcoholism cannot be cured. A good analogy would be an allergy to poison ivy. The reaction is based on genetics, and even if someone were never exposed to the plant, they would still be allergic. We simply have no way to reach into each cell in the body and “fix” the genes.

What can be cured

Genetics aren’t fate and they aren’t destiny. Someone who is never exposed to alcohol has no opportunity to fall victim to alcoholism. Furthermore, alcoholism is more than susceptibility; it is a pattern of harmful behavior. Behaviors can be changed.

Therapists shy away from saying the word “cure.” Instead, they prefer to think of alcoholism as being successfully treated. Someone who maintains abstinence from alcohol for some extended period (years) can then be said to be in remission or recovery instead of cured outright.

Treatment specialists are cautious when talking about a cure because there is no way to tell which alcoholic will relapse, even after many years of sobriety. It is said the Bill Wilson, one of the founders of Alcoholics Anonymous and a man who had more than 30 years of sobriety, asked for booze on his death bed. And that’s one of the problems with a change in behavior being labeled a cure. If behavior can change for the better, it can also change for the worse.

What about miracle cures?

A search on the Internet will bring up some very radical claims about curing alcoholism. One doctor or another will claim a new treatment has solved the problem. For example, there’s a US patent (#5418255) issued in 1995 that claims a 44 percent cure rate. It involves giving alcohol by intravenous infusion over a 10-day period. Other treatments periodically make the news, including topiramate (an anti-seizure medication) and naltrexone. So far, none of these has been shown to have broad applicability and strong scientific support.

This isn’t to say they may not be beneficial, just that they don’t deserve the title of cure. At best, they may be useful adjuncts to standard therapy.

Treatment instead of a cure

Our current understanding of alcoholism is that the condition is a mix of genetics, psychology and environmental factors. Treating these as a package and for an extended period yields the best results when abstinence is the yardstick.

The gold standard might be the 70 percent success rate seen under extended treatment for physicians who are addicted. This population is highly motivated to quit (they have their licenses on the line), well-funded and, because they often face sanctions if they slip up, well-supervised. Treatment consists of three to six months of inpatient care; follow-up therapy sessions for a year or more; monitoring of blood and urine and a case manager assigned to keep up with their progress. Unfortunately, the general population usually doesn’t have the motivation or funding to match this gold standard.

The closest thing we have to a cure is the long-term sobriety some alcoholics achieve. They are still considered alcoholics but not currently suffering from alcoholism. They are no longer a slave to booze, and alcohol no longer harms them. They have learned to live without alcohol and do so successfully. For most, that’s close enough to a cure.

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