Does treatment work?

None of the treatments or techniques I mention in this guide are guaranteed to work.

Anyone offering you any sort of help with your drinking will never be able to offer you any guarantee either. Don't trust anyone who does.

The best we can do is to look at the treatments that are most likely to work.

The best treatments

Again, there's no one best treatment. There's no one thing, no magic bullet, that works brilliantly.

There are, though, a range of treatments that have been shown to work well. If we look at treatments that aren't medical1, then broadly speaking, they are ones that work with 'cognitive behavioural' techniques23 . That is, they get you to change how you think, so that you can change what you do.

Additionally, a lot of research has discovered that - assuming that you're choosing specialist treatment that's sensible and based on proven techniques - what's more important than the type of treatment you get, is how well you get on with the person or people helping you.

So you should choose treatment that:

What's the success rate for treatments that help me to give up drinking?

A very good question. Now without wanting to fob you off, what do you mean by success? Do you mean someone who was not drinking for 6 months? Suppose they relapsed completely not long after this? Shall we exclude someone who relapsed for a short while a couple of times before going on to not drink for years?

Alcoholics Anonymous have claimed a 65% success rate of abstinence from alcohol ... for people who attended their meetings regularly for a year. So this is a self-selecting group of people who've found AA to be helpful and have therefore kept going to meetings for 12 months. It doesn't account for people who didn't go regularly, or who stopped going because they found it unhelpful, or who relapsed once and felt too ashamed to go back.

As you can see, success is a hard thing to measure.

But lets try to put some rough figures down. For the purposes of being methodologically precise, we'll assume that success means not drinking at all for the 6 months following treatment.

I'd say that your chances of not drinking, without any outside help, is about 5%4.

If you get some reasonably good help, this leaps up to around 20-25%.

That may sound disheartening, but bear with me - it's not as bad as it seems.

Most people will make a number of attempts at stopping before they might meet with success. So the number of people who eventually succeed is much higher than 25%. The 25% refers to a quarter of attempts, not people. So if (for example) 100 people each tried three times to stop, and were successful for the rest of their lives on the fourth attempt, that would only be a 25% success rate. But 100% of those people succeeded.

Secondly, a lot of people will try to stop before they are ready, or without planning it properly.

Thirdly, it often takes a few different attempts at stopping to really 'get' what it is you have to do. Most ex-smokers had a few bashes at it.

Fourthly, if the client doesn't get on very well with their therapist/counsellor/doctor, or these people are not really skilled enough, then you're swimming against the tide. A lot of research suggests it's not just what treatment you get, it's how it's delivered.

A known predictor of success that I haven't talked about is how many 'buffers' you have. Having money, being bright, having had an education, having a job, having a supportive family and a good set of friends - these are all things that protect you and help you.

Finally, you're reading this. And you've carried on reading up to this point. You're clearly interested and engaged in this business of stopping drinking. You've got so much more going for you, I reckon you've got at least an extra 10% chance in the bag already.

So think about how can you increase your percentage chance of success. Pay attention to what is known to work best, and choose what'll suit your character and personality. Pile up the odds so that they're leaning in your favour.

Footnotes

1 The medically assisted management of withdrawals - or Detoxification - and the use of medicines like Disulfiram & Acamprosate have their own strong body of evidence and best practice

2 Source: The Review of the Effectiveness of Treatment for Alcohol Problems

3 By the way, evidence shows that 12-step treatments work well for those who like it. I would argue that much of the 12 Step programme is based on cognitive-behavioural techniques - combined with social support & reinforcement, and a spiritual philosophy.

4 http://www.time.com/time/health/article/0,8599,1872779,00.html accessed 8 Sept 2011

Further reading (external sites)

The Review of the Effectiveness of Treatment for Alcohol Problems (pdf)

NICE guidelines on alcohol dependence (pdf)