bigsombrero

I know that in the support community, we act "as one" and support each other no matter what - I completely honor and agree with that method of support. I am on board with that. But for recovery purposes, sometimes I think that alcoholics should be separated into sub-groups, and assigned various treatment models based on their "type" of alcoholism. I am curious to know if anyone's ever heard of such a thing.

I almost wish there was a scientific registry of some kind, to categorize us and get us on the right track FASTER. Something like this example:

Group A: Weekend Bingers (drink an average of once per week, but often go weeks without alcohol).
Recommended recovery track: Outpatient treatment, one-on-one therapy.

Group B: Constant drinkers (drink mornings, hide alcohol, always seeking drinks).
Recommended recovery track: In-patient treatment, AA or other group meetings.

Group C: Reactive drinkers (only drink in stressful situations, often verbally abusive and in troubled relationships)
Recommended recovery track: Group addiction therapy, meditation.

Has anyone ever heard of science trying to figure this out?

I realize that some of you will think "does it matter?" - well, I'm not sure. But I think that we're often encouraged NOT to think about this kind of stuff. I am curious.

ElegantlyWasted

Agree.... I think if you talk to a Addiction Specialist PHD/MD who stays on top of recent research/literature they could come up with a personalized plan along those lines. I really believe AA is a great catch all for a lot of people, but there have been some really relevant advances in hard science and psych treatment that really make a better mousetrap for some who need it and could expedite the recovery process.

Olive1

In my opinion, it is all alcohol.
Doesn't matter that rate or the reason.

BlindsidedBetty

I don't know the answer to that, but I would to your list

Group D "Whiteknuckle Drinker" (Alcohol dependent drinker who may have success with moderation, but who can never stop obsessing, obsessing, obsessing). Recommended recovery track- Probably the same as Group B, since if you don't do something, you're headed for Group B anyway.

GroundhogDay

Don't forget

Group E: Alcohol abuser (exceeds recommended daily and/or weekly drink limits, not dependent or obsessing yet, but know that current road leads to Group B). Recommended recovery track-major life changes, psychotherapy, and healthier ways of dealing with anxiety.

No matter what the degree of alcohol-related problems, the key is a lifetime commitment to abstinence. Any other course of action is simply too dangerous and not worth the risk.

Dee74

I think the type of person, the type of personality you are, is probably a greater determinant to how successful any one approach might be, not how much or how frequently you drink.

D

Crossfitdad

What about subgroup F? The drinker who abuses by drinking a sixer every night? The drinker who doesn't physically crave it (like nicotine.. Mmm nicotine). The drinker who goes to sleep every night hoping not be hungover, but then wakes at 5:30 every morning on the dot with a full bladder and incredible anxiety? The drinker who can't fall asleep at night without at least 3 beers?

FeenixxRising

I've thought about categorization a little.

As a binge drinker and not a daily drinker, I often wonder if the recovery approach should be different than the approach for a daily drinker. I'm not saying one is better, just different, and each of these two types of drinkers have different challenges. For example, the daily drinker will probably require medical detox and would have a very hard time stopping for even one day. While a binge drinker usually can stop for at least a few days with minimal or no physical effects, but usually battles intense urges a week or so after the last drink.

But then the question becomes one of how far the categorization should go? With the addiction treatment community unable to agree on basic issues of whether addiction is a disease or if 12-step programs or some other treatment option is the best choice, I can only imagine what would take place if treatment was based on more nuanced categorization of "type".

Then again, if one is working with an addiction counselor or therapist, I think a more tailored approach would be appropriate.

Gottalife

Great question. The definition of alcoholism seems to be getting ever wider and more inclusive these days. At a talk recently a prominent pysychiatrist and head of our national addiction centre confirmed that the majority of alcoholics can be succesfully treated with the range of therapies and medications currently available.

But there is a group, not categorised above, which continues to get worse no matter what medical remedies are tried and medicine has no answers for them other than the medication to keep them alive through withdrawal. These are the hopeless cases and the group to which I belong. He stated that these ones need to have some kind of conversion experience to recover, something medical science is not able to offer at this stage.

These you might call spritual malady alcoholics for whom alcohol is not so much a problem as a solution essential to be able to live comfortably in the world. Eventually it turns on them and becomes a problem. But, remove the alcohol, and life gets worse. Treatment for this group requires a lot more than just stopping drinking. It requires a radical change in outlook, not easy to achieve.

bigsombrero

That is a good point - a doctor wouldn't recommend a spiritual awakening, would she? Of course that whole scenario raises more questions than answers, in total, so it's tough to even start down that wormhole. Very interesting input.

bigsombrero

Thanks for those thoughts Fenixx. I do think there is a basic difference that could be categorized....yet another problem is the alcoholic's willingness to admit which group they belong to. We are not very trustworthy or honest, often we dont even admit we have problems - how could an alcoholic be trusted to even place himself in the right starting gate....unless he was already at treatment and under supervision in the first place?

I am also nodding my head in agreement with Dee. Individual personalities might be just as, if not more, important than the way you abuse alcohol. Then again, does it reason to think that in most cases, folks with similar personalities would drink in the same way? Not all the time, of course, but enough to benefit from data?

I think the main issue is that we can PONDER these things but we won't know. You'd think if science can send a man to the moon, they'd have solved this by now. That said, recovery is a fairly new science as it's become more accepted, maybe this is the type of thing new med students can do their dissertations on or something. This all needs more attention from the sci-community IMO.

awuh1

I think this is a great question BigSom. I think your classification is largely based on how people drink i.e. on the frequency and pattern of consumption. The amount, frequency and long term pattern of consumption has a good deal to do with how to safely manage the physical withdrawal from alcohol (Phase 1). I believe this pattern of consumption often in turn reflects something a bit more fundamental that is going on. That has to do with why people drink.

The why is often quite complex. I see several broad categories or components. First is the Physical (i.e. biological) need due to acute withdrawal (mentioned above). The physical can include some lesser physical cravings from post-acute withdrawal syndrome (PAWS). There are often genetic components to this physical side as well. Then there are the psychological “causes” or components to desire. This area is quite broad and complicated. It includes everything from self-medication of depression and anxiety to an individual’s attempting to deal with stress of one sort or another. The psychological component, having to do with depression anxiety or other diagnostic category, needs to be teased out from the purely psychological aspect of addiction per sae. . This is the component that AVRT often deals with quite adequately an is generally referred to as “stinkin thinkin” in AA. Lastly there is a spiritual component for many. This is what Carl Jung referred to as the “unrecognized spiritual need” or the “thirst of our being wholeness”. The latter is most apparent in the low bottom alcoholic, but I believe also exists in less severe cases.

There are many different combinations of “how” and “why” (though there are often distinct clusters or patterns IMO) Identifying them all and how they interact with each other can make a solution that much more likely.

Justfor1

I was in group C. I tended to drink when negative & stressful things happened in my life. When things were going good I was able to cut back. However, as the years went by my "benders" became longer & much greater. I was able to cut back on my drug use but my alcohol use became a nightmare.
Sadly, I seem to become physically addicted after a few days of heavy drinking.

Baloo

I'm no expert, but I see myself at times in A, B and C.

And I think treatment should usually be hardcore if a person has the time/resources/support/whatever.

ReadyAndAble

At SR I found a wealth of information on the various approaches, and the freedom to explore them all. As much as I wish I could size someone up and steer them in the right direction, to do so would risk steering them in the wrong direction.

Information and encouragement—that's what I think people need most. My hope is that if people get plenty of both, they'll be able to find their way.

caboblanco

i think it's a good idea to see a psychologist that specializes in addiction. If you are honest with them they will give you the best plan of action to their knowledge. To just walk into AA and be told that we are all the same sick people might not hinder some peoples recovery but it definitely wont help it.

Michael66

Yep, I agree there are at least several types of problem drinkers. The term "alcoholic" may cover from one to all those groups, depending on whom you speak to.

I have sometimes wondered if there ought also to be an escalating protocol of treatment - though it took me far too many years to recognise that I was in a group, while maybe not being alcoholic by Big Book standards, where lifelong abstinence was the only sensible way forward.

2granddaughters

Alcoholism is progressive. It makes little difference how you drank in the past or recently, the crux of the problem is that if you don't address your alcoholism now it will become worse with time.

Alcoholics have to "hit bottom" before they see or accept this simple truth and by that time damage is usually done.

With me, how much I drank or how I drank wasn't the question anyway, the question was "How do you feel?" . I hated it when someone asked me that ... I had lost the ability to even recognize and name my feelings accurately. I usually said I was "all f'ed up" as I was so full of fear, remorse, denial, anger, depression, hopelessness etc that I couldn't sort them out any longer. Some here will know what I'm talking about, others are on their way there.

The 12 Steps of AA addresses all "types" and the recovery home I attended in 1989 addressed alcohol, drugs, sex, gambling, anorexia, etc with the same spiritual program.

All the best.

Bob R

Willowgardens

Mmm interesting. I'd have put myself in that category too, until very recently, even though I was intellectually aware that the drinking was in fact making my self esteem and coping abilities even worse. Somehow, for a long time, the price for obliteration seemed worth paying. Now it doesn't - maybe some of it the reflections following the death by suicide of two of my close immediate family (neither was alcoholic, but both shared a lot of my thoughts and feelings).

Whatever, I don't think I believe in hopeless cases. I think the changes required are smaller than they seem - we build them up so they look impossible, possibly so we can excuse ourselves the effort of such a doomed task, when waht we need to do is take the magnifying glasses off...

Fandy

I also really agree with this.
Not *everyone* has to hit bottom to recover and stop drinking. spiritual direction is not for all that have alcoholic tendencies. The idea of sitting in a meeting (day after day after day after day) would not help me at all, the idea is sad/depressing to dwell on it (for me).

Coming here and connecting/discussing helps enlighten me. I've learned so much and it carries over in other successes for me.