My View: Alcoholism Treatment

Those first few drinks are solutions to social anxiety, lack of confidence, naivete, nervousness and maybe fear. Alcohol made it possible for those anxious to speak with confidence, to calm those nervous about their approach toward the near-adult world, for hormone driven teens to explore their sexuality, for the fearful to act bravely. It is a false courage, but remembered in a totally different way. Initially, the person who could drink "everyone under the table" was a celebrity of sorts, the "life of the party".

As the cohort of friends eased into their late late 20s and 30s, about 85% of them did not continue to rely on alcohol as a solution. About 15% of them stopped relying on it as a solution too. For the latter group, it had become a necessity, demanding larger and larger doses with ever increasing frequency. It had become as essential to those people as air. About 15% had become alcoholics, or perhaps their genetic predispositions had doomed them from the start. Then alcohol became a solution and a problem. Each time it was drank, it was a solution for a brief time--it calmed the shakes and permitted functioning. Then, inexorably, it became a problem. The shakes and irritability returned before day's end, and nips were packed with lunch. In the next phase, the solution aspect of alcoholism disappears and it is only a problem, expressing itself in broken families, relationships, careers.

I have arrived at some conclusions about alcoholism treatment in my half century of social work because alcoholism affects at least 25-40 million Americans. Perhaps my conclusions will resonate with you too. If they do, maybe, I can help you soften or eliminate this "problem", along with the "pain" and "shame". What I view as treatment options are the thrust of this brief article.

Since the founding of Alcoholics Anonymous in the 1935-1940 period, it has become the most frequent prescription for alcoholism, but it has a low success rate. The world has changed. AA is not the only, or even the preferred option, for many alcoholics. In my opinion, a variety of medication assisted treatment and recovery options exist today. That is my first conclusion.

My second is that there are a half dozen medications that are approved by the FDA, and used outside the United States for treatment of alcoholism, but rarely used here. Many in the medical community have a convenient over-reliance on AA and the alcoholic is blamed for relapse because the steps were not followed, or the meetings were neglected, or the effort was too little. "They were just not ready". "They haven't reached their bottom yet". These are convenient justifications, in my opinion, The chronic alcoholic reaches "bottom" when buried, when the medical community has continued in the belief that this is a matter of "will" rather than "disease".

Of course, the disease concept is "well accepted by the medical community", however, it is often accepted in name only. I have seen too many alcoholics die because they "lacked the will to heal themselves." Supposedly, they "chose" all the misery and pain they endured. I see it as another example of "blaming the victim". That is my third conclusion.

My fourth and final conclusion is this. If you want help with your alcoholism, know that I am a judgement free therapist who believes that medication assisted treatment in conjunction with individual therapy will help alcoholics live and thrive rather than die. Family Guidance Centers of Chesterfield and Powhatan does not prescribe medications, but we refer to physicians or advanced practice nurses who can. More doctors and nurses are needed to learn about available medications and become willing to provide medication assisted treatment in conjunction with individual therapy for alcoholism I don't recommend group therapy with a "canned" program that alcoholics have often heard before. I invite you to check me out at Family Guidance Centers. There is hope for a solution.

Dr. D. Ray Sirry, ACSW, Licensed Clinical Social Worker, is a Clinical Associate with Family Guidance Centers in our Chesterfield office. He provides individual, child, family, and marital therapy. Dr. Sirry has experience reaching over 30 years. He can be reached at 804-743-0960, or be emailed

Dr. D. Ray Sirry, ACSW, Licensed Clinical Social Worker, is a Clinical Associate with Family Guidance Centers in our Chesterfield office. He provides individual, child, family, and marital therapy. Dr. Sirry has experience reaching over 30 years. He can be reached at 804-743-0960 or can be emailed at contact@familyguidancecenters.com.