Treatment options for loved ones of alcoholics - Al-Anon interview with Dr. Robert Huebner

0:00 welcome to first steps down on recovery from our own and family group
0:04 today we are pleased to have with us doctor robert
0:07 cuter who is director at the Division I have treatment and recovery research
0:12 at the National Institute on Alcohol Abuse and Alcoholism
0:16 where the NHL parlay doctor chief nurse here with us to talk about current
0:20 research
0:21 on the treatment options for alcohol use disorders
0:24 including alcohol abuse and alcoholism as they pertain to the drinker
0:29 into the drinkers family members and friends the
0:32 and I chipped away is one of the 27 institutes and centers
0:36 they comprise the National Institutes of Health which is a part of the United
0:40 States Department of Health and Human Services
0:43 DNA chip away supports and conducts research
0:46 on the impact alcohol use my human health and well-being
0:50 it is a leading funder alcohol research in the world
0:53 doctor here thank you for joining us today it's very nice to be with you and
0:57 if I may I just like to say that
0:59 and I AAA really appreciates the long-standing relationship we've had
1:03 with Alan on over the years
1:05 and we especially appreciate your active participation in our national advisory
1:10 council meetings
1:11 we benefit from your input and perspective
1:14 on complex issues surrounding the prevention and treatment of alcohol use
1:18 disorders
1:19 you know these disorders on a current vacuum they clearly impact family
1:23 relatives and friends of the drinker and
1:26 we appreciate your perspective on this issue thank you very much we are happy
1:31 to
1:31 hand and two stay turned on
1:35 the research that's going on in the field Patrick you here
1:38 practiced their current research no are the benefits to attending our nine
1:43 meetings
1:43 for those affected by someone else's problem drinking
1:46 tonight what question there is growing
1:49 body of research much love which was funded by
1:53 and IEEE that dresses the impact love mutual help
1:57 in general and Alan on in particular
2:00 specifically are researchers have addressed why people seek
2:04 out Alan on in the first place and looked at the potential benefits
2:09 to the concerned other family
2:11 a relative participating and Alan meaning
2:14 are so to found that people who are in relationships with individuals
2:19 so as a family member friend with an alcohol use disorder seek
2:22 gone because they are drawn to the idea but
2:26 disease concept a alcohol use disorders
2:29 today like format and accessibility
2:32 abound on meetings and of course its
2:35 commitment to anonymity they also believe that its affective
2:39 and perhaps most important Allen on provides
2:42 social support and pure advice that is
2:46 very attractive to potential participants this parallels for research
2:50 on the benefits of mutual help
2:52 or social support group for people
2:55 with family members who have other diseases such as cancer or multiple
2:58 sclerosis
3:00 so there's a growing body of research on that regard
3:03 when looking at the benefits around on for family members
3:06 research on the potential therapeutic benefits upon
3:10 shown that attending meetings is a good thing it can
3:14 bolster coping skills reduced vulnerability to
3:17 everyday stressors that we all face you can also lead to
3:21 reductions in family conflict and increased satisfaction with
3:25 relationships and finally
3:26 it can increase self-esteem which is always a challenging issue
3:30 when living are being a park above family system
3:34 that has a personal alcohol use disorders just to mention some specific
3:39 studies in fact on a compliment on on on its
3:42 recent membership surveys they generally cooperate these research findings people
3:47 who attend an Alanon meetings
3:49 a reported reduction negative emotions less anxiety
3:52 and left disappointment in addition
3:55 on our members reported clear improvements in
3:59 daily functioning such as an increased ability to concentrate
4:03 better able to balance work and home commitment and
4:06 plus to craft a nation so the benefits I think a pretty clear to important to
4:10 keep in mind that there are methodological
4:12 limitations in any research study and in membership surveys
4:16 and we need to do more search but I think the general pattern
4:20 up evidence suggests a real and genuine benefit
4:24 to participation in town on meetings and we believe
4:28 that I AAA that it represents a great option for family or friends
4:32 people with alcohol use disorders who have a tent at stake thank you for
4:37 telling us about
4:38 something external research group okay
4:41 tell us about current research showing benefits
4:45 to Rinker when their family or friends at 10 down on
4:49 sure sure it's a good question on this issue there are fewer studies
4:54 but there are some hints in one and I AAA supported
4:57 survey well non-members that suggest
5:01 down on membership can mean positive changes either direct or indirect
5:06 in the behavior of a drinker in the family to get this question
5:09 responses from long-term on our members were compared to
5:14 newcomers to on their responses to questions about the drink from their
5:19 lives appeared
5:20 to differ and a couple other important way suggesting that
5:23 participating in Alma meeting ski and influence
5:27 person in the family that is experiencing problems without cost first
5:30 long-term stable members about on our part far fewer problems with
5:34 driving under the influence by their significant others that's important
5:38 because that's a huge
5:39 national problem then newcomer member so there's a big difference there
5:43 seconds longer term members on on or more likely to report
5:47 the drinkers in their lives have sought and receive some kinda help further
5:52 drinking
5:53 you their professional help fire ant outpatient program for example
5:56 or mutual help groups like a a again at some point to qualify these findings are
6:01 suggestive
6:02 future research is due to come up and down that causal relationship between
6:06 on attendance and downstream changes and drinking behavior but
6:10 these are hints that again if a family member participate in town on people
6:14 have
6:15 either direct or indirect fax upon their significant other
6:18 related this question I leichter go on here is that
6:22 it is important for significant others
6:25 play a role in treatment if the family or friend
6:29 love somebody you d has decided to seek help and the family members comfortable
6:34 with lending a hand
6:35 matter research has consistently shown that
6:38 family member involvement in supporting treatment
6:41 is critical to long-term success speed-up topping taking medications
6:46 on schedule on all talk a bit about those later purging the drinker to do
6:50 their
6:51 homework but they've been assigned in treatment for
6:54 actively supporting absent all these things can make a huge
6:57 huge difference in treatment outcome for the drinker in fact I should mention
7:01 that
7:01 I remember years ago and I AAA supported a very large
7:05 complicated clinical trial a variety of treatment approaches both medications
7:10 and behavioral interventions
7:12 and the major behavior or intervention was called
7:16 combined behavioral intervention this was really an amazing
7:19 compilation love the best elements of all the behavioral interventions that
7:24 are available
7:25 the one the key element of that was including
7:28 family member in the treatment process if they were
7:31 ready and willing to do so and was associated with better outcomes
7:36 I think there can be some clear benefits
7:39 to the drinker love al-anon member to staying in town on and if they choose
7:44 my fair in a place for their comfortable they can play a big role in the trekkers
7:47 recovery process thank you sector he fare
7:51 how significant is the problem did not fail
7:55 in preventing a person who is suffering from the disease alcoholism
7:59 and this affected by a drinker from getting house
8:02 yeah we frame this issue in terms of identifying the factors that initiate
8:06 and maintain beha vior change
8:09 behavior change I think everyone is where is a
8:12 complicated process and its part to follow 5
8:16 discrete stages free contemplation contemplation
8:20 preparation action and maintenance in the pre contemplation
8:25 stage a person doesn't acknowledge the change things to happen
8:28 in the contemplation stage a person acknowledges there's an issue
8:33 but they're not sure they are ready for want to change
8:36 in the preparation stage a person gets ready to change
8:40 and finally in the action stage the behavior actually changes and in the 50
8:45 states maintenance
8:46 one maintains the change
8:48 that have been made the stage is a change my well
8:51 described the decision process a family member has
8:55 when considering attending and Alan on me because that represents
8:58 pretty significant behavior change the main point here is that changing
9:02 behavior does not happen
9:04 in a single step and it's very important to know what
9:07 stage have changed person is in
9:10 before seeking to encourage more support that behavior change
9:15 and motivational interviewing is one technique has been trying to increase
9:18 the probability
9:20 that a person moves from the pre contemplation stage
9:23 to the contemplation state and action stage
9:26 what a vision to bring isn't evidence-based behavioral intervention
9:30 this really accounts like technique that seeks to marshal
9:34 individuals internal motivation to change
9:37 by asking questions in a strategic way
9:40 for example what is not good about drinking and
9:44 what do you like about drinking home might you like things to be different
9:49 if you decide to quit how would you do it those kinda questions
9:53 fast enough fairly impassive ok and non church mental style
9:57 can help create an ambivalence with in
10:00 the drinker that eventually will
10:03 lead them to think a little more seriously about changing
10:07 so that's how we look at the issue of the Nile it's really about moving
10:11 someone from the pre contemplation stage to the contemplation stage
10:15 and there are techniques out there. second facility
10:18 that that is really helpful information
10:21 for hopefully reaching out to people who kitty somehow
10:25 says me very much okay witnessed the best courses action
10:30 for someone suffering from the effects someone else's drinking
10:34 sure the research on this issue
10:37 suggest that someone suffer me affects someone else's drinking
10:40 could consider one up to she's obviously one is approaching the issue
10:45 the other is aborting the problem and examples of the former
10:49 would be to talk about our friends and family of course attending Elena
10:53 meetings learning some
10:55 evidence-based coping skills and relaxation and mindfulness skills
10:59 examples avoidance would be of course try not to think about the problem
11:04 keeping feelings on the issue bottled up
11:06 and that typically leads to the downstream consequences of taking up
11:11 such feelings out on others
11:12 I think it's important to point out there are multiple pathways to
11:16 approaching
11:17 a problem a family member or friend striking first column is
11:21 one above the parten pathways here but I encourage family members
11:26 to consider others as well for example talking to primary care physicians
11:31 that are competent to discuss alcohol issues
11:34 state leaders ministers priest my rabbis
11:38 and lasting mental health professionals are other I think
11:41 viable approaches to beginning the process
11:44 love seeking some help for that difficult issues raised by
11:48 family members drinking yes thank you very much
11:52 okay what is just a family member as an alcoholic
11:56 need to know about treatment options that are currently available for the
12:00 drink
12:00 sure I think it's important to know that medical research most I've
12:05 which has been supported by NIH and the and IEEE over the last twenty years
12:09 has yielded a number love evidence-based treatments for people with alcohol
12:14 problems
12:15 and this in turn I think could give of family members and drinkers hope
12:20 first ball many people are aware that there are three FDA approved medications
12:25 available for the treatment of alcohol use disorders I saw from
12:29 trade name is antabuse the first one now truck some
12:32 second and the third is a camper say use a
12:36 these medications in combination with some
12:39 former behavioral treatment really work
12:42 for many people and then I AAAS supporting a lot of energy
12:46 spurred finding new medications in figuring out for
12:49 whom these medications work past the
12:53 big initiative here at the NIH's precision medicine so we want to find a
12:57 medication that works best for
12:59 each individual sup that's the main thing there are
13:03 a number of very important medications available and this can be prescribed by
13:07 one time
13:08 care doctor other affective treatment include
13:11 behavioral couples therapy and family therapy again for
13:16 family members who read a place in the process dealing with
13:19 their significant others drinking where they want to partner with their spouse
13:23 friend in seeking help and recovery use evidence-based therapies
13:27 focus on improving the dynamics for relationships such as communication
13:31 skills and problem-solving skills and the like
13:34 these relationships focused therapy seem like a good fit given the data
13:38 from this member survey we talked about a month ago the show that most
13:41 participants in town on
13:42 are indeed in long term relationships am report improvement about long-term
13:47 relationship as an important goal another
13:50 evidence-based option funded by an actor plays an approach called
13:53 community reinforcement and family training
13:57 Warcraft for short has been around for a long time the key idea behind this
14:01 approach is that family members
14:03 can again if they choose make a difference
14:06 in the drinkers path to recovery and it teaches them how to leverage
14:11 their considerable social influence to help drinkers
14:15 checked family members that undertake this
14:18 craft training can for example and to provide
14:21 positive reinforcement for abstinence and avoid inadvertently
14:25 reinforcing a loved one's alcohol or other drug use
14:28 in addition craft teaches people to keep an eye out
14:32 for windows of opportunity or Windows readiness going back to the
14:35 stages of change idea it's important to cut be aware when those happen and when
14:41 readiness to change happens or looks like readiness to change is about to
14:45 happen
14:45 one can links to drug arrest with help straightaway
14:48 these evidence-based approaches are nicely summarized in a new in a triple-a
14:53 publication
14:54 I won't mention call treatment for alcohol problems finding
14:58 and getting help and I should note that in that publication we
15:02 to highlights contact information for Alana
15:05 for family members as well one more thing if you don't mind I met one other
15:09 publication
15:10 I recommend this to all element
15:12 embers it's called rethinking drinking it provides spy cam research-based
15:17 general information about what constitutes a problem this is a question
15:20 that a lot of people have when do I know
15:23 my family member has a problem and this lays out some
15:27 important information on how to conduct such that
15:30 it also lays out the risks associated with drinking too much
15:33 and some suggestions for those who want to reduce their drinking
15:37 it's also on the IEEE website which has a number
15:40 features such as a calorie counter which usually surprises a lot of people when
15:45 they find out how many calories are involved in a typical
15:48 drink so the bottom line here there are multiple treatment options
15:52 available by medical research and these
15:55 options work for people that stick with some
15:59 doctors you heard thank you for talking with us today
16:02 about current research on the treatment options for alcohol use disorders as
16:06 they pertain to the drinker
16:08 into the tankers family members and friends and thank you everyone
16:12 for listening to first steps down on recovery your welcome to listen to
16:16 any at the Allen and family ko podcast at WWW
16:20 got Alan on that board you are also welcome to attend a face to face meeting
16:25 up down on family group
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16:31 or by calling one 8 a for our non
16:35 test one 8 8 45 2-6x
16:39 6 thank you for listening to first steps down