Substance abuse is a major problem in the United States and throughout the world. An article in American Scientists concluded that over 63 million Americans are addicted to various substances: 25 million nicotine addicts, 18 million alcoholics, 6 million cocaine addicts and nearly 15 million who abuse other substances. A more recent study projected that over 14 million Americans have a problem with alcohol.
Alcoholism is an equal opportunity disease that strikes both young and old, rich and poor, men and women. Rates of alcoholism are highest among those ages 18-29. Although more men than women abuse alcohol (male-to-female ratio is 3:1), alcohol's adverse effects are suffered disproportionately among women due to differences in body chemistry.
Many refer to alcoholism as a "family disease" since everyone close to the alcoholic is adversely affected by their drinking. In addition to the widespread negative personal consequences of alcoholism, the cost to the nation is also extremely high. Expenditures attributed to automobile accidents, medical complications, lost work productivity, crime, domestic problems, and legal costs amount in the billions.
Alcoholism is not a one-size-fits-all disease; there are a variety of medications and treatment approaches. The more treatment options a physician has at his/her disposal, the greater the probability of success may be, since what may work for one patient may not work for another. Remember also that alcoholism is both a physical and mental problem; an alcoholic's body and mind must both be treated.
An example from recent research supports this point. In a randomized 12-month single-blind trial comparing the efficacy of different alcohol treatment drugs, the group with greater attendance at psychotherapy support sessions had more abstinence. Thus, while individual attention must be given to each patient's situation and needs, all primary treatment methods should utilize both pharmacotherapy and psychosocial methods to treat alcoholism.
Pharmacotherapy treats the chemical aspect of the disease with medication, while psychosocial treatment helps patients deal with the psychological component of alcoholism. Psychosocial treatments help a recovering alcoholic change their behavior and learn to cope with life's problems without turning to alcohol. Examples of psychosocial treatments include Alcoholics Anonymous meetings, counseling, group therapy, and family therapy.
Psychosocial treatments are essential, but the value of pharmacotherapy in alcohol treatment should also not be underestimated. Many alcoholics have had success from the medications naltrexone and disulfiram, which are the primary forms of pharmacotherapy used to treat alcoholism in the United States today.