Statistics posted by the National Institute on Alcohol Abuse and Alcoholism (2017) show that 15.1 million of people aged 18 years and over, representing 6.2% of this age group, had alcohol use disorder, with women accounting for 5.3 million or 4.2% of the age group. Such is the predicament Nicky (real name withheld) found herself after they presented to the health practitioner seeking for a sleeping pill. Nicky is a 22-year-old female with a boyfriend of 2 years whom she lives with. She attended community college and currently works as a service agent for a local car-rental company. Prior to presentation to the health facility, Nicky consumed 2 glasses of wine at lunch, at least 3 glasses at dinner, including 1-2 two glasses of brandy. Her father whom she last saw when she was 10 had an alcohol problem and left home and has never been in contact, and her mother uses pills for nerves, but they are not in constant contact too.
Nicky was treated and recovered from alcohol dependence, an alcohol use disorder they exhibited in accordance with the diagnostic manual. Nicky experienced cravings to have a drink to calm her nerves and unwind, which can be classified as drinking for emotional or psychological relief. Nicky eventually lost control of her drinking, finishing up the whole bottle whenever she intended to have just a glass. As a result, Nicky developed a tolerance for her alcohol consumption, and despite being aware of the negative consequences, her continued use of alcohol cost her a valuable client and termination of her project.
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From Nicky’s personal account, the treatment recommended by the clinician was linked to her anti anxiety medication Xanax, whose dosage she could not control due to drinking. The assessment established that Nicky’s heightened tolerance and the potential for lethal drug overdose was an outcome of the synergistic effect on the central nervous system due to a combination of alcohol and benzodiazepine (Gudin, Mogali, Jones et al ., 2015). As a result, Nicky’s dependence on alcohol and benzodiazepine required a medical detox to treat. Nicky was referred by her counselor to a certified physician in addictive medicine for confirmation of the assessment. Nicky objected to in-patient detoxification program and was placed under outpatient medical detoxification and recovery program. However, Nicky observed that given her confessions about the initial inability to stop or reduce alcohol use, and the fact that this was her first attempt at detox, the clinician set up a contingency contract before her placement into out-patient detox to cater for cases of failure in the chosen alternative.
According to Nicky, her experience during the treatment program was both positive and negative. Positive in that they were able to appreciate the outcomes of the treatment as they cut their alcohol consumption by 50% and reduction in shakes and discomfort in the mornings. Nicky argues that her situation was helped by constant encouragement from the clinician during her sessions that alcohol dependence was treatable, which also motivated her immensely. “Despite some positive progress, I still had trouble with sleeping” was Nicky’s major complaint. Nicky also complained of the disruption of her normal routine because it appeared she spent more time at the health facility attending therapy sessions and discussion groups than at home with her partner and friends.
Nicky had support from her boyfriend throughout the treatment program. They also observed that they found solace in sharing their drinking experiences during social sessions set up by the management. “Sometimes I listened to folks in there, and I thought I was lucky not to have gone that far.” According to Nicky, the social sessions lifted an immense burden off her should because they were able to share her progress report with their partner, who gave her all the support she needed.
However, Nicky’s progress to recovery was impeded by a relapse that triggered the clause in the contingency contract; hence she was admitted to inpatient detoxification program. Nicky said the clinician attributed the relapse to a possible genetic link to her family history shows that her father may have been an alcoholic (Kissin & Begleiter, 2013). Nevertheless, not much detail was put into getting a good family history or genogram. Nicky observed that she felt suffocated by the inpatient program, but she was motivated by her partner’s positive attitude and resolved to see her treatment to the end.
As a result, Nicky tells her success story fighting alcoholism. While at first she was given a target of reducing alcohol consumption, her positive progress after the relapse led to a revision of measures for determining success from reduction to complete abstinence. Nicky confessed that it was not easy as from time to time, the argument will come back , almost overpowering her, but she was determined and resolved to lead a positive life and leave the shadow that had darkened her life since her teenage years.
Gudin, J. A., Mogali, S., Jones, J. D., & Comer, S. D. (2013). Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use. Postgraduate medicine , 125 (4), 115-130.
Kissin, B., & Begleiter, H. (2013). Social aspects of alcoholism (Vol. 4). Berlin: Springer Science & Business Media.
National Institute for Alcohol Abuse and Alcoholism – NIAAA. (2017). Alcohol facts and statistics. Retrieved 20/06/2017 from: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics.