Substance Abuse: Effective Non-Medication Approaches

Reducing drinking and drug use and withdrawal symptoms without medications

This is the first post in a series on alternative and integrative approaches to alcohol and drug abuse. In this post I briefly comment on the limitations of mainstream conventional (pharmacologic and psychotherapeutic) treatments of alcohol and drug abuse and introduce readers to a variety of non-medication therapies that can help you cut down or stop drinking, reduce hangover symptoms, and control craving. Future posts will go into more depth on specific alternative and integrative approaches including concise reviews of research evidence, safety issues when they exist.

Limitations of mainstream conventional treatments of alcohol and drug abuse

Controlled studies and patient surveys show that existing conventional pharmacological and psychosocial treatments of alcohol and drug abuse and dependence have a mixed success record in helping individuals to stop drinking or abusing other substances and maintain abstinence. It is estimated that one year after stopping drinking or using a drug approximately one third continue resume drinking or abuse the same substance at the previous level, one third use the same or another substance but in a more controlled way, and roughly one third remain abstinent. Following the one year mark, abstinence rates continue to decline. There are no effective conventional treatments of cocaine addiction, and recovering alcoholics engaged in 12-step programs continue to experience high relapse rates. Only one third of recovering alcoholics who attend regular Alcoholics Anonymous meetings remain sober for more than one year.

Alternative and integrative treatments for alcohol and drug abuse

There is consistent positive evidence for the beneficial effects of lifestyle changes and a variety of non-pharmacologic treatments of alcohol and drug abuse. Reducing caffeine and refined sugar in the diet while increasing omega-3 consumption is associated with reduced relapse rates in abstinent alcoholics.

Supplementation with select natural products may have significant beneficial effects on reducing drinking and reducing withdrawal symptoms. For example, there is evidence that the amino acid taurine reduces alcohol withdrawal symptoms, SAMe (S-adenosylmethionine) reduces alcohol intake, and L-tryptophan reduces alcohol craving. The amino acid acetyl-L-carnitine may improve cognitive functioning in abstinent alcoholics.

Anti-oxidant vitamins taken before heavy drinking may reduce the severity of hang-over symptoms, and nicotinic acid may reduce the risk of developing dependence in chronic drinkers. Alcoholics who take magnesium and zinc supplements may mitigate the long-term neuropsychological consequences of chronic alcohol abuse. Emerging research findings suggest that some traditionally used herbs in Chinese medicine and Ayurveda are beneficial treatments of alcohol and drug abuse and dependence.

Relaxation, meditation and mindfulness training

There is evidence that the regular practice of relaxation techniques such as guided imagery and others, may reduce withdrawal symptoms following discontinuation of benzodiazepines. The regular practice of yoga, meditation or mindfulness training probably improves general functioning in alcoholics and may reduce the rate of relapse in abstinent alcoholics and addicts.

EEG biofeedback, virtual reality graded exposure therapy (VRGET) and acupuncture

EEG biofeedback using an alpha-theta training protocol probably reduces the rate of relapse in abstinent alcoholics. The application of weak electrical current to the brain may significantly reduce symptoms of alcohol and opiate withdrawal while improving associated symptoms of anxiety. Virtual reality graduated exposure therapy is emerging as a potentially effective non-drug therapy for reducing nicotine and cocaine craving. Regular exposure to dim morning light may reduce the risk of relapse in abstinent alcoholics. Some acupuncture protocols may reduce symptoms of withdrawal after chronic alcohol or cocaine abuse is discontinued.

I will review the evidence for these and other non-pharmacologic therapies in more detail in future posts. You can find a concise overview of alternative and integrative approaches to alcohol and drug abuse and practical methods for using them for alcohol or drug abuse, in my book "Alcohol and Drug Abuse: The Integrative Mental Health Solution."