Psychological support + medication to help quit drinking is not difficult to prevent relapse on your own

By Zhang Shumei, Ming Pao

The challenge of quitting drinking is that stopping drinking is only the first step. The key is to prevent relapse, which means drinking more than before.

Experts point out that alcoholism is only a symptom, and there may be hidden emotional stress behind it. Only by dealing with the underlying reasons can one break away from alcohol addiction. At the same time, strategies for dealing with stress and negative emotions in the future should be formulated in advance to prevent relapse.

(Hong Kong) Artist Cheng Chung-kei, who once decided to quit drinking because of drunken trouble, recently issued a statement saying that he was suffering from depression and was once again using alcohol to escape reality. In order to solve the problem, he will go to the United States to participate in treatment at an alcohol rehabilitation center.

What is alcohol addiction? Everyone has different tolerance for alcohol. Dr. Tung Tsz-kwong, consultant of the Tuen Mun Alcohol and Drug Dependence Unit of Castle Peak Hospital, pointed out that in clinical diagnosis, the amount of alcohol consumed is not used as a criterion. “Some people may have addiction problems even if they don’t drink a lot due to genetics.” The diagnosis mainly refers to the symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for alcohol use disorder, such as the need to drink more to achieve the pleasure brought by drinking, anxiety, insomnia and other addiction symptoms after not drinking, difficulty controlling the desire to drink, or problems in health, social, work and other areas due to drinking.

Long-term drinking affects memory and emotions

Drinking after get off work or at a party is common, but some people use alcohol as a window to escape reality. Qiu Fengjun, social worker in charge of the Tung Wah Group of Hospitals’ “Stay Alcohol Free” alcohol prevention and treatment service, pointed out that the help-seekers have a low awareness of alcohol crisis. “For example, they initially used alcohol to deal with insomnia, but over time they needed to rely on alcohol to fall asleep, and even drank more and more, from one or two cans of beer to half a dozen or even a dozen to fall asleep; some people also found that they no longer had to think about troubles after drinking, and used alcohol to deal with current emotional distress and stress.”

Alcoholism is closely related to emotional illness. Cheng Chung-kei mentioned that he suffered from depression and used alcohol to escape reality. Dong Ziguang pointed out that when encountering problems, people resort to alcohol instead of solving them seriously, which will lead to more and more stress and even bring new problems, making them more susceptible to emotional illness.

She noticed that 40% to 50% of new patients who seek treatment at alcoholism clinics each year also suffer from mental illness, more than half of which suffer from depression. Alcohol addiction and mood disorders coexist, increasing the difficulty of treatment. “Alcohol is a central nervous system depressant, which can make depression more severe, make people think more negatively and lose motivation. It also reduces the patient’s motivation to receive treatment, because drinking problems mask depressive symptoms and make people miss the emotional problems behind them. Even after treatment, patients are affected by alcohol and their compliance with follow-up visits and medication will decrease, making depression more difficult to treat.”

Focus on psychological counseling and behavioral therapy

If you notice that you or someone you know is having problems with their life or health due to alcohol abuse, seek help as soon as possible.

“The people who come to help say they want to quit drinking, but after listening to them, I find that they don’t just want to quit drinking, but want to deal with the problems behind it.” Qiu Fengjun pointed out that the agency receives 200 to 300 cases of help every year, with a male-female ratio of about 7 to 3, and most of them are between 30 and 49 years old. The people who help are generally older and have health problems. For example, after drinking too much and being sent to the hospital, they were found to have high liver enzymes and fatty liver, so they come for help; “The second is that there are problems in family and close relationships. Emotions are easily agitated after drinking, conflicts increase, and they hope to quit drinking to improve relationships.”

Long-term drinking can affect mood and memory, slow down brain function, and slow down hand-eye coordination, which can affect work performance.

Treatment of alcohol addiction focuses on psychological counseling and behavioral therapy. Qiu Fengjun pointed out, “For example, if someone drinks because of insomnia, the problem comes from work pressure, and the person may not connect the two; or when facing negative emotions, he or she lacks positive support and resorts to alcohol. During the counseling process, we need to find out what he or she really needs.” Meditation can enhance the awareness of the body and emotional state of people who are quitting addiction; when conflicts occur, meditation can stabilize emotions and understand the problems to be dealt with, rather than habitually avoiding them and dealing with them with alcohol.

“People with alcohol addiction usually have their own problems. They have experienced many bad things and lost many things. We need to piece together these fragments and help fill the gaps.” Dong Ziguang said that drugs can suppress alcohol cravings. For example, naltrexone blocks the pleasure, comfort and excitement brought by alcohol; disulfiram causes adverse reactions after drinking, such as headaches, dizziness, and nausea.

But medication is only an auxiliary, and the focus of treatment is still on psychological support.

“In the treatment plan, there is a strong emphasis on giving addicts a new focus or meaning in life, so that they know what they do that makes them feel useful and develop things that can help relieve stress. Drinking will naturally no longer be a big temptation.” Medical staff and social workers will also help them establish new hobbies, social circles, find jobs and repair relationships with family members. This is a long-term treatment and support.

Just completed the high-risk period of alcohol relapse

“Stop drinking is just the beginning. The key is how to persevere and find ways to overcome the challenges that may arise in the future.” Dong Ziguang said that during treatment, medical staff will work with the person quitting drinking to predict crises and prepare response plans. The most dangerous period for relapse is when you have just completed alcohol abstinence treatment. Whether it is problem-solving ability or stress management, it is still very unstable. People around you may also be skeptical and lack encouragement. At this time, it is easy to be swayed and relapse. Or after quitting drinking for a period of time, your vigilance against alcohol is gradually reduced. Seeing that people around you can drink in moderation, you hesitate whether to give up the goal of not drinking at all. Once you relapse, you should confess as soon as possible, analyze the circumstances under which you “broke the rules”, see if you need additional help, or re-examine what you may have missed during previous treatment.

Once a person who has quit drinking relapses or feels that all his efforts have been in vain, he or she may become discouraged, and people around him or her may feel disappointed and criticize him or her, and he or she may quickly return to his or her old ways, or even get worse.

Prevent relapse by developing new interests

When you “break the habit” and come into contact with alcohol, will you become addicted again? He said it depends on the individual. If the original cause of alcoholism has been resolved, then it may not be a problem to come into contact with alcohol again. “But if there are unfavorable factors such as emotional illness or unresolved stress, or if the body is more prone to alcohol dependence, there is a higher risk.”

Ms. Chen Jiehua, a senior addiction counselor of the Tung Wah Group of Hospitals’ “Stay Alcohol Free” alcohol prevention and treatment service, recommends that people who are quitting drinking should try not to drink again, “because the body can easily recall the memory of drinking.” This is especially true for people with severe alcoholism, who may develop various health or emotional problems due to drinking. They can prevent relapse by cultivating new interests, “such as diverting their attention during exercise, rather than just dealing with stress through drinking,” or joining a mutual aid group for like-minded people, so that they can feel understood and gain support and strength during the talk.

GradualIncrease determination

1. Announce your thoughts and goals about quitting drinking

Public commitments can give people more determination and motivation to achieve their goals under pressure from the crowd. At the same time, people around you can avoid being tempted to drink and help supervise them.

2. It’s hard to adapt to stopping all the time

If you try to quit drinking on your own, you can first reduce your alcohol intake by a quarter to allow your body to slowly get used to it. Stopping drinking all of a sudden may be difficult to adapt to, especially for people who are highly dependent on alcohol, or who have severe alcohol withdrawal symptoms such as convulsions and seizures.

3. Record drinking patterns

Write down what you drink, how much you drink, and when you drink each time. When you look back a month later, you can find your high-risk drinking situations and find ways to deal with them. Keeping a record can strengthen your motivation to quit drinking. For example, if you write down that you drink 4 to 5 cans of beer a day, you will drink 150 cans in a month. This astonishing number can strengthen your determination to quit drinking. You can also record the cost of buying alcohol to see how much money you can save and increase your motivation to quit drinking.

Source:

Psychiatrist Tung Tsz-kwong | Registered social workers Chiu Fung-kwan and Chan Kit-wah

Residential addiction treatment center

Stay away from addictive things

We often hear about Hollywood stars going to addiction treatment centers for drug or alcohol treatment. Cheng Chung-kei also said that he will go to a treatment center in the United States to quit drinking.

Psychiatrist Dong Ziguang pointed out that this residential detoxification model allows addicts to stay away from their own environment and reduce their exposure to things that induce addiction. During the stay, experts will help analyze the causes of addiction, and then arrange psychological counseling and treatment for the source, and will also help addicts establish healthy living habits.

Finding more stable emotional methods

“Stay away from addiction addictions in a detoxification center and find ways to stabilize your mood and cope with stress, or develop new hobbies and positive relationships. This will help addicts build resilience when they return to the community, even if they encounter situations that trigger drinking urges.”

There are no dedicated accommodation facilities for people to quit drinking in Hong Kong. Most people who quit drinking remain in the community for treatment. If they develop serious mental problems due to drinking, such as severe depression, attempted suicide, etc., they will be sent to hospital to deal with their mental problems and alcohol addiction.

Dong Ziguang pointed out that hospitalization usually lasts only one or two months, which is not enough to produce obvious changes to resist dependence. Therefore, after returning to the community, follow-up treatment is still required to completely get rid of alcohol addiction.

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