Alcohol Dependence | Alcoholism | Addiction
I'm Dr. Robert R. Perkinson, the clinical director of Keystone Treatment Center. I specialize in alcoholism treatment, drug abuse treatment, teen drug abuse treatment, and problem gambling treatment. I have been treating alcoholics and addicts for over 30 years and have written the leading treatment manual for addiction counselors in the world. I thought I would give you an opportunity to learn more about addiction.
Acute Alcoholism Drug Withdrawal
To make a diagnosis, use the criteria listed in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Order a copy of this from The American Psychiatric Association, 1400 K Street, N.W., Washington, DC. 20005. A new edition comes out every few years so there will be changes in the criteria from time to time. The 1994 criteria are listed in Appendix 4, but this will change every few years (Ron: Use the 2000 criteria instead). If you are unsure of your abilities to use the diagnostic criteria, an instrument such as the Structured Clinical Interview for DSM-IV (First, Spitzer, Gibbon, & Williams, 2001) is the most readily available battery used in clinical evaluation.
Following is the DSM criteria for diagnosing Alcohol Abuse and Alcohol Dependence (Ron: Make sure you are using criteria from DSM-IV-TR (2000):
Diagnosis: Alcohol Abuse
A. A maladaptive pattern of psychoactive substance use leading to clinically significant impairment or distress indicated by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household).
2. Recurrent use in situations in which use is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use).
3. Recurrent substance-related legal problems.
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights).
B. The symptoms never met the criteria for Psychoactive Substance Dependence for this class of substance.
If you are unable to diagnose abuse, check with the family. This patient may be in denial and you may get more of the truth from someone else. Family members, particularly a spouse or a parent, may give you a more accurate clinical picture of the problems.
If you diagnose abuse, move on to the dependency questions.
Diagnosis: Alcohol Dependence
A maladaptive pattern of substance (alcohol) use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
1. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the substance to achieve
intoxication or desired effect.
b. Markedly diminished effect with continued use of the same amount of
2. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for the substance.
b. The same (or a closely related) substance is taken to relieve or avoid
- The substance is often taken in larger amounts or over a longer period of
time than was intended.
- There is a persistent desire or one or more unsuccessful efforts to cut
down or control substance use.
5. A great deal of time spent in activities necessary to get the substance,
use the substance, or recover from its effects.
6. Important social, occupational, or recreational activity given up or
reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent or recurrent psychological or physical problem that is likely to have caused or been exacerbated by the use of the substance (e.g., continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
With Physiological Dependence: evidence of tolerance or withdrawal.
If you think that you or someone you love has a problem with alcohol, drugs or gambling, the fact that you are reading this page is an incredible victory. It means you are thinking about getting help. Congratulations! An addict has only two choices get into recovery or die.
The first thing you need to do is see if there is an addiction problem. Answer these questions and be honest with yourself. You can answer the questions for yourself or the person you are concerned about. You have nothing to hide and nobody is going to know the results but you.
Has the person ever tried to cut down on his or her use?
Have people annoyed the person by talking to him or her about the use?
Has the person ever felt bad or guilty about his or her use?
Has the person ever used alcohol or drugs in the morning or broken the law to use?
Two or more of these questions answered yes indicates probable addiction. That means you are in trouble and you need help. Only 4% of addicts can quit on their own for the next year.
It is not just the addict who suffers. Everyone associated with an addicted person is under terrible stress. This will just get worse until you get into treatment.
If you or someone you love is addicted, you need to take action now! Don't let someone die because you stalled. I know you are afraid, but you don't have to be.
If you are an addict, or live with one, you are in great pain. Most addicts die of their addiction and they take their family members down with them. The first step in recovery is to get honest with yourself. Don't just sit there and think things are going to get better. Addiction doesn't get better. It gets worse until somebody dies. You need to take action and you need to take action now. The worst thing you can do is wait. How are you going to feel if this person kills someone in an accident or kills themselves? Don't let this happen to your family. It's time to get help. Call us for a free assessment at 1-800-992-1921. There is no obligation and you don't even have to tell us your name. We can help you get treatment in your area or we can help you come to our treatment center. We are a small treatment center where you won't get lost in the shuffle. We have a number of programs designed for specific populations such as duel diagnosis, cognitive deficits, gambling problems, a Christian program, an adolescent program, a young adult program, a Native American program and many more. We are very flexible about the cost of treatment. Most patients come into treatment at reduced rates. Many patients are state funded or come into treatment under Medicaid. If you are worried about the money, don't let that stop you. Money is the least of your worries. The money is not going to kill anyone and addiction kills everyone. Let us help you find a treatment you can afford. If you are an addict or if you live with one you are living in hell, you have no peace. Nothing you have tried works and you keep returning to the pain.
Don't Worry You Can't Afford Treatment
Our Location: Keystone Treatment Center, 1010 East Second Street, Canton, SD 57013
Call 1-800-992-1921 for a free assessment
Chemical Dependency Counseling: A Practical Guide, Fifth Edition: is a best-selling comprehensive guide for counselors and front-line professionals who work with the chemically dependent and addicted in a variety of treatment settings. The text shows the counselor how to use the best evidence-based treatments available, including motivational enhancement, cognitive behavioral therapy, skills training, medication and 12 step facilitation. Guiding the counselor step-by-step through treatment, this volume presents state-of-the-art tools, and forms and tests necessary to deliver outstanding treatment and to meet the highest standards demanded by accrediting bodies.
The Alcoholism and Drug Abuse Client Workbook, Third Edition:An evidence-based program that uses treatments including motivational enhancement, cognitive-behavioral therapy, skills training, medication, and 12-step facilitation. It provides a venue for clients to write down their thoughts and experiences as they progress through treatment.
The Gambling Addiction Client Workbook, Third Edition:An evidence-based program that uses treatments including motivational enhancement, cognitive-behavioral therapy, skills training, medication, and 12-step facilitation. This workbook walks clients through self-reflective activities and exercises meant to help them recognize the underlying motivations and causes of their gambling addiction and to learn the tools necessary for recovery. The Third Edition of this workbook includes coverage of all 12 steps of recovery. Chapters focused on honesty and relapse prevention as well as a personal recovery plan contribute to client success.
Alcoholics are one of the most difficult client groups to treat effectively. To preserve their way of life, they may lie about their problem or deny that one exists; that is the nature of this profoundly powerful disease. Yet if you can guide each of your clients through their own resistance towards the truth, not only will you be rewarded with starting them on the road to recovery, you will no doubt have saved their life as well. Achieving such a victory goes to the heart of being an addiction counselor; it is the experience of healing on a direct and tangible level.
Treating Alcoholism provides a complete road map for assessing, diagnosing, and treating this multifaceted and tenacious illness. Detailed clinical information on the disease accompanies ready-to-use tools for practice. With a special emphasis on the 12 Steps of Alcoholics Anonymous, the author walks you through the first five steps of this established methodology in comprehensive detail, showing how to easily apply each one to treatment.
The Big Book of Alcoholics Anonymous says that only God can relieve the illness of addiction. Here are a few spiritual tools to help you:
God Talks to You: Second Edition: God wants to communicate with you. God has been calling you for a long time. You have wanted God to speak to you for a long time. You have wanted to talk to God and get answers back. Here are a few quotes from spiritual leaders who have read the book: Reverend Mark Holland: “After reading Dr. Perkinson's book, I spent several minutes quieting myself, and then I asked God if there was a message for me. “Mark I’ve missed you!” Although there were no words spoken, I felt this message very clearly. I was quite surprised. Daily I was involved with spiritual matters, praying, preaching, and counseling. Nevertheless, I discovered that God was lonely for me.” Reverend Dave Waldowski: “This book and tape do not only “discuss” communication with God, moreover if you follow these simple principles you will “experience” and “hear” God’s voice on a daily basis.”
Peace Will Come CD Sit back and let the words and music sink into your soul. Come back often and play the songs over and over again. You won't be sorry. God will teach you many things you need to know.
A Communication From God: A meditation tape that will give you long communications from God. The tape takes you through two exercises where God speaks to you directly.
Addiction stops your spiritual progress.
Begin a new spiritual journey:www.godtalkstoyou.com
Read the latest research for a school paper or project from the National Library of Medicine