Primary care physician can see the ravages of alcohol reflected in the state of they body even when the affected individual has not asked for help. The approach to treating these people must be subtler than caring for those who voluntarily admit themselves to a rehabilitation center. Still, intervention at an early stage of alcoholism can drastically improve the course of the disease if it is performed successfully.
Doctors from the University of Wisconsin tested a combination phone-mail treatment on random individuals who exhibited clear symptoms of alcoholism while seeking treatment for other conditions. The treatment consisted of six telephone counseling sessions focusing on motivating and informing, and summaries of those sessions were mailed out as reminders afterwards. While one might not expect patients to be very receptive to treatment that they had no hand in initiating, the results were actually very promising.
Patients receiving the phone-mail treatment did significantly better than a control group that received only a pamphlet on alcoholism. Men reduced their number of risky drinking days by 30.6% as opposed to 8.3% for controls. Women reduced risky days by 17.2% while controls brought them down by 11.5%. Clearly, this treatment is very effective for curbing abuse in male patients. The results for women are harder to read but suggest several possibilities: women may have a socially-formed difference in the way that they view alcoholism and treatment. For them, being diagnosed as an alcoholic is the greatest impetus for change, and additional counseling has only a small beneficial effect. There may also be a biological difference in the nature of addiction for men and women. Previous studies suggested the female brain to be more vulnerable to brain damage because of its unique reaction to ethanol. Sex-specific treatments need to be devised.
The phone-mail treatment was still successful enough to merit its adoption by general practitioners. This trend is another example of how preventative care, in the primary care environment or even by specialists who are familiar with a client, can save money and time while helping one to avoid disastrous outcomes in the future. The technique requires minimal effort and can catch drinkers before they turn up at a clinic’s door after suffering irreparable damage to their health and relationships. The only element lacking from this study was a cost-effectiveness evaluation. While mail reminders are surely more economical than office visits, they seem antiquated in the Internet age. Many therapeutic techniques now utilize the conveniences of email and video-conferencing, and it reasonable to assume that the results of the phone-mail treatment course will be even more pronounced with the application of Internet tools.