Some people repeatedly put themselves or others at risk by drinking. One view is that such people could drink sensibly if they were more considerate and used more will power. Another increasingly accepted view is that many such individuals are in a state, existing in degrees of severity, in which the freedom to decide whether to change their drinking, and to adhere to that decision, is reduced compared with other drinkers. This state partly depends on perceived pay-offs for changing, and on acquired dispositions which are less accessible to conscious control. Such persons become aware of a wish, or urge, to drink which overcomes rational thought. They may then make up an explanation, for example 'No wonder I feel like a drink, I've had a hard day's.
Such individuals benefit from help to unlearn those patterns, and to learn different approaches to problems. Discussion, care, and encouragement from others can bolster their will to do so. Assistance to set up controls within or from outside themselves may help. Some people can do this without external help, and others with the help of Alcoholics Anonymous (AA) alone.(1)
This approach argues that dependence on alcohol should be managed like other relapsing disorders, such as diabetes and asthma, (2) by using long-term monitoring coupled with intermittent or continuous treatment. However, social and cultural influences are stronger than in relapsing medical conditions and have more effects on outcome.
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