Nonconventional and Integrative Treatments of Alcohol and Substance Abuse

CES involves the application of weak electrical current to specific points on the scalp or ears. In a 7-year prospective study of CES in the treatment of alcohol(Drug information on alcohol), drug, and nicotine(Drug information on nicotine) addiction, acute and chronic withdrawal symptoms were diminished, normal sleep patterns were restored more rapidly, and more patients remained addiction-free following regular CES treatments compared with conventional medication management. Patients addicted to alcohol, drugs, or nicotine who were treated using CES reported significantly fewer anxiety symptoms and higher quality-of-life measures than patients who underwent conventional drug treatments.⁹

Protocols that use daily CES treatments compare favorably with combined psychotherapy, relaxation training, and biofeedback for reducing anxiety in patients abusing any substance.¹⁰ Preliminary findings suggest that daily 30-minute CES treatments significantly improve cognitive functioning and reduce measures of stress and anxiety in inpatient alcohol abusers or polysubstance abusers.¹¹

In a 4-week, double-blind study, 20 patients who were depressed and abused alcohol were randomized to daily CES treatments (70 to 80 Hz, 4 to 7 mA), versus sham treatment. The patients treated with daily CES reported significantly reduced anxiety by the end of the study. These preliminary data suggest that CES may be a reasonable alternative treatment for anxiety in persons withdrawing from alcohol or other substances while avoiding the risk of cross-tolerance and dependence that is associated with the use of benzodiazepines in this population.¹²

Limited data suggest that electromyogram and thermal biofeedback¹³ as well as EEG biofeedback training may reduce relapse risk in abstinent alcoholics.^14.15 In EEG biofeedback training, the patient learns how to self-induce brain states that correspond with deep relaxation. Limited findings from case studies suggest that EEG biofeedback using an alpha-theta entrainment protocol reduces relapse risk in persons abstaining from alcohol,¹⁶ but not in persons abstaining from cocaine.¹⁷

Findings from a small controlled trial suggest that early morning exposure to dim light (ie, narrow-spectrum light with an intensity of 250 lux in contrast to full-spectrum white light with an intensity of 10,000 lux) improves depressed mood in persons abstaining from alcohol who have seasonal affective disorder.¹⁸ Since depressed mood is an established risk factor for alcohol addiction relapse, the postulated mood enhancing effects of early morning dim light may provide a beneficial approach to relapse prevention in persons abstaining from alcohol who experience seasonal mood changes. More research is needed to confirm these preliminary findings.

The effectiveness of acupuncture as a treatment for enhancing abstinence from alcohol, cocaine, and other drugs cannot be ascribed solely to a placebo effect.¹⁹ Numerous early studies showed that regular acupuncture treatment increased brain levels of endogenous opioid peptides.^20-22 Stimulating specific acupuncture points on the ears, hands, and back of the neck may reduce alcohol craving and decrease withdrawal symptoms in persons who abuse alcohol; however, acupuncture probably does not reduce craving and relapse after treatment is discontinued.^23,24

There are inconsistent findings for acupuncture in relapse prevention in persons abstaining from alcohol. Ambiguous findings may reflect the criteria used to select acupuncture points, the different treatment protocols (ie, conventional vs electroacupuncture), as well as differences in frequency or total duration of treatments, and the skill level or specialized training of individual practitioners. In 1 sham-controlled study, persons who abuse alcohol reported significant reductions in withdrawal symptoms within hours of initial treatment and no withdrawal symptoms within 72 hours of the second acupuncture treatment.²⁵ There is emerging evidence for correlations between specific acupuncture protocols and a significant reduction in alcohol craving and relapse rates in persons recovering from an alcohol addiction.^26,27 However, other findings do not support the hypothesis that acupuncture reduces craving and relapse risk among persons who abuse alcohol.²⁸