Aversion therapy

• Devlin (2008) :


  Article in Telegraph highlighted increase in spending on Antabuse & other drugs to treat alcoholism. In 2008, NHS spent just under £2.25 million on the medication, up from £1.08 million in 1998. Alcohol Concern responded by saying this was a small amount compared with money spent treating alcoholism & related problems on NHS. Argued that investing in treatment & prevention saves NHS money in long run. Financial costs damaging to society.
• No Quick Fix (centre for social justice, 2013) :

  Report highlights social costs of addiction- alcohol abuse costs taxpayer £21 billion a year. Addiction can lead to unemployment & claiming benefits. Effects on physical health cost NHS money- cost of alcohol use to NHS is £3.5 billion a year. Addiction causes breakdown of families, homelessness, debt & crime. Benefits of treatment to society may outweigh any costs (financial or ethical) associated.
• Risk of harm:

  Rapid smoking unpleasant & Antabuse causes negative effects if alcohol drank whilst on it. Valid consent given. People may choose not to rapid smoke or take Antabuse due to harmful effects- can create problems with effectiveness studies as people may drop out (affects results).
• More ethical alternatives:

  Covert sensitisation achieves same association e.g, imagine feelings of being sick & vomiting when urge to drink. Kraft (2005) : presents series of case studies highlighting although this technique not commonly used, can be a quick & highly effective treatment. More ethical than Antabuse drug to induce unpleasant reaction.
• Niederhofer & Staffen (2003) :


  Compared Antabuse to placebo & assessed participants using self-report methods & screening for 90 days. Antabuse patients had significantly greater abstinence duration than placebo group. Jorgensen et al (2011) found that those treated with Antabuse had more days until relapse & fewer drinking days.
• Ellis (2013) :


  Only few comparison studies between Antabuse & other alcoholism treatments & often use small samples. Also hard to carry out placebo studies as patients will be aware which condition they're in if they drink & no adverse effects are experienced.
• Studies on Antabuse effectiveness in long-term are rare & lack scientific rigour as they're not full randomised controlled trials.
• McRobbie (2007) :


  Study on 100 smokers attending a cessation clinic where rapid smoking compared with a control condition of watching video about giving up smoking. Rapid smoking group showed significant decrease in urge to smoke in the 24hours and week after procedure. At 4 weeks difference between the groups no longer significant & therefore impact of rapid smoking on long-term abstinence remains unclear. Reducing urges early on may help kick-start process & then other techniques can be employed.
• What are Antabuse implants?

  Slowly releases Antabuse into system. Lack of research into long-term effects. George Best footballer given it. Combats Antabuse compliance issue as you don't have tablets.
• What is rapid smoking?

  Smoker in closed room & will take a puff of cig every 6 seconds. For set amount of time or cigs, or until person feels sick.
• In the UK, what are the NICE guidelines for Antabuse?

  Suggest treatment can begin after person has undergone withdrawal. 200mg dose daily- may be increased if reaction with alcohol is not aversive enough. Remain under supervision every 2 weeks for first 2 months then monthly for 4 months following that.
• What is Antabuse?

  Drug that causes disulfiram reaction to occur which stops ALDH enzyme breaking down acetaldehyde into acetate (harmless). Therefore build up of acetaldehyde (harmful) in bloodstream. Makes you feel sick, sweat, heart palpitations & headaches. Tablet takes 10mins to work & lasts few hours.