Treating drunks not cut, paste job

“Is there a recommended period for rehabilitating an alcoholic? We recently booked a relative for a three-month rehabilitation session, but that doesn’t seem to have changed him much.”

A slightly different way of asking your question is as follows; do all alcoholics need the same help in terms of their treatment? If they do, then the treatment for all of them should be the same, or very similar.

An alternative way of asking the same question is as follows: - Is it true that there are different routes to the disease of addiction? If they are different, then clearly the exit from the disease should be different for different people.

Another question you could ask is as follows: - Are there different levels of severity of the disease of alcoholism. Put differently, are there people for whom there is little hope of recovery and are there those for whom much hope can be given?

As you can see, your question can and does provoke a great deal of thought and debate, long before we can comment on the duration of treatment. Just to complicate your life a little more, there are good and effective rehabilitation centres and there are others that are not!

Starting with the latter point, let me say categorically that there are some buildings that call themselves rehabilitation centres, but close examination reveals them to be death chambers. Just like not all places that call themselves hospitals are.

One has to be sure that what they call rehabs are properly inspected and registered as such by the government (Read NACADA). If it is not registered then it is something else not a rehab centre.

A few years ago, we saw a 25- year- old man who had been in a building called a rehab centre for one year. When we saw him, it was at the insistence of his sister who was visiting from the USA. Throughout the year, the patient who had been taken there because he had dropped out of university because of drinking too much was on the 12-step programme for alcoholics.

This was the fourth time he was being taken through the 12 steps. The reason he was not discharged was because he kept saying that a voice was telling him that Jesus made wine at a wedding and that wine was therefore good for him as well.

The pseudo experts at the house interpreted this to mean that the person was in denial and that what he needed was more time and more talk. When we saw him with his American sister, it became clear that this man was not in denial. He was suffering from Schizophrenia, which is a serious mental illness that sometimes comes with hearing voices. Following the diagnosis, he was put on medication.

The voices slowly went away, he no longer felt under the control of birds of the air and his urge to drink alcohol went away. He was followed up after discharge and he went back to university, finished his degree and no longer drinks.

In a different case, a man in his 40s was admitted to a rehab, as a last resort by his employer who was about to sack him. He had been to three institutions and was not getting better. When finally seen by a psychiatrist, a diagnosis of Post-Traumatic Stress Disorder (PTSD) was made. This man was a survivor of the 2008 post-election violence. He had left his adopted home to go live in another part of the country.

During the height of the clashes, he had witnessed extreme violence in which people suffered serious injuries and some died in his presence. At the time, he feared he would also be killed.

Months later he was unable to sleep, was easily startled, kept seeing visions of the dead and dying and again, used alcohol to calm his nerves. The 12- step programme did not help him. He improved upon a diagnosis of PTSD that was then treated. He went back to work and his family.

These two stories make the point that different people, of different ages and backgrounds require proper evaluation before one can be “committed” to a three month rehab programmed. Millions others benefit from attendance to Alcoholics Anonymous.