Antibuse is considered a drug of last resort by many, if not most clinicians who work with substance abusers and alcoholics. It is not an easy choice to put a patient on antibuse because of the terrible agony suffered by one who drinks while on antibuse.

A clinician must weigh the damage caused by the alcoholic to family, community, and self, before prescribing antibuse. Antibuse is a very dangerous drug. If drinking, the effects are major skin flushing, respiratory distress or difficulty breathing and swallowing. Convulsions are possible and the individual on the drug may go into cardiac failure.

The best way to deal with the antibuse patient who drinks is to get them to a hospital immediately. It is possible that without medical intervention, the patient will die.

The person who is unfamiliar with alcoholism may consider the risks of antibuse extreme or draconian, hardly worth the risk involved. Consider that the individual has a need to drink that is so compelling the risk of death is ignored in order to drink. Would a normal person take that risk? Of course not. No person in their right mind would. But the alcoholic has lost much of the reasoning ability to make right choices. Those who risk the danger of antibuse and drink anyway are on the very edge between life and death and aren't sure which they want to pursue.

Alcoholics Anonymous may help the most resistant of alcoholics who may return to sanity by going to meetings. It does work for 8 of 10 who have lost control, however, it may take several "slips" before the reality of AA is held on to.

These motivated individuals may be likely candidates for antibuse. It is well to be prepared in the event the alcoholic does drink. The drug has proven to be a lifesaver for some. The majority, however, are likely to do well in alcoholic treatment that emphasizes AA's twelve steps, a realistic outlook on life, love, and work.

It is well for the family and loved ones to get into alanon which teaches about the ways to cope and develop strategies for the future. The emphasis is taken from the alcoholic and put onto the family. the family is taught to get on with life, whether the alcoholic continues to drink or not.

The author admits the AA model is not the only way to get out of the alcoholic trap. He also is very cogent of his bias for AA because he has seen genuine miracles performed for those who sometimes are on the very brink of death. This is another paradoxical illness. The alcoholic, and sometimes his family too. are almost always walking through the valley of death. The paradox is every recovering alcoholic goes into a valley of death. The test is whether the experience will be transformational. The author and many of his colleagues observed many of these miraculous changings.

One day the suffering on the face of an alcoholic is too painful to look at. The depth of despair, along with hopelessness, causes not a few clucks of sorrow from the treatment team. "she or he's gone," may be heard from even seasoned treatment team members. As the suffering alcoholic slogs through that lonely valley, something wonderful and indescribably close to God takes place. The writer can only compare it to St. Paul's miraculous transformation from evil to good. Not all who recover find God, but are satisfied to give themselves up to a power great then self.

Afterwards, the same person resides in the same body, of course. Suddenly he/she is seeing the world that has been ignored. The pain is wiped away, though there may be many tears. It is an effort to hold back the joy. Something else is happening. There is a serene look, similar to that seen in psychiatric patients who have found "insight." It was there all along but the curtain remained closed until the pain causing distressful symptoms is finally confronted. Of course, the alcoholic usually must be at least "dry" for the major change to take place. It takes time for the long-term effects of the drug to wear off. It is important to go to a detox center to neutralize the toxins. The patient who is at home seeing bugs or animals, voices and other horrors is in withdrawal, which may be very dangerous. The advice: Give him/her a drink(not the bottle) and get him/her to a detox center immediately, by ambulance preferablly. If you have decided to stick it out, consider the importance of getting some help for yourself. Alanon and alateen have meetings just about anywhere in the U.S.

The family, and everyone else, may be caught off guard and try to maintain the family as before. Kids may act out where before they had controlled their anger, feelings of resentment, or the role of maintaining the family appearance of solidarity, or, "nuthin's wrong around here."

Remember, athiests too may experience the transformation, in fact it is no more unusal for an athiest to "get it" than a believer who has been given a similar chance at life.

The author has witnessed many new so-called treatments for substance abuse. A cognitive approach goes something like this: Buckets of booze placed before the patient who drinks until uncontrolablly sick as kind of "aversion therapy" was lauded for awhile. Alcoholics are used to drinking until sick and out of control. Naturally, the booze bucket method failed.

Another treatment along the same lines was to give the drinker an elelctric shock each time he/she raised a glass of alcohol to the lips. An elelctric shock is minor compared to some of the negative consequences alcoholics face. They regularly drive their car into things like cars and trees. Passengers and sometimes the alcoholic is killed or crippled for life.

Another researcher was sure he had a new treatment that would allow the alcoholic just two drinks during the cocktail hour. "the old controlled drinking experiment" comers around every few years, giving false hope for a cure that possibly will happen when the correct gene "turn off" is employed to inturrupt the signal that orders the alcoholic gene to turn itself on. Will it work? Alcoholics are adept at getting around locks, rules, and logic to get a drink. the author is taking no bets. When it comes to the disease of alcoholism, all bets are off, except the spiritual healings associated with the disease.

Why try to convince someone with 50 dui's, or a mother drinking cooking wine alone, an alcoholic who forgot he couldn't drink and spenjt 16 years behind bars for killing a pedestrian. the father who burned down the house when he decided to make chili and fell asleep with the burners on high. Luckily his wife and four chilren escaped. He was burned to toast on the sofa. there are thousands of stories like these. the author remembers with sadness the effects alcohol has on a community. It's irresponsible to try and teach an alcoholic how to drink safely. It might work for a few weeks or even a few months. The results of these experiments are usually not good. Why risk it at all?

What do you think? Do you know someone who has kicked the habit.? If so did they do it alone or did they have some help?