Zero Alcohol Drink Alcohol Detoxification Clinicle Therapy

Alcoholics Curewell Zero Alcohol Drink (ZAD)
In Essence

By: Valerian Texeira

Zero Alcohol Drink (ZAD) basically represents a unique, simple and safe low-alcohol drinking treatment to get rid of alcohol dependence. I discovered it during the year 1999-2000, which thankfully removed or “ cured” my previous 15 years of chronic alcohol dependency or the so called alcoholic disease so given the name “Alcoholics Curewell”.

It led me to devise this step by step alcohol minimizing method, which I named as Zero alcohol Drink (ZAD). I believe, any alcohol dependent person in general can successfully get rid of his/her alcohol dependence or any such serious alcohol(ism) problems by adopting to this simple low-alcohol drinking method, which in “essence” as follows:


“Whenever taking to drink alcohol, always mix (or simultaneously consume) ‘progressively adequate proportion’ of appetizing non-alcoholic beverages to reduce its alcohol content sufficiently to safe enough lower levels and drink it stomach-full, for satiety”!--- In other words, people while in the alcohol dependence never to consume those potentially “dangerous” high-alcohol (generally around 5% and above) beverages, instead always to consume sufficiently enough of the “safe” low-alcohol (preferably around 2% or less alcohol content by volume) beverages having the appealing, delicious taste and flavor that primarily fulfills its drinkers overall drink satiety desire so successfully prevents them from falling into the excessive alcohol consumption and from the serious alcohol(ism) problems."

Please Note: This ZAD in “essence” provides sufficient enough information for an average person to know, understand, how to enable anyone to come out of their Alcohol Dependence. One need not read any further into this research paper unless they want to know more of its research details. It done mainly to shows all my research study efforts in this matter.

Further study into this matter led me to the finding of a major “Alcohol Research Misconduct”, which is what I strongly contend as the “Root-Cause” of all the serious alcohol(ism) problems including the drunk driving. One can find its most important papers published in my other blog site http://alcohol-research-misconduct.blogspot.com

Zero Alcohol Drink
Alcohol Detoxification Clinical Therapy
(ZAD-ADCT) Part I

“Alcohol-related death and disability account for even greater costs to life and longevity than those caused by tobacco use, according to the global burden of disease study sponsored by the World Health Organization (WHO) and the World Bank. This study puts alcohol’s global health impact on a par with unsafe sex and above tobacco in terms of its contribution to the total number of years of life lost to death and disability as recorded in Disability Adjusted Life Years (DALYs). In addition to chronic diseases that may affect drinkers after many years of heavy use, alcohol contributes to traumatic outcomes that kill or disable at a relatively young age, resulting in the loss of many years of life to death or disability.”—WHO, Global Alcohol Database 2006.[4]


Introduction

After suffering from a long 15 years of alcohol “Dependence” Syndrome[5] or alcoholism[6,7] as defined in the ICD-10[8] and DSM-IV[9], all these years failing miserably to keep on my total abstinence resolve and falling back into that same decadent “relapse”; lately then I was earnestly started trying to explore some alternative ways to this “total abstinence” to come out of my alcohol dependence without having to abstain from my alcohol drink. In other words, I badly needed to continue with my alcohol drink but at the same time desperately trying to get rid of my alcohol dependence or the “addiction”, which is what I used to call it then. (To know more on this please read the forward of my ZAD book given in the Alcoholics Curewell website[10]). Finally, wonderfully enough I found a simple and successful alcohol minimizing lower-alcohol beverage (LAB) drinking method, (“Necessity is the Mother of Invention”) that within some days had gradually removed my almost 15 years of alcohol dependence. All my alcohol “craving”, “impaired (loss of) control”, alcohol physical dependence (withdrawals) tolerance all it symptoms[7] syndrome[5] have completely gone. (I had severe alcoholism symptoms or the dependence syndrome and many of those reckless behavioural anecdotes, besides I was brewing and distilling the alcohol when I could not afford to buy it, of course only for my private use.) I became able to successfully come out of my alcohol dependence while continue to drink alcohol by adapting to this lower-alcohol beverage drinking!

Obviously, my above finding stands in sharp contrast with the prevailing alcoholism diagnostic prevention, treatment, and recovery doctrines, promulgated by the worldwide alcoholism prevention and treatment concerns specially the leading world health Establishments; WHO and the USDHHS. They declare in general that the “substance (alcohol) dependence syndrome” manifests in: “often strong, sometimes overpowering” [8] ‘psychoactive drug desire’ (“craving”) and “Not being able to stop drinking once drinking has begun”[9] due to its “impaired (loss of) control” symptoms. Therefore it is not possible to the alcohol “dependent” alcoholics to come out of their alcoholism while continue to drink alcohol. It basically implies that the only option so far for the alcohol dependents (alcoholics) to get recovery from their ‘alcohol dependence’ lies fundamentally in the ‘total abstinence’ from drinking alcohol. They claim; “alcoholism is a chronic…disease”… “Alcoholism cannot be cured”[6,7], “Cutting down” on drinking doesn’t work; ‘cutting out alcohol is necessary for a successful recovery’ etc. So, by all these accounts it seems in my case, I had proven them wrong. Some how I found a complete CURE for the alcoholism. Since adapting to this new low-alcohol drinking strategy, I became absolutely able to control my alcohol consumption to such a minimum levels which is far below than the establishments moderate, low-risk or the safe drinking limits promulgations[11, 12], nevertheless I continue to fully enjoy my alcohol drinking. I named my newly found lower-alcoholic beverage drinking technique or strategy for the prevention, treatment and complete cure for alcohol dependence/addiction (alcoholism) as the Zero Alcohol Drink (ZAD) “Method” and latter as the “ZAD Practice”.

ZAD Findings Earlier Publications

In the course of the year 1998, it became clear to me that I got completely cured of my alcohol addiction or alcoholism (dependence) by this ZAD method. In the next year 1999, I wrote and published this findings in this paper titled: A Scientific Method to Minimize Alcohol THE ZERO ALCOHOL DRINK THEORY’ and sent it mainly to the World Health Organization (WHO) and other leading worlds authorities health concerns in the field. There was not much of a response. So in the year 2000, ‘Alcoholics Curewell’ was born (mainly with the testimony of my friend Victor Pais) and published the book of the same title[13]. It was mostly a revised version of my first ZAD paper in the book form. Neither there was much response to it this time either, except two book reviews. (Its web copies available in our Alcoholics Curewell book review section[10]). Luckily then I got subscription in the Addict-L mailing list[14], which helped me to learn and know a lot about the current addiction field its peoples, lobbies, politics involved. In between the years 2000 and 2003 I wrote many ZAD perspective papers and other literatures which are all now in our Curewell website[10],which was launched in beginning of the year 2003. However, the concerned establishment authorities so far mostly remained silent and seem to have ignored my ZAD findings. Nevertheless I should admit that none of my previous ZAD book and the paper was compliant with the establishments “substance dependence” “terminologies” used in their disease classifications, diagnosis documents[8, 9]. So it became highly important on my part to venture into a new ZAD Alcoholism Research Study paper, which incorporates all those feedback suggestions, advises that I received to my previous ZAD papers as much as possible.


Publication of the Preceding “ZAD Alcoholism Research Papers”

Following all those feedbacks to my previous ZAD papers came my next biggest landmark venture: “The ZAD alcoholism research paper”, in which I carried out an extensive and critical alcoholism research study on the establishments alcoholism (alcohol dependence) doctrines conducted under my ZAD perspective, and published it under the title; “The WHO and USDHHS Promoted World Alcoholism Mess (The Biggest World Health Blunder)[2] and the “ZAD Practice paper series” [3] in conjunction. It was first published (paper and electronic version) in September 2004 and mainly sent to the authorities of the WHO and NIAAA and some selected journals in the field, also posted to the Addict-L mailing List[14] on 16-9-2004. In this paper [2,3] besides my critical analysis and unrelenting expostulation against the establishments “drug desire bigoted alcoholism doctrines for its total disregard for the primary biological “drink (thirst, taste, and the stomach) satiety desire involved in the alcohol drinking”, I was also careful to use those alcoholism terminologies approved by the research establishments, at the same time avoid those terminologies which they stopped using (the word “addiction” for example) for whatever reasons. Importantly in this paper I provided many empirical research evidences that endorses the validity of the ZAD model. However the most significant feature of this paper was a comprehensive presentation of the ZAD model so far, with its newly gained perspective of three basic innovative approaches. 1. The ZAD Practice 2. The ZAD Therapy 3. The ZAD Alcohol policy.


The ZAD Practice In Essence

As mentioned earlier, the newly revised ZAD model consists of three basic innovative approaches or constituent parts namely: 1). ZAD Practice 2). ZAD Clinical Therapy 3). ZAD Alcohol Policy. Among the three, the “ZAD Practice” remained at its hegemony. The nucleus or the essence of this ZAD “practice” or method, importantly summed up in the “principle key notes” of this paper, which states: - “WHENEVER TAKING TO DRINK ALCOHOL, ALWAYS MIX (OR SIMULTANEOUSLY CONSUME) ‘PROGRESSIVELY ADEQUATE PROPORTION’ OF APPETIZING NON-ALCOHOLIC BEVERAGES TO REDUCE ITS ALOCHOL CONTENT SUFFICIENTLY SAFE ENOUGH LOWER LEVELS AND DRINK IT STOMACHFUL, FOR SATIETY”. IN OTHER WORDS, PEOPLE WHILE IN THE ALCOHOL DEPENDENCE NEVER TO DRINK HIGH-ALCOHOL PERCENTAGE BEVERAGES INSTEAD ALWAYS TO CONSUME EXCLUSSIVELY AND SUFFICIENTLY ENOUGH LOW-ALCOHOL BEVERAGES (“LAB”, HAVING 2.5% OR LESS ALCOHOL CONTENT BY VOLUME) WITH THE APPEALING, DELICIOUS TASTE AND FLAVOR THAT PRIMARILY FULFILLS ITS DRINKERS OVERALL DRINK SATIETY DESIRE.

Need of A ZAD Alcoholism Research Paper Sequel

My preceding ZAD Alcoholism research papers [2,3] were mainly addressed at the worlds leading alcoholism health concerned Establishments particularly to the WHO (its Substance Abuse Department) and the USDHHS (its National Institute for Alcohol Abuse and Alcoholism, NIAAA). --- In response to which the WHO Director sent me a sterile reply, telling me; “we are a technical agency” and for any of their consideration it needs to be published in the “peer reviewed journals”. Unfortunately, it was mostly the same ‘upright’ discouraging cold reply that they had send me in response to my first ZAD paper (latter the ZAD book) in 1999! On the other hand fortunately the letter I received from the NIAAA Directors was most amiable (it was indeed similar to their previous letters) and encouraging! In fact this ZAD-ADCT paper “sequel” mainly comes as the result of their advice to put forward some concrete ‘ZAD research proposal’ before them, so if it gets selected that may help me to continue with this ZAD research endeavor. However, apart from my purpose of submitting it before the NIAAA, the other main task intended by this paper most importantly is to overcome the entry barriers encountered by the ZAD practice in today’s alcoholism prevention and treatment field mentioned in the following section below.

Entry Barriers Encountered by the ZAD Practice

Although in my previous papers[2,3] the ZAD “Practice” has been projected at the forefront of the ZAD model, however latter in the years I began to realize it had its own limitations and problems in getting approved or accepted by the establishments involved in the prevention and treatment for the alcohol dependence due to the following main reasons: -

1). The strong alcoholism dogma of ‘drug desire’ that prevails worldwide today in the entire alcoholism establishments totally disregards the drink satiety desire involved in the alcoholism’ (which I have extensively dealt in my previous paper [2]). In this situation, from my underprivileged position, perhaps it is too early to expect the alcoholism prevention and treatment establishments and the affected people to abandon those age old dogmatic ‘total abstinence’ beliefs in favor of my ZAD practice!

2). Given my underprivileged position I have absolutely no medical institutional resources (clinics, hospitals) or any organizational, financial (NGO) support to go out and work in the field as this ZAD venture essentially demands. Moreover, I am already spending a substantial part of my own families earning and my productive time (which also cause a severe drain in my family income thus lots of predicament and hardship in our life) on this present ZAD alcoholism research study and its information disseminating work. Over and above now, venturing into its fieldwork is absolutely behind all my present resources. Apart from this, my experience in this endeavor so far taught me that the alcoholism establishments in this field would not accept any of my ZAD empirical evidence or the testimonials unless it is conducted under their recognizable institutional framework.

3). Anyone working in the field of alcoholism knows that the problem of “denial” and its “stigma” prevents most of the alcohol dependent people from seeking its treatment. Until the person not ready to admit that he has the problem and submits for the help one cannot administer its treatment. The main starting point of the alcoholism (dependence) treatment comes when they enter into the threshold of their alcohol detoxification (AW) facilities where they come overwhelmingly in large numbers, hundreds and thousands [15,16] in seeking treatment. This is the ideal starting point to offer our ZAD therapy to them. Therefore first of all, the ZAD model crucially needs to have some primary access into these existing alcohol detoxification treatment facilities (hospitals, clinics etc.), which is so far simply out of our reach.

4). Finally the most important of all is; so far the ZAD model had no comprehensive therapy to offer for those hundreds of thousands of people (pointed above) who get admitted into the hospitals seeking the alcohol detoxification (AW) treatment to get rid of their alcohol dependence! Unless the ZAD model devise a concrete alcohol detoxification (AW) treatment to these alcoholism treatment seekers at this critical stage then I realized it will be almost impossible for the ZAD model to enter into the existing alcoholism prevention, treatment field.

Fortunately now at this critical juncture the ZAD model succeeded in devising its so far greatest treatment venture in the form of this ZAD Alcohol Detoxification Clinical Trial (ZAD-ADCT) Therapy, deployed at its forefront, to persuade the concerned establishments in the first place that; like the total abstinence based conventional alcohol detoxification treatment it can also concretely undertake its own alcohol detoxification (AW) treatment to successfully remove the alcohol dependence, once and for all. In my previous paper[2], I have given the principle outline of this ZAD Clinical Therapy subject matter under the caption: “ZAD Clinical Therapy For Alcohol Dependence Treatment”. (I had also proposed the “ZAD Alcohol Policy” in that paper which I have also in mind to bring out independently as its another sequel paper). However in this sequel [1] I introduce many fundamental changes and present it in a renovated, dynamic form. Nevertheless, I still retain many of its important points that made it originally different from the conventional alcohol detoxification treatment.

Now before entering into the ZAD-ADCT therapy presentations let me first start with the ‘conventional total abstinence based Alcohol Detoxification alcoholism treatment’ perspective or the “overview” to know the basics of the alcohol detoxification treatments and fundamental difference between the two.

An Overview of the Conventional Alcohol Detoxification Treatment

Motoi Hayashida, M.D., Sc.D., a prominent researcher in the hitherto alcohol detoxification field comments at beginning paragraph of his research paper “An Overview of Outpatient and Inpatient Detoxification”[17] the following: “Alcohol detoxification can be defined as a period of medical treatment, usually including counseling, during which a person is helped to overcome physical and psychological dependence on alcohol (Chang and Kosten 1997). The immediate objectives of alcohol detoxification are to help the patient achieve a substance free state, relieve the immediate symptoms of withdrawal, and treat any co-morbid medical or psychiatric conditions. These objectives help prepare the patient for entry into long-term treatment or rehabilitation, the ultimate goal of detoxification (Swift 1997). The objectives of long-term treatment of rehabilitation include the long term maintenance of the alcohol free state and the incorporation of psychological, family and social interventions to help ensure its persistence (Swift 1997).”

The above research statement brilliantly sums up the conventional alcoholism treatments fundamental alcohol detoxification objectives in principle; i.e., ‘immediately to *achieve* a substance free state and in long term *maintenance* of this alcohol free state’-- in other words it is fundamentally “total abstinence” all in all. Total Abstinence is the basic foundation of the conventional alcohol detoxification treatment on which all the rest of their alcoholism prevention treatment and the alcoholics’ rehabilitation and recovery rests upon. They simply cannot comprehend any alcohol detoxification treatment for the alcohol dependents, which basically allow them the alcohol drinking (like the ZAD-ADCT) during their alcohol detoxification and the dependence treatment without having basically the total abstinence at its core.

The conventional Alcohol Detoxification Treatment (ADT) today has been administrated basically in two setups; the first one in the hospital or clinic (inpatient) settings and the second one in the ambulatory setting. [18]. This ambulatory setting is further divided into Hospital-Based day (out) patient Care[19] and the Home Detoxification [20]. There are many other important sources, which provide extensive details on the conventional alcohol detoxification treatments documentations [16, 21, 22, 23] that could help us to get a deeper understanding of this alcohol detoxification subject matter in general.

The Conventional ADT vs. The ZAD-ADCT

Like the conventional Alcohol Detoxification Therapy (ADT); the ZAD Alcohol Detoxification Clinical Trial therapy (ZAD-ADCT) that I am presenting in here also can be conducted equally in all the above-mentioned three treatment settings. However the fundamental differences between the conventional total abstinence and the ZAD alcohol detoxification treatment is that the “latter” stands diametrically opposite to the immediate “total abstinence” objectives of the “former”. The most interesting thing in here is the formers use of pharmacological drugs [16 to 25] in their alcohol detoxification (AW) treatment while totally banning the use of the drug alcohol. While on the other hand the ZAD strategically or judiciously use the drug alcohol and the drink satiety as a replacement or substitute to all the conventional pharmacological alcohol detoxification AW treatment medications (Benzodiazepines etc.) and its prevention drugs treatments like the disulfiram, nalrrexone, acamprosate etc. those pharmacotherapy’s commonly used in their immediate as well as in the long-term alcoholism treatments.

Further down, the ZAD-ADCT in its immediate alcohol detoxification (AW) treatment as well as in its long term (recovery) follow-up treatment basically use one and the same lower-alcohol beverages (LAB) drinking to get rid of the alcohol physical and psychological dependence and to cure them completely. However most of the conventional alcoholism treatments use the pharmacological drugs (baring some non-pharmacological “cold-turkey” treatments) specially the Benzodiazepines [16, 22] etc., in their immediate alcohol detoxification (AW) but at the same time they are highly apprehensive about these drugs causing extra drug dependence, or other adverse (side) effects therefore terminate its use within a short period or as soon as possible. Nevertheless in their further recovery treatment they start employing the alcohol aversive, opiate antagonist anti depression drugs like disulfiram (Antabuse®), naltrexone (ReVia™), Campral (acamprosate) [21, 22,24] and recently the Topiramate [25] and the “Ibogaine” (Howard S. Lotsof; Addict-L: ibogaine tours. 08 March 2004) pharmacotherapy when approved. All these drugs make their treatment still more complicated and controversial in the “drug free” sense! These contradictions get reflected in the strong differences arising between the “Minnesota” and the “Pennsylvania” Model of Recovery” (See; Lloyd Vacovsky: Addict-L, 10-8-2002).

However it is very important to know in here that even though the ZAD fundamentally disagree with the conventional alcohol detoxification’s total abstinence (alcohol free state) immediate and long-term objectives nevertheless, basically they both share the same “common goal” of the alcohol detoxification treatment mentioned in the following; “Alcohol detoxification can be defined as a period of medical treatment, usually including counseling, during which a person is helped to overcome physical and psychological dependence on alcohol (Chang and Kosten 1997)”[17]”. This gives us the great hopes that we both may realize the need to work together as the providers of alternative alcoholism treatment options to achieve our common goal to enable the alcohol dependents (alcoholics) to “overcome” their physical and psychological dependence on alcohol through out their life.

Most interestingly, there exists the “paradoxical” parallel between the two. The conventional total abstinence alcoholism treatments in the short term as well as on the longer run could potentially (biologically and psychologically) create desire, craving and temptation in those alcoholic people to drink and fall back into the same old or even worse kind of excessive amounts of alcohol consumption state or condition called as the “relapse”. According to the statistics an overwhelming majority of the alcohol dependent people who start to follow total abstinence tragically fall into the recidivism (relapse) within the first year. On the other hand the ZAD-ADCT claims that it could potentially turn the alcohol dependent into a very light or a social drinker who most of the times remain in a long time abstinence from the alcohol. Therefore, it is not right to assume that the ZAD model is against or in direct conflict with the total abstinence option. In fact, the ZAD model considers that the ZAD practice is the best, natural pathway of opting for any degree of alcohol abstinence (read our “Flexible ZAD Practice”[3]). What we fundamentally oppose is the establishments alcoholism dogma of total abstinence that instills fear psychosis, phobia, propagating falsehood about the alcohol drink causing the hidden abnormal (genetic) drug desire that specially turns the alcoholics getting out of control over its consumptions due its whatever mystical (“often strong, sometimes overpowering”) powers! They may have all their good intensions in promulgating such total abstinence dogmas but the main problem is; they encourage the persons “loss of (impaired) control” behavior while at the same time discouraging their any attempt to limit, reduce or control their drinking if they start it! In general, these conventional total abstinence based alcohol detoxification (AW) treatments brutally suppress the craving, urge, for the drink and spitefully deprive pleasure enjoyment of the drink satiety from the so called alcoholics lives, which could potentially backfire into the dreaded “relapse” bringing in tragic consequences in their life.

P.S. Continued Part II on the previous blog post.

Alcohol Detoxification Therapy Part - II

So far in the treatment of alcohol dependence (alcoholism), “total abstinence” has been projected as the only one basic option for the alcoholics to obtain their alcohol detoxification and the recovery. Now perhaps, it is for the first that Alcoholics Curewell offers an alternative to that conventional “total abstinence” based alcohol detoxification in the form of the lower-alcoholic beverage drinking. This ZAD-ADCT offers “alcohol as the treatment drug” for the alcohol dependents to successfully obtain their alcohol detoxification and to get rid of the dependence; projecting its “ZAD practice” as the most natural way for them to come out the dependence and getting cured of it (alcoholism) completely. Followings are its principle guidelines and the parameters.

Preliminary

A person in my situation putting forward a “Research Proposal” to conduct the ZAD Alcohol Detoxification Trial Therapy, first of all needs to conduct a “full-time” preliminary alcoholism treatment field survey assessment work. This mainly involves an extensive going around and locating the alcoholism treatments facilities available in a given area where one plans to start this ZAD-ADCT setting. Visit those alcohol detoxification (AW) treatment facilities in particular and meet their personals with appropriate channels. Make a presentation of the ZAD model, under the principal aim of general alcoholism prevention and treatment; Try to convince them that our first priority is to provide, “total abstinence” based alcohol detoxification treatment and only latter to provide the ZAD-ADCT therapy for only to those who fail so willing to take this alternative option. Request them to allow us (me) to participate, study and learn about their alcoholism treatment! Here I expect to encounter some resistance to my ZAD-ADCT ideas from these alcoholism treatment health establishments. It may take a great deal of time and effort on my part to overcome the possible opposition, hostility even to just gain a entry in to these alcohol detoxification facilities. I may need to visit other towns and cities on this purpose. If some of these facilities allow us (me) to participate and study in their treatment for a given period of time then I would consider it to be a big success on my part. It will provide me a great learning opportunity by understanding the realities of the alcohol detoxification (AW) and the conventional alcoholism treatment in general. (This is very important because one should remember that the best way to establish any ZAD-ADCT setup is; first to begin as a conventional alcohol detoxification center and start with providing exclusively “total abstinence” based detoxification, for those who seek the treatment.) Among other things, in this field survey work I am also hoping to get a critical overview of the given situation, to consider the required capacity (resources) to accomplish its forthcoming task. All this may require at least a year of “full-time work” on my part. With its completion, a major part of this “ZAD research proposals” preliminary field assessment (one year full-time) work would be over.

After the completion of the above-mentioned ZAD alcoholism field survey assessment work, the actual ZAD-ADCT project work will begin first with establishing an exclusive total abstinence based alcohol detoxification (AW) treatment facility. It should first start providing exclusively total abstinence based alcohol detoxification (AW) treatments during its first one and a half years. During this period it has to collect the details of the admitted patients alcohol drinking accounts, their problems, their social, economical, marital, educational, age, sex etc., status or backgrounds. Another major task during this project work is to find out in general how many of those who had undergone the alcohol detoxification treatment in this facilities in the fast or previous years have been successfully managed to remain total abstinent? How many of them fail and continue to “relapse” and become alcohol dependents again! Most important of all is how many of them admitted back into the alcohol detoxification treatment more than once. Collecting these empirical data’s are very important because ZAD-ADCT likes to select as many of those who continue to relapse again and again so willing to try some alternative ways to total abstinence.

After the first one and a half years of providing exclusively total abstinence based alcohol detoxification alcoholism treatment, then only this actual ZAD-ADCT therapy will start, it may need a period of one and a half more years as it probably require several more such trials together with its one year after care (follow-up) period. Therefore, the entire project may take around three years to complete (that excludes the first year of my “ZAD research proposals” preliminary field assessment survey, full-time work.). However, most part of the first one and a half years of providing the exclusively total abstinence based detoxification treatment part of the project work can be cancelled if a suitable professional (total abstinence based) alcohol detoxification treatment providing facility and its administrators come forward to share or to undertake this ZAD-ADCT research project work! Ideally, any well established leading international alcoholism clinical research institutions, their professional researchers are best placed to conduct a condensed version of this ZAD-ADCT research experiment. This will save a great deal of time, money and energy in this project together with making it very credible clinical experiments or trials for the future alcoholism research studies.

ZAD-ADCT Three-In-One New Dynamic Approach

As I mentioned somewhere earlier, I had given a rudimentary form of this ZAD-ADCT subject matter in my previous paper[2] under the caption: “ZAD Clinical Therapy For Alcohol Dependence Treatment”. However while giving it a deeper thought in preparation to this sequel paper[1] I realized that under the ZAD perspective it requires a fundamental change that endows in it a renewed dynamic approach to make it suitable and sensible to respond to the existing alcoholism detoxification (AW) treatment grounds (settings) reality.

The most fundamental change introduced in it first of all is that; instead of segregating it into three separate (Inpatient, Outpatient, Home) Alcohol Withdrawal (AW) detoxification therapy settings, we combine all these three settings into a single ZAD-ADCT composite dynamic form. Also, to correspond to these three settings we make it a three-week long therapy instead of its originally assigned four-week long period. The starting first week therapy will be conducted in the in-patient settings in which the basic alcohol detoxification (AW) treatment undertaken along with its principle ZAD Cognitive Motivational Therapy (CMT). After the completion of this first residential week the ZAD participants (patients) will be discharged and sent home only to return in the evening every day in the second week for the “out-patient LAB drinking therapy” sessions basically in which their full days exposure to the “loss of control” due to their LAB drinking will undergo a severe test. Finally in the third week the participants will be left to conduct their LAB drinking at their own home settings. They may be asked to meet in the evening couple of times in the week for the consultancy sessions or the staff members will be meeting them at their home or contacting them with the phone calls. At the end of the third week the formal ZAD-ADCT Therapy course will be over. This three-in-one new dynamic approach not only enable it to gain the advantages of all these three settings but it will also shorten the time period as well as drastically reducing the overall cost.

After the successful completion of this three weeks ZAD-ADCT therapy, there will be a three months period of the ZAD practice “follow up” in which those candidates asked to meet every week to monitor the progress while maintaining their daily drinking dairy. Thereafter they may still require a less intensive observational period till the end of the year in which the “ZAD Flexible Practice”[3] may be introduced depending on their confidence. During this observational period, once in a month meetings can be organized to deal with any issue that may arise and share the experience with one another to take care and to keep in track with all its records. Of course, the association of these people may continue, perhaps selected as the speakers for the future ZAD-ADCT motivational sessions as a life long mission.

ZAD-ADCT Principle Precondition

The principle precondition of the ZAD-ADCT is that; first of all to clearly inform all its intended candidates (participants) beforehand that this is a composite three weeks long therapy. In its first week they will be treated in the inpatient setting in the second week they will be sent into the outpatient treated setting and in the third week they will be settled in their own home settings. Afterwards the follow up of the therapy continued for the period of one year. Most important of all for them to know is that; this ZAD-ADCT therapy is only for those alcohol dependent people who genuinely seeks to find out, through this LAB drinking method whether they are capable of cutting, reducing or tapering down their alcohol consumption to a moderate safe, low-risk levels while continue enjoy the pleasures of their alcohol drinking through out their life, which mean getting completely “CURED’ of their alcoholism, instead of them being relegated into the total abstinence recovery state for life long! In here, first of all they should keep an open-mind (without any bias) and willing to accept the basic conditions of drinking sufficiently enough of the “safe standard lower-alcoholic drinks” containing between 2.5% to 1.2% alcohol content by volume (v/v) in it. Now the basic purpose of all this is to find out whether it is possible for them to successfully get alcohol detoxification and triumphantly come out of their alcohol dependence (especially the physical one) while continue to enjoy the pleasures of their low-alcohol drink. Here the participants should be aware that these LAB drinking potentially can turn anyone intoxicated, if they drink it in sufficient amounts but at the same time it is a test for them to examine and to find out as to what extent their overall drink desire satiety can reduce their overall alcohol drug desire and the “loss of (impaired) control” in a situation where they “attempt” to reduce or cut down their overall alcohol consumption. In general they should first basically undergo the experience the physical/biological and psychological effects of the LAB drink satiety in their overall alcohol consumption before getting intoxicated by it. They should drink neither to please (prove) us or to displease (disprove) us but as much as they want or desire without any other reservations or apprehensions.

It is also important to mentions to the selected participants that those who may fail in this ZAD-ADCT and become alcohol dependent, should be promptly advised to return back to the total abstinence detoxification treatment (also the patients who display untoward, uncooperative or incompliant behavior get removed from the therapy). By the way, here it is worth mentioning that there will be no second chance for them into this ZAD-ADCT, like that of the conventional total abstinence based alcohol detoxification treatment because they had already underwent its training (therapy) therefore can always practice it simply at their home environment if they ultimately decide!

ZAD-ADCT Patients Selection and Screening Modalities

In my previous paper[2] I have explained that the basic diagnostic criteria for the alcohol dependent patients to get admission into this ZAD Clinical Therapy is the ICD-10[8] or the DSM-IV[9] classified norms. In addition the CAGE, AUDIT, MAST and other such diagnostic instruments may help to verify their diagnosis. Moreover, the person should be drinking daily an average of 6 or more drinks to get qualified into this clinical trial therapy. Most importantly, to exploit its full potential in today’s alcoholism treatment and to subject it to a severe test, we would like to select mainly those who have been admitted for getting alcohol detoxification treatment more than once and have some history of relapse, constantly failing in their total abstinence resolve and falling back into dependence. Nevertheless, as mentioned before, those alcohol dependent people who have known to reject or never to really accept the total abstinence option in their recovery for whatever reasons but at the same time “attempt” or “try” to reduce their alcohol consumption, will be exempted from this last rule.

By the way, it is very important also to know that its screening procedures promptly disqualifies those patients having some extreme or severe health conditions. First of all, it would exclude all those alcohol dependent patients who are in an emergency or life threatening situations or having chronic disease like liver, heart, kidney etc. ‘Patients should be also excluded if they are currently in delirium tremens, actively psychotic, suicidal or had severe memory difficulties [19], or those having a history or violent or threatening behaviors or having co-dependence on other strong psychoactive drugs like; heroine, cocaine, designers drug etc. Also the persons having some grave socio-economic, (unemployment, marital, homeless etc.) problems may be excluded or kept out of this ZAD-ADCT program at this beginning stage.

This screening procedure necessarily needs to inquire some detailed accounts of the patients fast drinking patterns! This may come in the form a fill-in questionnaire. First to know some details about their social, economical, marital, educational, age, sex etc., status or backgrounds. Since how many years he/she has been drinking and facing the alcohol problem? The kind of alcoholic beverage (spirit, wine, beer) they were consuming during these time of alcohol dependence? Their favorite drinks any in particular? What are the alcoholic beverages that they usually consume? How many days in a week in average they drink? What time of the day that they usually take to their drinking and how long their drinking session usually lasts, how many drinks they usually (in average) consume in these each sessions. How much do they titrate to make their drink lower alcohol content while they drink it? What are their reasons for doing or not doing it? What place or environment where they usually conduct their drinking? Home, bars, alone, friends, company? In the fast year particularly in the last month or weeks what is his/her daily average alcohol consumption? How many days exceeding the safe drinking limits? How many days or incidence of binge drinking? This questionnaire session conducted once earlier in the preliminary part. Such detailed accounts of the patient past alcohol consumption not only useful in understanding the background history of the patient alcoholism but also become very useful in the future follow up and the observational period to determine the rate of success or failure or the long term overall outcome of this treatment.

Here I should also add that while getting admitted into this therapy, the Blood Alcohol Count (BAC) levels of the patients may need to be checked and monitored whenever required during the first, second and the third weeks of the trials to check the progress of the alcohol detoxification for the physical evidence and for the research study documentation.

ZAD-ADCT: Lower-Alcoholic Beverages (LAB) Research and Selections

Low-Alcohol Beverages, the LAB or the LAD, which contains in between 2.5% to 1.2% alcohol content by volume, plays the pivotal role in the entire ZAD model. Basically its “drink satiety” immediately as well as in the long run replaces and substitutes the pharmacological drugs, which are used in the conventional alcoholism treatments. The entire ZAD-ADCT stands on this LAB drinking foundation. Therefore first of all a very careful attention should be paid in the selection of the ZAD promulgated low-alcohol beverages benchmark between 2.5% to 1.2% alcohol content standards and it should also combined with varieties of taste/flavors, which stimulates the participants drinking appetite. While selecting these LAB’s it should be also kept in mind that such kind of beverages conveniently available for them for drinking in the future at their home environment.

The ZAD theory [13] in its core essence contends that; ‘the human habit of drinking alcohol (apart from its drug desire) originates from their biological need (desire) for the drink: ‘the ”thirst” (re-hydration), “taste” (intake of suitable nutrition’s, calories) and the “stomach” (its fuel or food carrying capacity) satiety”. --An 18^th century poet Edward Rowland Sill writes: “At the punch-bowl’s brink, Let the *thirsty* think, What they say in Japan: First the man takes a drink, Then the drink takes a drink” [26]. I think this passage points out some very deep hidden message about the principle role played by the “thirst” which is most of the time overlooked in the matters human alcohol drinking. First the alcohol drink draws the *thirsty* in for a drink but then comes its fatal entrapment. The alcohol part of the drink due to its diuretic effect could make them still more and more thirst for the drink. So; “First the man takes a drink, Then the drink takes a drink”. Of course loosening the inhibitions due to its drug effect is another factor that perhaps the author had in his mind in writing “the drinks takes a drink”. Now coming to its *taste* factor. There are many research findings that suggest that a liking for sweets (sweet tooth) a strong appetite or taste in humans are tied or a marker to alcoholism. Appetite-Linked Gene[27] A liking for sweets[28], Sweet tooth, a marker for alcoholism[29], which I mention as some of its research report references. A research conducted by: Baker-T-B; and Cannon-D-S. (1982) concludes: “The drinking patterns of human alcoholics appear to be consistent with taste mediated learning principles”[30]. This principle taste/flavor factor of alcohol can be also used (manipulated) into its aversion (disulfiram) to suppress its oral consumption. The experiments on Animal models could reveal more on this subject matters. Finally coming to the principle of the persons *stomach* factor its given capacity or its condition that ultimately determines the persons total amount of the beverage consumption, reflected in the “binge drinking”. Therefore under these above principle guidelines, select varieties of novel tasting sweet combined delicious low-alcohol (between 2.5 to1.2 percent) beverage for those alcohol dependent (alcoholic) people to be used in this drinking therapy. Perhaps some of it may follow the examples of the newly marketed designer drink popularly known as “alcopops” [31, 32, 33] that may be of some interest in this matter if it suits it well. Some of these beverages (including the non-alcoholic and the soft drinks) may be made of the taste and flavor (smell) of high standard alcohol, which may appeal or trigger their drinking appetite.

Here I should warn people not to mistake the concept of these lower-alcohol beverage (LAB) by assuming that it is not simply possible for the drinker in general to drink enough amount of these beverages that could provide any real pharmacological of intoxicating effect. As a matter of fact, they should know that these LAB drinks having between 2.5% to 1.2% alcohol range could potentially turn anyone intoxicated if they decide to consume it in sufficient amounts of their drinking capacity. To make this clear, an Australian Govt. Report of Investigation about the alcoholic beverages stipulates: An “alcoholic Drink means any beer, wine, spirits, cider or other spirituous of fermented drinks of an intoxicating nature, and is generally understood to refer to drinks of 1.15% or more alcohol by volume. The view of the Commonwealth Department of Health is that drinks of less than 1.15% alcohol by volume should be classified as “very low alcohol” drinks[34]. Although the researchers allow quite a liberal dose of alcohol content; Holford, N.H.G (1997) 2.75% [35]., Magnusdottir, K., et, al. (2000) 2.25% [36]., Skog-O-J (1988) 2.2% [37] while deliberating in their low or light alcohol drink research. Nevertheless the alcohol control or policy-making bodies impose a very strict limit over the alcohol content of the low or light alcoholic beverages. In addition to the above mentioned report, another report from Europe named: Innovation in Europe: Research and Result confirming the status of the low-alcohol beverages, states: “Drinks are described as "low alcohol" if they contain less than 0.5% alcohol and alcohol free if they have less than 0.05% alcohol content” [38]. Alarmingly enough, it is possible for a person to consume more than the amount of a standard alcohol drink by consuming these 0.5% beverages in a drinking session. The House of Commons Hansard debate on Licensing Low Alcohol Drinks bill Clause 1 on this account states: “Low-alcohol liquor not to be intoxicating liquor for the purpose of the Licensing Act 1964” [39] under which those parliamentarians argue that the alcoholic beverages which contains even less than 0.5% alcohol content up to0.1% levels should be considered dangerous to the vulnerable sections of population specially to the young children. Therefore one should know that the ZAD promulgated LAB benchmark having between 2.5% to 1.2% alcohol content could rate pretty high in these standard of its intoxicating effect. It is precisely because of this reason the ZAD model stick to the benchmark standard of between 2.5% to 1.2% alcohol content beverages as its “safe standard lower-alcohol drink” so the critics would not dismiss it as having no “intoxication” effect, so the alcohol dependent people would not like these LAB because they don’t get the alcohol intoxication, high, or the inebriation from drinking it.

The great ability of the LAB to modify (lower or increase) the amount of the alcohol content in it whenever needed in its ZAD-ADCT therapy is its biggest strategic advantage. This also provides a special provision to increase the alcohol content in order to bring a relief for those alcohol dependents who suffer from some severe Alcohol Withdrawals (AW) in their first days in the ZAD-ADCT. In some exceptional cases such patients can be discreetly given up to 5% alcohol content beverages as the first two or more drinks if it deemed necessary to substitute or replace all those pharmacological drugs like Benzodiazepines etc. [16, 25] used in the conventional alcohol detoxification (AW) treatment. Thereafter in the subsequent drinks the alcohol content can be lowered down to the 2.5% levels and then further reduced to 1.2% as the days progress into the week. By the way, the standard alcohol percentage of the lower alcohol beverages (LAB) need not be always exactly 2.5%, at times it can be strategically a little less say 2.0% or further lowered even to 1.15% as the situation of the treatment demands.

Besides these low-alcohol beverages the soft or non-alcoholic drinks also plays most important role in the ZAD-ADCT therapy that we will know latter when we deal into its manual. Nevertheless, here beforehand one should never underestimate the power of even the non-alcoholic beverages popularly called as non-alcoholic de-alcoholized[40] alcohol free [41] near beer[42] butter beer[43] etc. Although they are named as non-alcoholic nevertheless they can still contain up to 0.5% alcohol in them! Therefore most of the alcoholism prevention and treatment concerns still consider them as dangerous for example; the “Alcohol Beverages addiction Information Center” warns: ‘it is unsafe to any one with an alcohol problem, who has been advised to stop drinking, so they should completely avoid drinking even the low-alcohol beverages’[44]. According to the National Council on Alcoholism’s position statement: “these beverages contain alcohol they are unsafe for alcoholics, alcohol abusers, pregnant women, and women considering conceiving a child….those who choose abstinence should avoid drinks labeled “nonalcoholic” or “de-alcoholized” as they may contain up to 0.5 percent alcohol” [45].

By all these above mentioned alcoholic beverages standards where even the so called non-alcoholic beverages which may contain 0.5% alcohol is considered as unsafe or dangerous to the people at risk due to its drug desire and the “impaired (loss of) control” factor. Under this condition the alcoholic drinks containing around 2.5% to 1.2% alcohol content (by volume) could prove fatal to them also in respect to the ICD-10[] and the DSM-IV diagnostic criteria implications! In fact people in general are quite capable of consuming far over the safe drinking levels i.e. excessive, intoxicating or inebriating amounts of alcohol by consuming these 2.5 to 1.2% range of the lower alcohol drinks if they decide or if the alcohol drinks makes them “impaired” or “loose control” while they take to drinking these alcoholic beverages. The worlds famous media CNN report of alcoholics drinking 30 to 35 beers (around 12 liters) daily evening [46] months even years together! An European historical research record state: Brewery workers in Munich used to drink 8 to 10 liters of light beer daily[47]. Therefore now in this ZAD-ADCT therapy, all these conventional alcoholism establishments contentions and those doctrines and dogmas of alcoholic drinks stimulating the alcohol dependent peoples “alcohol drug desire, craving” and bringing out the “loss of control” manifestation in them will be put to a real test.

Finally to sum up, the ZAD-ADCT therapy LAB selection basically stands on the principle of drink (thirst, taste and the stomach) desire satiety of the alcohol dependent to reduce their overall alcohol consumption. It considers the beverages having between 2.5 to 1.2 alcohol percentages as its “benchmark” of the “safe standard lower-alcohol drinks”. Nevertheless these beverages still could have dangerously high enough intoxicating or inebriating effect on its drinkers. Even the beverages having the alcohol content as low as 0.5% could make its alcohol pharmacological effect felt and could be successfully used in this therapy! By the way, the title: “Zero Alcohol Drink (ZAD)” now seems perfectly fits to it, as it is a relative term that at its higher end it represents the “lower or light” alcohol drinks (2.5to 1.2%) and on its bottom line it could virtually mean the non-alcoholic beverages (ranging from 0.5 to 0%.) as its name prudently suggest!

ZAD-ADCT Cognitive Motivational Therapy (CMT)

The ZAD-ADCT Therapy in essence consists of two basic components. The main one is its concrete physical/biological ZAD “drink satiety”, which involves the practical LAB drinking, feeling, sensing, experiencing session. The second one is its psychological or behavioral component that we call “ZAD cognitive motivational therapy” (CMT) or its “session”. In my previous paper[2] I have named latter as; “Motivated Drinking Behavioral Change in the Choice of the Alcohol Beverage” (MDBCCAB) but now in this paper I simply call it as; the CMT. Although this ZAD cognitive motivational component considered as secondary to its “LAB drink satiety” component, nevertheless the successful outcome of the ZAD-ADCT therapy will mostly depend upon this ZAD presentations, expositions or administration of this CMT. A well prepared skillful and inspiring behavioral therapist or the psychologist (CBT, MET etc. specialists) can make it a great success while an unskilled, uninspiring, unprofessional may mess it up in a total failure.

The basic requirements (mentioned above in ‘principle precondition’) of this ZAD-ADCT motivational therapy is the alcohol dependence participants should have a genuine desire to enjoy the pleasures of the lower-alcoholic beverage drinking aimed at its all round drink satiety to find out whether it reduces their overall alcohol consumption to enable them to get rid of their alcohol dependence. Most important of all, they should keep an open-mind to find out whether this LAB drinking alternative is more preferable, acceptable, (with its pleasurable and enjoyable factors) for them to come out of their alcohol dependence and getting completely cured of their alcoholism instead of them being relegated to the dogmatic option of total abstinence for life long recovery at the dire threat of its disease relapsing again. To make them to understand more about this ZAD-ADCT perspectives the following main cognitive motivational sessions or the study classes needs to be conducted.

The basic lesson of this entire motivational therapy is to make every one clear that; this therapy is NOT about confining some alcohol dependent people in a place and supplying them with a strictly limited amount of alcohol by which trying to prove that they have achieved control over their alcohol consumption. This is basically about re-cognizing or understanding the humans natural biological needs that provides us pleasures or enjoyment with its fulfillment. Here our main objective is to explore the best ways to enjoy the pleasures of these human biological needs to its fullest (satiety) extent within the safe limits and once own given (available) means, without endangering the self. Someone may like a particular pleasure of life more than the other. However the matter of the fact is when one gets in more and more amounts of the pleasure consumption after a given levels, the particular pleasure starts radically declining, dissipating and starts degenerating. If stuffed more, it turns into a grotesque pain in its consequence. Now after undergoing the repeated suffering of its painful consequences sooner or later one may take an extreme decision of resorting to its “total abstinence” depriving themselves entirely form that particular pleasure. Sadly enough then it will also result in the constant battle against its desire, craving a nagging pain in life, which majority of the times (statistically within a year) treacherously leads them into its tragic “relapse” so the return of all its disastrous consequences. This vicious cycle may repeat in the life over and over again and lead to a tragic end!

However, the nature has endowed us humans with a great gift of “wisdom” that allows us to use the various substances or activities to fulfill the need and to enjoy the pleasure to its fullest (satiety) extent without getting into any of its negative effects, harm (abuse) or dangers. However tragically we stop exploring this great wisdom of nature and blindly follow the dogma of Total Abstinence”. But instead of surrendering to this total abstinence one can also effectively prevent the excessive consumption and its related harms or dangers of a particular pleasure reinforcing substance or activity paradoxically in the natures wisdom of SATIETY! According this natures discretion the best way to combat or prevent the excessive consumption of any particular substance is to combine (mix) it with more of its related or substitute pleasure providing substance, so this renewed product or activity can reduce or remove the excess or the dangerous portion of that particular substance or activity (partly or fully) replacing it with other benevolent pleasure providing substances, primarily to obtain its all round satiety and the health benefits! Unfortunately we close our mind and simply ignore, forget or dismiss it when we need it the most! This is especially true in the human biological desire (need) for the pleasures, food, drink, and sex. Therefore, the best way to prevent any human desire for excess pleasure when it turns malevolent or harmful is to replace, substitute or compensate it with the similar kind of pleasure providing substance or activities, which are safe and benevolent, guided by the wisdom of the open mind, instead of surrendering to the dogmatic “total abstinence” dictum.

For instance, in the matters of food take the particular substance sugar. It is commonsense for the people having problems with high sugar diet to replace it with the low sugar diet, even with the artificial sweeteners. The same can be said about the high fat diet. Of course the sugar, fat (protein) even the alcohol each may have their unique pleasures, nevertheless each have their own pleasure substitute substances capable of replacing or compensating it more or less provided one remains open-minded. In fact the substitute can be far more pleasurable, enjoyable and beneficial to the health as a whole if one accepts it with an open mind. On the other hand its total abstinence could be a nagging pain of depravity in life and we have only one life to live. Sex is the another highly compulsive subject where the excessive harmful indulgence (abuse) and its dangerous consequences can be prevented or avoided by using many of its available substitute that could provide far better pleasure enjoyment if one keeps an open-mind about it. When total abstinence is not an option for whatever reasons, one can find a safe alternative way to enjoy those pleasures (say condom among other things) instead directly exposing oneself to its deadly disease. It will be a big topic to elaborate so now here I only take our present issue of the excessive alcohol consumption and the best natural way to prevent it while continue to fully enjoy the pleasures of its drinking.

Of course we totally agree that the “alcohol drinking” the way it has been practiced today, the irresponsible way the alcohol policy makers allowing such high alcohol content (%) beverages as “standard alcohol drinks” of ‘safe drinking limits or levels’ without the proper safety precautions, could potentially lead the “people at risk” (young, vulnerable, predisposed) into its excessive alcohol consumption. Tragically enough, even their third standard alcohol drink of beer (12 ounce around 5% alcohol) which contains the lowest alcohol percentage in their recommended list of standard alcohol drinks, in fact positively and treacherously leads particularly the alcohol dependent (alcoholic) people mostly into its hazardous, harmful or the excessive use, termed as the “impaired (loss of) control” whether they like it or not, if they start its drinking.

Alcoholism; whatever may be its causes, genetic disease, psychosocial or behavioral disorders as claimed by the establishment. But one thing is very certain; in general these alcohol dependent people fully aware of the dangers of their excessive alcohol consumption and they “try” to limit control or cut down their alcohol consumption. But the main problem they encounter when they start consuming these establishments listed standard alcohol drinks; they some how loose the grip over their drinking and not able to stop or control their immediate instinct for drinking more of it thus become unsuccessful or fail in their attempts, which is basically termed as the “impaired control” in the diagnosis of alcoholism in the establishments leading alcohol dependence doctrines (ICD-10[8], DSM-IV[9]). What generally happens when the alcohol dependent people take to drinking these standard alcohol drink is; when they reach more or less at their stipulated count of the safe drinking levels or consumption limits, the person/s genuinely decides or “promises” for the moment this will be the last drink. However after they finish it, their biological desire for the drink still keeps them nagging for more of the drink for its satiety so they once again decide to take one more last drink but as they finish it up yet again the same nagging biological drinking urge or desire keeps reemerging, (the diuretic effect of alcohol can further aggravates their thirst) so again and again they fall into this drinking trap! When this repeats, out of exertion and with their increasing impaired inhibitions they become quite sloppy thus leave it entirely to their bingeing satisfaction or the drink (stomach) satiety. This happens mainly due to their innate (biological or call it genetic) drinking desire has not been satiated and they still have this physical/biological and the psychological capacity to drink more, so they continue to consume the alcoholic beverage that is available on their table! All of which gets manifested in their “loss of control” drinking behavior, as they are not much particular whether it is a spirit, wine, beer, high or low alcohol, or what else! What they instinctively want is a last drink that is been conveniently available for that moment by the courtesy of the establishment alcohol control policy making bodies (in consultation with the alcohol beverage industry?) stipulated standard alcohol (between 40% to 5%) drinks and as the result they end up in excessive alcohol consumption! Now this is where the alcoholism prevention treatment establishments appear in the scene and proclaim that the alcohol dependent people cannot cut down, reduce or stop their alcohol beverage drinking due to its triggering their “strong and some times overpowering drug desire” (craving) and their ‘impaired or loss of control’! They say, it does not matter whether they consume the high alcohol content or the low-alcohol content, if they take to the lower alcoholic beverage in the given standard alcohol drinks then they continue to consume it so much so that they will winds up with excessive alcohol consumption. Therefore one must completely give up their false presumptions (“denial”) and accept that the ‘total abstinence’ from any of the alcoholic beverages is the only remaining recovery option for them! Here I refrain from any more of my criticism on the establishment’s concerned doctrines or dogmas described in my previous paper[2]. So to cut it all short in this ZAD-ADCT we prove that opting to drinking the lower-alcohol beverage of between 2.5% to 1.2% can definitely prevent the people at risk (particularly the alcohol dependent) from excessive, harmful alcohol consumption. This is the above mentioned “satiety wisdom” bestowed on us by the nature to fully enjoy the pleasures of alcohol drinking without falling into its “loss of control” factor. In other words, here we claim that the alcohol dependent people by adapting to this LAB or the ZAD alcohol drinking method can indeed successfully reverse the entire process of their alcohol dependence or its addiction.

In general, if we question the alcohol dependent people if they have ever before “thought” of trying these lower-alcoholic beverages to reduce their overall alcohol consumption? Many may answer “yes”. So the next question is how many of them have really put it into practice to get rid of their alcohol dependence? Did they have the convenient LAB arrangements and the step-by-step ZAD reduction strategy in place? Did they have any idea how much lower the alcohol content they mean by their lower alcohol drink? Anyway, what was the final out come of such LAB drinking? Did they end up drinking more and more of it so the final tally of their alcohol consumption remained the same or even went up more? Or they have never really attempted it so far because of the establishments propaganda that implies that the ‘alcohol dependent people will anyway consume excessive amount even if they adopt to such a LAB drinking so it is not worth trying. After all what were their conclusions? Probably almost all of them will agree that they have never thought or attempted such a LAB drinking method to control, reduce or cut down their alcohol consumption before in their life.

Now lets us hypothetically investigate, what would happen when the alcohol dependent people opt to drinking the lower alcoholic beverages in order to cut-down their overall alcohol consumption. Suppose an alcohol dependent in a day average, used to drinking around 36 ounces (roughly 1.0 liter) of 10% alcohol content by volume (this also accounts distilled spirit titration) strong beverage which amounts roughly a total of 6 standard alcohol drinks mostly in the evening time, which is considered as excessive or binge drinking. So the person decides to cut-down his/her overall alcohol consumption at least to the half if possible by opting for lower alcoholic beverage say around 5%. What happens next according to the establishment’s argument is that; the person would end up consuming 72 ounces (roughly 2.0 liters) of that appetizing alcoholic beverage, which also amount to six standard alcohol drinks. Therefore they draw the conclusion that this whole idea of taking to the lowered alcohol drinking in order to reduce once overall alcohol consumption will ridiculously end up in a total failure. So their final assertion will be; “total abstinence” alone is the only recovery option for the alcohol dependent (alcoholic) people. Now wait a minute! The original idea is attempting or trying to cut down the alcohol consumption from the 6 drinks to around 3 drinks in a day by consuming the appetizing LAB, which is the original decision that is agreed upon! Now if the person able to consumes 72 ounces of the alcoholic beverage, then why shouldn’t it’s alcohol content once again reduced to its half (2.5% by volume) in their attempt or try to cut down or reduce their overall alcohol consumption from that standard six to a standard three. Do they think the same thing will repeat once again so the dependent people now will drink double that quantity 144 (around 4 liters) or even 200 ounces (around 6 liters) of this 2.5% LAB beverage day after days, months and years together for life long? Then why not reduce the alcohol content further to 1.2%. After all what really prevents them in reducing the alcohol content from the standard 5% to its half say the safe 2.5% or the safest 1.2%? At this alcohol percentage levels, quite enough of the intoxicating effect of the alcohol still remains and people still prefer for such LAB drinks. The “Innovation in Europe”: Research and Result document states: ‘As consumers health consciousness has increased in recent years, the consumption of beverages with low levels of alcohol also increase …Drinks are described as “low alcohol” if they contain less than 0.5% alcohol and alcohol free if they have less than 0.05% [38]. Another document from: Centre for Addiction and Mental Health; Toronto comments: “Low-alcohol beverages have become more popular in North America as people become more responsible about their health and the consequences of drinking and driving” [44]. So far to our search for the research finding in the area of Low-alcohol drinks overwhelmingly provides the evidence that the LAB (around 2.5% alcohol content or less) drinking in general enables people to reduce their overall alcohol consumption [48, 49, 50, 51] I have also put together many such empirical evidence in “The ZAD Empirical Evidence Surveillance” section of my previous paper[2]. Now if any one argues that it would be fundamentally different with the alcohol dependent people then we will be soon going to find it out at the end of this ZAD-ADCT therapy.

Another important topic that should be taken into study during this ZAD-ADCT motivational sessions is; the dogmatic argument of some of those so called recovering alcoholics proclamations of their intense or overwhelming drug desire that sets on their “loss of (impaired) control”. They may strongly argue that theirs is a genetic malfunction or a behavioral disorder therefore their biological drink desire satiety (LAB) never going to subdue or dampen their drug desire and stop their loss of control. They may further argue that: ‘taking to the lower-alcohol beverage will be simply a waste of time and money that they would rather prefer to consume some more of the alcohol drinks than spending it on making their alcohol drink appetizing, delicious and lowering its alcohol content. It is very difficult to convince those people having such rigid mindsets. Suppose, if they are sick and prescribed to take some medicine to come out of their sickness would they argue that it is simply waste of time and money to spend on the medicine instead they are happy with carrying on more with their disease. Analogically, LAB drinking is like a person who wants to enjoy the pleasures and the benefits of driving vehicles but at the same time realizing the extreme dangers involved in his/her driving therefore takes up all the safety precaution wears the safety belt and fits some mechanical technique in his vehicle that limits or controls (breaks) its speed as an insurance policy! Of course he or she needs to pay for the product that protects him/her from all those risks or dangers instead of totally abandoning (abstinence) the pleasures or benefits of the driving. However some people may adamantly argue I don’t wont seat belt or the speed limit “control” mechanism and the insurance cover, to the vehicle, instead I will totally give up driving any vehicle for life because it is extremely dangerous for me and I am simply “powerless” over it! It will be almost impossible to convince these people and we only wish good luck to them. Nevertheless one can just imagine the consequences of their decision when these people encounter the need of driving a vehicle for whatever reasons. Of course they may have their own rational to defend their position so we don’t argue with it any further.

However the above critique somehow seems to have some valid reason as they basically question the effectiveness of the LAB drinking in the prevention and treatment of alcoholism. Their argument perhaps, is that the alcoholics alcohol drug desire its craving, and the “loss of control” never will subside, or get mitigated by whatever quantities of the LAB they may consume, with all its maximum amounts of drink satiety they may experience. For example even after consuming lots of the LAB in a drinking session (say, in a 3 to 4 hours drinking around 200 ounces or 6.6 liters which in itself accounts for more than 8 standard drink in the 2.5% low-alcohol beverage in volume.) the alcoholics “loss of control” over the alcohol consumption will not subside. Perhaps the alcoholic may not drink one more of this LAB drink however if they were presented with the opportunity of a distilled spirit drink (perhaps they will actively seek to it) then they will immediately drink it to satisfy their drug desire. This argument seems to have some valid points on its surface but what it essentially lacks is the commonsense. -- Now let us take two similar kind of alcohol dependent persons, give the first dependent the amount of two standard alcohol drink in the form of around 40% alcohol content (distilled spirit) beverage (3 ounce in total) with little or no titration; to the second dependent give the same two standard alcohol drink (distilled spirit) but mix it with a total of 48 ounce delicious alcohol beverages in which the alcohol content get lowered to the 2.5% by volume. To cut it all short; the alcohol drink desire, its craving and the “impaired (loss of) control” of the first dependent who drinks this two standard alcohol drink in the form of the distilled spirit with little or no titration will be significantly more, still get aggravated by the alcohols combined diuretic thirst effect. On the other hand the second dependent persons alcohol drink desire will get significantly reduced or mitigated as the result the two standard alcohol drinks mixed in a total of 48 ounce (11320 ml) of the delicious beverage that together provides the overall biological drink desire satiety. Finally here it is not the question, whether the alcoholic still has the physical, biological or the stomach capacity ability to drink the high alcohol content drink after obtaining the drink satiety with the LAB, the question here is whether enough amount of the LAB could effectively reduce or dissipate the alcohol dependents immediate drug desire, craving and the “impaired control” while he/she is trying or attempting to cut down (ICD-10, DSM-IV, CAGE, etc. diagnostic criteria) their overall alcohol consumption, or not.

There are many such fundamental ZAD cognitive motivational topics that need to be addressed in this first week’s therapy session. Besides that a discussion on the ZAD book its perspective papers and some of its other literatures which are available in the Alcoholics Curewell website[10]. Most importunately the preceding the ZAD Alcoholism Research Papers[1, 2] may be taken for discussion on this CMT. However the scope and limitation of this (its sequel) paper does not allow me to enter into those topics in here. By the way in the ZAD-ADCT one-week inpatient stay there will be ample time and opportunities to explore into these topics at its CMT sessions! Apart from the above motivational topics, one may also successfully use the “positive-reinforcement” motivational approaches or techniques like the “Contingency Management”[52] in these three weeks ZAD-ADCT and even beyond this therapy.

PS. Continued Part III on the previous blog post.