Learning the language of abstinence in addiction treatment: some similarities between relapse-prevention with disulfiram, naltrexone, and other pharmacological antagonists and intensive "immersion" methods of foreign language teaching.
Relapse-prevention (RP) is an educational process. Learning to abstain from alcohol or opiates after years of dependence involves selectively suppressing old, maladaptive habits of thought and behavior and establishing new, adaptive ones. This process resembles foreign language (FL) learning. Effective FL teaching techniques are relevant to RP. "Immersion," the most effective FL teaching method, discourages students from using their first language ab initio, requiring them to use the FL instead, however inexpertly. It resembles exposure and response-prevention for phobic or compulsive disorders. Supervised disulfiram aids RP by discouraging alcoholics from responding to real-life drinking cues in the "language" of excessive drinking, requiring them, ab initio, to practice new, alcohol-free responses. Supervised or depot naltrexone acts similarly in opiate dependence. We discuss the concept of antagonist-assisted abstinence.
Brewer
Colin
C
The Stapleford Centre, London, United Kingdom. cbrewer@doctors.net.uk
Streel
Emmannuel
E
D000223:Adaptation, Psychological; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000517:prevention & control / Q000523:psychology; D032763:Behavior Control / Q000379:methods* / Q000523:psychology; D004221:Disulfiram / Q000627:therapeutic use*; D006801:Humans; D007802:Language; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D055502:Secondary Prevention; D019966:Substance-Related Disorders / Q000517:prevention & control* / Q000523:psychology; D013663:Teaching
D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D009271:Naltrexone; D004221:Disulfiram