Nonconventional and Integrative Treatments of Alcohol and Substance Abuse

James Lake, MD- Dr Lake is in private practice in Monterey, Calif, and is on clinical faculty in the department of psychiatry and behaviorial sciences at Stanford University Hospital. He co-chairs the American psychiatric Association Caucus on Complementary, Alternative, and Integrative Care (www.APACAM.org) and is author of the Textbook of Integrative Mental Health Care (Thieme).

In the first part of this column (Psychiatric Times, February 2007), I reviewed treatments whose beneficial effects are probably achieved through a discrete biological or pharmacological mechanism of action. These included dietary modifications; supplementation with specific vitamins, minerals, and amino acids; and medicinal herbs. In this part, I will review the evidence for approaches that reduce the risk of relapse, diminish craving, or mitigate withdrawal symptoms but for which there is no evidence for direct biological or pharmacological effect. These include exercise, mindfulness training, virtual reality graded exposure therapy (VRGET), cranio- electrotherapy stimulation (CES), dim light exposure,electroencephalogram (EEG) and electromyogram biofeedback, acupuncture, and qigong. Persons receiving conventional pharmacological treatments that seek to reduce the risk of relapse, diminish craving, and mitigate withdrawal symptoms may safely use these and other nonbiological therapies.

Treating Anxiety, Depression, and/or Insomnia with CES