I have a 34 year old son who is an alcoholic though of course he says he is not because he can control his drinking (which of course he cannot and does not). He is a high functioning alcoholic and holds a management position in which he excels. He does not however, excel at anything else because he is too wasted to do much more than sleep. Alcohol has changed him from a funny, sensitive and very loving person into an often nasty and disinterested person. He went to AA and mocked their premise (God-higher power) and said he was not comfortable there nor was he "like those people". He saw a counselor - who did him no good and he tried her "scientific approach" which allowed him to drink in moderation. My heart is broken and I miss the witty, bright young man who was my son. There is no pleading, talking or threatening that works. His marriage is rocky because of this addiction and even that is not enough to make him get clean. He is not nice to be around but I will not put him out of my life. It is bad enough he says he prefers to be alone (quite unlike the young man who used to be my son) & I believe the isolation enables him to drink more. I feel desolate and do not know what else I can do to help him.

Alcoholism is a pernicious condition that appears in various forms. Classification has baffled the best minds throughout recorded history. Even today, the definition of "alcoholism*" is ever changing in diagnostic manuals. So too are treatment recommendations.

Once the need for professional assistance is recognized, matching the individual to an effective treatment is equally difficult. What works for one is completely ineffective for another.

That's the bad news. On the brighter side, most alcoholics* quit on their own. Right at 50% simply quit or return to drinking at acceptable limits. Of course, alcohol is very toxic to the human body and the risk of physical problems, liver, heart etc are a continuing concern.

There are a couple of new treatment approaches that have emerged from the medical field that show some significant potential. In order, they are 1) the Sinclair Method, and 2) a system developed by Dr Olivier Ameisen, using baclofen.

Both of these systems depart the all or nothing, total abstinence model which has been a staple of American medicine since 1938. Each method brings about what is called pharmacologic extinction of the desire to drink. Neither requires initial abstinence on the part of the drinker. Procedurally, this amounts to meeting the problem drinker where (s)he is, as opposed to waiting out the so called "bottom out" philosophy.

The Sinclair Method, used extensively in Finland, has an impressive body of research spanning more than 20 years and clinical practice has proved it efficacious. Ameisen's method is newer, less research, but nonetheless impressive results thus far.

I certainly understand the frustration and concern on your part. Your son's rejection of AA isn't unusual nor is his lack of response to a given counselors approach. Getting through to the problem drinker is usually frustrating, difficult and even heart-breaking. It does seem however that he must have some awareness having tried AA and a counselor. That leaves a door unlocked. A possible avenue of approach and hope remains for a helpful intervention.

I would be happy to provide additional resources, books, research (if you like) on either of these methods or any other.

*Actually alcoholism hasn't appeared in the DSM (diagnostic manual) for nearly 30 years. Merged first into the vague class of substance abuse disorders and now scheduled to be further diluted into Spectrum Disorder in the DSM-V (scheduled 2013)