The classical use of medications for alcoholism is to encourage abstinence. Antabuse (also known as disulfiram), for instance, prevents the elimination of chemicals which cause severe discomfort when alcohol is ingested, effectively preventing the alcoholic from drinking in significant amounts while they take the medicine. Heavy drinking while on antabuse can result in severe illness and death.
Naltrexone has also been used because it helps curb cravings for alcohol while the person is on it. Both of these, however, have been demonstrated to cause a rebound effect when the user stops taking them. These do allow a person to overcome psychological addictions to alcohol, but they do not treat the neurochemical addiction.
In more recent studies it has been demonstrated that the use of naltrexone while the alcoholic continues to drink can result in extinction of the neurochemical addiction. Referred to as the "Sinclair Method", this technique is used with good results some US states and in Finland but has failed to penetrate much of the world because of the long-standing bias against any treatment that doesn't involve detoxification and abstinence.
Rationing
Rationing or other attempts to control use are increasingly ineffective as pathological attachment to the drug develops. Use often continues despite serious adverse health, personal, legal, work-related, and financial consequences.
Detoxification
Detoxification programs run by medical institutions often involve stays for a number of weeks in specialized hospital wards, where drugs may be used to avoid withdrawal symptoms. In severe cases, detoxification may lead to death. To that point, even a simple "de-tox" can involve seizures, if not properly monitored.
Post Detox Therapy
After detoxification, various forms of group therapy or psychotherapy are recommended to deal with underlying psychological issues leading to alcohol dependence. It is also used to provide the recovering addict with relapse prevention skills.
Aversion therapies may be supported by drugs like Disulfiram, which causes a strong and prompt sensitivity reaction whenever alcohol is consumed. Naltrexone or Acamprosate may improve compliance with abstinence planning by treating the physical aspects of cravings to drink. The standard pharmocopoeia of antidepressants, anxiolytics, and other psychotropic drugs treat underlying mood disorders, neuroses, and psychoses associated with alcoholic symptoms.
Group Counseling
In the mid-1930s, the mutual-help group-counseling approach to treatment began and has become very popular. Alcoholics Anonymous is the best-known example of this movement. Various branches are available for family members of the alcoholic or commonly referred to as the co-dependents. Other groups include LifeRing Secular Recovery and SMART Recovery.
Prevention
Some programs attempt to help problem drinkers before they become dependents. These programs focus on harm-reduction and reducing alcohol intake as opposed to cold-turkey approaches. One such program is called Moderation Management.
Nutritional therapy
Another treatment program is based on nutritional therapy. Many alcohol dependents have insulin resistance syndrome, a metabolic disorder where the body's difficulty in processing sugars causes an unsteady supply to the blood stream. While the disorder can be treated by a hypoglycemic diet, this can affect behavior and emotions, side-effects often seen among alcohol dependents in treatment. The metabolic aspects of such dependence are often overlooked, resulting in poor results.
Return to normal drinking
Although it has long been argued that alcoholic dependents cannot learn to drink in moderation, research by the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicates a small percentage of individuals in the US whose dependence began more than one year earlier are now drinking in moderation. In contrast, a high percentage who undergo naltrexone use-reduction therapy are capable of normal drinking habits. Use of Naltrexone involves taking the medication an hour before any drinking occurs in order to maintain this.
Societal Impact
Today, alcohol abuse and alcohol dependence are major public health problems in North America, costing the region's inhabitants, by some estimates, as much as US$170 billion annually. Alcohol abuse and alcohol dependence sometimes cause death, particularly through liver, pancreatic, or kidney disease, internal bleeding, brain deterioration, alcohol poisoning, and suicide. Heavy alcohol consumption by a pregnant mother can also lead to fetal alcohol syndrome, an incurable and damaging condition.
Additionally, alcohol abuse and alcohol dependence are major contributing factors for head injuries, motor vehicle accidents, violence and assaults, neurological, and other medical problems.
Alcohol addiction is a treatable disease. If you are an alcoholic or are a family member of an alcoholic, contact your physician for the most current treatments available.
