Alcoholism or alcohol use disorder (AUD) refers to an individual's dependence on the substance diagnosed by a medical professional. Untreated alcoholism can spiral out of control, causing life-threatening mental illnesses such as depression and anxiety. However, it's possible to treat it with medications.
The FDA has approved three medications for the treatment of alcoholism: disulfiram, acamprosate, and naltrexone. The medications have varying mechanisms. But they all help people with alcoholism reduce their drinking and prevent relapse by blocking the cravings and reward receptors associated with alcohol intake. Disulfiram counters alcohol metabolism. It’s also an effective psychological deterrent. It causes nausea, palpitations, and flushing of the skin - harsh reactions that can make drinking unpleasant. Drinking causes the body to produce endorphins, a “feel-good hormone” that causes one to feel calm and happy. Naltrexone blocks the receptors responsible for the reward feelings associated with drink. It makes alcohol consumption less rewarding, helping reduce heavy drinking. Naltrexone also helps with alcohol detox, ridding the body of alcohol content. Alcohol detox is the first step in treating alcoholism and reducing the severity of alcohol withdrawal symptoms. Professionals administer Acamprosate after a patient has completed detox. It works best when the patient is no longer dependent on alcohol. Acamprosate helps prevent relapse by reducing the urge to drink. Alcoholism medications are effective on their own. Studies show that combining medications with non-medical interventions improves treatment outcomes. Non-medical interventions for alcoholism include counseling and talk therapy. Some practitioners consider medications as a last resort when symptoms do not improve following non-medical interventions. Medications used for treating other conditions have also proved effective for treating alcoholism, such as Varenicline, an anti-smoking drug that reduces alcohol cravings. Another is Gabapentin, used for chronic pain treatment, which helps reduce heavy drinking and improve abstinence. Medications for alcoholism are not a cure, nor are they alcohol-substitution drugs. In most cases, the medications do not have habit-forming side effects, meaning it’s unlikely to lead to abuse. However, patients respond differently to the medications. Factors that may affect alcoholism drug efficacy include the extent of dependency, motivation to quit or reduce drinking, genetic predisposition to AUD, and environment. To improve treatment outcomes, individuals should avoid triggers that may cause relapse, like social pressure and stress, boredom, and alcohol advertisements. Alcohol treatment takes place in outpatient or in-patient settings, depending on severity. Outpatient treatment involves regular visits for medical support and counseling. A thorough assessment of an individual’s level of alcohol dependency and complications allows medical professionals to decide how to proceed. There are several advantages of undergoing treatment at an in-patient rehab facility. The facilities provide 24/7 monitoring of patients, helping better manage adverse side effects. It also improves abstinence due to the absence of most triggers associated with relapse. Watching a loved one struggle with alcoholism can be overwhelming. Loved ones may wonder how they can help and whether the person wants it. There are many ways of helping a loved one with alcoholism, including keeping them company to avoid boredom and loneliness, both known triggers for alcoholism. One can also help them seek treatment. When choosing an alcoholism treatment facility, consider the kinds of treatments available. A facility that provides various treatment options is preferable to one that relies on one approach. Also, consider whether the facility will tailor treatment programs to the individual and their expectations of them. A one-size-fits-all approach to the treatment of alcoholism no longer exists. Medicine alone may work for one person. For another, it may take a combination of medical and non-medical interventions to overcome alcoholism. Thanks to advances in alcoholism treatment, healthcare providers can tailor treatment approaches to individual needs.
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AuthorSince 2006, Dr. Sridhar Yaratha has worked for Central State Hospital in Petersburg, Virginia, as a forensic psychiatrist and attending physician for the men’s long-term forensic unit. Archives
January 2020
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