Alcoholism is a chronic or episodic consumption of alcohol characterized by the inability to control drinking, frequent intoxications, and preoccupation with alcohol.
Alcohol abuse leads to the psychological, mental and physical impairment and therefore should be treated.
Treatment of alcoholism aims to:
- Promote total abstinence from alcohol;
- Treat acute medical (especially alcohol withdrawal syndrome) and psychiatric conditions;
- Increase motivation for recovery;
- Begin treatment for chronic conditions and diseases, both medical and psychiatric;
- Locate the person in a suitable environment;
- Social support for recovery (help the patient to repair relationships and socialize);
- Enhance coping skills;
- Develop skills to prevent relapse (including social skills, identification and avoidance of high-risk situations);
- Improve occupational skills;
- Promote maintenance of recovery through participation in treatment or self-help groups.
The assessment of a person who suffers on alcoholism implies the 5 steps/phases that should be foreseen by the doctor:
Phase 1 – Ask – Every person should be questioned in details regarding his/her regarding the addiction and its reasons;
Phase 2 – Assess – The dependency degree should be estimated;
Phase 3 – Advise – A person should receive a feedback and a professional advice;
Phase 4 – Assist – A person should be given a plan regarding the further management;
Phase 5 – Arrange – Long-term management with the assistance of other medical professionals should be organized.
Pharmacotherapy hasn’t shown any benefit in alcoholism treatment except the management of withdrawal.
The medications that cause the unpleasant feeling after the consumption of alcohol are called alcohol-sensitizing drugs. In the 1940th alcohol-sensitizing drugs were invented. Since then Disulfiram (Antabuse) has been prescribed. The common dose of the drug varies from 125 mg to 500 mg.The drug interferes with the enzymes that are involved in the alcohol metabolism, especially ALDH (Aldehyde dehydrogenase).
Read also: Alcohol dependence
Management of alcohol withdrawal
A lot of medications are used to cope with the alcohol withdrawal. However, the benzodiazepines are preferable. Commonly Diazepam and
Chlordiazepoxide (20 mg four times a day for 7 days) may be used. Alternatively, Carbamazepin may be prescribed. Benzodiazepines are the option to treat seizures that are associated with the withdrawal from alcohol. Lorazepam is prescribed for the prophylaxis of the further seizures.
Thiamine (50–100 mg by mouth or intramuscular) and vitamins is administrated for the prevention and treatment of neurologic disorders related to alcohol abuse.
Nonpharmacological treatment of alcohol abuse includes both outpatient and residential measures that involve various types of psychotherapy: behavior therapy, group therapy and family treatment.
Counseling is a supportive therapy used to motivate or direct persons and their families through the course of recovery.
Cognitive and behavior therapies are usually used. The twelve steps therapy by Alcoholic Anonymous has also been reported as an effective one.
Behavior therapy includes social skills training, relapse prophylaxis, self-control training, deep muscle relaxation, stress management, cognitive training and social reinforcement to manage the addiction.